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Bather JR, Cuevas AG, Harris A, Kaphingst KA, Goodman MS. Associations between perceived discrimination over the life course, subjective social status, and health literacy: A racial/ethnic stratification analysis. PEC INNOVATION 2024; 5:100334. [PMID: 39257628 PMCID: PMC11384512 DOI: 10.1016/j.pecinn.2024.100334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 08/03/2024] [Accepted: 08/18/2024] [Indexed: 09/12/2024]
Abstract
Objective To analyze the relationship between perceived discrimination over the life course, social status, and limited health literacy (HL). Methods 5040 adults who participated in the 2023 Survey of Racism and Public Health. We applied stratified multilevel models adjusted for sociodemographic characteristics. Results The average age was 47 years, 48% identified as White, 20% as Latinx, and 17% as Black. In the overall sample, we observed associations of perceived discrimination (b = 0.05, 95% CI: 0.01, 0.09), subjective social status (b = -0.16, 95% CI: -0.23, -0.10), and their interaction (b = 0.02, 95% CI: 0.01, 0.03). More perceived discrimination was associated with lower HL in the White and Multiracial participants. Higher subjective social status was associated with higher HL in the White and Latinx participants. There was a statistically significant interaction between perceived discrimination and subjective social status on HL among the White, Latinx, and Multiracial participants. Conclusion This analysis has implications for public health practice, indicating that multi-level interventions are needed to address limited HL. Innovation Our findings provide novel insights for identifying key SDOH indicators to assess in clinical settings to provide health literate care.
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Affiliation(s)
- Jemar R Bather
- Center for Anti-racism, Social Justice & Public Health, New York University School of Global Public Health, New York, NY 10003, USA
- Department of Biostatistics, New York University School of Global Public Health, New York, NY 10003, USA
| | - Adolfo G Cuevas
- Center for Anti-racism, Social Justice & Public Health, New York University School of Global Public Health, New York, NY 10003, USA
- Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, NY 10003, USA
| | - Adrian Harris
- Center for Anti-racism, Social Justice & Public Health, New York University School of Global Public Health, New York, NY 10003, USA
| | - Kimberly A Kaphingst
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
- Department of Communication, University of Utah, Salt Lake City, UT 84112, USA
| | - Melody S Goodman
- Center for Anti-racism, Social Justice & Public Health, New York University School of Global Public Health, New York, NY 10003, USA
- Department of Biostatistics, New York University School of Global Public Health, New York, NY 10003, USA
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Slimovitch R, Lee SY, Vergara-Lopez C, Bublitz MH, Stroud LR. Reactivity to Peer Rejection Moderates the Effect of Victimization on Adolescent Girls' Depressive Symptoms: A Prospective Study. Res Child Adolesc Psychopathol 2024; 52:1901-1912. [PMID: 39287770 PMCID: PMC11624055 DOI: 10.1007/s10802-024-01243-4] [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] [Accepted: 08/25/2024] [Indexed: 09/19/2024]
Abstract
Peer victimization and bullying behaviors are prevalent during adolescence and have been linked to depression. This study examined whether peer rejection reactivity, defined as physiological responses to peer exclusion, moderated the associations of victimization and bullying behaviors with depressive symptoms 12 months later in a sample of female youths (N = 79, Mage = 13.37 ± 2.31). Participants underwent the Yale Interpersonal Stressor-Child, during which systolic and diastolic blood pressure and heart rate were continuously measured. Parent and youth reports of the youth's depressive symptoms were utilized. Our results demonstrate that peer rejection reactivity moderates the relationship between victimization and subsequent depressive symptoms but does not moderate the relationship between bullying behaviors and subsequent depressive symptoms. Higher victimization was associated with increased youth-reported depressive symptoms among girls with high reactivity but decreased depressive symptoms among girls with low reactivity. Future research can explore whether reducing emotional and physiological reactivity to peer rejection, as well as increasing interpersonal effectiveness in peer relationships, can reduce depressive symptoms in adolescent girls experiencing victimization.
