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Gailey S, Ncube CN, Sadler RC, Bruckner TA. Neighborhood mobility and racial disparities in preterm birth: A sibling study in California. Health Place 2024; 89:103280. [PMID: 38954962 DOI: 10.1016/j.healthplace.2024.103280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 04/15/2024] [Accepted: 05/24/2024] [Indexed: 07/04/2024]
Abstract
Recent work finds that upward neighborhood mobility-defined as reductions in neighborhood socioeconomic disadvantage due to moving-may improve birth outcomes. Less work, however, explores whether changes in socioeconomic context differentially impact birth outcomes by maternal race and ethnicity. In the US, mothers of minoritized racial and ethnic identity often experience worse neighborhood conditions and pregnancy outcomes than White mothers. Using a sibling-linked dataset, we examined whether neighborhood mobility corresponds with changes in preterm birth risk among Asian (N = 130,079), Black (N = 50,149), Hispanic (N = 429,938), and White (N = 233,428) mothers who delivered multiple live births in California between 2005 and 2015. We linked residential addresses at each birth to census-derived indices of neighborhood disadvantage and defined levels of neighborhood mobility as moving-induced changes in disadvantage between pregnancies. We mapped neighborhood mobility patterns and fit conditional logistic regression models estimating the odds of preterm birth in the sibling delivered after moving, controlling for the risk of preterm birth in the sibling delivered before moving, by maternal race and ethnicity. Dot density maps highlight racialized patterns of neighborhood mobility and segregation between Black and White mothers. Regression results show that Black and, in some cases, Asian and Hispanic mothers who experienced upward mobility (moves away from neighborhood disadvantage) exhibited reduced odds of preterm birth in the second delivery. Upward mobility did not reduce the odds of preterm birth among White mothers. Findings suggest that policies and programs that enable opportunities for neighborhood mobility may reduce persistent racial and ethnic disparities in adverse birth outcomes.
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Affiliation(s)
- Samantha Gailey
- Department of Forestry, Michigan State University, East Lansing, MI, USA; Department of Public Health, Michigan State University, Flint, MI, USA.
| | - Collette N Ncube
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
| | - Richard C Sadler
- Department of Public Health, Michigan State University, Flint, MI, USA.
| | - Tim A Bruckner
- Program in Public Health and Center for Population, Inequality and Policy, University of California, Irvine, USA.
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Abreu TC, Mackenbach JD, Heuvelman F, Schoonmade LJ, Beulens JW. Associations between dimensions of the social environment and cardiometabolic risk factors: Systematic review and meta-analysis. SSM Popul Health 2024; 25:101559. [PMID: 38148999 PMCID: PMC10749911 DOI: 10.1016/j.ssmph.2023.101559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/27/2023] [Accepted: 11/11/2023] [Indexed: 12/28/2023] Open
Abstract
Aim The social environment (SE), including social contacts, norms and support, is an understudied element of the living environment which impacts health. We aim to comprehensively summarize the evidence on the association between the SE and risk factors of cardiometabolic disease (CMD). Methods We performed a systematic review and meta-analysis based on studies published in PubMed, Scopus and Web of Science Core Collection from inception to 16 February 2021. Studies that used a risk factor of CMD, e.g., HbA1c or blood pressure, as outcome and social environmental factors such as area-level deprivation or social network size as independent variables were included. Titles and abstracts were screened in duplicate. Study quality was assessed using the Newcastle-Ottawa Scale. Data appraisal and extraction were based on the study protocol published in PROSPERO. Data were synthesized through vote counting and meta-analyses. Results From the 7521 records screened, 168 studies reported 1050 associations were included in this review. Four meta-analyses based on 24 associations suggested that an unfavorable social environment was associated with increased risk of cardiometabolic risk factors, with three of them being statistically significant. For example, individuals that experienced more economic and social disadvantage had a higher "CVD risk scores" (OR = 1.54, 95%CI: 1.35 to 1.84). Of the 458 associations included in the vote counting, 323 (71%) pointed towards unfavorable social environments being associated with higher CMD risk. Conclusion Higher economic and social disadvantage seem to contribute to unfavorable CMD risk factor profiles, while evidence for other dimensions of the social environment is limited.
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Affiliation(s)
- Taymara C. Abreu
- Department of Epidemiology & Data Science, Amsterdam UMC - location VUmc, Amsterdam, Noord-Holland, the Netherlands
- Upstream Team, the Netherlands
| | - Joreintje D. Mackenbach
- Department of Epidemiology & Data Science, Amsterdam UMC - location VUmc, Amsterdam, Noord-Holland, the Netherlands
- Upstream Team, the Netherlands
| | - Fleur Heuvelman
- Department of Epidemiology & Data Science, Amsterdam UMC - location VUmc, Amsterdam, Noord-Holland, the Netherlands
| | - Linda J. Schoonmade
- University Library, Vrije Universiteit Amsterdam, Amsterdam, Noord-Holland, the Netherlands
| | - Joline W.J. Beulens
- Department of Epidemiology & Data Science, Amsterdam UMC - location VUmc, Amsterdam, Noord-Holland, the Netherlands
- Upstream Team, the Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Utrecht, the Netherlands
- Amsterdam Public Health, Amsterdam Cardiovascular Sciences, Amsterdam, Noord-Holland, the Netherlands
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Gallego A, López-Gil JF. The role of individual and contextual economic factors in obesity among adolescents: A cross-sectional study including 143 160 participants from 41 countries. J Glob Health 2024; 14:04035. [PMID: 38389438 PMCID: PMC10884718 DOI: 10.7189/jogh.14.04035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024] Open
Abstract
Background To our knowledge, no previous study has examined the role of index of economic freedom (IEF) in the prevalence of excess weight and obesity in adolescents. The aim of this study was to determine the association between both individual and contextual economic factors and the prevalence of overweight and obesity (i.e. excess weight) or obesity in adolescents from different countries. Methods A cross-sectional study was carried out using data from the 2017/2018 wave of the Health Behaviour School-Aged Children study. Body mass index z-score was determined following the International Obesity Task Force criteria and, subsequently, excess weight and obesity were computed. The Family Affluence Scale was used to assess socioeconomic status. The index of IEF was used to estimate the benefits of economic freedom, both for individuals and for society as a whole. Results An inverse association was shown between socioeconomic status (SES) and excess weight or obesity, with adolescents with high SES and medium SES being less likely to have excess weight compared to adolescents with low SES (medium SES: odds ratio (OR) = 0.79; 95% confidence interval (CI) = 0.77-0.82, P < 0.001; high SES: OR = 0.65; 95% CI = 0.62-0.68, P < 0.001). For obesity, lower odds were also found for adolescents with medium SES (medium SES: OR = 0.74; 95% CI = 0.69-0.80, P < 0.001) or high SES (high SES: OR = 0.55; 95% CI 0.49-0.61, P < 0.001), in comparison with their counterparts with low SES. On the other hand, it was observed a greater likelihood of having excess weight and obesity in mostly unfree countries (excess weight: OR = 0.72; 95% CI = 0.51-1.00, P = 0.052; obesity: OR = 0.60; 95% CI = 0.39-0.92, P = 0.019) compared to free/mostly free countries. These results remained significant after adjusting for several sociodemographic and lifestyle covariates. Conclusions Both individual and contextual factors seem to have a crucial role in the prevalence of excess weight and obesity in adolescents.
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Affiliation(s)
- Alejandra Gallego
- Department of Applied Economics, Faculty of Economics and Business, University of Murcia, Murcia, Spain
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Morelli V, Heizelman RJ. Monitoring Social Determinants of Health Assessing Patients and Communities. Prim Care 2023; 50:527-547. [PMID: 37866829 DOI: 10.1016/j.pop.2023.04.005] [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] [Indexed: 10/24/2023]
Abstract
Because of the devastating health effects of social determinants of health (SDoH), it is important for the primary care provider to assess and monitor these types of stressors. This can be done via surveys, geomapping, or various biomarkers. To date, however, each of these methods is fraught with obstacles. There are currently are no validated "best" SDoH screening tools for use in clinical practice. Nor is geomapping, a perfect solution. Although mapping can collect location specific factors, it does not account for the fact that patients may live in one area, work in another and travel frequently to a third.
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Affiliation(s)
- Vincent Morelli
- Department of Family and Community Medicine, Meharry Medical College, 3rd Floor, Old Hospital Building, 1005 Dr. D. B. Todd, Jr., Boulevard, Nashville, TN 37208-3599, USA.
| | - Robert Joseph Heizelman
- Department of Family Medicine, Medical Informatics, University of Michigan, 3rd Floor, Old Hospital Building, 1005 Dr. D. B. Todd, Jr., Boulevard, Nashville, TN 37208-3599, USA
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Cha J, Bustamante G, Lê-Scherban F, Duprez D, Pankow JS, Osypuk TL. Ethnic Enclaves and Incidence of Cancer Among US Ethnic Minorities in the Multi-Ethnic Study of Atherosclerosis. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01814-z. [PMID: 37801279 PMCID: PMC11110072 DOI: 10.1007/s40615-023-01814-z] [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: 06/06/2023] [Revised: 09/16/2023] [Accepted: 09/19/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Since immigrants and their descendants represent a growing proportion of the US population, there is a strong demographic imperative for scientists to better understand the cancer risk factors at multiple levels that exist for these populations. Understanding the upstream causes of cancer, including neighborhood context, may help prevention efforts. Residence in ethnic enclaves may be one such contextual cause; however, the evidence is mixed, and past research has not utilized prospective designs examining cancer incidence or mortality. METHODS We examined the association between residency in ethnic enclaves and cancer events among Hispanic (n = 753) and Chinese (n = 451) participants without a history of cancer in the Multi-Ethnic Study of Atherosclerosis (MESA), a prospective cohort study that enrolled participants ages 45-84 in six US cities. Cancer events included deaths and hospitalization for any cancer diagnosis from 2000-2012. Residency in an ethnic enclave was operationalized as their geocoded baseline census tract having a concentration of residents of the same ethnicity greater than the 75th percentile (compared to non-ethnic enclave otherwise). Potential confounders were blocked into three categories: sociodemographic, acculturation, and biomedical/health behavior variables. To examine the association between ethnic enclaves and cancer, we estimated hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox proportional hazards models. RESULTS Among Hispanic participants, residing in ethnic enclaves (vs. not) was associated with a 39% reduction in cancer risk (HR 0.61, 95%CI: 0.31, 1.21) after adjusting for sociodemographic variables. Among Chinese participants, residing in ethnic enclaves was associated with a 2.8-fold increase in cancer risk (HR 2.86, 95%CI; 1.38, 5.94) after adjusting for sociodemographic variables. CONCLUSIONS Our results suggest that the association between ethnic enclaves and cancer events differs by ethnic group, suggesting that different social and contextual factors may operate in different communities.
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Affiliation(s)
- Jinhee Cha
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
- Program in Health Disparities Research, Medical School, University of Minnesota, Minneapolis, MN, USA
| | - Gabriela Bustamante
- Program in Health Disparities Research, Medical School, University of Minnesota, Minneapolis, MN, USA
- Instituto de Medicina Social & Desafíos Globales, School of Public Health, Universidad San Francisco de Quito, Quito, Ecuador
| | - Félice Lê-Scherban
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
- Department of Epidemiology & Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Daniel Duprez
- Cardiovascular Division, Medical School, University of Minnesota, Minneapolis, MN, USA
| | - James S. Pankow
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Theresa L. Osypuk
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
- Minnesota Population Center, University of Minnesota, Minneapolis, MN, USA
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Gailey S. Changes in Residential Greenspace and Birth Outcomes among Siblings: Differences by Maternal Race. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6790. [PMID: 37754649 PMCID: PMC10531468 DOI: 10.3390/ijerph20186790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/06/2023] [Accepted: 08/19/2023] [Indexed: 09/28/2023]
Abstract
Growing research investigates the perinatal health benefits of greenspace in a mother's prenatal environment. However, evidence of associations between residential greenspace and birth outcomes remains mixed, limiting the relevance this work holds for urban policy and greening interventions. Past research relies predominantly on cross-sectional designs that are vulnerable to residential selection bias, and rarely tests effect modification by maternal race/ethnicity, which may contribute to heterogeneous findings. This study uses a rigorous, longitudinal sibling comparison design and maternal fixed effect analyses to test whether increases in maternal exposure to residential greenspace between pregnancies precede improved birth outcomes among non-Hispanic (NH) white (n = 247,285) and Black (n = 54,995) mothers (mean age = 28 years) who had at least two consecutive live births in California between 2005 and 2015. Results show that increases in residential greenspace correspond with higher birthweight (coef. = 75.49, 95% CI: 23.48, 127.50) among Black, but not white (coef. = -0.51, 95% CI: -22.90, 21.90), infants. Additional analyses suggest that prior evidence of perinatal benefits associated with residential greenspace among white mothers may arise from residential selection; no such bias is observed for Black mothers. Taken together, these findings support urban greening initiatives in historically under-resourced neighborhoods. Efforts to evenly distribute residential greenspace may reduce persistent racial disparities in birth outcomes, an important step towards promoting health equity across the life course.
