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Bridger Staatz C, Gutin I, Tilstra A, Gimeno L, Moltrecht B, Moreno-Agostino D, Moulton V, Narayanan MK, Dowd JB, Gaydosh L, Ploubidis GB. Midlife health in Britain and the United States: a comparison of two nationally representative cohorts. Int J Epidemiol 2024; 53:dyae127. [PMID: 39357882 PMCID: PMC11446604 DOI: 10.1093/ije/dyae127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 09/04/2024] [Indexed: 10/04/2024] Open
Abstract
BACKGROUND Older adults in the USA have worse health and wider socioeconomic inequalities in health compared with those in Britain. Less is known about how health in the two countries compares in mid-life, a time of emerging health decline, including inequalities in health. METHODS We compare measures of current regular smoking status, obesity, self-rated health, cholesterol, blood pressure and glycated haemoglobin using population-weighted modified Poisson regression in the 1970 British Cohort Study (BCS70) in Britain (N = 9665) and the National Longitudinal Study of Adolescent to Adult Health (Add Health) in the USA (N = 12 300), when cohort members were aged 34-46 and 33-43, respectively. We test whether associations vary by early- and mid-life socioeconomic position. RESULTS US adults had higher levels of obesity, high blood pressure and high cholesterol. Prevalence of poor self-rated health and current regular smoking was worse in Britain. We found smaller socioeconomic inequalities in mid-life health in Britain compared with the USA. For some outcomes (e.g. smoking), the most socioeconomically advantaged group in the USA was healthier than the equivalent group in Britain. For other outcomes (hypertension and cholesterol), the most advantaged US group fared equal to or worse than the most disadvantaged groups in Britain. CONCLUSIONS US adults have worse cardiometabolic health than British counterparts, even in early mid-life. The smaller socioeconomic inequalities and better overall health in Britain may reflect differences in access to health care, welfare systems or other environmental risk factors.
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Affiliation(s)
| | - Iliya Gutin
- Department of Sociology, University of Texas at Austin, Austin, TX, USA
- The Maxwell School for Citizenship and Public Affairs, Syracuse University, Syracuse, NY, USA
| | - Andrea Tilstra
- Leverhulme Centre for Demographic Science, Nuffield College, and Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Laura Gimeno
- Centre for Longitudinal Studies, University College London, London, UK
| | - Bettina Moltrecht
- Centre for Longitudinal Studies, University College London, London, UK
| | - Dario Moreno-Agostino
- Centre for Longitudinal Studies, University College London, London, UK
- ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Vanessa Moulton
- Centre for Longitudinal Studies, University College London, London, UK
| | | | - Jennifer B Dowd
- Leverhulme Centre for Demographic Science, Nuffield College, and Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Lauren Gaydosh
- Department of Sociology, University of Texas at Austin, Austin, TX, USA
- Department of Sociology, The University of North Carolina at Chapel Hill, North Carolina, USA
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2
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Panico L, Goisis A, Martinson M. Gradients in low birthweight by maternal education: A comparative perspective. SSM Popul Health 2024; 26:101674. [PMID: 38711567 PMCID: PMC11070621 DOI: 10.1016/j.ssmph.2024.101674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 04/19/2024] [Accepted: 04/24/2024] [Indexed: 05/08/2024] Open
Abstract
Background Longstanding research has shown strong inequalities in low birthweight by household income. However, most such research has focused on Anglophone countries, while evidence emerging from other developed countries suggest a stronger role of education rather than incomes in creating inequalities at birth. This paper compares gradients in low birthweight by maternal education, as well as explores underlying mechanisms contributing to these gradients, in France, the United States, and the United Kingdom. Methods Analyses are based on harmonized data from large, nationally-representative samples from France, UK and US. We use regression models and decomposition methods to explore the relative role of several possible mechanisms in producing birthweight inequalities. Results Inequalities in low birth weight across maternal education groups were relatively similar in the United States, the United Kingdom and France. However, the individual-level mechanisms producing such inequalities varied substantially across the three countries, with income being most important in the US, pregnancy smoking being most evident in France, and the UK occupying an intermediate position. Differences in the mechanisms producing birth health inequalities mirror differences in the policy environment in the three countries. Conclusion While inequalities in health appear from the earliest moments in many countries, our results suggest research on birth health inequalities, and therefore policies, is not easily generalizable across national contexts, and call for more scholarship in uncovering the "whys" of health inequalities in a variety of contexts.
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Affiliation(s)
- Lidia Panico
- Center for Research on Social Inequalities (CRIS), Sciences Po, CNRS, 27, rue Saint-Guillaume, 75337, Paris, Cedex 07, France
- Institut National d’Etudes Démographiques (INED), 9 cours des Humanités, CS 50004, 93322, Aubervilliers, Cedex, France
| | - Alice Goisis
- Centre for Longitudinal Studies, Department of Social Science, University College London, 55-59 Gordon Square, London, WC1H 0NU, UK
| | - Melissa Martinson
- School of Social Work, University of Washington, 4101 15th Ave NE, Seattle, WA, 98105-6299, USA
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3
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Swearinger H, Lapham JL, Martinson ML, Berridge C. Older Adults' Unmet Needs at the End of Life: A Cross-Country Comparison of the United States and England. J Aging Health 2024:8982643241245249. [PMID: 38613317 DOI: 10.1177/08982643241245249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
Objectives: This study aimed to compare the end-of-life (EOL) experiences in concentration with place of death, for older adults in the U.S. and England. Methods: Weighted comparative analysis was conducted using harmonized Health and Retirement Study and English Longitudinal Study of Ageing datasets covering the period of 2006-2012. Results: At the EOL, more older adults in the U.S. (64.14%) than in England (54.09%) had unmet needs (I/ADLs). Home was the main place of death in the U.S. (47.34%), while it was the hospital in England (58.01%). Gender, marital status, income, place of death, previous hospitalization, memory-related diseases, self-rated health, and chronic diseases were linked to unmet needs in both countries. Discussion: These findings challenge the existing assumptions about EOL experiences and place of death outcomes, emphasizing the significance of developing integrated care models to bolster support for essential daily activities of older adults at the EOL.
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Affiliation(s)
- Hazal Swearinger
- Department of Social Work, Cankiri Karatekin University, Çankırı, Turkey
| | | | | | - Clara Berridge
- Department of Social Work, University of Washington, Seattle, WA, USA
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Bagińska M, Kałuża A, Tota Ł, Piotrowska A, Maciejczyk M, Mucha D, Ouergui I, Kubacki R, Czerwińska-Ledwig O, Ambroży D, Witkowski K, Pałka T. The Impact of Intermittent Hypoxic Training on Aerobic Capacity and Biometric-Structural Indicators among Obese Women-A Pilot Study. J Clin Med 2024; 13:380. [PMID: 38256514 PMCID: PMC10816855 DOI: 10.3390/jcm13020380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/04/2024] [Accepted: 01/06/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Obesity, a common lifestyle-related condition, is correlated with factors like inadequate physical activity. Its connection to diverse health issues presents a significant challenge to healthcare. This pilot study investigated the effects of hypoxic training on aerobic capacity and biometric-structural indicators in obese women. The secondary objective was to determine the feasibility, effectiveness, and safety of the planned research procedures and their potential for larger-scale implementation. MATERIAL AND METHODS Forty-one non-trained women with first-degree obesity were randomly assigned to even normobaric hypoxic training (H + E), normoxic training (E), passive exposure to hypoxia (H), and a control group (C). Training sessions were conducted three times a week for four weeks (12 training sessions). Body composition parameters were assessed, metabolic thresholds were determined, and maximal oxygen consumption (VO2max) was measured before and after interventions. RESULTS The results demonstrated that training in hypoxic conditions significantly affected somatic parameters, with the H + E group achieving the best outcomes in terms of weight reduction and improvements in body composition indicators (p < 0.001). Normoxic training also induced a positive impact on body weight and body composition, although the results were less significant compared to the H + E group (p < 0.001). Additionally, training in hypoxic conditions significantly improved the aerobic capacity among the participants (p < 0.001). The H + E group achieved the best results in enhancing respiratory endurance and oxygen consumption (p < 0.001). CONCLUSIONS The results of this pilot study suggest, that hypoxic training can be effective for weight reduction and improving the aerobic capacity in obese women. Despite study limitations, these findings indicate that hypoxic training could be an innovative approach to address obesity and related conditions. Caution is advised in interpreting the results, considering both the strengths and limitations of the pilot study. Before proceeding to a larger-scale study, the main study should be expanded, including aspects such as dietary control, monitoring physical activity, and biochemical blood analysis.
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Affiliation(s)
- Małgorzata Bagińska
- Institute of Biomedical Sciences, Department of Physiology and Biochemistry, University of Physical Education in Kraków, 31-571 Kraków, Poland (T.P.)
| | - Anna Kałuża
- Institute of Biomedical Sciences, Department of Physiology and Biochemistry, University of Physical Education in Kraków, 31-571 Kraków, Poland (T.P.)
| | - Łukasz Tota
- Institute of Biomedical Sciences, Department of Physiology and Biochemistry, University of Physical Education in Kraków, 31-571 Kraków, Poland (T.P.)
| | - Anna Piotrowska
- Department of Chemistry and Biochemistry, Faculty of Physiotherapy, University of Physical Education in Krakow, 31-571 Kraków, Poland
| | - Marcin Maciejczyk
- Institute of Biomedical Sciences, Department of Physiology and Biochemistry, University of Physical Education in Kraków, 31-571 Kraków, Poland (T.P.)
| | - Dariusz Mucha
- Department of Body Renovation and Body Posture Correction, Faculty of Physical Education and Sport, University of Physical Education in Kraków, 31-571 Kraków, Poland
| | - Ibrahim Ouergui
- Sports Science, Health and Movement, High Institute of Sport and Physical Education of Kef, University of Jendouba, El Kef 7100, Tunisia
| | - Rafał Kubacki
- Faculty of Physical Education and Sports, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland
| | - Olga Czerwińska-Ledwig
- Department of Chemistry and Biochemistry, Faculty of Physiotherapy, University of Physical Education in Krakow, 31-571 Kraków, Poland
| | - Dorota Ambroży
- Institute of Sports Sciences, University of Physical Education in Krakow, 31-571 Kraków, Poland
| | - Kazimierz Witkowski
- Faculty of Physical Education and Sports, University of Physical Education in Wrocław, 31-571 Kraków, Poland
| | - Tomasz Pałka
- Institute of Biomedical Sciences, Department of Physiology and Biochemistry, University of Physical Education in Kraków, 31-571 Kraków, Poland (T.P.)