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Affiliation(s)
- Rachel Slimovitch
- Department of Epidemiology, School of Public Health, Brown University
| | - Sharon Y. Lee
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University
- Center for Behavioral and Preventive Medicine, The Miriam Hospital
| | - Chrystal Vergara-Lopez
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University
- Center for Behavioral and Preventive Medicine, The Miriam Hospital
| | - Margaret H. Bublitz
- Department of Medicine, Warren Alpert Medical School, Brown University
- Women’s Medicine Collaborative, The Miriam Hospital
| | - Laura R. Stroud
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University
- Center for Behavioral and Preventive Medicine, The Miriam Hospital
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De A, Jung KH, Davis H, Siddiqui A, Kattan M, Quinn J, Rundle A, Green NS, Lovinsky-Desir S. Effects of Air Pollution on Respiratory Events and Pain Crises among Children with Sickle Cell Disease in New York City. Ann Am Thorac Soc 2024; 21:1733-1741. [PMID: 39194342 DOI: 10.1513/annalsats.202310-860oc] [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: 10/06/2023] [Accepted: 08/27/2024] [Indexed: 08/29/2024] Open
Abstract
Rationale: The disease burden of sickle cell disease (SCD) is highest among U.S. Black and Hispanic populations, which are often disproportionately represented in communities with poor air quality. There are limited data on the effects of air pollution exposure and social environmental factors on health outcomes in children with SCD. Objectives: The objectives of our study were to examine the associations between air pollution exposure and acute respiratory and vaso-occlusive pain crises (VOCs) and to further study the associations when stratifying by asthma status and neighborhood disadvantages. Methods: We conducted a retrospective study, collecting data on outpatient sick and emergency department visits, hospital admissions for respiratory events (i.e., respiratory tract infections, asthma exacerbation, acute chest syndrome), and hospitalizations for VOCs among children with SCD in a tertiary care center in New York City from 2015 to 2018. Modeled data from the New York City Community Air Survey data using home addresses' estimated street-level annual average exposure to air pollution (i.e., black carbon, particulate matter with an aerodynamic diameter ≤2.5 μm, and nitrogen dioxide). The area deprivation index (ADI) continuous national ranking percentile (1-100) was used, representing a composite index for neighborhood-level social disadvantage. We further dichotomized study participants at the upper tertile (high vs. low ADI). Multivariable Poisson regression in generalized estimating equation models were used to estimate relative risks (RRs) after adjusting for potential covariates. Results: A total of 114 children with SCD were included in this study and had between one and four annual repeated measures of annual average air pollutants over a total of 425 visits. Overall, there were no significant associations between air pollution levels and acute respiratory pain crises and VOCs among children with SCD and when stratified by asthma status. We found significant interactions between air pollution levels and the continuous ADI variable on respiratory outpatient and frequent respiratory outpatient/ED visits (P < 0.1). When stratified by high ADI, increased exposure to particulate matter with an aerodynamic diameter ≤2.5 μm was significantly associated with more frequent respiratory outpatient/emergency department visits among children residing in higher ADI neighborhoods (RR [95% confidence interval], 1.13 [1.01, 1.27]; P < 0.05), but not among those in lower ADI neighborhoods. Increased exposure to nitrogen dioxide was associated with more outpatient respiratory events for children in high ADI neighborhoods (RR [95% confidence interval], 2.74 [1.24, 6.08]; P < 0.05) compared with low ADI neighborhoods. Conclusions: Air pollution exposures increased respiratory complications among children with SCD living in deprived neighborhoods.
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Affiliation(s)
- Aliva De
- Division of Pediatric Pulmonology
| | | | - Haley Davis
- Division of Allergy Immunology and Rheumatology, Department of Pediatrics, Columbia University Irving Medical Center
| | - Abeer Siddiqui
- Division of Allergy Immunology and Rheumatology, Department of Pediatrics, Columbia University Irving Medical Center
| | | | | | | | - Nancy S Green
- Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Vagelos College of Physicians and Surgeons
| | - Stephanie Lovinsky-Desir
- Division of Pediatric Pulmonology
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York
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Park SW, Wong M, Kiefe CI, Gordon-Larsen P, Kershaw KN. Associations of Neighborhood Food and Physical Activity Environments in Young Adulthood With Cardiovascular Health in Midlife: The CARDIA Study. J Am Heart Assoc 2024; 13:e036035. [PMID: 39547998 DOI: 10.1161/jaha.124.036035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 09/30/2024] [Indexed: 11/17/2024]
Abstract
BACKGROUND Adults who maintain ideal cardiovascular health (CVH) profiles up to midlife have lower risk of several chronic diseases and better quality of life. Some evidence suggests that individual-level exposures earlier in life shape midlife CVH, but the impact of neighborhood-level exposures over the life course remains understudied. METHODS AND RESULTS Participants were 3017 Black and White men and women aged 18 to 30 years at baseline (1985-1986), recruited from Birmingham, Alabama; Minneapolis, Minnesota; Chicago, Illinois; and Oakland, California, as part of the CARDIA (Coronary Artery Risk Development in Young Adults) study. Measures of the neighborhood food and physical activity environment were linked to participant addresses collected at baseline. CVH was measured on the basis of the American Heart Association's Life's Simple 7 criteria in young adulthood and 30 years later (2015-2016) when participants were midlife (aged 48-60 years). Associations of young adult neighborhood food environment and physical activity resources with midlife CVH (moderate versus high and low versus high) were examined using multinomial logistic regression. Models were adjusted for young adult sociodemographic factors. Participants who lived farther away from a major park in young adulthood were more likely to have low versus high CVH scores (odds ratio, 1.54 [95% CI, 1.22-1.96]) and more likely to have moderate versus high CVH scores (odds ratio, 1.39 [95% CI, 1.12-1.73]) in midlife. No other neighborhood measures were significantly associated with CVH. CONCLUSIONS Young adulthood may be a sensitive period in which having convenient access to physical activity-promoting resources may help them establish healthy habits that can carry into midlife.
