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Choi PM, Tscharke B, Samanipour S, Hall WD, Gartner CE, Mueller JF, Thomas KV, O'Brien JW. Social, demographic, and economic correlates of food and chemical consumption measured by wastewater-based epidemiology. Proc Natl Acad Sci U S A 2019; 116:21864-21873. [PMID: 31591193 PMCID: PMC6815118 DOI: 10.1073/pnas.1910242116] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Wastewater is a potential treasure trove of chemicals that reflects population behavior and health status. Wastewater-based epidemiology has been employed to determine population-scale consumption of chemicals, particularly illicit drugs, across different communities and over time. However, the sociodemographic or socioeconomic correlates of chemical consumption and exposure are unclear. This study explores the relationships between catchment specific sociodemographic parameters and biomarkers in wastewater generated by the respective catchments. Domestic wastewater influent samples taken during the 2016 Australian census week were analyzed for a range of diet, drug, pharmaceutical, and lifestyle biomarkers. We present both linear and rank-order (i.e., Pearson and Spearman) correlations between loads of 42 biomarkers and census-derived metrics, index of relative socioeconomic advantage and disadvantage (IRSAD), median age, and 40 socioeconomic index for area (SEIFA) descriptors. Biomarkers of caffeine, citrus, and dietary fiber consumption had strong positive correlations with IRSAD, while tramadol, atenolol, and pregabalin had strong negative correlation with IRSAD. As expected, atenolol and hydrochlorothiazide correlated positively with median age. We also found specific SEIFA descriptors such as occupation and educational attainment correlating with each biomarker. Our study demonstrates that wastewater-based epidemiology can be used to study sociodemographic influences and disparities in chemical consumption.
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Affiliation(s)
- Phil M Choi
- Queensland Alliance for Environmental Health Science, The University of Queensland, Woolloongabba, QLD 4102, Australia;
| | - Benjamin Tscharke
- Queensland Alliance for Environmental Health Science, The University of Queensland, Woolloongabba, QLD 4102, Australia
| | | | - Wayne D Hall
- Centre for Youth Substance Abuse Research, The University of Queensland, Herston, QLD 4029, Australia
| | - Coral E Gartner
- Queensland Alliance for Environmental Health Science, The University of Queensland, Woolloongabba, QLD 4102, Australia
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
| | - Jochen F Mueller
- Queensland Alliance for Environmental Health Science, The University of Queensland, Woolloongabba, QLD 4102, Australia
| | - Kevin V Thomas
- Queensland Alliance for Environmental Health Science, The University of Queensland, Woolloongabba, QLD 4102, Australia
| | - Jake W O'Brien
- Queensland Alliance for Environmental Health Science, The University of Queensland, Woolloongabba, QLD 4102, Australia
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Hintsa T, Elovainio M, Jokela M, Ahola K, Virtanen M, Pirkola S. Is there an independent association between burnout and increased allostatic load? Testing the contribution of psychological distress and depression. J Health Psychol 2016; 21:1576-86. [DOI: 10.1177/1359105314559619] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Burnout has been suggested to be related to depression. We examined the relationship between burnout and allostatic load, and whether this association is independent of psychological distress and depression. We measured burnout psychological distress, depression, and allostatic load in 3283 participants. Higher burnout ( β = 0.06, p =0.003) and cynicism ( β = 0.03, p = 0.031) and decreased professional efficacy ( β = 0.03, p = 0.007) were related to higher allostatic load independent of age, sex, education, occupation and psychological distress. Depression, however, explained 60 percent of the association. Burnout is related to higher allostatic load, and this association partly overlaps with co-occurring depression.