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Bridger Staatz C, Gutin I, Tilstra A, Gimeno L, Moltrecht B, Moreno-Agostino D, Moulton V, Narayanan MK, Dowd JB, Gaydosh L, Ploubidis GB. Midlife Health in Britain and the US: A comparison of Two Nationally Representative Cohorts. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.12.21.23300366. [PMID: 38196627 PMCID: PMC10775406 DOI: 10.1101/2023.12.21.23300366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
Background Older adults in the United States (US) have worse health and wider socioeconomic inequalities in health compared to Britain. Less is known about how health in the two countries compares in midlife, a time of emerging health decline, including inequalities in health. Methods We compare measures of smoking status, alcohol consumption, obesity, self-rated health, cholesterol, blood pressure, and glycated haemoglobin using population-weighted modified Poisson regression in the 1970 British Cohort Study (BCS70) in Britain (N= 9,665) and the National Longitudinal Study of Adolescent to Adult Health (Add Health) in the US (N=12,297), when cohort members were aged 34-46 and 33-43, respectively. We test whether associations vary by early- and mid-life socioeconomic position. Findings US adults had higher levels of obesity, high blood pressure and high cholesterol. Prevalence of poor self-rated health, heavy drinking, and smoking was worse in Britain. We found smaller socioeconomic inequalities in midlife health in Britain compared to the US. For some outcomes (e.g., smoking), the most socioeconomically advantaged group in the US was healthier than the equivalent group in Britain. For other outcomes (hypertension and cholesterol), the most advantaged US group fared equal to or worse than the most disadvantaged groups in Britain. Interpretation US adults have worse cardiometabolic health than British counterparts, even in early midlife. The smaller socioeconomic inequalities and better overall health in Britain may reflect differences in access to health care, welfare systems, or other environmental risk factors. Funding ESRC, UKRI, MRC, NIH, European Research Council, Leverhulme Trust.
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Affiliation(s)
| | - Iliya Gutin
- The University of Texas at Austin, Austin, Texas, USA
| | - Andrea Tilstra
- Leverhulme Centre for Demographic Science, Nuffield College, and Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Laura Gimeno
- Centre for Longitudinal Studies, University College London, London, UK
| | - Bettina Moltrecht
- Centre for Longitudinal Studies, University College London, London, UK
| | - Dario Moreno-Agostino
- Centre for Longitudinal Studies, University College London, London, UK
- ESRC Centre for Society and Mental Health, King’s College London, London, UK
| | - Vanessa Moulton
- Centre for Longitudinal Studies, University College London, London, UK
| | | | - Jennifer B. Dowd
- Leverhulme Centre for Demographic Science, Nuffield College, and Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Stapińska-Syniec A, Kupryjaniuk A, Sobstyl M. Deep Brain Stimulation for Morbid Obesity: An Underutilized Neuromodulatory Treatment for Severely Obese Patients? J Neurol Surg A Cent Eur Neurosurg 2022; 83:471-477. [DOI: 10.1055/s-0041-1740616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Abstract
Background Morbid obesity (MO) has been steadily increasing in the last few years. Pharmacotherapy and bariatric surgeries remain the main treatment modalities for MO, although in the long-term they may lose their effectiveness. Other treatment approaches are urgently needed and deep brain stimulation (DBS) is a promising therapy. Disturbed energy homeostasis caused by intake of highly palatable and caloric foods may induce hedonic eating. The brain nuclei responsible for energy homeostasis and hedonia are the hypothalamic nuclei and nucleus accumbens. These brain structures constitute the stereotactic targets approached with DBS to treat MO.
Material and Methods We have performed a literature search of all available clinical applications of DBS for MO in humans. We were able to identify three case series reports and additional six case reports involving 16 patients. The selected stereotactic targets included lateral hypothalamus in eight patients, ventromedial hypothalamus in two patients, and nucleus accumbens in six patients.
Results In general, the safety profile of DBS in refractory MO patients was good. Clinical improvement regarding the mean body mass index could be observed in obese patients.
Conclusions MO is a demanding condition. Since in some cases standardized treatment is ineffective, new therapies should be implemented. DBS is a promising therapy that might be used in patients suffering from MO, however, more studies incorporating more individuals and with a longer follow-up are needed to obtain more reliable results concerning its effectiveness and safety profile.
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Affiliation(s)
| | - Anna Kupryjaniuk
- Department of Neurosurgery, Instytut Psychiatrii i Neurologii, Warsaw, Poland
| | - Michał Sobstyl
- Department of Neurosurgery, Instytut Psychiatrii i Neurologii, Warsaw, Poland
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7
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Martinson ML, Lapham J, Ercin-Swearinger H, Teitler JO, Reichman NE. Generational Shifts in Young Adult Cardiovascular Health? Millennials and Generation X in the United States and England. J Gerontol B Psychol Sci Soc Sci 2022; 77:S177-S188. [PMID: 35195713 PMCID: PMC9154229 DOI: 10.1093/geronb/gbac036] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES To compare cardiovascular (CV) risks/conditions of Millennials (born 1981-1996) to those of Generation X (Gen X; born 1965-1980) at ages 20-34 years, across 2 countries (United States, England), by gender. METHODS Using data from the National Health and Nutrition Examination Survey (United States) and Health Survey for England, we estimated weighted unadjusted and adjusted gender-specific proportions of CV risk factors/conditions, separately for Millennials and Generation X in each country. We also further calculated sex-specific generational differences in CV risk factor/conditions by income tercile and for individuals with normal body weight. RESULTS Millennials in the United States were more obese compared to their Gen X counterparts and more likely to have diabetes risk but less likely to smoke or have high cholesterol. Millennials in England had higher diabetes risk but similar or lower rates of other CV risk/conditions compared to their Gen X counterparts. Generational changes could not be fully attributed to increases in obesity or decreases in income. DISCUSSION We expected that Millennial CV risk factors/conditions would be worse than those of Gen X, particularly in the United States, because Millennials came of age during the Great Recession and a period of increasing population obesity. Millennials generally fared worse than their Gen X counterparts in terms of obesity and diabetes risk, especially in the United States, but had lower rates of smoking and high cholesterol in both countries. Secular trends of increasing obesity and decreased economic opportunities did not appear to lead to uniform generational differences in CV risk factors.
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Affiliation(s)
| | - Jessica Lapham
- School of Social Work, University of Washington, Seattle, Washington, USA
| | | | - Julien O Teitler
- School of Social Work, Columbia University, New York City, New York, USA
| | - Nancy E Reichman
- Department of Pediatrics and Child Health Institute of New Jersey, Rutgers University, New Brunswick, New Jersey, USA
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8
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Karpińska M, Czauderna M. Pancreas-Its Functions, Disorders, and Physiological Impact on the Mammals' Organism. Front Physiol 2022; 13:807632. [PMID: 35431983 PMCID: PMC9005876 DOI: 10.3389/fphys.2022.807632] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 02/04/2022] [Indexed: 12/15/2022] Open
Abstract
This review aimed to analyze the scientific literature on pancreatic diseases (especially exocrine pancreatic insufficiency). This review also describes the correlation between the physiological fitness of the pancreas and obesity. The influence of the pancreatic exocrine function on the development of the organism of adults and adolescents was also described. The results of piglet studies available in the literature were cited as an established model used to optimize treatments for pancreatic diseases in humans. The pancreas has an exocrine and hormonal function. Consequently, it is one of the key internal organs in animals and humans. Pancreatic diseases are usually severe and particularly troublesome. A properly composed diet and taken dietary supplements significantly improve the patient's well-being, as well as the course of the disease. Therefore, a diet and a healthy lifestyle positively affect maintaining the optimal physiological efficiency of the pancreas.
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Affiliation(s)
- Monika Karpińska
- The Kielanowski Institute of Animal Physiology and Nutrition, Polish Academy of Sciences, Warsaw, Poland
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9
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Pongiglione B, Ploubidis GB, Dowd JB. Older Adults in the United States Have Worse Cardiometabolic Health Compared to England. J Gerontol B Psychol Sci Soc Sci 2022; 77:S167-S176. [PMID: 35217868 PMCID: PMC9154237 DOI: 10.1093/geronb/gbac023] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Indexed: 01/09/2023] Open
Abstract
Explanations for lagging life expectancy in the United States compared to other high-income countries have focused largely on "deaths of despair," but attention has also shifted to the role of stalling improvements in cardiovascular disease and the obesity epidemic. Using harmonized data from the U.S. Health and Retirement Study and English Longitudinal Study of Ageing, we assess differences in self-reported and objective measures of health, among older adults in the United States and England and explore whether the differences in body mass index (BMI) documented between the United States and England explain the U.S. disadvantage. Older adults in the United States have a much higher prevalence of diabetes, low high-density lipoprotein cholesterol, and high inflammation (C-reactive protein) compared to English adults. While the distribution of BMI is shifted to the right in the United States with more people falling into extreme obesity categories, these differences do not explain the cross-country differences in measured biological risk. We conclude by considering how country differences in health may have affected the burden of coronavirus disease 2019 mortality in both countries.
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Affiliation(s)
- Benedetta Pongiglione
- Address correspondence to: Benedetta Pongiglione, PhD, Centre for Research on Health and Social Care Management (CERGAS), Bocconi University, Via Sarfatti 10, 20136 Milano, Italy. E-mail:
| | | | - Jennifer B Dowd
- Leverhulme Centre for Demographic Science, University of Oxford, Oxford, UK
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10
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Börsch-Supan A, Weiss LM, Börsch-Supan M, Potter AJ, Cofferen J, Kerschner E. Dried blood spot collection, sample quality, and fieldwork conditions: Structural validations for conversion into standard values. Am J Hum Biol 2021; 33:e23517. [PMID: 33063418 PMCID: PMC10980534 DOI: 10.1002/ajhb.23517] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 09/29/2020] [Accepted: 09/30/2020] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES SHARE, a pan-European panel study in 27 European countries and Israel, has collected dried blood spot (DBS) samples from approximately 27 000 respondents in 13 countries. We aim to obtain factors to convert analyte values between DBS and venous blood samples (VBS) taking account of adverse fieldwork conditions such as small spot size, high temperature and humidity, short drying time and long shipment times. METHODS We obtained VBS and DBS from a set of 20 donors in a laboratory setting, and treated the DBS in a systematic and controlled fashion simulating SHARE fieldwork conditions. We used the 3420 outcomes to estimate from DBS analyte values the values that we would have obtained had it been feasible to collect and analyze the donors' venous blood samples. RESULTS The influence of field conditions and sample quality on DBS analyte values is significant and differs among assays. Varying spot size is the main challenge and affects all markers except HbA1c. Smaller spots lead to overly high measured levels. A missing desiccant is detrimental for all markers except CRP and tHb. The temperature to which the samples are exposed plays a significant role for HDL and CysC, while too brief a drying time affects CRP and CysC. Lab-based adjustment formulae only accounting for the differences between re-liquefied DBS and venous blood do not address these fieldwork conditions. CONCLUSIONS By simulating adverse fieldwork conditions in the lab, we were able to validate DBS collected under such conditions and established conversion formulae with high prediction accuracy.
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Affiliation(s)
- Axel Börsch-Supan
- Munich Center for the Economics of Aging (MEA) at the Max Planck Institute for Social Law and Social Policy, Munich, Germany
- Department of Economics and Business, Technical University of Munich (TUM), Munich, Germany
- National Bureau of Economic Research (NBER), Cambridge, Massachusetts
| | - Luzia M. Weiss
- Munich Center for the Economics of Aging (MEA) at the Max Planck Institute for Social Law and Social Policy, Munich, Germany
| | - Martina Börsch-Supan
- Survey of Health, Aging and Retirement in Europe (SHARE Biomarker Project), Munich, Germany
| | - Alan J. Potter
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington
| | - Jake Cofferen
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington
| | - Elizabeth Kerschner
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington
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11
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Abstract
Policy Points Explanations for the troubling trend in US life expectancy since the 1980s should be grounded in the dynamic changes in policies and political landscapes. Efforts to reverse this trend and put US life expectancy on par with other high-income countries must address those factors. Of prime importance are the shifts in the balance of policymaking power in the United States, the polarization of state policy contexts, and the forces behind those changes.