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Affiliation(s)
- Seong W Park
- Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL USA
| | - Mandy Wong
- Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL USA
| | - Catarina I Kiefe
- Department of Population and Quantitative Health Services University of Massachusetts Chan Medical School Worcester MA USA
| | - Penny Gordon-Larsen
- Department of Nutrition University of North Carolina Gillings School of Global Public Health Chapel Hill NC USA
| | - Kiarri N Kershaw
- Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL USA
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Murtha K, Perlstein S, Paz Y, Seidlitz J, Raine A, Hawes S, Byrd A, Waller R. Callous-unemotional traits, cognitive functioning, and externalizing problems in a propensity-matched sample from the ABCD study. J Child Psychol Psychiatry 2024. [PMID: 39496559 DOI: 10.1111/jcpp.14062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/15/2024] [Indexed: 11/06/2024]
Abstract
BACKGROUND Many studies show that both callous-unemotional (CU) traits (e.g., low empathy, lack of guilt) and cognitive difficulties increase risk for externalizing psychopathology across development. However, other work suggests that some aggression (e.g., relational, proactive) may rely on intact cognitive function, which could vary based on the presence of CU traits. Moreover, no prior research has adequately accounted for common risk factors shared by CU traits, cognitive difficulties, and externalizing problems, which confounds conclusions that can be drawn about their purported relationships. The current study addressed these knowledge gaps by leveraging rigorous propensity matching methods to isolate associations between CU traits and different dimensions of cognitive function and externalizing problems. METHODS Associations between CU traits, cognitive functioning, and externalizing outcomes were tested within dimensional (n = 11,868) and propensity-matched group-based (n = 1,224) models using data from the Adolescent Brain Cognitive Development Study®, with rigorous statistical control for shared sociodemographic risk factors. Cross-sectional outcomes were parent-reported symptoms of conduct disorder (CD), oppositional defiant disorder (ODD), and attention deficit hyperactivity disorder (ADHD). Longitudinal outcomes were child-reported overt and relational aggression. RESULTS CU traits were uniquely related to more parent-reported CD, ODD, ADHD symptoms, as well as more child-reported aggressive behaviors. Effects of cognitive difficulties were domain specific and were not consistent across dimensional and propensity matched models. There was minimal evidence for divergent associations between CU traits and externalizing outcomes as a function of cognition (i.e., no moderation). CONCLUSIONS Rigorous control for sociodemographic factors within propensity-matched models establish CU traits as a robust and unique risk factor for externalizing psychopathology, over and above difficulties with cognitive functioning.
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Affiliation(s)
- Kristin Murtha
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - Samantha Perlstein
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - Yael Paz
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - Jakob Seidlitz
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
- Department of Child and Adolescent Psychiatry and Behavioral Science, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Lifespan Brain Institute, The Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, PA, USA
| | - Adrian Raine
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
- Department of Criminology, University of Pennsylvania, Philadelphia, PA, USA
| | - Samuel Hawes
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Amy Byrd
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Rebecca Waller
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
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Bulled N. Recommendations for empirical syndemics analyses: A stepwise methodological guide. Heliyon 2024; 10:e38931. [PMID: 39430532 PMCID: PMC11489353 DOI: 10.1016/j.heliyon.2024.e38931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 08/13/2024] [Accepted: 10/02/2024] [Indexed: 10/22/2024] Open
Abstract
Syndemic theory posits that co-occurring diseases interact in a manner that increases disease transmission, progression, and negative health outcomes. And that adverse socioeconomic and environmental conditions promote this disease or health condition clustering and interaction. The concept offers two important contributions to the health sciences. First, it positions socioeconomic, structural, and environmental conditions as central to disease burdens. Second, as a portmanteau - 'syn' for synergy and 'demic' for disease epidemics - syndemic theory indicates that in some cases diseases do not merely co-occur but synergistically interact to affect an outcome that is more than the accumulation of the individual disease effects. The difficulty in operationalizing these central elements has resulted in a divergence of scholarship from the centralizing principles of the theory towards a simpler accumulation perspective in which more conditions equate to worse health outcomes. In addition, all empirical syndemic assessments should include robust qualitative assessments of the dynamics, however, much syndemic scholarship focuses only on quantitative analyses. To address these issues, a five-step approach to quantitative analyses of syndemic arrangements is proposed: (1) identifying disease clusters within a defined population; (2) determining the relevant social and structural factors that support disease clustering; (3) determining if clusters are distinct by social/demographic groups within the population; (4) evaluating if the identified disease cluster contributes to worse health outcomes; and (5) assessing for synergy between clustering diseases. This stepwise strategy ensures not only a rigorous assessment of hypothesized syndemic interactions but also presents a closer alignment of scholarship with syndemics theory. As an illustration, the approach is applied to an assessment of a hypothesized HIV/cardiovascular disease syndemic in South Africa. While syndemics theory has proven valuable in guiding public health interventions and policy, progressive improvement must be made in the application of the theory to ensure that it continues to effectively inform comprehensive practice.
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Ranapurwala SI, Cruz TH, Hohl B, Murray R, Rexing C, Villarreal S, Rose DM, Brooks-Russell A. Answering the call for better science: an update on SAVIR's efforts to advance antiracism in injury and violence research. Inj Prev 2024:ip-2024-045504. [PMID: 39358041 DOI: 10.1136/ip-2024-045504] [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: 09/16/2024] [Accepted: 09/19/2024] [Indexed: 10/04/2024]
Abstract
In response to the call for better science that the Society for Advancement of Violence and Injury Research (SAVIR) put out 4 years ago, SAVIR established its Anti-racism Interest Group (AIG) and charged it to lead antiracism efforts at SAVIR. The SAVIR AIG has led SAVIR's efforts to actively integrate antiracism principles and frameworks into injury and violence prevention (IVP) education, research, methods, dissemination and implementation as a field, and more specifically into each of SAVIR committee activities and strategies. In this article, we detail those efforts and outline the immediate next steps of a vision that is developing and the course we are taking. But we acknowledge that these efforts are only the beginning on the long road ahead to fully rid ourselves (as a society), our science and our field of IVP of the scourge that racism is.