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Affiliation(s)
| | | | | | - Kirsi Ahola
- Finnish Institute of Occupational Health, Finland
| | | | - Sami Pirkola
- National Institute for Health and Welfare, Finland
- Lapland Hospital District, Finland
- University of Oulu, Finland
- Helsinki University Central Hospital, Finland
- University of Tampere, Finland
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Zambrana RE, López L, Dinwiddie GY, Ray RM, Eaton CB, Phillips LS, Wassertheil-Smoller S. Association of Baseline Depressive Symptoms with Prevalent and Incident Pre-Hypertension and Hypertension in Postmenopausal Hispanic Women: Results from the Women's Health Initiative. PLoS One 2016; 11:e0152765. [PMID: 27124184 PMCID: PMC4849764 DOI: 10.1371/journal.pone.0152765] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 03/19/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Depression and depressive symptoms are risk factors for hypertension (HTN) and cardiovascular disease (CVD). Hispanic women have higher rates of depressive symptoms compared to other racial/ethnic groups yet few studies have investigated its association with incident prehypertension and hypertension among postmenopausal Hispanic women. This study aims to assess if an association exists between baseline depression and incident hypertension at 3 years follow-up among postmenopausal Hispanic women. METHODS Prospective cohort study, Women's Health Initiative (WHI), included 4,680 Hispanic women who participated in the observational and clinical trial studies at baseline and at third-year follow-up. Baseline current depressive symptoms and past depression history were measured as well as important correlates of depression-social support, optimism, life events and caregiving. Multinomial logistic regression was used to estimate prevalent and incident prehypertension and hypertension in relation to depressive symptoms. RESULTS Prevalence of current baseline depression ranged from 26% to 28% by hypertension category and education moderated these rates. In age-adjusted models, women with depression were more likely to be hypertensive (OR = 1.25; 95% CI 1.04-1.51), although results were attenuated when adjusting for covariates. Depression at baseline in normotensive Hispanic women was associated with incident hypertension at year 3 follow-up (OR = 1.74; 95% CI 1.10-2.74) after adjustment for insurance and behavioral factors. However, further adjustment for clinical covariates attenuated the association. Analyses of psychosocial variables correlated with depression but did not alter findings. Low rates of antidepressant medication usage were also reported. CONCLUSIONS In the largest longitudinal study to date of older Hispanic women which included physiologic, behavioral and psychosocial moderators of depression, there was no association between baseline depressive symptoms and prevalent nor incident pre-hypertension and hypertension. We found low rates of antidepressant medication usage among Hispanic women suggesting a possible point for clinical intervention. TRIAL REGISTRATION Clinicaltrials.gov NCT00000611.
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Affiliation(s)
- Ruth E. Zambrana
- Department of Women’s Studies, Consortium on Race, Gender and Ethnicity, University of Maryland, College Park, Maryland, United States of America
| | - Lenny López
- Division of Hospital Medicine, University of California, San Francisco, California, United States of America
| | - Gniesha Y. Dinwiddie
- African American Studies Department, University of Maryland, College Park, Maryland, United States of America
| | - Roberta M. Ray
- Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Charles B. Eaton
- Family Medicine & Epidemiology, Alpert Medical School, Brown University, Providence, Rhode Island, United States of America
| | - Lawrence S. Phillips
- Division of Endocrinology and Metabolism, Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Sylvia Wassertheil-Smoller
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York, United States of America
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Socioeconomic status and health: education and income are independent and joint predictors of ambulatory blood pressure. J Behav Med 2013; 38:9-16. [PMID: 23645146 DOI: 10.1007/s10865-013-9515-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Accepted: 04/25/2013] [Indexed: 10/26/2022]
Abstract
Epidemiological research suggests that different indicators of socioeconomic status (SES) such as income and education may have independent and/or interactive effects on health outcomes. In this study, we examined both simple and more complex associations (i.e., interactions) between different indicators of SES and ambulatory blood pressure (ABP) during daily life. Our sample consisted of 94 married couples who completed a one-day ABP protocol. Both income and education were independently related to systolic blood pressure and only income was significantly related to diastolic blood pressure. There were also statistical interactions such that individuals with high levels of both income and education evidenced the lowest ABP. Gender moderated these findings. Three-way interactions revealed that, in general, women appear to benefit from either indicator of SES, whereas men appear to benefit more from income. The findings are consistent with epidemiological research and suggest one important physiological mechanism by which income and education may have independent and interactive effects on health.
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Sanjuán P, Arranz H, Castro A. Effect of negative attributions on depressive symptoms of patients with coronary heart disease after controlling for physical functional impairment. Br J Health Psychol 2013; 19:380-92. [DOI: 10.1111/bjhp.12044] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 02/25/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Pilar Sanjuán
- School of Psychology; Universidad Nacional de Educación a Distancia (UNED); Madrid Spain
| | - Henar Arranz
- Cardiac Rehabilitation Unit; Hospital La Paz; Madrid Spain
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Chen E, Lee WK, Cavey L, Ho A. Role Models and the Psychological Characteristics That Buffer Low-Socioeconomic-Status Youth From Cardiovascular Risk. Child Dev 2012; 84:1241-52. [DOI: 10.1111/cdev.12037] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Chen E. Protective Factors for Health Among Low-Socioeconomic-Status Individuals. CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE 2012. [DOI: 10.1177/0963721412438710] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Low socioeconomic status (SES) is associated with a wide array of poor health outcomes. Nonetheless, some low-SES individuals maintain good physical health despite facing recurrent, severe adversities in life. This article describes a “shift-and-persist” model that explains why that is. The model states that in the midst of adversity, some low-SES children find role models who teach them to trust others, to better regulate their emotions, and to focus on their futures. Over a lifetime, these low-SES individuals may develop an approach to life that prioritizes shifting (accepting stress for what it is and adapting oneself to it) in combination with persisting (enduring life challenges by holding on to meaning and optimism). This combination of shifting and persisting strategies mitigates physiological responses to the barrage of stressors confronted by low-SES individuals and forestalls pathogenic sequelae that lead to chronic disease. Identifying health-relevant protective qualities that naturally occur in some low-SES individuals represents one important approach for improving the health of those who confront a lifetime of disadvantages.