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12
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O'Neil A, Russell JD, Thompson K, Martinson ML, Peters SAE. The impact of socioeconomic position (SEP) on women's health over the lifetime. Maturitas 2020; 140:1-7. [PMID: 32972629 PMCID: PMC7273147 DOI: 10.1016/j.maturitas.2020.06.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/29/2020] [Accepted: 06/02/2020] [Indexed: 12/18/2022]
Abstract
The "social gradient of health" refers to the steep inverse associations between socioeconomic position (SEP) and the risk of premature mortality and morbidity. In many societies, due to cultural and structural factors, women and girls have reduced access to the socioeconomic resources that ensure good health and wellbeing when compared with their male counterparts. Thus, the objective of this paper is to review how SEP - a construct at the heart of the Social Determinants of Health (SDoH) theory - shapes the health and longevity of women and girls at all stages of the lifespan. Using literature identified from PubMed, Cochrane, CINAHL and EMBASE databases, we first describe the SDoH theory. We then use examples from each stage of the life course to demonstrate how SEP can differentially shape girls' and women's health outcomes compared with boys' and men's, as well as between sub-groups of girls and women when other axes of inequalities are considered, including ethnicity, race and residential setting. We also explore the key consideration of whether conventional SEP markers are appropriate for understanding the social determinants of women's health. We conclude by making key recommendations in the context of clinical, research and policy development.
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Affiliation(s)
- Adrienne O'Neil
- Heart & Mind Research, iMPACT Institute, Deakin University, 3220, VIC, Australia.
| | - Josephine D Russell
- Heart & Mind Research, iMPACT Institute, Deakin University, 3220, VIC, Australia
| | - Kelly Thompson
- Global Women's Health, The George Institute for Global Health, University of New South Wales, Australia
| | | | - Sanne A E Peters
- The George Institute for Global Health, University of Oxford, Oxford, UK; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; The George Institute for Global Health, University of New South Wales, Sydney, Australia
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13
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Choi H, Steptoe A, Heisler M, Clarke P, Schoeni RF, Jivraj S, Cho TC, Langa KM. Comparison of Health Outcomes Among High- and Low-Income Adults Aged 55 to 64 Years in the US vs England. JAMA Intern Med 2020; 180:1185-1193. [PMID: 32897385 PMCID: PMC7358980 DOI: 10.1001/jamainternmed.2020.2802] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
IMPORTANCE Socioeconomic differences in life expectancy, health, and disability have been found in European countries as well as in the US. Identifying the extent and pattern of health disparities, both within and across the US and England, may be important for informing public health and public policy aimed at reducing these disparities. OBJECTIVE To compare the health of US adults aged 55 to 64 years with the health of their peers in England across the high and low ranges of income in each country. DESIGN, SETTING, AND PARTICIPANTS Using data from the Health and Retirement Study (HRS) and the English Longitudinal Study of Ageing (ELSA) for 2008-2016, a pooled cross-sectional analysis of comparably measured health outcomes, with adjustment for demographic characteristics and socioeconomic status, was conducted. The analysis sample included community-dwelling adults aged 55 to 64 years from the HRS and ELSA, resulting in 46 887 person-years of observations. Data analysis was conducted from September 17, 2019, to May 12, 2020. EXPOSURES Residence in the US or England and yearly income. MAIN OUTCOMES AND MEASURES Sixteen health outcomes were compared, including 5 self-assessed outcomes, 3 directly measured outcomes, and 8 self-reported physician-diagnosed health conditions. RESULTS This cross-sectional study included 12 879 individuals and 31 928 person-years from HRS (mean [SD] age, 59.2 [2.8] years; 51.9% women) and 5693 individuals and 14 959 person-years from ELSA (mean [SD] age, 59.3 [2.9] years; 51.0% women). After adjusting for individual-level demographic characteristics and socioeconomic status, a substantial health gap between lower-income and higher-income adults was found in both countries, but the health gap between the bottom 20% and the top 20% of the income distribution was significantly greater in the US than England on 13 of 16 measures. The adjusted US-England difference in the prevalence gap between the bottom 20% and the top 20% ranged from 3.6 percentage points (95% CI, 2.0-5.2 percentage points) in stroke to 9.7 percentage points (95% CI, 5.4-13.9 percentage points) for functional limitation. Among individuals in the lowest income group in each country, those in the US group vs the England group had significantly worse outcomes on many health measures (10 of 16 outcomes in the bottom income decile); the significant differences in adjusted prevalence of health problems in the US vs England for the bottom income decile ranged from 7.6% (95% CI, 6.0%-9.3%) vs 3.8% (95% CI, 2.6%-4.9%) for stroke to 75.7% (95% CI, 72.7%-78.8%) vs 59.5% (95% CI, 56.3%-62.7%) for functional limitation. Among individuals in the highest income group, those in the US group vs England group had worse outcomes on fewer health measures (4 of 16 outcomes in the top income decile); the significant differences in adjusted prevalence of health problems in the US vs England for the top income decile ranged from 36.9% (95% CI, 33.4%-40.4%) vs 30.0% (95% CI, 27.2%-32.7%) for hypertension to 35.4% (95% CI, 32.0%-38.7%) vs 22.5% (95% CI, 19.9%-25.1%) for arthritis. CONCLUSIONS AND RELEVANCE For most health outcomes examined in this cross-sectional study, the health gap between adults with low vs high income appeared to be larger in the US than in England, and the health disadvantages in the US compared with England are apparently more pronounced among individuals with low income. Public policy and public health interventions aimed at improving the health of adults with lower income should be a priority in the US.
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Affiliation(s)
- HwaJung Choi
- Department of Internal Medicine, School of Medicine, University of Michigan, Ann Arbor.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Michele Heisler
- Department of Internal Medicine, School of Medicine, University of Michigan, Ann Arbor.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor.,Veterans Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor
| | - Philippa Clarke
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor.,Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor.,Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor
| | - Robert F Schoeni
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor.,Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor.,Gerald R. Ford School of Public Policy, University of Michigan, Ann Arbor
| | - Stephen Jivraj
- Institute of Epidemiology and Health Care, University College London, London, United Kingdom
| | - Tsai-Chin Cho
- Department of Internal Medicine, School of Medicine, University of Michigan, Ann Arbor
| | - Kenneth M Langa
- Department of Internal Medicine, School of Medicine, University of Michigan, Ann Arbor.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor.,Veterans Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor.,Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor
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14
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Montez JK, Beckfield J, Cooney JK, Grumbach JM, Hayward MD, Koytak HZ, Woolf SH, Zajacova A. US State Policies, Politics, and Life Expectancy. Milbank Q 2020; 98:668-699. [PMID: 32748998 PMCID: PMC7482386 DOI: 10.1111/1468-0009.12469] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Policy Points Changes in US state policies since the 1970s, particularly after 2010, have played an important role in the stagnation and recent decline in US life expectancy. Some US state policies appear to be key levers for improving life expectancy, such as policies on tobacco, labor, immigration, civil rights, and the environment. US life expectancy is estimated to be 2.8 years longer among women and 2.1 years longer among men if all US states enjoyed the health advantages of states with more liberal policies, which would put US life expectancy on par with other high‐income countries.
Context Life expectancy in the United States has increased little in previous decades, declined in recent years, and become more unequal across US states. Those trends were accompanied by substantial changes in the US policy environment, particularly at the state level. State policies affect nearly every aspect of people's lives, including economic well‐being, social relationships, education, housing, lifestyles, and access to medical care. This study examines the extent to which the state policy environment may have contributed to the troubling trends in US life expectancy. Methods We merged annual data on life expectancy for US states from 1970 to 2014 with annual data on 18 state‐level policy domains such as tobacco, environment, tax, and labor. Using the 45 years of data and controlling for differences in the characteristics of states and their populations, we modeled the association between state policies and life expectancy, and assessed how changes in those policies may have contributed to trends in US life expectancy from 1970 through 2014. Findings Results show that changes in life expectancy during 1970‐2014 were associated with changes in state policies on a conservative‐liberal continuum, where more liberal policies expand economic regulations and protect marginalized groups. States that implemented more conservative policies were more likely to experience a reduction in life expectancy. We estimated that the shallow upward trend in US life expectancy from 2010 to 2014 would have been 25% steeper for women and 13% steeper for men had state policies not changed as they did. We also estimated that US life expectancy would be 2.8 years longer among women and 2.1 years longer among men if all states enjoyed the health advantages of states with more liberal policies. Conclusions Understanding and reversing the troubling trends and growing inequalities in US life expectancy requires attention to US state policy contexts, their dynamic changes in recent decades, and the forces behind those changes. Changes in US political and policy contexts since the 1970s may undergird the deterioration of Americans’ health and longevity.
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Affiliation(s)
| | | | | | | | | | | | | | - Anna Zajacova
- University of Western Ontario.,Coauthors listed alphabetically
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15
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Nguyen TH, Milburn JM, Duszak R, Savoie J, Horný M, Hirsch JA. Medicare for All: Considerations for Neuroradiologists. AJNR Am J Neuroradiol 2020; 41:772-776. [PMID: 32299804 PMCID: PMC7228185 DOI: 10.3174/ajnr.a6524] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 03/07/2020] [Indexed: 11/07/2022]
Abstract
The year 2019 featured extensive debates on transforming the United States multipayer health care system into a single-payer system. At a time when reimbursement structures are in flux and potential changes in government may affect health care, it is important for neuroradiologists to remain informed on how emerging policies may impact their practices. The purpose of this article is to examine potential ramifications for neuroradiologist reimbursement with the Medicare for All legislative proposals. An institution-specific analysis is presented to illustrate general Medicare for All principles in discussing issues applicable to practices nationwide.
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Affiliation(s)
- T H Nguyen
- From the Department of Radiology (T.H.N., J.M.), Ochsner Health System, New Orleans, Louisiana
| | - J M Milburn
- From the Department of Radiology (T.H.N., J.M.), Ochsner Health System, New Orleans, Louisiana
| | - R Duszak
- Department of Radiology and Imaging Sciences (R.D., M.H.), Emory University School of Medicine, Atlanta, Georgia
| | - J Savoie
- Imaging Services Administration (J.S.), University of Southern California Keck School of Medicine, Los Angeles, California
| | - M Horný
- Department of Radiology and Imaging Sciences (R.D., M.H.), Emory University School of Medicine, Atlanta, Georgia
- Department of Health Policy and Management (M.H.), Emory University Rollins School of Public Health, Atlanta, Georgia
| | - J A Hirsch
- Department of Radiology (J.A.H.), Massachusetts General Hospital, Boston, Massachusetts
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16
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Teitler J, Martinson M, Reichman NE. Does Life in the United States Take a Toll on Health? Duration of Residence and Birthweight among Six Decades of Immigrants. INTERNATIONAL MIGRATION REVIEW 2018. [DOI: 10.1111/imre.12207] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We used data from the 1998–2009 waves of the National Health Interview Survey to investigate cohort differences in low birthweight among US-born children of mothers arriving in the United States between 1955 and 2009, cohort-adjusted patterns in low birthweight by maternal duration of residence in the United States, and cohort-adjusted patterns in low birthweight by maternal duration of US residence stratified by age at arrival and region of origin. We found a consistent deterioration in infant health with successive immigrant cohorts and heterogeneous effects of cohort-adjusted duration in the United States by age at arrival and region. Most notably, we found evidence that maternal health (as proxied by low birthweight) deteriorates with duration in the United States only for immigrant mothers who came to the United States as children. For mothers who arrived as adults, we found no evidence of deterioration. The findings underscore the importance of considering age at arrival and place of origin when studying post-migration health trajectories and provide indirect evidence that early life exposures are a key to understanding why the United States lags other developed nations in health.