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Affiliation(s)
- Shabbar I Ranapurwala
- Department of Epidemiology, The University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
- Injury Prevention Research Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Theresa H Cruz
- Prevention Research Center, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA
| | - Bernadette Hohl
- Penn Injury Science Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Regan Murray
- Department of Mental Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Christen Rexing
- Society for Advancement of Violence and Injury Research Media, Media, Pennsylvania, USA
| | - Silvia Villarreal
- Department of Health Policy and Management, Johns Hopkins University, Baltimore, Maryland, USA
| | - Dominique M Rose
- Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Ashley Brooks-Russell
- Community and Behavioral Health, Colorado School of Public Health, Aurora, Colorado, USA
- Injury and Violence Prevention Center, Colorado School of Public Health, Aurora, Colorado, USA
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Sheean P, O'Connor P, Joyce C, Wozniak A, Vasilopoulos A V, Seigal J, Formanek P. Validating the use of body mass index with computed tomography in a racially and ethnically diverse cohort of patients admitted with SARS-CoV-2. Nutr Clin Pract 2024; 39:1259-1269. [PMID: 38877983 DOI: 10.1002/ncp.11164] [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: 01/30/2024] [Revised: 04/24/2024] [Accepted: 05/10/2024] [Indexed: 10/11/2024] Open
Abstract
BACKGROUND Body mass index (BMI) is criticized for being unjust and biased in relatively healthy racial and ethnic groups. Therefore, the current analysis examines if BMI predicts body composition, specifically adiposity, in a racially and ethnically diverse acutely ill patient population. METHODS Patients admitted with SARS-CoV-2 having an evaluable diagnostic chest, abdomen, and/or pelvic computed tomography (CT) study (within 5 days of admission) were included in this retrospective cohort. Cross-sectional areas (centimeters squared) of the subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), and intramuscular adipose tissue (IMAT) were quantified. Total adipose tissue (TAT) was calculated as sum of these areas. Admission height and weight were applied to calculate BMI, and self-reported race and ethnicity were used for classification. General linear regression models were conducted to estimate correlations and assess differences between groups. RESULTS On average, patients (n = 134) were aged 58.2 (SD = 19.1) years, 60% male, and racially and ethnically diverse (33% non-Hispanic White [NHW], 33% non-Hispanic Black [NHB], 34% Hispanic). Correlations between BMI and SAT and BMI and TAT were strongest revealing estimates of 0.707 (0.585, 0.829) and 0.633 (0.534, 0.792), respectively. When examining the various adiposity compartments across race and ethnicity, correlations were similar and significant differences were not detected for TAT with SAT, VAT, or IMAT (all P ≥ 0.05). CONCLUSIONS These findings support the routine use of applying BMI as a proxy measure of total adiposity for acutely ill patients identifying as NHW, NHB, and Hispanic. Our results inform the validity and utility of this tool in clinical nutrition practice.
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Affiliation(s)
- Patricia Sheean
- Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, Illinois, USA
| | - Paula O'Connor
- Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, Illinois, USA
| | - Cara Joyce
- Loyola University Chicago, Maywood, Illinois, USA
| | - Amy Wozniak
- Loyola University Medical Center, Maywood, Illinois, USA
| | | | - Jared Seigal
- Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, Illinois, USA
| | - Perry Formanek
- Department of Medicine, Loyola University Medical Center, Maywood, Illinois, USA
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Werden Abrams S, Kurosu A, Namasivayam-Macdonald A. Participant Characteristics for Dysphagia Research: A Proposed Checklist. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:2196-2206. [PMID: 39151056 DOI: 10.1044/2024_ajslp-22-00183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/18/2024]
Abstract
PURPOSE Participant characteristics are underreported; however, they impact swallowing impairments and subsequent access to assessment and intervention. Standards for rigorous and transparent reporting of dysphagia research are required. The Framework for RigOr aNd Transparency In REseaRch on Swallowing (FRONTIERS) offers a critical appraisal tool for dysphagia research. This article outlines questions for participant characteristics in dysphagia research as part of the larger FRONTIERS tool. METHOD An exploratory literature review was conducted to determine how participant characteristics, eligibility criteria, and definitions of health and dysphagia are reported in the literature. Findings were cross-referenced with other relevant critical appraisal tools. A list of questions was generated and refined iteratively with the entire FRONTIERS collaborative until consensus was met. RESULTS The participant characteristics portion of the FRONTIERS tool includes eight questions and 16 possible subquestions. Examples for how the tool might be used, as well as rationales for inclusion of all questions, are included. CONCLUSIONS Including detailed characteristics of research participants may support understanding of how best to serve marginalized and underrepresented populations more effectively. Critical appraisal tools, such as FRONTIERS, may help to improve the rigor and transparency in dysphagia research, ultimately improving patient care.