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Affiliation(s)
- Samantha Gailey
- Department of Forestry, Michigan State University, East Lansing, MI 48824, USA;
- Department of Public Health, Michigan State University, Flint, MI 48502, USA
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Kim SJ, Martin M, Caskey R, Weiler A, Van Voorhees B, Glassgow AE. The Effect of Neighborhood Disorganization on Care Engagement Among Children With Chronic Conditions Living in a Large Urban City. FAMILY & COMMUNITY HEALTH 2023; 46:112-122. [PMID: 36799944 PMCID: PMC9930887 DOI: 10.1097/fch.0000000000000356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Neighborhood context plays an important role in producing and reproducing current patterns of health disparity. In particular, neighborhood disorganization affects how people engage in health care. We examined the effect of living in highly disorganized neighborhoods on care engagement, using data from the Coordinated Healthcare for Complex Kids (CHECK) program, which is a care delivery model for children with chronic conditions on Medicaid in Chicago. We retrieved demographic data from the US Census Bureau and crime data from the Chicago Police Department to estimate neighborhood-level social disorganization for the CHECK enrollees. A total of 6458 children enrolled in the CHECK between 2014 and 2017 were included in the analysis. Families living in the most disorganized neighborhoods, compared with areas with lower levels of disorganization, were less likely to engage in CHECK. Black families were less likely than Hispanic families to be engaged in the CHECK program. We discuss potential mechanisms through which disorganization affects care engagement. Understanding neighborhood context, including social disorganization, is key to developing more effective comprehensive care models.
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Affiliation(s)
- Sage J. Kim
- Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago (Dr Kim and Ms Weiler); and Department of Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago (Drs Martin, Caskey, Van Voorhees, and Glassgow)
| | - Molly Martin
- Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago (Dr Kim and Ms Weiler); and Department of Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago (Drs Martin, Caskey, Van Voorhees, and Glassgow)
| | - Rachel Caskey
- Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago (Dr Kim and Ms Weiler); and Department of Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago (Drs Martin, Caskey, Van Voorhees, and Glassgow)
| | - Amanda Weiler
- Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago (Dr Kim and Ms Weiler); and Department of Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago (Drs Martin, Caskey, Van Voorhees, and Glassgow)
| | - Benjamin Van Voorhees
- Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago (Dr Kim and Ms Weiler); and Department of Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago (Drs Martin, Caskey, Van Voorhees, and Glassgow)
| | - Anne Elizabeth Glassgow
- Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago (Dr Kim and Ms Weiler); and Department of Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago (Drs Martin, Caskey, Van Voorhees, and Glassgow)
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Beese S, Postma J, Graves JM. Allostatic Load Measurement: A Systematic Review of Reviews, Database Inventory, and Considerations for Neighborhood Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192417006. [PMID: 36554888 PMCID: PMC9779615 DOI: 10.3390/ijerph192417006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 05/27/2023]
Abstract
BACKGROUND Neighborhoods are critical to understanding how environments influence health outcomes. Prolonged environmental stressors, such as a lack of green spaces and neighborhood socioeconomic disadvantage, have been associated with higher allostatic load levels. Since allostatic load levels experienced earlier in life have stronger associations with mortality risk, neighborhoods may be uniquely suited to monitor and mitigate the impacts of environmental stressors. Researchers often study allostatic load in neighborhoods by utilizing administrative boundaries within publicly accessible databases as proxies for neighborhoods. METHODS This systematic review of reviews aims to identify commonly used biomarkers in the measurement of allostatic load, compare measurement approaches, inventory databases to study allostatic load, and spotlight considerations referenced in the literature where allostatic load is studied in neighborhoods. The review was conducted using the search term "allostatic load" in the MEDLINE, CINAHL, and PsychINFO databases. The search results were filtered to include reviews. RESULTS The search returned 499 articles after deduplication. Overall, 18 synthesis reviews met the inclusion criteria and were retained for extraction. The synthesis reviews analyzed represented 238 studies published from 1995 to 2020. The original ten biomarkers were most often used to measure allostatic load. More recently, body mass index and C-reactive protein have additionally been frequently used to measure allostatic load burden. CONCLUSIONS The scientific contributions of this study are that we have identified a clear gap in geographic considerations when studying allostatic load. The implication of this study is that we have highlighted geographic concepts when conducting neighborhood-level research using administrative databases as a neighborhood proxy and outlined emerging future trends that can enable future study of allostatic load in the neighborhood context.
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Affiliation(s)
- Shawna Beese
- College of Agricultural, Human, and Natural Resources Sciences, Washington State University, Pullman, WA 99164, USA
- College of Nursing, Washington State University, Spokane, WA 99202, USA
| | - Julie Postma
- College of Nursing, Washington State University, Spokane, WA 99202, USA
| | - Janessa M. Graves
- College of Nursing, Washington State University, Spokane, WA 99202, USA
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Cunningham-Myrie C, Theall KP, Younger-Coleman N, Wiggan J, McFarlane S, Francis D, Bennett N, Tulloch-Reid M, Ferguson TS, Davidson T, Govia I, Guthrie-Dixon N, Aiken W, Grant A, Webster-Kerr K, Wilks R. Who moves in vulnerable Caribbean neighborhoods? Positive deviance for physical activity: Findings from the Jamaica health and Lifestyle Survey 2017 (JHLS III). Prev Med Rep 2022; 30:101998. [PMID: 36189127 PMCID: PMC9519374 DOI: 10.1016/j.pmedr.2022.101998] [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: 04/22/2021] [Revised: 09/17/2022] [Accepted: 09/20/2022] [Indexed: 11/26/2022] Open
Abstract
Decreased physical activity (PA) has been associated with residents living in neighborhoods perceived as being disordered or having high crime levels. What is unknown are the characteristics of individuals who engage in moderate to vigorous levels of PA (MVPA) despite living in these vulnerable neighborhoods, or who may be referred to as positive deviants (PD). We examined the factors associated with PD for PA among Jamaicans. Between 2016 and 2017 the Jamaica Health and Lifestyle Survey, a cross-sectional nationally representative survey (n = 2807), was conducted on individuals aged 15 years and older. Regression analyses were performed to identify associations with PD, defined using engagement in MVPA among persons living in vulnerable neighborhoods (N = 1710). Being female (odds ratio [OR]a = 0.64 (0.48, 0.86); p = 0.003), obese while living in an urban area (ORa = 0.39; 95 % CI = 0.26, 0.59; p < 0.0001), unemployed (ORa = 0.53; 95 % CI = 0.39, 0.73; p < 0.0001), or a student (ORa = 0.62; 95 % CI = 0.39, 0.98); p = 0.041) was associated with a significantly lower likelihood of PD, while having a personal medical history of at least one chronic disease significantly increased likelihood (ORa = 1.43; 95 % CI = 1.08, 1.90; p = 0.014). Taking a PD approach may be one angle to consider in trying to determine what is working and for whom, so that this may be harnessed in policy, prevention and intervention programming to increase PA.
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Affiliation(s)
- C Cunningham-Myrie
- Department of Community Health & Psychiatry, University of the West Indies, Mona, Kingston, Jamaica
| | - K P Theall
- Departments of Social, Behavioral, and Population Sciences and Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - N Younger-Coleman
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - J Wiggan
- Ministry of Health & Wellness, Jamaica
| | - S McFarlane
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - D Francis
- School of Health and Human Performance, Georgia College and State University, Milledgeville, GA, USA
| | - N Bennett
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - M Tulloch-Reid
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - T S Ferguson
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | | | - I Govia
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - N Guthrie-Dixon
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - W Aiken
- Department of Surgery, Radiology, Anaesthesia & Intensive Care, University of the West Indies, Mona, Kingston, Jamaica
| | - A Grant
- Ministry of Health & Wellness, Jamaica
| | | | - R Wilks
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
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Gailey S. Moving to greener pastures: Health selection into neighborhood green space among a highly mobile and diverse population in California. Soc Sci Med 2022; 315:115411. [PMID: 36399985 PMCID: PMC10224763 DOI: 10.1016/j.socscimed.2022.115411] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 08/11/2022] [Accepted: 09/27/2022] [Indexed: 01/26/2023]
Abstract
Global urbanization has sparked substantial environmental, public health, and social science research on the importance of conserving and propagating natural environments. A large subset of this work focuses on the benefits of green space for health. An often-overlooked methodological concern when examining relations between green space and health, however, involves residential self-selection. The selective movement of individuals into greener neighborhoods on the basis of preexisting health and correlated social factors may bias associations, particularly in cross-sectional studies, which predominate existing green space/health research. To quantify the extent of residential self-selection bias, this study used a longitudinal sibling comparison design with repeated individual and neighborhood measures to estimate associations between pre-move health factors, including maternal body mass index (BMI) and infant birthweight, and post-move neighborhood green space in a residentially mobile sample of mothers in California, 2007 to 2015 (n = 288,333). Results show that better health before moving predicted higher levels of neighborhood green space after moving, providing evidence of health selection. Findings also indicate some support for differential health selection into neighborhood green space by race/ethnicity, including that evidence of selection emerges for white and Hispanic, but not Black, mothers. However, weak relations between pre-move individual factors and post-move neighborhood green space across analyses suggest that potential bias due to residential self-selection appears relatively minimal in a large, diverse, and highly mobile sample of families in California. Findings support calls to increase green space in historically marginalized neighborhoods as a means to promote environmental and health equity.
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Affiliation(s)
- Samantha Gailey
- Minnesota Population Center, University of Minnesota, Twin Cities, USA.
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11
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Castruita PA, Piña-Escudero SD, Rentería ME, Yokoyama JS. Genetic, Social, and Lifestyle Drivers of Healthy Aging and Longevity. CURRENT GENETIC MEDICINE REPORTS 2022; 10:25-34. [PMID: 38031561 PMCID: PMC10686287 DOI: 10.1007/s40142-022-00205-w] [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] [Accepted: 09/08/2022] [Indexed: 10/14/2022]
Abstract
Purpose of Review "Healthy aging" is the state of the aging process in which a person can maintain physical, social, mental, and spiritual wellness. This literature review presents an overview of recent studies that explore how biological, social, and environmental factors contribute to healthy aging. Recent Findings A number of genome-wide association studies have been conducted recently for traits related to healthy aging, such as frailty index, healthspan, muscle strength, and parental longevity, leading to the discovery of dozens of genetic variants associated with these traits. In parallel, associations between healthy aging measures and multiple non-biological environmental elements have been identified as key moderators of the aging process, indirectly influencing day-to-day homeostatic processes. Summary Individual variations in lifespan and healthspan are influenced by genetic factors, with a heritability of ~ 25% in developed countries. Non-genetic risk variance is explained in part by social, cultural, and lifestyle conditions. Altogether, these factors contribute to a multifaceted state of wellness over time, shaping individual risk to frailty and resilience during the aging process. Notably, "Blue Zone" populations, which are characterized by an abundance in healthy lifestyles across generations, share some commonalities regarding determinants of health.