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17
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Kindig D, Nobles J, Zidan M. Meeting the Institute of Medicine's 2030 US Life Expectancy Target. Am J Public Health 2018; 108:87-92. [PMID: 29161064 PMCID: PMC5719677 DOI: 10.2105/ajph.2017.304099] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2017] [Indexed: 01/22/2023]
Abstract
OBJECTIVES To quantify the improvement in US life expectancy required to reach parity with high-resource nations by 2030, to document historical precedent of this rate, and to discuss the plausibility of achieving this rate in the United States. METHODS We performed a demographic analysis of secondary data in 5-year periods from 1985 to 2015. RESULTS To achieve the United Nations projected mortality estimates for Western Europe in 2030, the US life expectancy must grow at 0.32% a year between 2016 and 2030. This rate has precedent, even in low-mortality populations. Over 204 country-periods examined, nearly half exhibited life-expectancy growth greater than 0.32%. Of the 51 US states observed, 8.2% of state-periods demonstrated life-expectancy growth that exceeded the 0.32% target. CONCLUSIONS Achieving necessary growth in life expectancy over the next 15 years despite historical precedent will be challenging. Much all-cause mortality is structured decades earlier and, at present, older-age mortality reductions in the United States are decelerating. Addressing mortality decline at all ages will require enhanced political will and a strong commitment to equity improvement in the US population.
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Affiliation(s)
- David Kindig
- David Kindig is with the Department of Population Health Sciences, University of Wisconsin-Madison. Jenna Nobles is with the Department of Sociology, University of Wisconsin-Madison. Moheb Zidan is with the Department of Economics, University of Wisconsin-Madison
| | - Jenna Nobles
- David Kindig is with the Department of Population Health Sciences, University of Wisconsin-Madison. Jenna Nobles is with the Department of Sociology, University of Wisconsin-Madison. Moheb Zidan is with the Department of Economics, University of Wisconsin-Madison
| | - Moheb Zidan
- David Kindig is with the Department of Population Health Sciences, University of Wisconsin-Madison. Jenna Nobles is with the Department of Sociology, University of Wisconsin-Madison. Moheb Zidan is with the Department of Economics, University of Wisconsin-Madison
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18
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Miller DP, Bazzi AR, Allen HL, Martinson ML, Salas-Wright CP, Jantz K, Crevi K, Rosenbloom DL. A Social Work Approach to Policy: Implications for Population Health. Am J Public Health 2017; 107:S243-S249. [PMID: 29236535 DOI: 10.2105/ajph.2017.304003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The substantial disparities in health and poorer outcomes in the United States relative to peer nations suggest the need to refocus health policy. Through direct contact with the most vulnerable segments of the population, social workers have developed an approach to policy that recognizes the importance of the social environment, the value of social relationships, and the significance of value-driven policymaking. This approach could be used to reorient health, health care, and social policies. Accordingly, social workers can be allies to public health professionals in efforts to eliminate disparities and improve population health.
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Affiliation(s)
- Daniel P Miller
- Daniel P. Miller, Christopher P. Salas-Wright, and Katherine Crevi are with the School of Social Work, Boston University, Boston, MA. Angela R. Bazzi and David L. Rosenbloom are with the School of Public Health, Boston University. Heidi L. Allen is with the School of Social Work, Columbia University, New York, NY. Melissa L. Martinson is with the School of Social Work, University of Washington, Seattle. Kathryn Jantz is with the Steadman Group, Denver, CO
| | - Angela R Bazzi
- Daniel P. Miller, Christopher P. Salas-Wright, and Katherine Crevi are with the School of Social Work, Boston University, Boston, MA. Angela R. Bazzi and David L. Rosenbloom are with the School of Public Health, Boston University. Heidi L. Allen is with the School of Social Work, Columbia University, New York, NY. Melissa L. Martinson is with the School of Social Work, University of Washington, Seattle. Kathryn Jantz is with the Steadman Group, Denver, CO
| | - Heidi L Allen
- Daniel P. Miller, Christopher P. Salas-Wright, and Katherine Crevi are with the School of Social Work, Boston University, Boston, MA. Angela R. Bazzi and David L. Rosenbloom are with the School of Public Health, Boston University. Heidi L. Allen is with the School of Social Work, Columbia University, New York, NY. Melissa L. Martinson is with the School of Social Work, University of Washington, Seattle. Kathryn Jantz is with the Steadman Group, Denver, CO
| | - Melissa L Martinson
- Daniel P. Miller, Christopher P. Salas-Wright, and Katherine Crevi are with the School of Social Work, Boston University, Boston, MA. Angela R. Bazzi and David L. Rosenbloom are with the School of Public Health, Boston University. Heidi L. Allen is with the School of Social Work, Columbia University, New York, NY. Melissa L. Martinson is with the School of Social Work, University of Washington, Seattle. Kathryn Jantz is with the Steadman Group, Denver, CO
| | - Christopher P Salas-Wright
- Daniel P. Miller, Christopher P. Salas-Wright, and Katherine Crevi are with the School of Social Work, Boston University, Boston, MA. Angela R. Bazzi and David L. Rosenbloom are with the School of Public Health, Boston University. Heidi L. Allen is with the School of Social Work, Columbia University, New York, NY. Melissa L. Martinson is with the School of Social Work, University of Washington, Seattle. Kathryn Jantz is with the Steadman Group, Denver, CO
| | - Kathryn Jantz
- Daniel P. Miller, Christopher P. Salas-Wright, and Katherine Crevi are with the School of Social Work, Boston University, Boston, MA. Angela R. Bazzi and David L. Rosenbloom are with the School of Public Health, Boston University. Heidi L. Allen is with the School of Social Work, Columbia University, New York, NY. Melissa L. Martinson is with the School of Social Work, University of Washington, Seattle. Kathryn Jantz is with the Steadman Group, Denver, CO
| | - Katherine Crevi
- Daniel P. Miller, Christopher P. Salas-Wright, and Katherine Crevi are with the School of Social Work, Boston University, Boston, MA. Angela R. Bazzi and David L. Rosenbloom are with the School of Public Health, Boston University. Heidi L. Allen is with the School of Social Work, Columbia University, New York, NY. Melissa L. Martinson is with the School of Social Work, University of Washington, Seattle. Kathryn Jantz is with the Steadman Group, Denver, CO
| | - David L Rosenbloom
- Daniel P. Miller, Christopher P. Salas-Wright, and Katherine Crevi are with the School of Social Work, Boston University, Boston, MA. Angela R. Bazzi and David L. Rosenbloom are with the School of Public Health, Boston University. Heidi L. Allen is with the School of Social Work, Columbia University, New York, NY. Melissa L. Martinson is with the School of Social Work, University of Washington, Seattle. Kathryn Jantz is with the Steadman Group, Denver, CO
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19
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Martinson ML, Tienda M, Teitler JO. Low birthweight among immigrants in Australia, the United Kingdom, and the United States. Soc Sci Med 2017; 194:168-176. [DOI: 10.1016/j.socscimed.2017.09.043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 09/23/2017] [Accepted: 09/26/2017] [Indexed: 11/17/2022]
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20
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Mulugeta B, Williamson S, Monks R, Hack T, Beaver K. Cancer through black eyes - The views of UK based black men towards cancer: A constructivist grounded theory study. Eur J Oncol Nurs 2017; 29:8-16. [DOI: 10.1016/j.ejon.2017.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 04/24/2017] [Indexed: 11/24/2022]
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21
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Bendayan R, Cooper R, Wloch EG, Hofer SM, Piccinin AM, Muniz-Terrera G. Hierarchy and Speed of Loss in Physical Functioning: A Comparison Across Older U.S. and English Men and Women. J Gerontol A Biol Sci Med Sci 2017; 72:1117-1122. [PMID: 27753610 PMCID: PMC5861940 DOI: 10.1093/gerona/glw209] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 09/25/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND We aimed to identify the hierarchy of rates of decline in 16 physical functioning measures in U.S. and English samples, using a systematic and integrative coordinated data analysis approach. METHODS The U.S. sample consisted of 13,612 Health and Retirement Study participants, and the English sample consisted of 5,301 English Longitudinal Study of Ageing participants. Functional loss was ascertained using self-reported difficulties performing 6 activities of daily living and 10 mobility tasks. The variables were standardized, rates of decline were computed, and mean rates of decline were ranked. Mann-Whitney U tests were performed to compare rates of decline between studies. RESULTS In both studies, the rates of decline followed a similar pattern; difficulty with eating was the activity that showed the slowest decline and climbing several flights of stairs and stooping, kneeling, or crouching the fastest declines. There were statistical differences in the speed of decline in all 16 measures between countries. American women had steeper declines in 10 of the measures than English women. Similar differences were found between American and English men. CONCLUSIONS Reporting difficulties climbing several flights of stairs without resting, and stooping, kneeling, or crouching are the first indicators of functional loss reported in both populations.
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Affiliation(s)
| | - Rachel Cooper
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | | | - Scott M Hofer
- Department of Psychology, University of Victoria, British Columbia, Canada
| | - Andrea M Piccinin
- Department of Psychology, University of Victoria, British Columbia, Canada
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22
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Hargreaves DS, Struijs JN, Schuster MA. US Children And Adolescents Had Fewer Annual Doctor And Dentist Contacts Than Their Dutch Counterparts, 2010-12. Health Aff (Millwood) 2017; 34:2113-20. [PMID: 26643632 DOI: 10.1377/hlthaff.2015.0709] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Children and adolescents in the United States have been found to be less healthy than their counterparts in other high-income countries. The contribution of pediatric health care use to health outcomes--either as an independent determinant or as a mediator of wider social factors--is not well understood. We found that, compared to their peers in the Netherlands, US children and adolescents had fewer annual doctor and dental contacts in 2012. In both countries, poorer health status was reported among low-income compared to high-income children; however, this status was accompanied by greater or equal number of doctor and dental contacts among low-income Dutch children compared to their higher-income Dutch peers. By contrast, low-income US children had 28-65 percent fewer care episodes than high-income US children. Further research is needed to investigate the potential impact of greater equity and use of pediatric services on US health outcomes. Possible policy responses might include a focus on improving the quality, coverage, and benefits of health insurance, as well as on the workforce implications of providing high-quality pediatric care to all.