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Affiliation(s)
| | - Atsuko Kurosu
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison
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Harriman NW, Chen JT, Lee S, Slopen N. Individual-Level Experiences of Structural Inequity and Their Association with Subjective and Objective Sleep Outcomes in the Adolescent Brain Cognitive Development Study. J Adolesc Health 2024; 75:461-470. [PMID: 39001748 DOI: 10.1016/j.jadohealth.2024.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 03/24/2024] [Accepted: 05/03/2024] [Indexed: 07/15/2024]
Abstract
PURPOSE Research has documented that adolescent sleep is impacted by various stressors, including interpersonal experiences and structural disadvantage. This study extends existing knowledge by empirically examining interconnected individual experiences of structural inequity and assessing its association with subjective and objective sleep outcomes. METHODS We utilized data from the Adolescent Brain and Cognitive Development Study to identify seven conceptual domains of structural inequity: perceived discrimination, low school inclusivity, neighborhood safety, unmet medical needs, legal problems, material hardship, and housing insecurity. We operationalized experiences of structural inequity as latent classes, a cumulative exposure, and each domain separately. Sleep disturbances were measured using the Sleep Disturbance Scale, and sleep duration was assessed using Fitbits. Mixed effects linear regression estimated the association between our measures of structural inequity, longitudinal sleep disturbances, and cross-sectional sleep duration. RESULTS Latent class analysis revealed common exposure profiles (low risk, interpersonal, and systemic) of experiences of structural inequity across our sample. In longitudinal models, structural inequity was associated with higher Sleep Disturbance Scale scores, whether measured as latent classes, a cumulative exposure, or individual domains. Individuals with interpersonal exposures, those with at least one exposure, and those with legal problems, material hardship, and housing insecurity had lower mean sleep duration. DISCUSSION Results are consistent with literature that frames structural inequity as a lifelong determinant of sleep disturbance and duration. Adolescence represents a crucial time for interventions aimed at improving sleep and redressing inequities throughout the life course; our work can inform the development of policies and interventions toward this end.
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Affiliation(s)
- Nigel Walsh Harriman
- Social and Behavioral Sciences Department, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
| | - Jarvis T Chen
- Social and Behavioral Sciences Department, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Sunmin Lee
- Department of Medicine, University of California Irvine School of Medicine, Irvine, California
| | - Natalie Slopen
- Social and Behavioral Sciences Department, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Harvard University, Center on the Developing Child, Cambridge, Massachusetts
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Kelly NK, Ranapurwala SI, Pence BW, Hightow-Weidman LB, Slaughter-Acey J, French AL, Hosek S, Pettifor AE. The relationship between anti-LGBTQ+ legislation and HIV prevention among sexual and gender minoritized youth. AIDS 2024; 38:1543-1552. [PMID: 38742882 PMCID: PMC11239282 DOI: 10.1097/qad.0000000000003926] [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] [Indexed: 05/16/2024]
Abstract
OBJECTIVE The aim of this study was to estimate the longitudinal associations of state-level anti-LGBTQ+ policies and county-level politics with individual HIV prevention outcomes among sexual and gender minoritized (SGM) youth. DESIGN Keeping it LITE-1 prospectively enrolled 3330 SGM youth and young adults (ages 13-34) at increased risk of HIV throughout the United States from 2017 to 2022. METHODS Semiannual surveys collected self-reported HIV prevention measures [current preexposure prophylaxis (PrEP) use, weekly PrEP adherence, HIV/STI testing in the past 6 months]. Geolocation was linked with state-level LGBTQ+ policy data and county-level election data. Generalized linear models with GEE estimated the single and joint longitudinal associations for two exposures [state-level policy climate (more discriminatory vs. less discriminatory) and county-level political majority (Democratic/swing vs. Republican)] with each outcome. RESULTS Among participants living in a state with more discriminatory laws, those in a Democratic/swing county had a 6-percentage point increase in PrEP use (95% confidence interval: 0.02, 0.09) compared to those in a Republican county. Those living in a Republican county but a state with less discriminatory laws saw a similar increase (0.05; -0.02,0.11). Residing in both a Democratic/swing county and a state with less discriminatory laws, relative to a Republican county and a state with more discriminatory laws, was associated with a 10-percentage point increase in PrEP use (0.10; 0.06,0.14) and a 5-percentage point increase in HIV/STI testing (0.05; 0.00,0.09). CONCLUSION More progressive state and local policies were each associated with increased PrEP use, and together, doubled the magnitude of this association. PrEP is underutilized among SGM youth, and anti-LGBTQ+ policies may exacerbate this gap in coverage.
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Affiliation(s)
- Nicole K Kelly
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Shabbar I Ranapurwala
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Brian W Pence
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Lisa B Hightow-Weidman
- Institute on Digital Health and Innovation, Florida State University, College of Nursing, Tallahassee, Florida
| | - Jaime Slaughter-Acey
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Audrey L French
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Sybil Hosek
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Audrey E Pettifor
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Lehman J, Balangoy D, Mejia AP, Cardenas-Iniguez C, Marek S, Randolph AC. Negligence in biomedical research: an anti-racist approach for substance use researchers. Front Public Health 2024; 12:1401221. [PMID: 39145167 PMCID: PMC11322128 DOI: 10.3389/fpubh.2024.1401221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 07/15/2024] [Indexed: 08/16/2024] Open
Abstract
Racism is embedded in the fabric of society at structural, disciplinary, hegemonic, and interpersonal levels, working as a mechanism that drives health disparities. In particular, stigmatized views of substance use get entangled with racialization, serving as a tool to uphold oppressive systems. While national health institutions have made commitments to dismantle these systems in the United States, anti-racism has not been integrated into biomedical research practice. The ways in which substance use researchers use and interpret race data-without engaging in structural racism as a mechanism of health inequity-can only be described as inadequate. Drawing upon concepts from the Public Health Critical Race praxis, QuantCrit, and an anti-racism research framework, we recommend a set of guidelines to help biomedical researchers conceptualize and engage with race more responsibly in substance use research.