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Affiliation(s)
- Patricia Alejandra Castruita
- Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
- Health Equity Research Lab, San Francisco State University, San Francisco, CA, USA
| | - Stefanie Danielle Piña-Escudero
- Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA
| | - Miguel E. Rentería
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA
- Mental Health & Neuroscience Program, QIMR Berghofer Medical Research Insitute, Brisbane, QLD, Australia
| | - Jennifer S. Yokoyama
- Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA
- Department of Neurology, Weill Institute of Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
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12
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Boehm JK, Qureshi F, Kubzansky LD. Psychological Well-Being in Childhood and Cardiometabolic Risk in Middle Adulthood: Findings From the 1958 British Birth Cohort. Psychol Sci 2022; 33:1199-1211. [PMID: 35771978 PMCID: PMC9807774 DOI: 10.1177/09567976221075608] [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: 01/07/2023] Open
Abstract
Childhood adversity is linked to poor cardiometabolic outcomes, but less is known about positive childhood factors. Using data from 4,007 members of the 1958 British Birth Cohort, we investigated whether children with greater psychological well-being had lower adulthood cardiometabolic risk. At age 11, participants wrote essays about their future. Two judges rated each essay for nine psychological well-being items (Finn's r = .82-.91), which were combined into a standardized overall score (Cronbach's α = .91). When participants reached age 45, nurses assessed their blood pressure, heart rate, lipids, glycosylated hemoglobin, fibrinogen, and C-reactive protein, which were standardized and summed for total cardiometabolic risk. Regressions indicated that children with greater psychological well-being had lower cardiometabolic risk (b = -0.14, 95% confidence interval [CI] = [-0.28, -0.006]): specifically, healthier total cholesterol (b = -0.04, 95% CI = [-0.07, -0.003]) and triglycerides (b = -0.06, 95% CI = [-0.09, -0.02]). Childhood psychological well-being may promote adulthood cardiometabolic health.
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Affiliation(s)
- Julia K. Boehm
- Department of Psychology, Chapman University,Julia K. Boehm, Chapman University, Department of Psychology
| | - Farah Qureshi
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health,Lee Kum Sheung Center for Health and Happiness, Harvard T. H. Chan School of Public Health
| | - Laura D. Kubzansky
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health,Lee Kum Sheung Center for Health and Happiness, Harvard T. H. Chan School of Public Health
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Kim B, Branas CC, Rudolph KE, Morrison CN, Chaix B, Troxel WM, Duncan DT. Neighborhoods and sleep health among adults: A systematic review. Sleep Health 2022; 8:322-333. [DOI: 10.1016/j.sleh.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 03/21/2022] [Accepted: 03/23/2022] [Indexed: 11/26/2022]
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Versey HS. Perceptions of community among suburban and urban-dwelling adults aging in place. J Aging Stud 2021; 59:100969. [PMID: 34794714 DOI: 10.1016/j.jaging.2021.100969] [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: 07/30/2020] [Revised: 08/22/2021] [Accepted: 09/02/2021] [Indexed: 10/20/2022]
Abstract
Community is important for late-midlife adults, offering a sense of belonging and opportunities for social engagement during the transition to older age. The current study examines perceptions of community and geographical ties among a sample of older adults aging in place. Using data from the Foley Longitudinal Study of Adulthood (FLSA; N = 163; aged 61-64) and a qualitative GIS approach, major themes were categorized and mapped to create a comprehensive picture of how perceptions of community varied among respondents and neighborhoods. Core themes were connections to place, space, people, and relational benefits gained from community involvement. Residents of a suburban enclave more frequently noted connections to people as being important to community, compared to residents in more densely-populated areas. Implications for future research are discussed.
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Affiliation(s)
- H Shellae Versey
- Department of Psychology, Fordham University, United States of America.
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Ehrlich KB, Yu T, Sadiq A, Brody GH. Neighborhood poverty, allostatic load, and changes in cellular aging in African American young adults: the moderating role of attachment. Attach Hum Dev 2021; 24:339-352. [PMID: 34617499 DOI: 10.1080/14616734.2021.1976934] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Attachment experiences are thought to contribute to physical health across the lifespan. Evidence suggests that attachment style may serve as a protective factor for individuals' physical health by mitigating the negative effects of social and environmental risk factors. In the present study, we evaluated how attachment styles may moderate the link between African American adolescents' exposure to neighborhood poverty and accelerated cellular aging in young adulthood. Analyses revealed that allostatic load at age 19 mediated the association between neighborhood poverty in adolescence and changes in cellular aging from age 20 to 27. Notably, attachment avoidance (but not attachment anxiety) moderated this association, such that allostatic load was only associated with faster cellular aging for individuals who were high in avoidance. These findings suggest that allostatic load may give rise to faster cellular aging, but these detrimental effects of allostatic load can be offset by young adults' effective use of attachment figures.
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Affiliation(s)
- Katherine B Ehrlich
- Center for Family Research, University of Georgia, Athens, GA, USA.,Department of Psychology, University of Georgia, Athens, GA, USA
| | - Tianyi Yu
- Center for Family Research, University of Georgia, Athens, GA, USA
| | - Aishat Sadiq
- Center for Family Research, University of Georgia, Athens, GA, USA
| | - Gene H Brody
- Center for Family Research, University of Georgia, Athens, GA, USA
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Psychological resilience predicting cardiometabolic conditions in adulthood in the Midlife in the United States Study. Proc Natl Acad Sci U S A 2021; 118:2102619118. [PMID: 34341103 DOI: 10.1073/pnas.2102619118] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Early adversity is associated with poor cardiometabolic health, potentially via psychological distress. However, not everyone exposed to adversity develops significant distress. Psychological resilience and positive psychological health despite adversity may protect against unfavorable cardiometabolic outcomes that are otherwise more likely. We examined early adversity, psychological resilience, and cardiometabolic risk among 3,254 adults in the Midlife in the United States Study. Psychological resilience was defined according to both early psychosocial adversity and adult psychological health (characterized by low distress and high wellbeing) at Wave 1 (1994 to 1995). Categorical resilience was derived by cross-classifying adversity (exposed versus unexposed) and psychological health (higher versus lower). We also assessed count of adversities experienced and psychological symptoms as separate variables. Incident cardiometabolic conditions (e.g., heart attack, stroke, and diabetes) were self-reported at Waves 2 (2004 to 2005) and 3 (2013 to 2014). Secondary analyses examined biological cardiometabolic risk using a composite of biomarkers available within a Wave-2 subsample. Logistic and Poisson regressions evaluated associations of resilience with cardiometabolic health across 20 follow-up y, adjusting for relevant covariates. In this initially healthy sample, nonresilient (adversity-exposed, lower psychological health) versus resilient (adversity-exposed, high psychological health) individuals had 43% higher odds of cardiometabolic conditions (95% CI 1.10 to 1.85). Odds of cardiometabolic conditions were similar among resilient versus unexposed, psychologically healthy individuals. More adversity experiences were associated with increased odds, while better psychological health with decreased odds of cardiometabolic conditions, and effects were largely independent. Patterns were similar for objectively assessed cardiometabolic risk. Psychological resilience in midlife may protect against negative cardiometabolic impacts of early adversity.
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Talegawkar SA, Jin Y, Kandula NR, Kanaya AM. Associations between Cumulative Biological Risk and Subclinical Atherosclerosis in Middle- and Older-Aged South Asian Immigrants in the United States. JOURNAL OF ASIAN HEALTH 2021; 1:e202104. [PMID: 35510154 PMCID: PMC9062994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION The aim of this study was to investigate associations between cumulative biological risk and subclinical atherosclerosis in South Asian immigrants. METHODS Data from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study, including 858 participants at baseline (mean age = 56 [standard deviation = 9] years, 46% women). A cumulative biological risk score was derived using nine biomarkers across cardiovascular, immune, and metabolic systems with a possible score range of 0-9. Common and internal carotid artery intima media thickness (CIMT) and coronary artery calcium (CAC) were used as indicators of subclinical atherosclerosis. RESULTS Higher cumulative biological risk score was significantly associated with higher common and internal CIMT and higher odds of CAC at baseline. The odds of new CAC after 5 years of follow-up were 31% higher per 1-point increase in cumulative biological risk score, and the higher cumulative biological risk score was also associated with CAC progression. CONCLUSIONS Among South Asian immigrants, cumulative biological risk was directly associated with subclinical atherosclerosis and its progression.
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Affiliation(s)
- Sameera A. Talegawkar
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC
- Sumner M. Redstone Global Center for Prevention and Wellness, Milken Institute School of Public Health, The George Washington University, Washington, DC
| | - Yichen Jin
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC
| | - Namratha R. Kandula
- Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Alka M. Kanaya
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, CA
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Gullon P, Bilal U, Hirsch JA, Rundle AG, Judd S, Safford MM, Lovasi GS. Does a physical activity supportive environment ameliorate or exacerbate socioeconomic inequities in incident coronary heart disease? J Epidemiol Community Health 2021; 75:637-642. [PMID: 33318134 PMCID: PMC8200362 DOI: 10.1136/jech-2020-215239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/30/2020] [Accepted: 11/29/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND Efforts to reduce socioeconomic inequities in cardiovascular disease include interventions to change the built environment. We aimed to explore whether socioeconomic inequities in coronary heart disease (CHD) incidence are ameliorated or exacerbated in environments supportive of physical activity (PA). METHODS We used data from the Reasons for Geographic and Racial Differences in Stroke study, which recruited US residents aged 45 or older between 2003 and 2007. Our analyses included participants at risk for incident CHD (n=20 808), followed until 31 December 2014. We categorised household income and treated it as ordinal: (1) US$75 000+, (2) US$35 000-US$74 000, (3) US$20 000-US$34 000 and (4) RESULTS We found a 25% (95% CI 1.17% to 1.34%) increased hazard of CHD per 1-category decrease in household income category. Adjusting for PA-supportive environments slightly reduced this association (HR=1.24). The income-CHD association was strongest in areas without walking destinations (HR=1.57), an interaction which reached statistical significance in analyses among men. In contrast, the income-CHD association showed a trend towards being strongest in areas with the highest percentage of green land cover. CONCLUSIONS Indicators of a PA supportive environment show divergent trends to modify socioeconomic inequities in CHD . Built environment interventions should measure the effect on socioeconomic inequities.
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Affiliation(s)
- Pedro Gullon
- Public Health and Epidemiology Research Group, Universidad de Alcala de Henares Facultad de Medicina y Ciencias de la Salud, Alcala de Henares, Spain
- Urban Health Collaborative, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA
| | - Usama Bilal
- Urban Health Collaborative, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA
- Epidemiology and Statistics, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA
| | - Jana A Hirsch
- Urban Health Collaborative, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA
- Epidemiology and Statistics, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA
| | - Andrew G Rundle
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Suzanne Judd
- Department of Biostatistics, University of Alabama at Birmingham College of Arts and Sciences, Birmingham, Alabama, USA
| | - Monika M Safford
- Department of Medicine, Joan and Sanford I Weill Medical College of Cornell University, New York, New York, USA
| | - Gina S Lovasi
- Urban Health Collaborative, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA
- Epidemiology and Statistics, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA
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Halling M, Timmer-Murillo S, Hunt JC, Geier T, Beyer KM, Malecki KM, deRoon-Cassini TA. Exposure to socioenvironmental stress as a predictor of physical and mental health. J Health Psychol 2021; 27:2091-2103. [PMID: 34112016 DOI: 10.1177/13591053211024712] [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: 11/15/2022] Open
Abstract
The literature demonstrates links between socioenvironmental characteristics, dysregulation of the stress response system, and PTSD, though few studies integrate these factors in one model. In a secondary analysis of cross-sectional data collected by the Survey of the Health of Wisconsin (SHOW), structural equation modeling evaluated the relationships between socioenvironmental stress, cumulative biological risk (CBR), and PTSD symptom severity. The model hypothesized that exposure to socioenvironmental stress was associated with PTSD and that this relationship is mediated by increased CBR. Indices suggest the model provided a good fit to the data and supported socioenvironmental stress and CBR as valid latent constructs. Although the association between CBR and PTSD was not found to be statistically significant in this study, socioenvironmental stress was a significant predictor of PTSD and CBR. Given the role of socioenvironmental factors on CBR and PTSD symptoms, providers need to better assess and incorporate social stressors within evaluation and treatment.