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Chen E, Miller GE. "Shift-and-Persist" Strategies: Why Low Socioeconomic Status Isn't Always Bad for Health. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2012; 7:135-58. [PMID: 23144651 PMCID: PMC3491986 DOI: 10.1177/1745691612436694] [Citation(s) in RCA: 201] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Some individuals, despite facing recurrent, severe adversities in life such as low socioeconomic status (SES), are nonetheless able to maintain good physical health. This article explores why these individuals deviate from the expected association of low SES and poor health and outlines a "shift-and-persist" model to explain the psychobiological mechanisms involved. This model proposes that, in the midst of adversity, some children find role models who teach them to trust others, better regulate their emotions, and focus on their futures. Over a lifetime, these low-SES children develop an approach to life that prioritizes shifting oneself (accepting stress for what it is and adapting the self through reappraisals) in combination with persisting (enduring life with strength by holding on to meaning and optimism). This combination of shift-and-persist strategies mitigates sympathetic-nervous-system and hypothalamic-pituitary-adrenocortical responses to the barrage of stressors that low-SES individuals confront. This tendency vectors individuals off the trajectory to chronic disease by forestalling pathogenic sequelae of stress reactivity, like insulin resistance, high blood pressure, and systemic inflammation. We outline evidence for the model and argue that efforts to identify resilience-promoting processes are important in this economic climate, given limited resources for improving the financial circumstances of disadvantaged individuals.
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Phillips JE, Klein WMP. Socioeconomic Status and Coronary Heart Disease Risk: The Role of Social Cognitive Factors. SOCIAL AND PERSONALITY PSYCHOLOGY COMPASS 2010; 4:704-727. [PMID: 21785652 PMCID: PMC3140045 DOI: 10.1111/j.1751-9004.2010.00295.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The aim of this study is to examine existing research on social cognitive factors that may, in part, mediate the relationship between socioeconomic status (SES) and coronary heart disease (CHD). We focus on how social status is 'carried' in the mental systems of individuals, and how these systems differentially affect CHD risk and associated behaviors. To this end, literatures documenting the association of various social cognitive factors (e.g., social comparison, perceived discrimination, and self-efficacy) with cardiovascular disease are reviewed as are literatures regarding the relationship of these factors to SES. Possible mechanisms through which social cognitions may affect health are addressed. In addition, directions for future research are discussed, and a model identifying the possible associations between social cognitive factors, SES, and coronary disease is provided.
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Bennett KK, Elliot M. Pessimistic Explanatory Style and Cardiac Health: What is the Relation and the Mechanism that Links Them? BASIC AND APPLIED SOCIAL PSYCHOLOGY 2010. [DOI: 10.1207/s15324834basp2703_5] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Roy B, Diez-Roux AV, Seeman T, Ranjit N, Shea S, Cushman M. Association of optimism and pessimism with inflammation and hemostasis in the Multi-Ethnic Study of Atherosclerosis (MESA). Psychosom Med 2010; 72:134-40. [PMID: 20100888 PMCID: PMC2842951 DOI: 10.1097/psy.0b013e3181cb981b] [Citation(s) in RCA: 144] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To investigate the association between optimism/pessimism and concentrations of seven inflammation and hemostasis markers. Optimism and pessimism are associated with cardiovascular disease mortality and progression; however, the biological mechanism remains unclear. METHODS This cross-sectional study used data from the Multi-Ethnic Study of Atherosclerosis (MESA), a study of 6814 persons aged 45 to 84 years with no history of clinical cardiovascular disease. The Life-Orientation Test-Revised (LOT-R) was used to measure dispositional optimism and pessimism. Regression analyses were used to estimate associations of optimism and pessimism with interleukin (IL)-6, C-reactive protein (CRP), fibrinogen, homocysteine, Factor VIII, D-dimer, and plasmin-antiplasmin, before and after adjustment for sociodemographics, depression, cynicism, health behaviors, body mass index (BMI), hypertension, and diabetes. RESULTS Higher scores on the LOT-R (positive disposition) were related to lower concentrations of IL-6 (p = .001), fibrinogen (p < .001), and homocysteine (p = .031). Associations were stronger for the pessimism subscale. After adjustment for demographics, the percentage differences in inflammatory markers corresponding to a 2-standard deviation increase in pessimism were 6.01% (p = .001) for IL-6, 10.31% (p = .001) for CRP, 2.47% (p < .0001) for fibrinogen, and 1.36% (p = .07) for homocysteine. Associations were attenuated but significant after adjustment for sociodemographics, depression, cynical distrust, and behaviors. Further adjustment for hypertension, BMI, and diabetes reduced associations for CRP and IL-6. Pessimism remained associated with a 1.36% (p = .02) increase in fibrinogen in the fully adjusted model. Factor VIII, D-dimer, and plasmin-antiplasmin were not associated with the LOT-R or subscales. CONCLUSIONS Pessimism is related to higher levels of inflammation. Health behaviors, BMI, hypertension, and diabetes seem to play a mediating role.