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Affiliation(s)
- Dougal S Hargreaves
- Dougal S. Hargreaves is an associate professor in the Population, Policy, and Practice program at the Institute of Child Health, University College London, in England
| | - Jeroen N Struijs
- Jeroen N. Struijs is a senior researcher in the Department of Quality of Care and Health Economics at the National Institute of Public Health and the Environment (RIVM), in Bilthoven, the Netherlands
| | - Mark A Schuster
- Mark A. Schuster is the William Berenberg Professor of Pediatrics at Harvard Medical School and chief of the Division of General Pediatrics and vice chair for health policy in the Department of Medicine at Boston Children's Hospital, in Massachusetts
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23
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Martinson ML, Teitler JO, Plaza R, Reichman NE. Income disparities in cardiovascular health across the lifespan. SSM Popul Health 2016; 2:904-913. [PMID: 29349197 PMCID: PMC5757909 DOI: 10.1016/j.ssmph.2016.10.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Revised: 10/13/2016] [Accepted: 10/21/2016] [Indexed: 01/04/2023] Open
Abstract
Using data from the 1999-2014 National Health and Nutrition Examination Survey (n ~ 46,000), this study documents income disparities in the age patterning of cardiovascular conditions across the lifespan in the U.S. The conditions were assessed from laboratory test results, self-reports of medications used to treat specific conditions, and anthropometric measurements, allowing us to capture whether individuals at given ages had developed the various conditions, regardless of previous diagnosis and treatment. We found evidence of large income disparities in the presence of cardiovascular conditions and risk factors for females, smaller disparities in the same conditions for males, and few disparities that increased with age for either gender. Results were very similar when considering disparities by education instead of income. The findings suggest that the widening socioeconomic gradients in health over the lifespan found in many previous studies-which have generally focused on self-rated health, activity limitations, or diagnosed conditions-reflect, at least to some extent, differences in diagnosis, treatment, and management of health conditions rather than age-related differences in developing them. The findings also suggest that preventive healthcare is not an important source of socioeconomic disparities in cardiovascular health in the U.S., at least for men. The observed patterns of income disparities in cardiovascular conditions over the lifespan are more consistent with theories of early life conditions and the imprinting of health endowments and susceptibilities early in life than with cumulative life exposure or stress hypotheses.
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Affiliation(s)
- Melissa L. Martinson
- University of Washington, School of Social Work, 4101 15th Avenue NE, Seattle, WA 98105, United States
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24
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Casagrande SS, Menke A, Cowie CC. Cardiovascular Risk Factors of Adults Age 20-49 Years in the United States, 1971-2012: A Series of Cross-Sectional Studies. PLoS One 2016; 11:e0161770. [PMID: 27552151 PMCID: PMC4995093 DOI: 10.1371/journal.pone.0161770] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 08/11/2016] [Indexed: 11/30/2022] Open
Abstract
Background The health of younger adults in the U.S. has important public health and economic-related implications. However, previous literature is insufficient to fully understand how the health of this group has changed over time. This study examined generational differences in cardiovascular risk factors of younger adults over the past 40 years. Methods Data were from 6 nationally representative cross-sectional National Health and Nutrition Examination Surveys (1971–2012; N = 44,670). Participants were adults age 20–49 years who self-reported sociodemographic characteristics and health conditions, and had examination/laboratory measures for hypertension, hyperlipidemia, diabetes, obesity, and chronic kidney disease. Prevalences of sociodemographic characteristics and health status were determined by study period. Logistic regression was used to determine the odds [odds ratio (OR), 95% confidence interval] of health conditions by study period: models adjusted only for age, sex, and race, and fully adjusted models additionally adjusted for socioeconomic characteristics, smoking, BMI, diabetes, and/or hypertension (depending on the outcome) were assessed. Results Participants in 2009–2012 were significantly more likely to be obese and have diabetes compared to those in 1971–1975 (OR = 4.98, 3.57–6.97; OR = 3.49, 1.59–7.65, respectively, fully adjusted). Participants in 2009–2012 vs. 1988–1994 were significantly more likely to have had hypertension but uncontrolled hypertension was significantly less likely (OR = 0.67, 0.52–0.86, fully adjusted). There was no difference over time for high cholesterol, but uncontrolled high cholesterol was significantly less likely in 2009–2012 vs. 1988–1994 (OR = 0.80, 0.68–0.94, fully adjusted). The use of hypertensive and cholesterol medications increased while chronic kidney and cardiovascular diseases were relatively stable. Conclusions Cardiovascular risk factors of younger U.S. adults have worsened over the past 40 years, but treatment for hypertension and high cholesterol has improved. The sub-optimal and worsening health in younger adults may have a substantial impact on health care utilization and costs, and should be considered when developing health care practices.
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Affiliation(s)
- Sarah S. Casagrande
- Public Health Research, Social & Scientific Systems, Inc., Silver Spring, Maryland, United States of America
- * E-mail:
| | - Andy Menke
- Public Health Research, Social & Scientific Systems, Inc., Silver Spring, Maryland, United States of America
| | - Catherine C. Cowie
- Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, United States of America
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25
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Martinson ML, Reichman NE. Socioeconomic Inequalities in Low Birth Weight in the United States, the United Kingdom, Canada, and Australia. Am J Public Health 2016; 106:748-54. [PMID: 26794171 DOI: 10.2105/ajph.2015.303007] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To compare associations between socioeconomic status and low birth weight across the United States, the United Kingdom, Canada, and Australia, countries that share cultural features but differ in terms of public support and health care systems. METHODS Using nationally representative data from the United States (n = 8400), the United Kingdom (n = 12 018), Canada (n = 5350), and Australia (n = 3452) from the early 2000s, we calculated weighted prevalence rates and adjusted odds of low birth weight by income quintile and maternal education. RESULTS Socioeconomic gradients in low birth weight were apparent in all 4 countries, but the magnitudes and patterns differed across countries. A clear graded association between income quintile and low birth weight was apparent in the United States. The relevant distinction in the United Kingdom appeared to be between low, middle, and high incomes, and the distinction in Canada and Australia appeared to be between mothers in the lowest income quintile and higher-income mothers. CONCLUSIONS Socioeconomic inequalities in low birth weight were larger in the United States than the other countries, suggesting that the more generous social safety nets and health care systems in the United Kingdom, Canada, and Australia played buffering roles.
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Affiliation(s)
- Melissa L Martinson
- Melissa L. Martinson is with the School of Social Work, University of Washington, Seattle. Nancy E. Reichman is with the Department of Pediatrics, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ
| | - Nancy E Reichman
- Melissa L. Martinson is with the School of Social Work, University of Washington, Seattle. Nancy E. Reichman is with the Department of Pediatrics, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ
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Borrescio-Higa F. Can Walmart make us healthier? Prescription drug prices and health care utilization. JOURNAL OF HEALTH ECONOMICS 2015; 44:37-53. [PMID: 26376457 DOI: 10.1016/j.jhealeco.2015.07.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 07/03/2015] [Accepted: 07/19/2015] [Indexed: 06/05/2023]
Abstract
This paper analyzes how prices in the retail pharmaceutical market affect health care utilization. Specifically, I study the impact of Walmart's $4 Prescription Drug Program on utilization of antihypertensive drugs and on hospitalizations for conditions amenable to drug therapy. Identification relies on the change in the availability of cheap drugs introduced by Walmart's program, exploiting variation in the distance to the nearest Walmart across ZIP codes in a difference-in-differences framework. I find that living close to a source of cheap drugs increases utilization of antihypertensive medications by 7 percent and decreases the probability of an avoidable hospitalization by 6.2 percent.
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Cieza A, Oberhauser C, Bickenbach J, Jones RN, Üstün TB, Kostanjsek N, Morris JN, Chatterji S. The English are healthier than the Americans: really? Int J Epidemiol 2015; 44:229-38. [PMID: 25231371 PMCID: PMC4339758 DOI: 10.1093/ije/dyu182] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: When comparing the health of two populations, it is not enough to compare the prevalence of chronic diseases. The objective of this study is therefore to propose a metric of health based on domains of functioning to determine whether the English are healthier than the Americans. Methods: We analysed representative samples aged 50 to 80 years from the 2008 wave of the Health and Retirement Study (N = 10 349) for the US data, and wave 4 of the English Longitudinal Study of Ageing (N = 9405) for English counterpart data. We first calculated the age-standardized disease prevalence of diabetes, hypertension, all heart diseases, stroke, lung disease, cancer and obesity. Second, we developed a metric of health using Rasch analyses and the questions and measured tests common to both surveys addressing domains of human functioning. Finally, we used a linear additive model to test whether the differences in health were due to being English or American. Results: The English have better health than the Americans when population health is assessed only by prevalence of selected chronic health conditions. The English health advantage disappears almost completely, however, when health is assessed with a metric that integrates information about functioning domains. Conclusions: It is possible to construct a metric of health, based on data directly collected from individuals, in which health is operationalized as domains of functioning. Its application has the potential to tackle one of the most intractable problems in international research on health, namely the comparability of health across countries.