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Gailey S, Cross RI, Messer LC, Bruckner TA. Characteristics associated with downward residential mobility among birthing persons in California. Soc Sci Med 2021; 279:113962. [PMID: 34020159 DOI: 10.1016/j.socscimed.2021.113962] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/10/2021] [Accepted: 04/21/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Substantial research documents health consequences of neighborhood disadvantage. Patterns of residential mobility that differ by race/ethnicity and socioeconomic status (SES) may sort non-Hispanic (NH) Black and low-SES families into disadvantaged neighborhoods. In this study, we leverage a sibling-linked dataset to track residential mobility among birthing persons between pregnancies and investigate baseline characteristics associated with downward mobility, including race/ethnicity, SES, and pre-existing health conditions. METHODS We used a probabilistic linkage strategy to identify births to the same person between 2007 and 2015 (n = 624,222) and categorized downward residential mobility by quartile-level increases in neighborhood disadvantage. We defined strong downward mobility as a move from a neighborhood with very low (quartile 1) to very high (quartile 4) disadvantage and estimated the logit (i.e., log-odds) of strong downward mobility as a function of racial/ethnic, sociodemographic, and health characteristics of the birthing person and their first birth. We further explored the role of neighborhood housing affordability by examining changes in affordability from first to second birth by race/ethnicity. RESULTS NH Black birthing persons show an over three-fold increased odds of strong downward mobility relative to NH white birthing persons (OR = 3.34, CI: 2.91, 3.84). To a lesser extent, Hispanic race/ethnicity, WIC receipt, low educational attainment, obesity, and infant preterm birth (PTB) also predict strong downward mobility. Examination of changes in neighborhood affordability indicate that over half of NH Black birthing persons move to a more affordable neighborhood, compared to less than a quarter of NH white birthing persons, before the birth of their second child. Results remain consistent across outcomes, measures of neighborhood SES, and modified log-Poisson models. CONCLUSION We find an elevated risk of strong downward mobility among NH Black and low-SES birthing persons. Future research may identify other factors (e.g., housing affordability) that generate downward residential mobility to identify interventions that promote neighborhood equity.
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Affiliation(s)
- Samantha Gailey
- School of Social Ecology, University of California Irvine, Irvine, CA, USA.
| | - Rebekah Israel Cross
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Lynne C Messer
- OHSU-PSU School of Public Health, Portland State University, Portland, OR, USA
| | - Tim A Bruckner
- Program in Public Health & Center for Population, Inequality, and Policy, University of California Irvine, Irvine, CA, USA
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Gailey S, McElroy S, Benmarhnia T, Bruckner TA. Green mobility and obesity risk: A longitudinal analysis in California. Health Place 2021; 68:102503. [PMID: 33493964 DOI: 10.1016/j.healthplace.2020.102503] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 12/05/2020] [Accepted: 12/13/2020] [Indexed: 11/25/2022]
Abstract
Previous work reports an inverse association between neighborhood greenness and obesity. Limitations of this work, which relies largely on cross-sectional data, include that studies often lack control for unmeasured genetic and sociodemographic factors that may confound associations, and cannot disentangle temporal order between neighborhood greenness and obesity. We move beyond a cross-sectional approach and leverage a longitudinal sibling-linked dataset with health, residential, and demographic information on women with two births in California between 2007 and 2015 (N = 552,929). We used a sibling comparison design to control for unmeasured stable characteristics of women and tested whether a positive change in neighborhood greenness (i.e., "upward green mobility") precedes a reduction in obesity risk. Models also adjusted for baseline obesity risk and time-varying individual- and neighborhood-level socioeconomic factors. As hypothesized, we find that upward green mobility varies inversely with the odds of obesity. Results indicate that small decreases in neighborhood greenness may also show protective associations with obesity risk. Our findings, if replicated, suggest that changing levels (particularly increases) of greenness in the residential environment may combat the rise of obesity.
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Affiliation(s)
- Samantha Gailey
- University of California Irvine, School of Social Ecology, USA.
| | - Sara McElroy
- University of California San Diego, Family Medicine and Public Health, USA.
| | - Tarik Benmarhnia
- University of California San Diego, Family Medicine and Public Health & Scripps Institution of Oceanography, USA.
| | - Tim A Bruckner
- University of California Irvine, Program in Public Health & Center for Population, Inequality, and Policy, USA.
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GERONIMUS ARLINET, PEARSON JAYA, LINNENBRINGER ERIN, EISENBERG ALEXAK, STOKES CARMEN, HUGHES LANDOND, SCHULZ AMYJ. Weathering in Detroit: Place, Race, Ethnicity, and Poverty as Conceptually Fluctuating Social Constructs Shaping Variation in Allostatic Load. Milbank Q 2020; 98:1171-1218. [PMID: 33135829 PMCID: PMC7772642 DOI: 10.1111/1468-0009.12484] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Policy Points Despite 30 years of attention to eliminating population health inequity, it remains entrenched, calling for new approaches. Targeted universalism, wellness-based local development, and Jedi Public Health approaches that are community informed, evidence based, and focused on improving everyday settings and diverse lived experiences are important policy directions. State and federal revenue transfers are necessary to mitigate the harms of austerity and assure greater equity in fiscal and population health in places like Detroit, Michigan. CONTEXT US population health inequity remains entrenched, despite mandates to eliminate it. To promote a public health approach of consequence in this domain, stakeholders call for moving from risk-factor epidemiology toward consideration of dynamic local variations in the physiological impacts of structured lived experience. METHODS Using a community-based, participatory research approach, we collected and analyzed a unique data set of 239 black, white, and Mexican adults from a stratified, multistage probability sample of three Detroit, Michigan, neighborhoods. We drew venous blood, collected saliva, took anthropometric measurements, and assayed specimens to measure allostatic load (AL), an indicator of stress-mediated biological dysregulation, linking participants' AL scores and survey responses. In a series of nested Poisson models, we regressed AL on socioeconomic, psychosocial, neighborhood, and behavioral stressors to test the hypothesis that race/ethnicity and poverty-to-income ratio (PIR) are conceptually fluctuating variables whose impacts on AL are sensitive to structured lived experience. FINDINGS White and Mexican Detroit participants with PIR < 1 have higher AL than counterparts nationally; black participants in Detroit and nationwide had comparable AL. Within Detroit, disparities by PIR were higher in whites than blacks, with no significant difference by PIR in Mexicans. The size of estimated effects of having PIR < 1 for whites is 58 percentage points greater than that of Mexicans and twice that of blacks. CONCLUSIONS Structurally rooted unobserved heterogeneity bias threatens the validity of independent main effects interpretations of associations between race/ethnicity, socioeconomic characteristics, or place and health. One-size-fits-all analytic or policy models developed from the perspective of the dominant social group insufficiently address the experiences of diverse populations in specific settings and historical moments; nor do they recognize culturally mediated protective resources residents may have developed against material and psychosocial hardship.
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Affiliation(s)
- ARLINE T. GERONIMUS
- School of Public HealthUniversity of Michigan
- Institute for Social Research, University of Michigan
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Neighborhood perceptions and allostatic load: Evidence from Midlife in the United States study. Health Place 2020; 61:102263. [PMID: 32329729 DOI: 10.1016/j.healthplace.2019.102263] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 11/15/2019] [Accepted: 11/28/2019] [Indexed: 12/31/2022]
Abstract
Allostatic load, which represents the cumulative wear and tear on physiological systems resulting from long-term exposure to stress, provides a theoretical framework that can be applied to understand the association between neighborhood conditions and health outcomes. Within allostatic load theory perception plays a key role, as the cognitive appraisal process associated with one's perceptions determines whether external stimuli-such as neighborhood conditions-are deemed threatening or benign. With data from the Midlife Development in the United States, this study employed structural equation modeling to assess the association between neighborhood perceptions and cumulative, systems-level allostatic load scores. The findings demonstrate that neighborhood perception, as operationalized as a combination of perceived trust in neighbors, perceived neighborhood safety, and perceived neighborhood conditions, was inversely associated with allostatic load even when controlling for objective neighborhood conditions.
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Powell-Wiley TM, Gebreab SY, Claudel SE, Ayers C, Andrews MR, Adu-Brimpong J, Berrigan D, Davis SK. The relationship between neighborhood socioeconomic deprivation and telomere length: The 1999-2002 National Health and Nutrition Examination Survey. SSM Popul Health 2019; 10:100517. [PMID: 31872036 PMCID: PMC6909179 DOI: 10.1016/j.ssmph.2019.100517] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 11/13/2019] [Accepted: 11/14/2019] [Indexed: 12/29/2022] Open
Abstract
Socioeconomically disadvantaged neighborhoods have been associated with poor health outcomes. Little is known about the biological mechanism by which deprived neighborhood conditions exert negative influences on health. Data from the 1999–2002 National Health and Nutrition Examination Surveys (NHANES) were used to assess the relationship between neighborhood deprivation index (NDI) and log-transformed leukocyte telomere length (LTL) via multilevel modeling to control for census tract level clustering. Models were constructed using tertiles of NDI (ref = low NDI). NDI was calculated using census tract level socioeconomic indicators from the 2000 U.S. Census. The sample (n = 5,106 adults) was 49.8% female and consisted of 82.9% non-Hispanic whites, 9.4% non-Hispanic blacks, and 7.6% Mexican Americans. Mean age was 45.8 years. Residents of neighborhoods with high NDI were younger, non-white, had lower educational attainment, and had a lower poverty to income ratio (all p < 0.0001). Neighborhood deprivation was inversely associated with LTL among individuals living in neighborhoods with medium NDI (β = −0.043, SE = 0.012, p = 0.0005) and high NDI (β = −0.039, SE = 0.013, p = 0.003). Among men, both medium (β = −0.042, SE = 0.015, p = 0.006) and high (β = −0.047, SE = 0.015, p = 0.001) NDI were associated with shorter LTL. Among women, only medium NDI (β = −0.020, SE = 0.016, p = 0.009) was associated with shorter LTL. After controlling for individual characteristics, including individual-level socioeconomic status, increasing neighborhood socioeconomic deprivation is associated with shorter LTL among a nationally representative sample of US adults. This suggests that telomere shortening may be a mechanism through which neighborhood deprivation results in poor health outcomes. Neighborhood deprivation is inversely related to telomere length. This persists after adjusting for behavior and individual socioeconomic status. Telomere shortening in high deprivation represented 7.5 years of accelerated aging. Telomere shortening may be a mechanism linking neighborhoods and health.
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Affiliation(s)
- Tiffany M. Powell-Wiley
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
- Corresponding author. Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, DIR, NHLBI, Building 10-CRC, Room 5-5332, MSC 1454 10 Center Drive, Bethesda, MD, 20892, USA.
| | - Samson Y. Gebreab
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Sophie E. Claudel
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Colby Ayers
- Reynolds Cardiovascular Clinical Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Marcus R. Andrews
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Joel Adu-Brimpong
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - David Berrigan
- National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Sharon K. Davis
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
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Torche F. Early-Life Circumstances and Their Effects Over the Life Course. POPULATION RESEARCH AND POLICY REVIEW 2019. [DOI: 10.1007/s11113-019-09555-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Hargrove TW. Light Privilege? Skin Tone Stratification in Health among African Americans. SOCIOLOGY OF RACE AND ETHNICITY (THOUSAND OAKS, CALIF.) 2019; 5:370-387. [PMID: 32123694 PMCID: PMC7051017 DOI: 10.1177/2332649218793670] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Skin tone is a significant marker used by others to evaluate and rank the social position of minorities. While skin color represents a particularly salient dimension of race, its consequences for health remains unclear. This study uses four waves of panel data from the Coronary Artery Risk Development in Young Adults (CARDIA) Study and random intercept multilevel models to address three research questions critical to understanding the skin color-health relationship among African American adults (N=1,680): what is the relationship between skin color and two global measures of health (cumulative biological risk and self-rated health)? To what extent are these relationships gendered? Do socioeconomic resources, stressors, and discrimination help explain the skin color-health relationship? Findings indicate that dark-skinned women have more physiological deterioration and self-report worse health than lighter-skinned women. These associations are not evident among men, and socioeconomic factors, stressors, and discrimination do not explain the light-dark disparity in physiological deterioration among women. Differences in self-ratings of health among women are partially explained by education and income. Results of this study highlight heterogeneity in determinants of health among African Americans, and provide a more nuanced understanding of health inequality by identifying particularly disadvantaged members of racial groups that are often assumed to have monolithic experiences.