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Affiliation(s)
- Jonathan Lehman
- Masonic Institute for the Developing Brain, University of Minnesota, Minneapolis, MN, United States
| | - Danniella Balangoy
- Masonic Institute for the Developing Brain, University of Minnesota, Minneapolis, MN, United States
| | - Angie P. Mejia
- Masonic Institute for the Developing Brain, University of Minnesota, Minneapolis, MN, United States
| | - Carlos Cardenas-Iniguez
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, United States
| | - Scott Marek
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United States
- Neuroimaging Labs Research Center, Washington University School of Medicine, St. Louis, MO, United States
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
- AI Institute for Health, Washington University School of Medicine, St. Louis, MO, United States
| | - Anita C. Randolph
- Masonic Institute for the Developing Brain, University of Minnesota, Minneapolis, MN, United States
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States
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Spaur M, Galvez-Fernandez M, Chen Q, Lombard MA, Bostick BC, Factor-Litvak P, Fretts AM, Shea SJ, Navas-Acien A, Nigra AE. Association of Water Arsenic With Incident Diabetes in U.S. Adults: The Multi-Ethnic Study of Atherosclerosis and the Strong Heart Study. Diabetes Care 2024; 47:1143-1151. [PMID: 38656975 PMCID: PMC11208750 DOI: 10.2337/dc23-2231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 04/02/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE We examined the association of arsenic in federally regulated community water systems (CWS) and unregulated private wells with type 2 diabetes (T2D) incidence in the Strong Heart Family Study (SHFS), a prospective study of American Indian communities, and the Multi-Ethnic Study of Atherosclerosis (MESA), a prospective study of racially and ethnically diverse urban U.S. communities. RESEARCH DESIGN AND METHODS We evaluated 1,791 participants from SHFS and 5,777 participants from MESA who had water arsenic estimates available and were free of T2D at baseline (2001-2003 and 2000-2002, respectively). Participants were followed for incident T2D until 2010 (SHFS cohort) or 2019 (MESA cohort). We used Cox proportional hazards mixed-effects models to account for clustering by family and residential zip code, with adjustment for sex, baseline age, BMI, smoking status, and education. RESULTS T2D incidence was 24.4 cases per 1,000 person-years (mean follow-up, 5.6 years) in SHFS and 11.2 per 1,000 person-years (mean follow-up, 14.0 years) in MESA. In a meta-analysis across the SHFS and MESA cohorts, the hazard ratio (95% CI) per doubling in CWS arsenic was 1.10 (1.02, 1.18). The corresponding hazard ratio was 1.09 (0.95, 1.26) in the SHFS group and 1.10 (1.01, 1.20) in the MESA group. The corresponding hazard ratio (95% CI) for arsenic in private wells and incident T2D in SHFS was 1.05 (0.95, 1.16). We observed statistical interaction and larger magnitude hazard ratios for participants with BMI <25 kg/m2 and female participants. CONCLUSIONS Low to moderate water arsenic levels (<10 µg/L) were associated with T2D incidence in the SHFS and MESA cohorts.
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Affiliation(s)
- Maya Spaur
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY
| | - Marta Galvez-Fernandez
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY
| | - Qixuan Chen
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY
| | | | | | - Pam Factor-Litvak
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY
| | - Amanda M. Fretts
- Department of Epidemiology, University of Washington, Seattle, WA
| | - Steven J. Shea
- Department of Medicine, Vagelos College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY
| | - Anne E. Nigra
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY
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Aiello AE, Mishra AA, Martin CL, Levitt B, Gaydosh L, Belsky DW, Hummer RA, Umberson DJ, Harris KM. Familial Loss of a Loved One and Biological Aging: NIMHD Social Epigenomics Program. JAMA Netw Open 2024; 7:e2421869. [PMID: 39073817 PMCID: PMC11287397 DOI: 10.1001/jamanetworkopen.2024.21869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 03/29/2024] [Indexed: 07/30/2024] Open
Abstract
Importance The link between familial loss of a loved one and long-term health decline is complex and not fully understood. Objective To test associations of losing a parent, sibling, child, or partner or spouse with accelerated biological aging. Design, Setting, and Participants Data from the National Longitudinal Study of Adolescent to Adult Health, a US population-based longitudinal cohort study, were analyzed. Participants were enrolled from 1994 to 1995 for wave 1, while in grades 7 to 12, and followed up through wave 5 in 2018. The study analyzed participant reports of loss collected at each wave from 1 to 5 over 24 years and used a banked wave 5 blood sample for subsequent DNA methylation testing and epigenetic clock calculation from 2018 to 2024. Data were analyzed from January 2022 to July 2024. Exposure Loss of biological parents or parental figures, partners or spouses, siblings, or children at waves 1 to 3 or during childhood, adolescence (aged <18 years), or adulthood at wave 4 to wave 5 (aged 18-43 years). Main Outcomes and Measures Biological aging assessed from blood DNA methylation using the Horvath, PhenoAge, GrimAge, and DunedinPACE epigenetic clocks at wave 5. Results Data from 3963 participants were analyzed, with a weighted mean (range) age of 38.36 (36.78-39.78) years at wave 5; 2370 (50.3%) were male, 720 (15.97%) were Black, 400 (8.18%) were Hispanic, and 2642 (72.53%) were White. Nearly 40% of participants experienced loss by wave 5 when they were aged 33 to 43 years, and participants who were Black (379 participants [56.67%]), Hispanic (152 participants [41.38%]), and American Indian (18 participants [56.08%]) experienced a greater proportion of losses compared with White participants (884 participants [34.09%]). Those who experienced 2 or more losses tended to have older biological ages for several of the clocks (PhenoAge β = 0.15; 95% CI, 0.02 to 0.28; GrimAge β = 0.27; 95% CI, 0.09 to 0.45; DunedinPACE β = 0.22; 95% CI, 0.10 to 0.34) compared with those with no losses. In contrast, there were no associations with 2 or more losses for the Horvath clock (β = -0.08; 95% CI, -0.23 to 0.06). Conclusions and Relevance This study reveals associations between various measures of loss experienced from childhood to adulthood and biological aging in a diverse sample of the US population. These findings underscore the potentially enduring impact of loss on biological aging even before middle age and may contribute to understanding racial and ethnic disparities in health and mortality.