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Affiliation(s)
- Alarcos Cieza
- Faculty of Social and Human Sciences, University of Southampton, Southampton, UK, Department of Medical Informatics, Biometry and Epidemiology, Pettenkofer School of Public Health (PSPH), Research Unit for Biopsychosocial Health, Ludwig-Maximilians University, Munich, Germany, Swiss Paraplegic Research, Nottwil, Switzerland, Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland, Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA, Classification, Terminology and Standards, Department of Health Statistics and Informatics, World Health Organization, Geneva, Switzerland, Institute for Aging Research, Social and Health Policy Research, Hebrew SeniorLife, Boston, MA, USA and Surveys, Measurement and Analysis, Department of Measurement and Health Information Systems, World Health Organization, Geneva, Switzerland
- *Corresponding author. Faculty of Social and Human Sciences, Academic Unit Psychology, University of Southampton, Southampton SO17 1BJ, UK. E-mail:
| | - Cornelia Oberhauser
- Faculty of Social and Human Sciences, University of Southampton, Southampton, UK, Department of Medical Informatics, Biometry and Epidemiology, Pettenkofer School of Public Health (PSPH), Research Unit for Biopsychosocial Health, Ludwig-Maximilians University, Munich, Germany, Swiss Paraplegic Research, Nottwil, Switzerland, Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland, Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA, Classification, Terminology and Standards, Department of Health Statistics and Informatics, World Health Organization, Geneva, Switzerland, Institute for Aging Research, Social and Health Policy Research, Hebrew SeniorLife, Boston, MA, USA and Surveys, Measurement and Analysis, Department of Measurement and Health Information Systems, World Health Organization, Geneva, Switzerland
| | - Jerome Bickenbach
- Faculty of Social and Human Sciences, University of Southampton, Southampton, UK, Department of Medical Informatics, Biometry and Epidemiology, Pettenkofer School of Public Health (PSPH), Research Unit for Biopsychosocial Health, Ludwig-Maximilians University, Munich, Germany, Swiss Paraplegic Research, Nottwil, Switzerland, Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland, Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA, Classification, Terminology and Standards, Department of Health Statistics and Informatics, World Health Organization, Geneva, Switzerland, Institute for Aging Research, Social and Health Policy Research, Hebrew SeniorLife, Boston, MA, USA and Surveys, Measurement and Analysis, Department of Measurement and Health Information Systems, World Health Organization, Geneva, Switzerland
| | - Richard N Jones
- Faculty of Social and Human Sciences, University of Southampton, Southampton, UK, Department of Medical Informatics, Biometry and Epidemiology, Pettenkofer School of Public Health (PSPH), Research Unit for Biopsychosocial Health, Ludwig-Maximilians University, Munich, Germany, Swiss Paraplegic Research, Nottwil, Switzerland, Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland, Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA, Classification, Terminology and Standards, Department of Health Statistics and Informatics, World Health Organization, Geneva, Switzerland, Institute for Aging Research, Social and Health Policy Research, Hebrew SeniorLife, Boston, MA, USA and Surveys, Measurement and Analysis, Department of Measurement and Health Information Systems, World Health Organization, Geneva, Switzerland
| | - Tevfik Bedirhan Üstün
- Faculty of Social and Human Sciences, University of Southampton, Southampton, UK, Department of Medical Informatics, Biometry and Epidemiology, Pettenkofer School of Public Health (PSPH), Research Unit for Biopsychosocial Health, Ludwig-Maximilians University, Munich, Germany, Swiss Paraplegic Research, Nottwil, Switzerland, Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland, Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA, Classification, Terminology and Standards, Department of Health Statistics and Informatics, World Health Organization, Geneva, Switzerland, Institute for Aging Research, Social and Health Policy Research, Hebrew SeniorLife, Boston, MA, USA and Surveys, Measurement and Analysis, Department of Measurement and Health Information Systems, World Health Organization, Geneva, Switzerland
| | - Nenad Kostanjsek
- Faculty of Social and Human Sciences, University of Southampton, Southampton, UK, Department of Medical Informatics, Biometry and Epidemiology, Pettenkofer School of Public Health (PSPH), Research Unit for Biopsychosocial Health, Ludwig-Maximilians University, Munich, Germany, Swiss Paraplegic Research, Nottwil, Switzerland, Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland, Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA, Classification, Terminology and Standards, Department of Health Statistics and Informatics, World Health Organization, Geneva, Switzerland, Institute for Aging Research, Social and Health Policy Research, Hebrew SeniorLife, Boston, MA, USA and Surveys, Measurement and Analysis, Department of Measurement and Health Information Systems, World Health Organization, Geneva, Switzerland
| | - John N Morris
- Faculty of Social and Human Sciences, University of Southampton, Southampton, UK, Department of Medical Informatics, Biometry and Epidemiology, Pettenkofer School of Public Health (PSPH), Research Unit for Biopsychosocial Health, Ludwig-Maximilians University, Munich, Germany, Swiss Paraplegic Research, Nottwil, Switzerland, Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland, Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA, Classification, Terminology and Standards, Department of Health Statistics and Informatics, World Health Organization, Geneva, Switzerland, Institute for Aging Research, Social and Health Policy Research, Hebrew SeniorLife, Boston, MA, USA and Surveys, Measurement and Analysis, Department of Measurement and Health Information Systems, World Health Organization, Geneva, Switzerland
| | - Somnath Chatterji
- Faculty of Social and Human Sciences, University of Southampton, Southampton, UK, Department of Medical Informatics, Biometry and Epidemiology, Pettenkofer School of Public Health (PSPH), Research Unit for Biopsychosocial Health, Ludwig-Maximilians University, Munich, Germany, Swiss Paraplegic Research, Nottwil, Switzerland, Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland, Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA, Classification, Terminology and Standards, Department of Health Statistics and Informatics, World Health Organization, Geneva, Switzerland, Institute for Aging Research, Social and Health Policy Research, Hebrew SeniorLife, Boston, MA, USA and Surveys, Measurement and Analysis, Department of Measurement and Health Information Systems, World Health Organization, Geneva, Switzerland
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van Hedel K, Avendano M, Berkman LF, Bopp M, Deboosere P, Lundberg O, Martikainen P, Menvielle G, van Lenthe FJ, Mackenbach JP. The contribution of national disparities to international differences in mortality between the United States and 7 European countries. Am J Public Health 2015; 105:e112-9. [PMID: 25713947 DOI: 10.2105/ajph.2014.302344] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES This study examined to what extent the higher mortality in the United States compared to many European countries is explained by larger social disparities within the United States. We estimated the expected US mortality if educational disparities in the United States were similar to those in 7 European countries. METHODS Poisson models were used to quantify the association between education and mortality for men and women aged 30 to 74 years in the United States, Belgium, Denmark, Finland, France, Norway, Sweden, and Switzerland for the period 1989 to 2003. US data came from the National Health Interview Survey linked to the National Death Index and the European data came from censuses linked to national mortality registries. RESULTS If people in the United States had the same distribution of education as their European counterparts, the US mortality disadvantage would be larger. However, if educational disparities in mortality within the United States equaled those within Europe, mortality differences between the United States and Europe would be reduced by 20% to 100%. CONCLUSIONS Larger educational disparities in mortality in the United States than in Europe partly explain why US adults have higher mortality than their European counterparts. Policies to reduce mortality among the lower educated will be necessary to bridge the mortality gap between the United States and European countries.
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Affiliation(s)
- Karen van Hedel
- Karen van Hedel, Frank J. van Lenthe, and Johan P. Mackenbach are with the Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands. Mauricio Avendano is with the London School of Economics and Political Science, LSE Health and Social Care, London, UK, and the Department of Social and Behavioral Sciences, Harvard School of Public Health, Cambridge, MA. Lisa F. Berkman is with the Harvard Center for Population and Development Studies, Harvard School of Public Health, Cambridge, MA. Matthias Bopp is with the Institute of Social and Preventive Medicine, University of Zurich, Zurich, Switzerland. Patrick Deboosere is with the Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium. Olle Lundberg is with the Center for Health Equity Studies, Stockholms Universitet Karolinska Institute, Stockholm, Sweden. Pekka Martikainen is with the Department of Sociology, University of Helsinki, Helsinki, Finland. Gwenn Menvielle is with the Inserm, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, and Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
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Martinson ML, McLanahan S, Brooks-Gunn J. Variation in child body mass index patterns by race/ethnicity and maternal nativity status in the United States and England. Matern Child Health J 2015; 19:373-80. [PMID: 24894727 DOI: 10.1007/s10995-014-1519-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This paper examines body mass index (BMI) trajectories among children from different race/ethnic and maternal nativity backgrounds in the United States and England from early- to middle-childhood. This study is the first to examine race/ethnic and maternal nativity differences in BMI trajectories in both countries. We use two longitudinal birth cohort studies-The Fragile Families and Child Wellbeing Study (n = 3,285) for the United States and the Millennium Cohort Study (n = 6,700) for England to estimate trajectories in child BMI by race/ethnicity and maternal nativity status using multilevel growth models. In the United States our sample includes white, black, and Hispanic children; in England the sample includes white, black, and Asian children. We find significant race/ethnic differences in the initial BMI and BMI trajectories of children in both countries, with all non-white groups having significantly steeper BMI growth trajectories than whites. Nativity differences in BMI trajectories vary by race/ethnic group and are only statistically significantly higher for children of foreign-born blacks in England. Disparities in BMI trajectories are pervasive in the United States and England, despite lower overall BMI among English children. Future studies should consider both race/ethnicity and maternal nativity status subgroups when examining disparities in BMI in the United States and England. Differences in BMI are apparent in early childhood, which suggests that interventions targeting pre-school age children may be most effective at stemming childhood disparities in BMI.
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Affiliation(s)
- Melissa L Martinson
- School of Social Work, University of Washington, 4101 15th Avenue NE, Seattle, WA, 98105, USA,
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How does self-reported and newly-identified hypertension differently predict the risk of developing type 2 diabetes among urban adults in Mainland China? A pooled analysis of community-based prospective cohort studies. Int J Diabetes Dev Ctries 2014. [DOI: 10.1007/s13410-014-0198-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Poverty, ethnicity, and risk of obesity among low birth weight infants. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2014. [DOI: 10.1016/j.appdev.2014.01.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Ho JY. Mortality under age 50 accounts for much of the fact that US life expectancy lags that of other high-income countries. Health Aff (Millwood) 2014; 32:459-67. [PMID: 23459724 DOI: 10.1377/hlthaff.2012.0574] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Life expectancy at birth in the United States is among the lowest of all high-income countries. Most recent studies have concentrated on older ages, finding that Americans have a lower life expectancy at age fifty and experience higher levels of disease and disability than do their counterparts in other industrialized nations. Using cross-national mortality data to identify the key age groups and causes of death responsible for these shortfalls, I found that mortality differences below age fifty account for two-thirds of the gap in life expectancy at birth between American males and their counterparts in sixteen comparison countries. Among females, the figure is two-fifths. The major causes of death responsible for the below-fifty trends are unintentional injuries, including drug overdose--a fact that constitutes the most striking finding from this study; noncommunicable diseases; perinatal conditions, such as pregnancy complications and birth trauma; and homicide. In all, this study highlights the importance of focusing on younger ages and on policies both to prevent the major causes of death below age fifty and to reduce social inequalities.
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Affiliation(s)
- Jessica Y Ho
- University of Pennsylvania, in Philadelphia, USA.
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Avendano M, Kawachi I. Why do Americans have shorter life expectancy and worse health than do people in other high-income countries? Annu Rev Public Health 2014; 35:307-25. [PMID: 24422560 PMCID: PMC4112220 DOI: 10.1146/annurev-publhealth-032013-182411] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Americans lead shorter and less healthy lives than do people in other high-income countries. We review the evidence and explanations for these variations in longevity and health. Our overview suggests that the US health disadvantage applies to multiple mortality and morbidity outcomes. The American health disadvantage begins at birth and extends across the life course, and it is particularly marked for American women and for regions in the US South and Midwest. Proposed explanations include differences in health care, individual behaviors, socioeconomic inequalities, and the built physical environment. Although these factors may contribute to poorer health in America, a focus on proximal causes fails to adequately account for the ubiquity of the US health disadvantage across the life course. We discuss the role of specific public policies and conclude that while multiple causes are implicated, crucial differences in social policy might underlie an important part of the US health disadvantage.
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Affiliation(s)
- Mauricio Avendano
- London School of Economics and Political Science, Department of Social Policy, LSE Health and Social Care, London, United Kingdom
- Harvard School of Public Health, Department of Social and Behavioral Sciences, Boston, USA
| | - Ichiro Kawachi
- Harvard School of Public Health, Department of Social and Behavioral Sciences, Boston, USA
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Sultan SM, Schupf N, Dowling MM, Deveber GA, Kirton A, Elkind MSV. Review of lipid and lipoprotein(a) abnormalities in childhood arterial ischemic stroke. Int J Stroke 2013; 9:79-87. [PMID: 24148253 DOI: 10.1111/ijs.12136] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
National organizations recommend cholesterol screening in children to prevent vascular disease in adulthood. There are currently no recommendations for cholesterol and lipoprotein (a) testing in children who experience an arterial ischemic stroke. While dyslipidemia and elevated lipoprotein (a) are associated with ischemic stroke in adults, the role of atherosclerotic risk factors in childhood arterial ischemic stroke is not known. A review of the literature was performed from 1966 to April 2012 to evaluate the association between childhood arterial ischemic stroke and dyslipidemia or elevated lipoprotein (a). Of 239 citations, there were 16 original observational studies in children (with or without neonates) with imaging-confirmed arterial ischemic stroke and data on cholesterol or lipoprotein (a) values. Three pairs of studies reported overlapping subjects, and two were eliminated. Among 14 studies, there were data on cholesterol in 7 and lipoprotein (a) in 10. After stroke, testing was performed at >three-months in nine studies, at ≤three-months in four studies, and not specified in one study. There were five case-control studies: four compared elevated lipoprotein (a) and one compared abnormal cholesterol in children with arterial ischemic stroke to controls. A consistent positive association between elevated lipoprotein (a) and stroke was found [Mantel-Haenszel OR 4·24 (2·94-6·11)]. There was no association in one study on total cholesterol, and a positive association in one study on triglycerides. The literature suggests that elevated lipoprotein (a) may be more likely in children with arterial ischemic stroke than in control children. The absence of confirmatory study on dyslipidemia should be addressed with future research.