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Bruckner TA, Kane JB, Gailey S. Strong upward neighborhood mobility and preterm birth: a matched-sibling design approach. Ann Epidemiol 2019; 36:48-54.e1. [PMID: 31324410 DOI: 10.1016/j.annepidem.2019.05.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 05/10/2019] [Accepted: 05/31/2019] [Indexed: 01/05/2023]
Abstract
PURPOSE Much cross-sectional work reports an association between neighborhood disadvantage and adverse birth outcomes. Limitations of this work include that mothers with pre-existing unmeasured morbidity may "select" into, or out of, certain neighborhoods. This selection issue remains a key rival explanation for work concerned with place-based disparities in birth outcomes. We move beyond a cross-sectional approach and exploit a sibling-linked data set in California to test whether upwardly mobile mothers, who move from a very high to a very low disadvantaged neighborhood, exhibit a lower than expected risk of preterm birth (PTB) (i.e., delivery <37 weeks). METHODS We used a matched-sibling design for 461,061 sibling pairs (i.e., 922,122 births total) to mothers in urban areas in who gave birth in California from 2005 to 2010. We linked mother's address at two time points (i.e., two sibling birth dates) to a census-derived composite indicator of neighborhood disadvantage. Conditional logistic regression methods controlled for mother's risk of PTB in the sibling delivered before the move when estimating the relation between strong upward mobility and preterm of the subsequent birth after the move. RESULTS As hypothesized, strong upward mobility (relative to no mobility) varies inversely with the odds of PTB of the second sibling (odds ratio [OR] for PTB = 0.83, 95% confidence interval: 0.74, 0.93). CONCLUSIONS Mothers moving from very high to very low disadvantaged neighborhoods show a reduced odds of PTB. Our findings, if replicated, raise the possibility that improvements in neighborhood quality may improve perinatal health in a relatively short time span.
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Affiliation(s)
- Tim A Bruckner
- Program in Public Health, College of Health Sciences, University of California, Irvine.
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Cuevas AG, Trudel-Fitzgerald C, Cofie L, Zaitsu M, Allen J, Williams DR. Placing prostate cancer disparities within a psychosocial context: challenges and opportunities for future research. Cancer Causes Control 2019; 30:443-456. [PMID: 30903484 PMCID: PMC6484832 DOI: 10.1007/s10552-019-01159-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 03/12/2019] [Indexed: 01/13/2023]
Abstract
Black men are more likely to be diagnosed with prostate cancer compared with White men. Despite advances in prevention and treatment strategies, disparities in prostate cancer among Black men persist. While research on the causes of higher incidence and mortality is ongoing, there is limited evidence in the existing literature that clearly speaks to the potential psychological or social factors that may contribute to disparities in prostate cancer incidence. Given the lack of attention to this issue, we review scientific evidence of the ways in which social factors, including socioeconomic status and racial segregation, as well as psychological factors, like depression and anxiety, are related to subsequent prostate cancer risk, which could occur through behavioral and biological processes. Our objective is to illuminate psychosocial factors and their context, using a racial disparity lens, which suggests opportunities for future research on the determinants of prostate cancer. Ultimately, we aim to contribute to a robust research agenda for the development of new prostate cancer prevention measures to reduce racial disparities.
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Affiliation(s)
- Adolfo G Cuevas
- Department of Community Health, Tufts University, Medford, MA, 02155, USA.
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.
| | - Claudia Trudel-Fitzgerald
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Leslie Cofie
- Health Education and Promotion, East Carolina University, Greenville, NC, 27858, USA
| | - Masayoshi Zaitsu
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Jennifer Allen
- Department of Community Health, Tufts University, Medford, MA, 02155, USA
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
- Department of African and African American Studies, Harvard University, Cambridge, MA, 02138, USA
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Petteway R, Mujahid M, Allen A. Understanding Embodiment in Place-Health Research: Approaches, Limitations, and Opportunities. J Urban Health 2019; 96:289-299. [PMID: 30613858 PMCID: PMC6458222 DOI: 10.1007/s11524-018-00336-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Research on how place affects health continues to grow. Within the place-health research field, there is increasing focus on how place becomes embodied-i.e., how place-based social and environmental experiences and exposures "get under our skin" to affect physiological functioning and health. While much has been learned, currently favored place-embodiment research approaches present limitations that inhibit continued gains in understanding. This article presents a brief summary of place-health literature related to place-embodiment, highlighting common approaches. Core limitations are then discussed with an eye towards improving research going forward, highlighting mixed-method, spatially dynamic, and participatory intergenerational approaches as promising considerations.
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Affiliation(s)
- Ryan Petteway
- Oregon Health & Science University-Portland State University School of Public Health, Portland, OR, USA.
| | - Mahasin Mujahid
- University of California, Berkeley School of Public Health, Berkeley, CA, 94720, USA
| | - Amani Allen
- University of California, Berkeley School of Public Health, Berkeley, CA, 94720, USA
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Social relationships, neighbourhood poverty and cumulative biological risk: findings from a multi-racial US urban community. J Biosoc Sci 2019; 51:799-816. [PMID: 30803459 DOI: 10.1017/s002193201900004x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Prior research has established associations between neighbourhood poverty and cumulative biological risk (CBR). CBR is conceptualized as indicative of the effects of stress on biological functioning, and is linked with increased morbidity and mortality. Studies suggest that supportive social relationships may be health protective, and may erode under conditions of poverty. This study examines whether social relationships are inversely associated with CBR and whether associations between neighbourhood poverty and CBR are mediated through social relationships. Data were from a stratified probability sample community survey (n=919) of residents of Detroit, Michigan, USA (2002-2003) and from the 2000 US Census. The outcome variable, CBR, included anthropometric and clinical measures. Independent variables included four indicators of social relationships: social support, neighbourhood satisfaction, social cohesion and neighbourhood participation. Multilevel models were used to test both research questions, with neighbourhood poverty and social relationships included at the block group level, and social relationships also included at the individual level, to disentangle individual from neighbourhood effects. Findings suggest some associations between social relationships and CBR after accounting for neighbourhood poverty and individual characteristics. In models that accounted for all indicators of social relationships, individual-level social support was associated with greater CBR (β=0.12, p=0.04), while neighbourhood-level social support was marginally significantly protective of CBR (within-neighbourhood: β=-0.36, p=0.06; between-neighbourhood: β=-0.24, p=0.06). In contrast, individual-level neighbourhood satisfaction was protective of CBR (β=-0.10, p=0.02), with no within-neighbourhood (β=0.06, p=0.54) or between-neighbourhood association (β=-0.04, p=0.38). Results indicate no significant association between either social cohesion or neighbourhood participation and CBR. Associations between neighbourhood poverty and CBR were not mediated by social relationships. These findings suggest that neighbourhood-level social support and individual-level neighbourhood satisfaction may be health protective and that neighbourhood poverty, social support and neighbourhood satisfaction are associated with CBR through independent pathways.
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Abstract
Exposure to environmental stressors is highly prevalent and unequally distributed along socioeconomic lines and may have enduring negative consequences, even when experienced before birth. Yet, estimating the consequences of prenatal stress on children's outcomes is complicated by the issue of confounding (i.e., unobserved factors correlated with stress exposure and with children's outcomes). I combine a natural experiment-a strong earthquake in Chile-with a panel survey to capture the effect of prenatal exposure on acute stress and children's cognitive ability. I find that stress exposure in early pregnancy has no effect on children's cognition among middle-class families, but it has a strong negative influence among disadvantaged families. I then examine possible pathways accounting for the socioeconomic stratification in the effect of stress, including differential exposure across socioeconomic status, differential sensitivity, and parental responses. Findings suggest that the interaction between prenatal exposures and socioeconomic advantage provides a powerful mechanism for the intergenerational transmission of disadvantage.
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Affiliation(s)
- Florencia Torche
- Department of Sociology, Stanford University, 450 Serra Mall, Building 120 McClatchy Hall, Room 244, Stanford, CA, 94305, USA.
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Kane JB, Farshchi E. Neighborhood affluence protects against antenatal smoking: evidence from a spatial multiple membership model. MATHEMATICAL POPULATION STUDIES 2019; 26:186-207. [PMID: 31749519 PMCID: PMC6865281 DOI: 10.1080/08898480.2018.1553399] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A spatial multiple membership model formalizes the effect of neighborhood affluence on antenatal smoking. The data are geocoded New Jersey birth certificate records linked to United States census tract-level data from 1999 to 2007. Neighborhood affluence shows significant spatial autocorrelation and local clustering. Better model fit is observed when incorporating the spatial clustering of neighborhood affluence into multivariate analyses. Relative to the spatial multiple membership model, the multilevel model that ignores spatial clustering produced downwardly biased standard errors; the effective sample size of the key parameter of interest (neighborhood affluence) is also lower. Residents of communities located in high-high affluence clusters likely have better access to health-promoting institutions that regulate antenatal smoking behaviors.
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Affiliation(s)
| | - Ehsan Farshchi
- Department of Sociology, University of California, Irvine
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Cunningham-Myrie CA, Mabile E, Govia I, Younger NO, Tulloch-Reid MK, McFarlane S, Francis D, Gordon-Strachan G, Wilks R, Greene LG, Lyew-Ayee P, Theall KP. Neighbourhood characteristics and cumulative biological risk: evidence from the Jamaica Health and Lifestyle Survey 2008: a cross-sectional study. BMJ Open 2018; 8:e021952. [PMID: 30552247 PMCID: PMC6303643 DOI: 10.1136/bmjopen-2018-021952] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 08/11/2018] [Accepted: 10/04/2018] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To examine whether neighbourhood characteristics are associated with cumulative biological risk (CBR) and sex differences in CBR in a nationally representative sample in Jamaica, a small island developing country with increasing prevalence of non-communicable diseases (NCDs). DESIGN Cross-sectional study SETTING: A population-based cross-sectional survey, the Jamaica Health and Lifestyle Survey 2008 (JHLS II) recruited persons at their homes over a 4 month period from all 14 parishes and 113 neighbourhoods defined as enumeration districts (EDs). PARTICIPANTS 2544 persons aged 15-74 years old from the 2008 Jamaica Health and Lifestyle Survey (JHLS II), who completed interviewer-administered questionnaires and had biomarkers assessed, and whose home addresses could be reliably geocoded. PRIMARY OUTCOME A summary measure CBR was created using seven markers-systolic and diastolic blood pressure readings, waist circumference, body mass index, total cholesterol, fasting blood glucose levels and self-reported asthma. Weighted multilevel models examined clustering, using the intraclass correlation coefficient (ICC), of CBR across neighbourhoods and the impact of neighbourhood characteristics (recreational space availability and neighbourhood disorder) on CBR. RESULTS Women had significantly higher mean CBR scores than men across all age groups. There was significant clustering of CBR by ED, and among women versus men (ICC: F=6.9%, M=0.7%). Women living in more disordered neighbourhoods were 26% more likely to have high CBR as those in less disordered ones (aOR=1.26, 95% CI=1.08 to 1.47; p<0.05). Individuals living in EDs with greater recreational space availability were 25% less likely to have a high CBR (aOR=0.75, 95% CI=0.64 to 0.90; p<0.05). CONCLUSIONS Policy-makers in Jamaica should pay greater attention to neighbourhood factors such as recreational space availability and neighbourhood disorder that may contribute to CBR in any effort to curtail the epidemic of NCDs.