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Affiliation(s)
- Allison E. Aiello
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
- Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, New York, New York
| | - Aura Ankita Mishra
- Department of Psychology, College of Humanities and Social Sciences, North Carolina State University, Raleigh
| | - Chantel L. Martin
- Carolina Population Center, University of North Carolina at Chapel Hill
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | - Brandt Levitt
- Carolina Population Center, University of North Carolina at Chapel Hill
| | | | - Daniel W. Belsky
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
- Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, New York, New York
| | - Robert A. Hummer
- Carolina Population Center, University of North Carolina at Chapel Hill
- Department of Sociology, University of North Carolina at Chapel Hill
| | | | - Kathleen Mullan Harris
- Carolina Population Center, University of North Carolina at Chapel Hill
- Department of Sociology, University of North Carolina at Chapel Hill
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McClure ES, Ranapurwala SI, Nocera M, Richardson DB. Heat-related fatalities in North Carolina 1999-2017. Am J Ind Med 2024; 67:551-555. [PMID: 38624268 DOI: 10.1002/ajim.23587] [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: 01/02/2024] [Revised: 03/05/2024] [Accepted: 04/06/2024] [Indexed: 04/17/2024]
Abstract
OBJECTIVES Research shows the highest rates of occupational heat-related fatalities among farm laborers and among Black and Hispanic workers in North Carolina (NC). The Hispanic population and workforce in NC have grown substantially in the past 20 years. We describe the epidemiology of heat-related fatal injuries in the general population and among workers in NC. METHODS We reviewed North Carolina death records and records of the North Carolina Office of the Chief Medical Examiner to identify heat-related deaths (primary International Classification of Diseases, Tenth Revision diagnosis code: X30 or T67.0-T67.9) that occurred between January 1, 1999, and December 31, 2017. Decedent age, sex, race, and ethnicity were extracted from both the death certificate and the medical examiner's report as well as determinations of whether the death occurred at work. RESULTS In NC between 1999 and 2017, there were 225 deaths from heat-related injuries, and 25 occurred at work. The rates of occupational heat-related deaths were highest among males, workers of Hispanic ethnicity, workers of Black, multiple, or unknown race, and in workers aged 55-64. The highest rate of occupational heat-related deaths occurred in the agricultural industry. CONCLUSIONS Since the last report (2001), the number of heat-related fatalities has increased, but fewer were identified as workplace fatalities. Rates of occupational heat-related deaths are highest among Hispanic workers. NC residents identifying as Black are disproportionately burdened by heat-related fatalities in general, with a wider apparent disparity in occupational deaths.