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Affiliation(s)
- Sally M Sultan
- Neurologic Institute, Department of Neurology, Columbia University Medical Center, New York, NY, USA
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Joffres M, Falaschetti E, Gillespie C, Robitaille C, Loustalot F, Poulter N, McAlister FA, Johansen H, Baclic O, Campbell N. Hypertension prevalence, awareness, treatment and control in national surveys from England, the USA and Canada, and correlation with stroke and ischaemic heart disease mortality: a cross-sectional study. BMJ Open 2013; 3:e003423. [PMID: 23996822 PMCID: PMC3758966 DOI: 10.1136/bmjopen-2013-003423] [Citation(s) in RCA: 308] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2013] [Revised: 07/26/2013] [Accepted: 07/29/2013] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Comparison of recent national survey data on prevalence, awareness, treatment and control of hypertension in England, the USA and Canada, and correlation of these parameters with each country stroke and ischaemic heart disease (IHD) mortality. DESIGN Non-institutionalised population surveys. SETTING AND PARTICIPANTS England (2006 n=6873), the USA (2007-2010 n=10 003) and Canada (2007-2009 n=3485) aged 20-79 years. OUTCOMES Stroke and IHD mortality rates were plotted against countries' specific prevalence data. RESULTS Mean systolic blood pressure (SBP) was higher in England than in the USA and Canada in all age-gender groups. Mean diastolic blood pressure (DBP) was similar in the three countries before age 50 and then fell more rapidly in the USA, being the lowest in the USA. Only 34% had a BP under 140/90 mm Hg in England, compared with 50% in the USA and 66% in Canada. Prehypertension and stages 1 and 2 hypertension prevalence figures were the highest in England. Hypertension prevalence (≥140 mm Hg SBP and/or ≥90 mm Hg DBP) was lower in Canada (19·5%) than in the USA (29%) and England (30%). Hypertension awareness was higher in the USA (81%) and Canada (83%) than in England (65%). England also had lower levels of hypertension treatment (51%; USA 74%; Canada 80%) and control (<140/90 mm Hg; 27%; the USA 53%; Canada 66%). Canada had the lowest stroke and IHD mortality rates, England the highest and the rates were inversely related to the mean SBP in each country and strongly related to the blood pressure indicators, the strongest relationship being between low hypertension awareness and stroke mortality. CONCLUSIONS While the current prevention efforts in England should result in future-improved figures, especially at younger ages, these data still show important gaps in the management of hypertension in these countries, with consequences on stroke and IHD mortality.
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Affiliation(s)
- Michel Joffres
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Emanuela Falaschetti
- Imperial Clinical Trial Unit, School of Public Health, Imperial College London, London, UK
| | - Cathleen Gillespie
- Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention,Atlanta, Georgia, USA
| | - Cynthia Robitaille
- Centre for Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Fleetwood Loustalot
- Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention,Atlanta, Georgia, USA
| | - Neil Poulter
- International Centre for Circulatory Health, Imperial College London, London, UK
| | - Finlay A McAlister
- Division of General Internal Medicine, University of Alberta Hospital, Edmonton, Alberta, Canada
| | - Helen Johansen
- Department of Community Medicine and Epidemiology, University of Ottawa, Epidemiology & Community Medicine, Ottawa, Ontario, Canada
| | - Oliver Baclic
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Norm Campbell
- Departments of Medicine, Community Health Sciences and of Physiology and Pharmacology, Libin Cardiovascular Institute, University of Calgary, Canada Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada
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Wahrendorf M, Reinhardt JD, Siegrist J. Relationships of disability with age among adults aged 50 to 85: evidence from the United States, England and continental europe. PLoS One 2013; 8:e71893. [PMID: 23977172 PMCID: PMC3743762 DOI: 10.1371/journal.pone.0071893] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 07/04/2013] [Indexed: 11/19/2022] Open
Abstract
Objectives To extend existing research on the US health disadvantage relative to Europe by studying the relationships of disability with age from midlife to old age in the US and four European regions (England/Northern and Western Europe/Southern Europe/Eastern Europe) including their wealth-related differences, using a flexible statistical approach to model the age-functions. Methods We used data from three studies on aging, with nationally representative samples of adults aged 50 to 85 from 15 countries (N = 48225): the US-American Health and Retirement Study (HRS), the English Longitudinal Study of Ageing (ELSA) and the Survey of Health, Ageing and Retirement in Europe (SHARE). Outcomes were mobility limitations and limitations in instrumental activities of daily living. We applied fractional polynomials of age to determine best fitting functional forms for age on disability in each region, while controlling for socio-demographic characteristics and important risk factors (hypertension, diabetes, obesity, smoking, physical inactivity). Results Findings showed high levels of disability in the US with small age-related changes between 50 and 85. Levels of disability were generally lower in Eastern Europe, followed by England and Southern Europe and lowest in Northern and Western Europe. In these latter countries age-related increases of disability, though, were steeper than in the US, especially in Eastern and Southern Europe. For all countries and at all ages, disability levels were higher among adults with low wealth compared to those with high wealth, with largest wealth-related differences among those in early old age in the USA. Conclusions This paper illustrates considerable variations of disability and its relationship with age. It supports the hypothesis that less developed social policies and more pronounced socioeconomic inequalities are related to higher levels of disability and an earlier onset of disability.
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Affiliation(s)
- Morten Wahrendorf
- International Centre for Life Course Studies in Society and Health (ICLS), Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
- * E-mail:
| | - Jan D. Reinhardt
- Swiss Paraplegic Research, Nottwil, Switzerland
- University of Lucerne, Department of Health Sciences & Health Policy, Lucerne, Switzerland
| | - Johannes Siegrist
- Senior Professorship on Work Stress Research, Faculty of Medicine, University of Duesseldorf, Duesseldorf, Germany
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Merhi ZO, Keltz J, Zapantis A, Younger J, Berger D, Lieman HJ, Jindal SK, Polotsky AJ. Male adiposity impairs clinical pregnancy rate by in vitro fertilization without affecting day 3 embryo quality. Obesity (Silver Spring) 2013; 21:1608-12. [PMID: 23754329 DOI: 10.1002/oby.20164] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Accepted: 10/29/2012] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Male adiposity is detrimental for achieving clinical pregnancy rate (CPR) following assisted reproductive technologies (ART). The hypothesis that the association of male adiposity with decreased success following ART is mediated by worse embryo quality was tested. DESIGN AND METHODS Retrospective study including 344 infertile couples undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) cycles was performed. Cycle determinants included number of oocytes retrieved, zygote PN-score, total number of embryos available on day 3, number of embryos transferred, composite day 3 grade for transferred embryos, composite day 3 grade per cycle, and CPR. RESULTS Couples with male body mass index (BMI) over 25 kg m(-2) (overweight and obese) exhibited significantly lower CPR compared to their normal weight counterparts (46.7% vs. 32.0% respectively, P = 0.02). No significant difference was observed for any embryo quality metrics when analyzed by male BMI: mean zygote PN-scores, mean composite day 3 grades for transferred embryos or composite day 3 grades per cycle. In a multivariable logistic regression analysis adjusting for female age, female BMI, number of embryos transferred and sperm concentration, male BMI over 25 kg m(-2) was associated with a lower chance for CPR after IVF (OR = 0.17 [95% CI: 0.04-0.65]; P = 0.01) but not after ICSI cycles (OR = 0.88 [95% CI: 0.41-1.88]; P = 0.75). In this cohort, male adiposity was associated with decreased CPR following IVF but embryo quality was not affected. CONCLUSIONS Embryo grading based on conventional morphologic criteria does not explain the poorer clinical pregnancy outcomes seen in couples with overweight or obese male partner.
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Affiliation(s)
- Zaher O Merhi
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Vermont College of Medicine, Burlington, VT, USA
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Powell-Young YM, Zabaleta J, Velasco-Gonzalez C, Sothern MS. A cohort study evaluating the implications of biology, weight status and socioeconomic level on global self-esteem competence among female African-American adolescents. JOURNAL OF NATIONAL BLACK NURSES' ASSOCIATION : JNBNA 2013; 24:1-8. [PMID: 24218867 PMCID: PMC4036223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The link between obesity and self-esteem among minority youth has received minimal empirical evaluation. This study aims to describe the magnitude of risk that body mass index, household income, and transitional age have on global self-esteem levels among African-American adolescents. These analyses were conducted on cross-sectional data obtained from 264 urban-dwelling African-American females between 14 and 18 years of age. Survey data on global self-esteem levels, transitory age, and socioeconomic levels were collected using self-administered questionnaires. Measured height and weight values were used to calculate and categorize weight status according to body mass index. Logistic regression models examined the probability of reporting less than average levels of global self-esteem. Adolescent African-American females residing in low-income households were 10 times more likely to report lower global self-esteem scores than those individuals from more affluent households (95% CI: 1.94, 60.19, p < .001). Neither weight status (95% CI: 0.81, 2.55; p = .26) nor age (95% CI: 0.05, 1.87; p = .82) were significant risk indicators for lower than average levels of global self-esteem among participants in this study. Household income appears to be the greatest predictor of global self-esteem levels. Further research in this area is needed to fully elucidate precursors for psychological health vulnerability and facilitate intervention development.
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Affiliation(s)
- Paula Braveman
- Center on Social Disparities in Health, University of California, San Francisco, CA 94118, USA.
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Riddle DL, Stratford PW. Body weight changes and corresponding changes in pain and function in persons with symptomatic knee osteoarthritis: a cohort study. Arthritis Care Res (Hoboken) 2013; 65:15-22. [PMID: 22505346 DOI: 10.1002/acr.21692] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Accepted: 03/26/2012] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To determine if a dose-response relationship exists between percentage changes in body weight in persons with symptomatic knee osteoarthritis (OA) and self-reported pain and function. METHODS Data from persons in the Osteoarthritis Initiative (OAI) and the Multicenter Osteoarthritis (MOST) study data sets (n = 1,410) with symptomatic function-limiting knee OA were studied. For the OAI, we used baseline and 3-year followup data, while for the MOST study, baseline and 30-month data were used. Key outcome variables were Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function and pain change scores. In addition to covariates, the predictor variable of interest was the extent of weight change over the study period divided into 5 categories representing different percentages of body weight change. RESULTS A significant dose-response relationship (P < 0.003) was found between the extent of percentage change in body weight and the extent of change in WOMAC physical function and WOMAC pain scores. For example, persons who gained ≥10% of body weight had WOMAC physical function score changes of -5.4 (95% confidence interval -8.7, -2.00) points, indicating worsening physical function relative to the reference group of persons with weight changes between <5% weight gain and <5% weight reduction. CONCLUSION Our data suggest a dose-response relationship exists between changes in body weight and corresponding changes in pain and function. The threshold for this response gradient appears to be body weight shifts of ≥10%. Weight changes of ≥10% have the potential to lead to important changes in pain and function for patient groups as well as individual patients.