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Affiliation(s)
| | - Emily Mabile
- Louisiana Department of Health, Office of Public Health, Bureau of Family Health, Baton Rouge, Louisiana, USA
| | - Ishtar Govia
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - Novie O Younger
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | | | - Shelly McFarlane
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - Damian Francis
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | | | - Rainford Wilks
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - Lisa-Gaye Greene
- Mona GeoInformatics Institute, University of the West Indies, Mona, Jamaica
| | - Parris Lyew-Ayee
- Mona GeoInformatics Institute, University of the West Indies, Mona, Jamaica
| | - Katherine P Theall
- Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA
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Portacolone E, Perissinotto C, Yeh JC, Greysen SR. "I Feel Trapped": The Tension Between Personal and Structural Factors of Social Isolation and the Desire for Social Integration Among Older Residents of a High-Crime Neighborhood. THE GERONTOLOGIST 2018; 58:79-88. [PMID: 28329804 DOI: 10.1093/geront/gnw268] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 02/15/2017] [Indexed: 11/13/2022] Open
Abstract
Background and Objectives The aim of this study was to examine the factors contributing to the social isolation of older residents of a high-crime neighborhood through the in-depth examination of their lived experiences. A deeper understanding of factors contributing to social isolation can allow policymakers and health care providers to create policies and programs to alleviate the social isolation of these vulnerable and understudied individuals. Research Design and Methods Participants were recruited through the support of the Housing Authority and Police and Fire Departments of Richmond, California, a town with a high-crime rate. Fifty-nine ethnographic interviews were conducted with 20 individuals of 58-95 years of age. Transcripts and fieldnotes were analyzed with a focus on the specific factors contributing the social isolation of participants. Results An overarching theme of tension between personal and structural factors of social isolation and desire for social integration emerged from qualitative content analysis. A tension emerged between a longing to participate in society and the immersion in a reality so dense with obstacles that made participation in society difficult to attain. Four specific themes also emerged. Three themes demonstrated underlying factors of social isolation stemming from the personal sphere and the physical and social environment. The fourth theme illustrated participants' desire for social integration. Discussion and Implications Findings demonstrate the salience of interventions and programs to make neighborhoods safe and accessible to older residents. Findings also suggest a need to reframe the conceptual framework for social isolation to better measure and alleviate this public health problem.
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Affiliation(s)
- Elena Portacolone
- Institute for Health and Aging, University of California-San Francisco.,Institute for the Study of Societal Issues, University of California-Berkeley
| | - Carla Perissinotto
- Division of Geriatric Medicine, School of Medicine, University of California-San Francisco
| | - Jarmin Christine Yeh
- Department of Social and Behavioral Sciences, University of California-San Francisco
| | - S Ryan Greysen
- Division of Geriatrics, Department of Medicine, Penn University, Philadelphia
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Kane JB, Teitler JO, Reichman NE. Ethnic enclaves and birth outcomes of immigrants from India in a diverse U.S. state. Soc Sci Med 2018; 209:67-75. [PMID: 29800770 PMCID: PMC11263911 DOI: 10.1016/j.socscimed.2018.05.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 05/15/2018] [Accepted: 05/17/2018] [Indexed: 01/08/2023]
Abstract
Sociological theory suggests that ethnic enclaves promote immigrant health. Existing studies of ethnic enclaves and immigrant birth outcomes have generally focused on blacks and Hispanics, while few have focused on immigrants from India - the second largest immigrant group in the U.S., after Mexicans. Paradoxically, this group generally exhibits worse birth outcomes than non-Hispanic whites, despite their high levels of education. This study investigates associations between residence in South Central Asian ethnic enclaves and both birth outcomes and prenatal behaviors of immigrant mothers from India, using population-level birth record data from the state of New Jersey in the U.S. (1999-2012; n = 64,375). Results indicate that residence in a South Central Asian enclave is associated with less prenatal smoking and earlier prenatal care, but not with birthweight- or gestational-age related outcomes, among immigrant mothers from India. These findings are consistent with theory suggesting that social support, social capital, and social norms transmitted through the social networks present in ethnic enclaves foster health-promoting behaviors. Notably, the prenatal behaviors of non-Hispanic white mothers were not associated to a large degree with living in South Central Asian enclaves, which is also consistent with theory and bolsters our confidence that the observed associations for immigrant mothers from India are not spurious.
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Affiliation(s)
- Jennifer B Kane
- Department of Sociology, University of California, Irvine, 4171 Social Sciences Plaza A, Irvine, CA, 92697, USA.
| | - Julien O Teitler
- School of Social Work, Columbia University, 1255 Amsterdam Avenue, New York, NY 10027, USA
| | - Nancy E Reichman
- Department of Pediatrics, Robert Wood Johnson Medical School, Rutgers University, 89 French Street, New Brunswick, NJ 08903, USA
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Hussein M, Diez Roux AV, Mujahid MS, Hastert TA, Kershaw KN, Bertoni AG, Baylin A. Unequal Exposure or Unequal Vulnerability? Contributions of Neighborhood Conditions and Cardiovascular Risk Factors to Socioeconomic Inequality in Incident Cardiovascular Disease in the Multi-Ethnic Study of Atherosclerosis. Am J Epidemiol 2018; 187:1424-1437. [PMID: 29186311 DOI: 10.1093/aje/kwx363] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 11/16/2017] [Indexed: 12/12/2022] Open
Abstract
Risk factors can drive socioeconomic inequalities in cardiovascular disease (CVD) through differential exposure and differential vulnerability. In this paper, we show how econometric decomposition directly enables simultaneous, policy-oriented assessment of these 2 mechanisms. We specifically estimate contributions of neighborhood environment and proximal risk factors to socioeconomic inequality in CVD incidence via these mechanisms. We followed 5,608 participants in the Multi-Ethnic Study of Atherosclerosis (2000-2012) to their first CVD event (median length of follow-up, 12.2 years). We used a summary measure of baseline socioeconomic position (SEP). Covariates included baseline demographics, neighborhood characteristics, and psychosocial, behavioral, and biomedical risk factors. Using Poisson models, we decomposed the difference (inequality) in incidence rates between low- and high-SEP groups into contributions of 1) differences in covariate means (differential exposure) and 2) differences in CVD risk associated with covariates (differential vulnerability). Notwithstanding large uncertainty in neighborhood estimates, our analysis suggested that differential exposure to poorer neighborhood socioeconomic conditions, adverse social environment, diabetes, and hypertension accounted for most of the inequality. Psychosocial and behavioral contributions were negligible. Further, neighborhood SEP, female sex, and white race were more strongly associated with CVD among low-SEP (vs. high-SEP) participants. These differentials in vulnerability also accounted for nontrivial portions of the inequality and could have important implications for intervention.
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Affiliation(s)
- Mustafa Hussein
- Joseph J. Zilber School of Public Health, University of Wisconsin–Milwaukee, Milwaukee, Wisconsin
| | - Ana V Diez Roux
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Mahasin S Mujahid
- Department of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, California
| | - Theresa A Hastert
- Department of Oncology, School of Medicine and Karmanos Cancer Institute, Wayne State University, Detroit, Michigan
| | - Kiarri N Kershaw
- Division of Epidemiology, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Alain G Bertoni
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Ana Baylin
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
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Perceptions of Neighborhood Mediate the Relationship Between PTSD Symptoms and Coping in a Neighborhood-Matched Substance-Using Sample. J Addict Med 2018; 11:440-448. [PMID: 28885301 DOI: 10.1097/adm.0000000000000343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES People with substance use problems living in neighborhoods with high levels of disorder are disproportionately likely to experience trauma and develop PTSD symptoms. We sought to evaluate the relationships between objective neighborhood disorder, perceptions of neighborhood, and the use of maladaptive coping behaviors among both non-substance-using and substance-using participants with and without PTSD symptoms. METHODS Participants (255 non-drug users [NDUs], 168 marijuana and/or alcohol users [MAUs], and 273 opioid and/or stimulant users) completed the Addiction Severity Index, PTSD Checklist-Civilian Version, The COPE Inventory, and the Perceived Neighborhood Scale. The Neighborhood Inventory for Environmental Typology (NIfETy) was used to objectively assess neighborhood disorder at participants' home addresses. Regression modeling was used to assess within-group predictors of PTSD and test for mediation in the relationships between PTSD, perceptions of neighborhood, and coping behaviors. RESULTS In NDUs, lower sense of community partially mediated the relationship between PTSD symptoms and using mental disengagement to cope. In MAUs, higher levels of perceived crime partially mediated the individual relationships between PTSD symptoms and using mental disengagement, focusing on and venting emotions, and using substances to cope. Opioid and/or stimulant users with PTSD symptoms reported using higher levels of mental disengagement, focusing on and venting emotions, and substances to cope and perceived a higher degree of crime; no mediation was inferred. CONCLUSION Perceptions of community and crime may be more predictive of PTSD symptoms than objectively measured neighborhood disorder. These perceptions partially mediate the relationship between maladaptive coping behaviors and PTSD symptoms.
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Vogel N, Ram N, Goebel J, Wagner GG, Gerstorf D. How does availability of county-level healthcare services shape terminal decline in well-being? Eur J Ageing 2018; 15:111-122. [PMID: 29867296 DOI: 10.1007/s10433-017-0425-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Both lifespan psychology and life course sociology highlight that contextual factors influence individual functioning and development. In the current study, we operationalize context as county-level care services in inpatient and outpatient facilities (e.g., number of care facilities, privacy in facilities) and investigate how the care context shapes well-being in the last years of life. To do so, we combine 29 waves of individual-level longitudinal data on life satisfaction from now deceased participants in the nationwide German Socio-Economic Panel Study (N = 4557; age at death: M = 73.35, SD = 14.20; 47% women) with county-level data from the Federal Statistical Office. Results from three-level growth models revealed that having more inpatient care facilities, more employees per resident, and more staff in administration are each uniquely associated with higher late-life well-being, independent of key individual (age at death, gender, education, disability) and county (affluence, demographic composition) characteristics. Number of employees in physical care, residential comfort, and flexibility and care indicators in outpatient institutions were not found to be associated with levels or change in well-being. We take our results to provide empirical evidence that some contextual factors shape well-being in the last years of life and discuss possible routes how local care services might alleviate terminal decline.
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Affiliation(s)
- Nina Vogel
- 1German Institute for Economic Research (DIW Berlin), Mohrenstraße 58, 10117 Berlin, Germany
- 2Department of Psychology, Humboldt University Berlin, Unter den Linden 6, 10099 Berlin, Germany
- Present Address: The German Environment Agency, Berlin, Germany
| | - Nilam Ram
- 1German Institute for Economic Research (DIW Berlin), Mohrenstraße 58, 10117 Berlin, Germany
- 3Pennsylvania State University, HDFS, 417 BBH Building, University Park, PA 16802 USA
| | - Jan Goebel
- 1German Institute for Economic Research (DIW Berlin), Mohrenstraße 58, 10117 Berlin, Germany
| | - Gert G Wagner
- 1German Institute for Economic Research (DIW Berlin), Mohrenstraße 58, 10117 Berlin, Germany
- 4Max Planck Institute for Human Development, Berlin, Germany
| | - Denis Gerstorf
- 1German Institute for Economic Research (DIW Berlin), Mohrenstraße 58, 10117 Berlin, Germany
- 2Department of Psychology, Humboldt University Berlin, Unter den Linden 6, 10099 Berlin, Germany
- 3Pennsylvania State University, HDFS, 417 BBH Building, University Park, PA 16802 USA
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Ribeiro AI, Amaro J, Lisi C, Fraga S. Neighborhood Socioeconomic Deprivation and Allostatic Load: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1092. [PMID: 29843403 PMCID: PMC6024893 DOI: 10.3390/ijerph15061092] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 05/21/2018] [Accepted: 05/24/2018] [Indexed: 12/02/2022]
Abstract
Residing in socioeconomically deprived neighborhoods may pose substantial physiological stress, which can then lead to higher allostatic load (AL), a marker of biological wear and tear that precedes disease. The aim of the present study was to map the current evidence about the relationship between neighborhood socioeconomic deprivation and AL. A scoping review approach was chosen to provide an overview of the type, quantity, and extent of research available. The review was conducted using three bibliographic databases (PubMed, SCOPUS, and Web of Science) and a standardized protocol. Fourteen studies were identified. Studies were predominantly from the USA, cross-sectional, focused on adults, and involved different races and ethnic groups. A wide range of measures of AL were identified: the mode of the number of biomarkers per study was eight but with large variability (range: 6⁻24). Most studies (n = 12) reported a significant association between neighborhood deprivation and AL. Behaviors and environmental stressors seem to mediate this relationship and associations appear more pronounced among Blacks, men, and individuals with poor social support. Such conclusions have important public health implications as they enforce the idea that neighborhood environment should be improved to prevent physiological dysregulation and consequent chronic diseases.