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Affiliation(s)
- Brita Roy
- Center for Social Epidemiology and Population Health, University of Michigan, Ann Arbor, MI
| | - Ana V. Diez-Roux
- Center for Social Epidemiology and Population Health, University of Michigan, Ann Arbor, MI
| | - Teresa Seeman
- Division of Geriatrics, School of Medicine, University of California Los Angeles
| | - Nalini Ranjit
- Center for Social Epidemiology and Population Health, University of Michigan, Ann Arbor, MI
| | - Steven Shea
- Division of General Medicine, College of Physicians and Surgeons, and Division of Epidemiology, School of Public Health, Columbia University New York, NY
| | - Mary Cushman
- Department of Medicine, University of Vermont, Burlington
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Abstract
OBJECTIVE To investigate the potential for gene x environment interaction in hypertension by examining the extent to which educational attainment modifies the heritability of hypertension in male twins. Prior twin and family studies have established that hypertension runs in families and is heritable. In addition, epidemiological research indicates that the prevalence of hypertension differs by socioeconomic factors, such as educational attainment. METHODS Twin structural equation modeling was used to examine educational attainment as a moderator of heritability of hypertension. Participants were 4301 monozygotic and 3414 dizygotic male Vietnam-era twins who provided data on both education (in years) and self-report of physician diagnosis of hypertension or medication usage. RESULTS Heritability was 17 points lower among co-twins concordant for educational attainment of < or =14 years (0.46, 95% CI = 0.32-0.57) relative to co-twins concordant for >14 years of education (0.63, 95% CI = 0.54-0.71). The significant moderation of the heritability (p = .04) was confirmed in twin models examining educational attainment as a continuous moderator of hypertension. CONCLUSIONS These results demonstrate that the expression of genetic vulnerability to hypertension can vary as a function of environmental factors, including education level, and that nongenetic pathways may differentially contribute to risk among those with fewer years of education.
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Hong S, Nelesen RA, Krohn PL, Mills PJ, Dimsdale JE. The association of social status and blood pressure with markers of vascular inflammation. Psychosom Med 2006; 68:517-23. [PMID: 16868259 DOI: 10.1097/01.psy.0000227684.81684.07] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Low socioeconomic status (SES) is associated with low-grade inflammation. Vascular inflammation often accompanies high blood pressure (BP) and has clinical implications for future vascular diseases, including atherosclerosis. Elevated plasma levels of soluble intercellular adhesion molecule-1 (sICAM-1) and endothelin-1 (ET-1) are reliable indicators of vascular inflammation. We examined the associations among BP, social status, and sICAM-1 and ET-1 levels in 121 European American and African American men and women. METHODS Social status of the subjects was determined by using the Hollingshead Two Factor Index of Social Position scale, and plasma sICAM-1 and ET-1 levels were assessed using immunoassays. RESULTS Correlation analyses revealed positive correlations among plasma sICAM-1 levels, BP, and social status. Levels of ET-1 were also significantly correlated with BP (p < .01) and social status (p < .001). When subjects were categorized into three social classes, sICAM-1 levels were significantly higher in the lowest social class as compared with the upper (p < .05) or middle (p < .01) class. The levels of ET-1 were higher in the low (p < .01) and middle (p < .05) social classes as compared with the upper class. Multiple hierarchic regression analyses revealed that even after controlling for demographic and health characteristics (gender, ethnicity, age, body mass index, and smoking) and systolic BP, social status accounted for additional variance of sICAM-1 or ET-1 levels. CONCLUSION These results suggest that low-social-status individuals may incur risk for future vascular diseases through vascular inflammation.
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Affiliation(s)
- Suzi Hong
- Department of Psychiatry, University of California, San Diego, San Diego, California, USA.
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