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Affiliation(s)
- Daniel L Riddle
- Departments of Physical Therapy and Orthopaedic Surgery, Virginia Commonwealth University, Richmond, VA 23298, USA.
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Reichman NE, Teitler JO. Lifecourse Exposures and Socioeconomic Disparities in Child Health. NATIONAL SYMPOSIUM ON FAMILY ISSUES 2013. [DOI: 10.1007/978-1-4614-6194-4_9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Vasunilashorn S, Kim JK, Crimmins EM. International differences in the links between obesity and physiological dysregulation: the United States, England, and Taiwan. J Obes 2013; 2013:618056. [PMID: 23781331 PMCID: PMC3679767 DOI: 10.1155/2013/618056] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Accepted: 04/08/2013] [Indexed: 01/22/2023] Open
Abstract
Excess weight has generally been associated with adverse health outcomes; however, the link between overweight and health outcomes may vary with socioeconomic, cultural, and epidemiological conditions. We examine associations of weight with indicators of biological risk in three nationally representative populations: the US National Health and Nutrition Examination Survey, the English Longitudinal Study of Ageing, and the Social Environment and Biomarkers of Aging Study in Taiwan. Indicators of biological risk were compared for obese (defined using body mass index (BMI) and waist circumference) and normal weight individuals aged 54+. Generally, obesity in England was associated with elevated risk for more markers examined; obese Americans also had elevated risks except that they did not have elevated blood pressure (BP). Including waist circumference in our consideration of BMI indicated different links between obesity and waist size across countries; we found higher physiological dysregulation among those with high waist but normal BMI compared to those with normal waist and normal BMI. Americans had the highest levels of biological risk in all weight/waist groups. Cross-country variation in biological risk associated with obesity may reflect differences in health behaviors, lifestyle, medication use, and culture.
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Martinson ML. Income inequality in health at all ages: a comparison of the United States and England. Am J Public Health 2012; 102:2049-56. [PMID: 22994174 PMCID: PMC3477975 DOI: 10.2105/ajph.2012.300929] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2012] [Indexed: 11/04/2022]
Abstract
OBJECTIVES I systematically examined income gradients in health in the United States and England across the life span (ages birth to 80 years), separately for females and males, for a number of health conditions. METHODS Using data from the National Health and Nutrition Examination Survey for the United States (n = 36 360) and the Health Survey for England (n = 55 783), I calculated weighted prevalence rates and risk ratios by income level for the following health risk factors or conditions: obesity, hypertension, diabetes, low high-density lipoprotein cholesterol, high cholesterol ratio, heart attack or angina, stroke, and asthma. RESULTS In the United States and England, the income gradients in health are very similar across age, gender, and numerous health conditions, and are robust to adjustments for race/ethnicity, health behaviors, body mass index, and health insurance. CONCLUSIONS Health disparities by income are pervasive in England as well as in the United States, despite better overall health, universal health insurance, and more generous social protection spending in England.
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Hatch SL, Thornicroft G. Report from England I: innovative approaches to reducing mental health disparities related to ethnicity. J Nerv Ment Dis 2012; 200:843-6. [PMID: 23034573 DOI: 10.1097/nmd.0b013e31826b6d34] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Stephani L Hatch
- Department of Psychological Medicine, Institute of Psychiatry, King's College London, England.
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Yan S, Li J, Li S, Zhang B, Du S, Gordon-Larsen P, Adair L, Popkin B. The expanding burden of cardiometabolic risk in China: the China Health and Nutrition Survey. Obes Rev 2012; 13:810-21. [PMID: 22738663 PMCID: PMC3429648 DOI: 10.1111/j.1467-789x.2012.01016.x] [Citation(s) in RCA: 177] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
China faces a major increase in cardiovascular disease, yet there is limited population-based data on risk factors, particularly in children. Fasting blood samples, anthropometry and blood pressure were collected on 9,244 children and adults aged ≥7 years in late 2009 as part of the national China Health and Nutrition Survey. Prevalent overweight, elevated blood pressure, and cardiometabolic risk factors: glucose, HbA1c, triglycerides (TG), total cholesterol (TC), high- and low-density lipoprotein cholesterol (HDL-C and LDL-C), and C-reactive protein (CRP) are presented. We found that 11% of Chinese children and 30% of Chinese adults are overweight. Rates of diabetes, dyslipidaemia, hypertension and inflammation are high and increased with age and were associated with urbanization. Approximately 42% of children have at least one of the following: pre-diabetes or diabetes, hypertension, high TC, LDL-C, TG, and CRP and low HDL-C, as do 70% men and 60% women aged 18-40 years and >90% of men and women ≥60 years. In sum, the HbA1c findings suggest that as many as 27.7 million Chinese children and 334 million Chinese adults may be pre-diabetic or diabetic. The high prevalence in less urban areas and across all income levels suggests that cardiometabolic risk is pervasive across rural and urban China.
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Affiliation(s)
- S Yan
- Beijing Homa Biological Engineering Co., Ltd, Beijing, China
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Rujeni N, Taylor DW, Mutapi F. Human schistosome infection and allergic sensitisation. J Parasitol Res 2012; 2012:154743. [PMID: 22970345 PMCID: PMC3434398 DOI: 10.1155/2012/154743] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Accepted: 06/28/2012] [Indexed: 12/24/2022] Open
Abstract
Several field studies have reported an inverse relationship between the prevalence of helminth infections and that of allergic sensitisation/atopy. Recent studies show that immune responses induced by helminth parasites are, to an extent, comparable to allergic sensitisation. However, helminth products induce regulatory responses capable of inhibiting not only antiparasite immune responses, but also allergic sensitisation. The relative effects of this immunomodulation on the development of protective schistosome-specific responses in humans has yet to be demonstrated at population level, and the clinical significance of immunomodulation of allergic disease is still controversial. Nonetheless, similarities in immune responses against helminths and allergens pose interesting mechanistic and evolutionary questions. This paper examines the epidemiology, biology and immunology of allergic sensitisation/atopy, and schistosome infection in human populations.
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Affiliation(s)
- Nadine Rujeni
- Institute of Immunology and Infection Research, Centre for Immunity, Infection, and Evolution, School of Biological Sciences, University of Edinburgh, Ashworth Laboratories, King's Buildings, West Mains Rd, Edinburgh EH9 3JT, UK
| | - David W. Taylor
- Institute of Immunology and Infection Research, Centre for Immunity, Infection, and Evolution, School of Biological Sciences, University of Edinburgh, Ashworth Laboratories, King's Buildings, West Mains Rd, Edinburgh EH9 3JT, UK
| | - Francisca Mutapi
- Institute of Immunology and Infection Research, Centre for Immunity, Infection, and Evolution, School of Biological Sciences, University of Edinburgh, Ashworth Laboratories, King's Buildings, West Mains Rd, Edinburgh EH9 3JT, UK
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Kataoka-Yahiro MR, Wong KA, Tamashiro J, Page V, Ching J, Li D. Evaluation of the National Kidney Foundation of Hawai'i's Kidney Early Detection Screening program. HAWAI'I JOURNAL OF MEDICINE & PUBLIC HEALTH : A JOURNAL OF ASIA PACIFIC MEDICINE & PUBLIC HEALTH 2012; 71:186-92. [PMID: 22787570 PMCID: PMC3392553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
PURPOSE Discussion of the formative program evaluation results of the National Kidney Foundation of Hawai'i (NKFH) Kidney Early Detection Screening (KEDS) program for Chronic Kidney Disease (CKD). The formative program evaluation had 921 participants who enrolled in the NKFH KEDS screening program between 2006-2009. The evaluation included 14 KEDS sites in Honolulu, Maui, and Hawai'i counties. MAIN FINDINGS Based on the results of the formative evaluation, process changes were made to program recruitment, training, and procedure. A majority of participants were women, between 46 and 75 years old. The ethnic groups represented were: White, Japanese, Hawaiian/Part Hawaiian, Filipino, Chinese, Hispanic, and Other. The three most common risk factors identified were: (1) blood relative with diabetes, (2) blood relative with cardiovascular disease, and (3) self-reported high blood pressure. Participants in Hawai'i County had the highest mean for total risk factors. Ethnicity, gender, and age were significantly associated with selected vital signs, physiological measures, and lab tests. Fourteen percent of KEDS participants had an abnormal albumin:creatinine (A:C) ratio and 12% had an abnormal glomerular filtration rate (GFR), requiring follow-up by a health care professional. PRINCIPAL CONCLUSIONS The KEDS formative program evaluation findings improved program planning and implementation. Summative program evaluation and implications for conducting research studies in this area will be the next step in the evaluation process.
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Affiliation(s)
- Merle R Kataoka-Yahiro
- Department of Nursing, School of Nursing and Dental Hygiene, University of Hawai'i at Manoa, Honolulu, HI 96822, USA
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Bezruchka S. The Hurrider I Go the Behinder I Get: The Deteriorating International Ranking of U.S. Health Status. Annu Rev Public Health 2012; 33:157-73. [DOI: 10.1146/annurev-publhealth-031811-124649] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Stephen Bezruchka
- Departments of Health Services and Global Health, School of Public Health, University of Washington, Seattle, Washington 98195-7660;
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Clarke P, Smith J. Aging in a cultural context: cross-national differences in disability and the moderating role of personal control among older adults in the United States and England. J Gerontol B Psychol Sci Soc Sci 2011; 66:457-67. [PMID: 21666145 DOI: 10.1093/geronb/gbr054] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVES We investigate cross-national differences in late-life health outcomes and focus on an intriguing difference in beliefs about personal control found between older adult populations in the U.K. and United States. We examine the moderating role of control beliefs in the relationship between physical function and self-reported difficulty with daily activities. METHOD Using national data from the United States (Health and Retirement Study) and England (English Longitudinal Study on Ageing), we examine the prevalence in disability across the two countries and show how it varies according to the sense of control. Poisson regression was used to examine the relationship between objective measures of physical function (gait speed) and disability and the modifying effects of control. RESULTS Older Americans have a higher sense of personal control than the British, which operates as a psychological resource to reduce disability among older Americans. However, the benefits of control are attenuated as physical impairments become more severe. DISCUSSION These results emphasize the importance of carefully considering cross-national differences in the disablement process as a result of cultural variation in underlying psychosocial resources. This paper highlights the role of culture in shaping health across adults aging in different sociopolitical contexts.
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Affiliation(s)
- Philippa Clarke
- Institute for Social Research, University of Michigan, Ann Arbor, MI 48106-1248, USA.
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