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Affiliation(s)
- Ana Isabel Ribeiro
- EPIUnit⁻Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal.
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal.
| | - Joana Amaro
- EPIUnit⁻Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal.
| | - Cosima Lisi
- EPIUnit⁻Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal.
| | - Silvia Fraga
- EPIUnit⁻Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal.
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal.
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McClure E, Feinstein L, Ferrando-Martínez S, Leal M, Galea S, Aiello AE. The Great Recession and Immune Function. THE RUSSELL SAGE FOUNDATION JOURNAL OF THE SOCIAL SCIENCES : RSF 2018; 4:62-81. [PMID: 30288397 PMCID: PMC6168205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The Great Recession precipitated unprecedented home foreclosures increases, but documentation of related neighborhood changes and population health is scant. Using the Detroit Neighborhood Health Study (N = 277), we examined associations between neighborhood-level recession indicators and thymic function, a life course immunological health indicator. In covariate-adjusted multilevel models, each 10 percentage point increase in abandoned home prevalence and 1 percentage point increase in 2009 home foreclosures was associated with 1.7-year and 3.3-year increases in thymic aging, respectively. Associations attenuated after adjustment for neighborhood-level social cohesion, suggesting community ties may buffer recession-related immune aging. Effects of neighborhood stressors were strongest in middle-income households, supporting theory of excess vulnerability in this group. Future research should assess whether ongoing foreclosure and blight reduction efforts improve health for residents of recession impacted neighborhoods.
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Affiliation(s)
- Elizabeth McClure
- The Carolina Population Center and Department of Epidemiology, University of North Carolina at Chapel Hill
| | | | | | - Manuel Leal
- The Laboratory of Immunovirology, Clinic Unit of Infectious Diseases, Microbiology and Preventive Medicine, Institute of Biomedicine of Seville, IBiS, Virgen del Rocio University Hospital, Seville, Spain
| | | | - Allison E Aiello
- The Carolina Population Center and Department of Epidemiology, University of North Carolina at Chapel Hill
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Danos DM, Ferguson TF, Simonsen NR, Leonardi C, Yu Q, Wu XC, Scribner RA. Neighborhood disadvantage and racial disparities in colorectal cancer incidence: a population-based study in Louisiana. Ann Epidemiol 2018; 28:316-321.e2. [PMID: 29678311 DOI: 10.1016/j.annepidem.2018.02.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 01/09/2018] [Accepted: 02/09/2018] [Indexed: 12/17/2022]
Abstract
PURPOSE Colorectal cancer (CRC) continues to demonstrate racial disparities in incidence and survival in the United States. This study investigates the role of neighborhood concentrated disadvantage in racial disparities in CRC incidence in Louisiana. METHODS Louisiana Tumor Registry and U.S. Census data were used to assess the incidence of CRC diagnosed in individuals 35 years and older between 2008 and 2012. Neighborhood concentrated disadvantage index (CDI) was calculated based on the PhenX Toolkit protocol. The incidence of CRC was modeled using multilevel binomial regression with individuals nested within neighborhoods. RESULTS Our study included 10,198 cases of CRC. Adjusting for age and sex, CRC risk was 28% higher for blacks than whites (risk ratio [RR] = 1.28; 95% confidence interval [CI] = 1.22-1.33). One SD increase in CDI was associated with 14% increase in risk for whites (RR = 1.14; 95% CI = 1.10-1.18) and 5% increase for blacks (RR = 1.05; 95% CI = 1.02-1.09). After controlling for differential effects of CDI by race, racial disparities were not observed in disadvantaged areas. CONCLUSION CRC incidence increased with neighborhood disadvantage and racial disparities diminished with mounting disadvantage. Our results suggest additional dimensions to racial disparities in CRC outside of neighborhood disadvantage that warrants further research.
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Affiliation(s)
- Denise M Danos
- Stanley S. Scott Cancer Center, Louisiana State University Health-New Orleans, School of Medicine, New Orleans, LA
| | - Tekeda F Ferguson
- Stanley S. Scott Cancer Center, Louisiana State University Health-New Orleans, School of Medicine, New Orleans, LA; Department of Epidemiology, Louisiana State University Health-New Orleans, School of Public Health, New Orleans, LA.
| | - Neal R Simonsen
- Stanley S. Scott Cancer Center, Louisiana State University Health-New Orleans, School of Medicine, New Orleans, LA
| | - Claudia Leonardi
- Stanley S. Scott Cancer Center, Louisiana State University Health-New Orleans, School of Medicine, New Orleans, LA; Department of Community and Behavioral Health, Louisiana State University Health-New Orleans, School of Public Health, New Orleans, LA
| | - Qingzhao Yu
- Stanley S. Scott Cancer Center, Louisiana State University Health-New Orleans, School of Medicine, New Orleans, LA; Department of Biostatistics, Louisiana State University Health-New Orleans, School of Public Health, New Orleans, LA
| | - Xiao-Cheng Wu
- Department of Epidemiology, Louisiana State University Health-New Orleans, School of Public Health, New Orleans, LA; Louisiana Tumor Registry, Louisiana State University Health-New Orleans, School of Public Health, New Orleans, LA
| | - Richard A Scribner
- Stanley S. Scott Cancer Center, Louisiana State University Health-New Orleans, School of Medicine, New Orleans, LA; Department of Epidemiology, Louisiana State University Health-New Orleans, School of Public Health, New Orleans, LA
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Oates GR, Hamby BW, Bae S, Norena MC, Hart HO, Fouad MN. Bikeshare Use in Urban Communities: Individual and Neighborhood Factors. Ethn Dis 2017; 27:303-312. [PMID: 29158655 DOI: 10.18865/ed.27.s1.303] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Objective Bicycling is an affordable way to increase access to employment, schooling, and services and an effective measure against obesity. Bikeshare programs can make bicycling accessible to diverse populations, but little evidence exists on their adoption in low-resource neighborhoods. Our study examined factors associated with bikeshare use in a metropolitan area in the southern United States. Methods We performed a retrospective cross-sectional analysis of a database of clients (N=815) who rented a bicycle from Zyp Bikeshare in Birmingham, Alabama between October 2015 and November 2016. Individual-level variables included bike use frequency, average speed, total miles traveled, total minutes ridden, bike type (traditional vs electricity-assisted pedelec), membership type, sex, and age. Area-level data aggregated to Census tracts, proxies for neighborhoods, were obtained from the 2010 US Census after geocoding clients' billing addresses. Using exploratory factor analysis, a neighborhood socioeconomic disadvantage index (SDI) was constructed. Bikeshare station presence in a tract was included as a covariate. Multivariate linear regression models, adjusted for clustering on Census tracts, were estimated to determine predictors of bikeshare use. Results In a multivariate regression model of individual and neighborhood characteristics adjusted for clustering, each decile increase in the SDI was associated with a 9% increase in bikeshare use (P<.001). Bikeshare use was also positively associated with speed (.1, P<.001), total miles (.008, P<.001), and pedelec use (1.02, P<.01). Conclusion Higher neighborhood socioeconomic disadvantage is associated with higher bikeshare use. Bikeshare is a viable transportation option in low-resource neighborhoods and may be an effective tool to improve the connectivity, livability, and health of urban communities.
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Affiliation(s)
- Gabriela R Oates
- Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Bryant W Hamby
- Sociology, University of Alabama at Birmingham, Birmingham, AL
| | - Sejong Bae
- Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Maria C Norena
- Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL
| | | | - Mona N Fouad
- Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL
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Oates GR, Hamby BW, Stepanikova I, Knight SJ, Bhatt SP, Hitchcock J, Schumann C, Dransfield MT. Social Determinants of Adherence to Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease. COPD 2017; 14:610-617. [PMID: 29020525 DOI: 10.1080/15412555.2017.1379070] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Adherence to pulmonary rehabilitation (PR) is low. Previous studies have focused on clinical predictors of PR completion. We aimed to identify social determinants of adherence to PR. A cross-sectional analysis of a database of COPD patients (N = 455) in an outpatient PR program was performed. Adherence, a ratio of attended-to-prescribed sessions, was coded as low (<35%), moderate (35-85%), and high (>85%). Individual-level measures included age, sex, race, BMI, smoking status, pack-years, baseline 6-minute walk distance (6MWD: <150, 150-249, ≥250), co-morbidities, depression, and prescribed PR sessions (≤20, 21-30, >30). Fifteen area-level measures aggregated to Census tracts were obtained from the U.S. Census after geocoding patients' addresses. Using exploratory factor analysis, a neighborhood socioeconomic disadvantage index was constructed, which included variables with factor loading >0.5: poverty, public assistance, households without vehicles, cost burden, unemployment, and minority population. Multivariate regression models were adjusted for clustering on Census tracts. Twenty-six percent of patients had low adherence, 23% were moderately adherent, 51% were highly adherent. In the best fitted full model, each decile increase in neighborhood socioeconomic disadvantage increased the risk of moderate vs high adherence by 14% (p < 0.01). Smoking tripled the relative risk of low adherence (p < 0.01), while each increase in 6MWD category decreased that risk by 72% (p < 0.01) and 84% (p < 0.001), respectively. These findings show that, relative to high adherence, low adherence is associated with limited functional capacity and current smoking, while moderate adherence is associated with socioeconomic disadvantage. The distinction highlights different pathways to suboptimal adherence and calls for tailored intervention approaches.
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Affiliation(s)
- Gabriela R Oates
- a Preventive Medicine , University of Alabama at Birmingham , Birmingham , AL , USA
| | - Bryant W Hamby
- b Sociology , University of Alabama at Birmingham , Birmingham , AL , USA
| | - Irena Stepanikova
- b Sociology , University of Alabama at Birmingham , Birmingham , AL , USA
| | - Sara J Knight
- a Preventive Medicine , University of Alabama at Birmingham , Birmingham , AL , USA.,c Birmingham Veterans Affairs Medical Center , Birmingham , AL , USA
| | - Surya P Bhatt
- d Lung Health Center and Pulmonary, Allergy and Critical Care Medicine , University of Alabama at Birmingham , Birmingham , AL , USA
| | - Jason Hitchcock
- e Cardiopulmonary Rehabilitation , University of Alabama at Birmingham , Birmingham , AL , USA
| | - Christopher Schumann
- e Cardiopulmonary Rehabilitation , University of Alabama at Birmingham , Birmingham , AL , USA
| | - Mark T Dransfield
- c Birmingham Veterans Affairs Medical Center , Birmingham , AL , USA.,d Lung Health Center and Pulmonary, Allergy and Critical Care Medicine , University of Alabama at Birmingham , Birmingham , AL , USA
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King KE, Fillenbaum GG, Cohen HJ. A Cumulative Deficit Laboratory Test-based Frailty Index: Personal and Neighborhood Associations. J Am Geriatr Soc 2017; 65:1981-1987. [PMID: 28665517 PMCID: PMC5603383 DOI: 10.1111/jgs.14983] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To explore the association between a newly developed cumulative laboratory-based frailty index (FI) and intrinsic (personal) and extrinsic (social, environmental) characteristics. DESIGN Cross-sectional longitudinal study. SETTING The third and fourth waves of the community-representative, five-county, 10-year Duke Established Populations for Epidemiologic Studies of the Elderly study, carried out in a health service-rich area. PARTICIPANTS Cognitively intact survivors of the third wave (N = 1,740), who provided blood samples for standard laboratory work. MEASUREMENTS Biomarkers (n = 28) were measured to develop a cumulative deficit laboratory test-based FI (Duke FI) derived from standard laboratory tests: SMAC-24 chemistry panel, high-density lipoprotein cholesterol panel, and complete blood count. Information was gathered on scales assessing intrinsic characteristics (personal locus of control, life satisfaction, self-esteem, depressive symptomatology) and extrinsic characteristics (support received from and provided to family and friends, stressful life events, neighborhood disadvantage). RESULTS The newly developed Duke FI had content, construct, concurrent, and predictive validity. In addition to sex, race, and income, the Duke FI was associated at the intrinsic level with locus of control, self-esteem, life satisfaction, and depressive symptomatology (each P < .01) and at the extrinsic level with provision (P < .01) and with receipt of instrumental help (P < .10), social stressors (P < .03), and neighborhood disadvantage (P < .01) in unadjusted analysis; race fully explained neighborhood disadvantage. CONCLUSION Intrinsic (personality) characteristics and personally close extrinsic characteristics (contacts with family and friends, personal stressors) are associated with laboratory test-based frailty, as is neighborhood disadvantage, although in this accessible, health service-rich environment, race fully explained association with neighborhood disadvantage, suggesting that interventions to reduce frailty in residents in such an environment should pay particular attention to characteristics that immediately affect the individual.