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Affiliation(s)
- Elizabeth S McClure
- Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Shabbar I Ranapurwala
- Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Maryalice Nocera
- Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - David B Richardson
- Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine, California, USA
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Ball N, Wyber R, Cornforth F. Descriptive epidemiology must not perpetuate deficit discourse and mask systemic racism. Intern Med J 2024; 54:1044-1045. [PMID: 38881455 DOI: 10.1111/imj.16410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 03/03/2024] [Indexed: 06/18/2024]
Affiliation(s)
- Nicola Ball
- National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Rosemary Wyber
- National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, Australian National University, Canberra, Australian Capital Territory, Australia
- Telethon Kids Institute, Perth, Western Australia, Australia
| | - Fiona Cornforth
- National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, Australian National University, Canberra, Australian Capital Territory, Australia
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Williams L, Oro V, Blackwell CK, Liu C, Miller EB, Ganiban J, Neiderhiser JM, DeGarmo DS, Shaw DS, Chen T, Natsuaki MN, Leve LD. Influence of early childhood parental hostility and socioeconomic stress on children's internalizing symptom trajectories from childhood to adolescence. Front Psychiatry 2024; 15:1325506. [PMID: 38694000 PMCID: PMC11062022 DOI: 10.3389/fpsyt.2024.1325506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 03/26/2024] [Indexed: 05/03/2024] Open
Abstract
Introduction Children and adolescents with elevated internalizing symptoms are at increased risk for depression, anxiety, and other psychopathology later in life. The present study examined the predictive links between two bioecological factors in early childhood-parental hostility and socioeconomic stress-and children's internalizing symptom class outcomes, while considering the effects of child sex assigned at birth on internalizing symptom development from childhood to adolescence. Materials and Methods The study used a sample of 1,534 children to test the predictive effects of socioeconomic stress at ages 18 and 27 months; hostile parenting measured at child ages 4-5; and sex assigned at birth on children's internalizing symptom latent class outcomes at child ages 7-9, 10-12, 13-15, and 16-19. Analyses also tested the mediating effect of parenting on the relationship between socioeconomic stress and children's symptom classes. Other covariates included parent depressive symptoms at child ages 4-5 and child race and ethnicity. Results Analyses identified three distinct heterogenous internalizing symptom classes characterized by relative symptom levels and progression: low (35%); moderate and increasing (41%); and higher and increasing (24%). As anticipated, higher levels of parental hostility in early childhood predicted membership in the higher and increasing symptom class, compared with the low symptom class (odds ratio (OR) = .61, 95% confidence interval (CI) [.48,.77]). Higher levels of early childhood socioeconomic stress were also associated with the likelihood of belonging to the higher-increasing symptom class compared to the low and moderate-increasing classes (OR = .46, 95% CI [.35,.60] and OR = .56, 95% CI [.44,.72], respectively). The total (c = .61) and direct (c' = .57) effects of socioeconomic stress on children's symptom class membership in the mediation analysis were significant (p <.001). Discussion Study findings suggest that intervening on modifiable bioecological stressors-including parenting behaviors and socioeconomic stressors-may provide important protective influences on children's internalizing symptom trajectories.
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Affiliation(s)
- Lue Williams
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Veronica Oro
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Courtney K. Blackwell
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Chang Liu
- Department of Psychology, Washington State University, Pullman, WA, United States
| | - Elizabeth B. Miller
- NYU Grossman School of Medicine, New York University, New York, NY, United States
| | - Jody Ganiban
- Department of Psychological & Brain Sciences, George Washington University, Washington, DC, United States
| | - Jenae M. Neiderhiser
- Department of Psychology, The Pennsylvania State University, University Park, PA, United States
| | - David S. DeGarmo
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Daniel S. Shaw
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Tong Chen
- Department of Psychology, The Pennsylvania State University, University Park, PA, United States
| | - Misaki N. Natsuaki
- Department of Psychology, University of California, Riverside, Riverside, CA, United States
| | - Leslie D. Leve
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
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18
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MacConnachie L, Zhang YS, Farina M, Gutierrez C, Hoover A, He Y, Aiello AE, Noppert GA. The association between incarceration and housing insecurity and advanced immune age during late life. Soc Sci Med 2024; 347:116698. [PMID: 38461610 PMCID: PMC11164318 DOI: 10.1016/j.socscimed.2024.116698] [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: 10/13/2023] [Revised: 02/08/2024] [Accepted: 02/14/2024] [Indexed: 03/12/2024]
Abstract
Emerging evidence suggests that psychosocial stress ages the immune system. Accordingly, immune aging may be an important potential mechanism linking psychosocial stress to aging-related decline and disease. Incarceration and housing insecurity represent severe and complex experiences of a multitude of psychosocial stressors, including discrimination, violence, and poverty. In this study, we investigated the association between incarceration and/or housing insecurity and advanced immune age in adults aged 55 and older. Our sample was derived from the Health and Retirement Survey (HRS), with n = 7003 individuals with valid housing insecurity data and n = 7523 with valid incarceration data. From 2016 Venous Blood Study data, we assessed immune aging using a comprehensive set of immune markers including inflammatory markers (IL-6, CRP, s-TNFR1), markers of viral control (CMV IgG antibodies), and ratios of T cell phenotypes (CD8+:CD4+, CD+ Memory: Naïve, CD4+ Memory: Naïve, CD8+ Memory: Naïve ratios). We found that both incarceration and housing insecurity were strongly associated with more advanced immune aging as indicated by increased inflammation, reduced viral control, and reduction in naïve T cells relative to memory T cells. Given that those who experienced incarceration, housing insecurity, and/or are racialized minorities were less likely to be included in this study, our results likely underestimated these associations. Despite these limitations, our study provided strong evidence that experiencing incarceration and/or housing insecurity may accelerate the aging of the immune system.
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Affiliation(s)
- Lauren MacConnachie
- Institute for Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI, 48103, USA.
| | - Yuan S Zhang
- Department of Sociomedical Sciences and Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - Mateo Farina
- Department of Human Development and Family Sciences, Population Research Center, University of Texas at Austin, Austin, TX, USA.
| | - Carmen Gutierrez
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Public Policy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Andrew Hoover
- Institute for Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI, 48103, USA.
| | - Yuelin He
- Institute for Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI, 48103, USA.
| | - Allison E Aiello
- Department of Epidemiology and Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - Grace A Noppert
- Institute for Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI, 48103, USA.
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