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Affiliation(s)
- Katherine E. King
- Department of Community and Family Medicine, Duke University Medical Center, Durham, NC
| | - Gerda G. Fillenbaum
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC
| | - Harvey J. Cohen
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC
- Department of Medicine, Division of Geriatrics, Duke University Medical Center, Durham, NC
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Kane JB, Miles G, Yourkavitch J, King K. Neighborhood context and birth outcomes: Going beyond neighborhood disadvantage, incorporating affluence. SSM Popul Health 2017; 3:699-712. [PMID: 29349258 PMCID: PMC5769105 DOI: 10.1016/j.ssmph.2017.08.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 07/17/2017] [Accepted: 08/13/2017] [Indexed: 11/25/2022] Open
Abstract
Neighborhood affluence protects against the risk of poor birth outcome.
The protective effect of affluence holds for Whites, Blacks, Hispanics and Asians.
Mediation of these pathways by prenatal smoking varies by racial group.
The discourse on neighborhoods and birth outcomes should include affluence.
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Affiliation(s)
- Jennifer B Kane
- Department of Sociology, University of California, Irvine, 4171 Social Sciences Plaza A, Irvine, CA 92697, United States
| | - Gandarvaka Miles
- Department of Epidemiology, University of North Carolina, 2101 McGavran-Greenberg Hall, Chapel Hill, NC 27599-7435, United States
| | - Jennifer Yourkavitch
- Department of Epidemiology, University of North Carolina, 2101 McGavran-Greenberg Hall, Chapel Hill, NC 27599-7435, United States
| | - Katherine King
- Department of Family and Community Medicine, Duke University, Durham, NC 27708, United States
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Lucumi DI, LeBrón AMW, Schulz AJ, Mentz G. Social patterning of cardiovascular and metabolic risk in Colombian adults. ETHNICITY & HEALTH 2017; 22:389-401. [PMID: 27829294 DOI: 10.1080/13557858.2016.1244628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVES To test for differences in cardiovascular and metabolic risk (CMR) by educational attainment and physical capital. To compare CMR among black, indigenous, and mixed populations, accounting for socioeconomic status (SES). DESIGN We conducted multivariate analyses using cross-sectional data from a national survey of Colombian adults (n = 10,814) to examine the social patterning of CMR. In sex/gender-stratified models, a CMR index was regressed on educational attainment, physical capital, ethnicity/race, and age. RESULTS Women with a primary education (OR = 1.64, 95% CI: 1.25, 2.15) had higher age- and ethnicity/race-adjusted odds of CMR than women with more than secondary education. Men with a primary education (OR = 0.67, 95% CI: 0.48, 0.92) had significantly lower adjusted odds of CMR than men with more than secondary education; these associations did not remain significant after adjustments for physical capital. Men in the first (OR = 0.45, 95% CI: 0.36, 0.57) and second (OR = 0.72, 95% CI: 0.57, 0.91) physical capital tertiles had significantly lower adjusted odds of CMR than those in the highest tertile. There was not a significant patterning of CMR by ethnicity/race for women or men, or by physical capital for women. CONCLUSIONS Findings suggest that for Colombian adults CMR is patterned by SES; these associations differ by sex/gender.
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Affiliation(s)
- Diego I Lucumi
- a School of Government , Universidad de los Andes , Bogotá , Colombia
| | - Alana M W LeBrón
- b Program in Public Health , University of California , Irvine , CA , USA
- c Department of Chicano/Latino Studies , University of California , Irvine , CA , USA
| | - Amy J Schulz
- d Department of Health Behavior and Health Education , University of Michigan School of Public Health , Ann Arbor , MI , USA
| | - Graciela Mentz
- d Department of Health Behavior and Health Education , University of Michigan School of Public Health , Ann Arbor , MI , USA
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Scribner RA, Simonsen NR, Leonardi C. The Social Determinants of Health Core: Taking a Place-Based Approach. Am J Prev Med 2017; 52:S13-S19. [PMID: 27989288 PMCID: PMC6540790 DOI: 10.1016/j.amepre.2016.09.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 08/31/2016] [Accepted: 09/19/2016] [Indexed: 12/16/2022]
Abstract
INTRODUCTION There is growing recognition that health disparities research needs to incorporate social determinants in the local environment into explanatory models. In the transdisciplinary setting of the Mid-South Transdisciplinary Collaborative Center (TCC), the Social Determinants of Health (SDH) Core developed an approach to incorporating SDH across a variety of studies. This place-based approach, which is geographically based, transdisciplinary, and inherently multilevel, is discussed. METHODS From 2014 through 2016, the SDH Core consulted on a variety of Mid-South TCC research studies with the goal of incorporating social determinants into their research designs. The approach used geospatial methods (e.g., geocoding) to link individual data files with measures of the physical and social environment in the SDH Core database. Once linked, the method permitted various types of analysis (e.g., multilevel analysis) to determine if racial disparities could be explained in terms of social determinants in the local environment. RESULTS The SDH Core consulted on five Mid-South TCC research projects. In resulting analyses for all the studies, a significant portion of the variance in one or more outcomes was partially explained by a social determinant from the SDH Core database. CONCLUSIONS The SDH Core approach to addressing health disparities by linking neighborhood social and physical environment measures to an individual-level data file proved to be a successful approach across Mid-South TCC research projects.
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Affiliation(s)
- Richard A Scribner
- Louisiana Cancer Research Center, School of Public Health, Louisiana State University, New Orleans, Louisiana.
| | - Neal R Simonsen
- Louisiana Cancer Research Center, School of Public Health, Louisiana State University, New Orleans, Louisiana
| | - Claudia Leonardi
- Louisiana Cancer Research Center, School of Public Health, Louisiana State University, New Orleans, Louisiana
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Brenner AB, Clarke PJ. Understanding Socioenvironmental Contributors to Racial and Ethnic Disparities in Disability Among Older Americans. Res Aging 2016; 40:103-130. [PMID: 27909061 DOI: 10.1177/0164027516681165] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Our understanding of the mechanisms through which racial/ethnic disparities in disability in older adults develop and are maintained is limited. We examined the role of physical impairment, socioeconomic factors and health for racial/ethnic disparities in activities of daily living (ADL), and the modifying role of the indoor home environment. Data come from the National Health and Aging Trends Study ( N = 5,640), and negative binomial regression models were specified separately for men and women. Blacks and Hispanics reported more ADL difficulty than Whites. Living in homes with clutter was associated with higher rates of ADL difficulty, but it was not related to racial/ethnic disparities. Racial/ethnic differences were explained by physical impairment for men, but not for women. Socioeconomic factors and health accounted for remaining disparities for Black, but not for Hispanic women. Attention to individual and environmental factors is necessary to fully understand and address race/ethnic disparities in disability in older Americans.
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Affiliation(s)
- Allison B Brenner
- 1 Survey Research Center at the Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Philippa J Clarke
- 1 Survey Research Center at the Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
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Kabisch N, Haase D, Annerstedt van den Bosch M. Adding Natural Areas to Social Indicators of Intra-Urban Health Inequalities among Children: A Case Study from Berlin, Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:E783. [PMID: 27527197 PMCID: PMC4997469 DOI: 10.3390/ijerph13080783] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 07/07/2016] [Accepted: 07/21/2016] [Indexed: 12/20/2022]
Abstract
Research suggests that there is a relationship between the health of urban populations and the availability of green and water spaces in their daily environment. In this paper, we analyze the potential intra-urban relationships between children's health determinants and outcomes and natural areas in Berlin, Germany. In particular, health indicators such as deficits in viso-motoric development in children are related to environmental indicators such as the natural area cover, natural area per capita and distance to natural areas; however, these indicators are also correlated with social determinants of health. The methodological approach used in this study included bivariate and multivariate analyses to explore the relations between health inequalities and social, socio-economic, and land use parameters. The results on a sub-district level indicated that there was a correlation between natural areas and social health determinants, both of which displayed a certain intra-urban spatial pattern. In particular, a lower percentage of natural area cover was correlated with deficits in viso-motoric development. However, results with percentage of natural area cover and per capita natural area with childhood overweight were not conclusive. No significant correlation was found for percentage of natural area cover and overweight, while significant negative correlation values were found between overweight and per capita natural area. This was identified particularly in the districts that had lower social conditions. On the other hand, the districts with the highest social conditions had the comparatively lowest levels of complete measles immunization. This study may facilitate public health work by identifying the urban areas in which the strengthening of health resources and actions should be prioritized and also calls for the inclusion of natural areas among the social health indicators included in intra-urban health inequality tools.
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Affiliation(s)
- Nadja Kabisch
- Department of Geography, Humboldt-Universität zu Berlin, Berlin 10099, Germany.
- Department of Ecosystem Services, Helmholtz Centre for Environmental Research-UFZ, Leipzig 04318, Germany.
- German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Leipzig 04103, Germany.
| | - Dagmar Haase
- Department of Geography, Humboldt-Universität zu Berlin, Berlin 10099, Germany.
- Department of Computational Landscape Ecology, Helmholtz Centre for Environmental Research-UFZ, Leipzig 04318, Germany.
| | - Matilda Annerstedt van den Bosch
- Department of Work Science, Business Economics and Environmental Psychology, Swedish University of Agricultural Sciences, Alnarp 23053, Sweden.
- School of Population and Public Health and Department of Forest and Conservation Sciences, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
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Fleckman JM, Drury SS, Taylor CA, Theall KP. Role of Direct and Indirect Violence Exposure on Externalizing Behavior in Children. J Urban Health 2016; 93:479-92. [PMID: 27184572 PMCID: PMC4899335 DOI: 10.1007/s11524-016-0052-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The objective of this study was to examine the association between externalizing behaviors and indirect violence exposure, assessed both within the household and at the community level, as well as the interaction effect of indirect and direct violence exposure. A sample of parents of children ages 4-15 who have not been referred or enrolled in child welfare (n = 82) were recruited from the greater New Orleans community. Externalizing behavior was assessed with the Child Behavior Checklist (CBCL). The child's indirect exposure to violence included witnessing community violence, witnessing physical assault, and witnessing fighting or domestic violence at home. Direct exposure to violence included the child experiencing physical aggression from a caregiver. All assessments were based on caregiver reports. To decrease potential for confounding, children were matched for analysis based on age, Hurricane Katrina exposure, and their propensity to be exposed to high indirect violence. Cumulative indirect exposure to violence was significantly positively correlated with CBCL scores. After controlling for key covariates, CBCL externalizing T score increased significantly by approximately 1.25 points for each level increase in indirect violence exposure (β = 1.25, SE = 0.57, p = 0.027). There also was a significant interaction between indirect and direct exposure to violence in the association with CBCL score (β = -0.08, SE = 0.03, p = 0.002). These findings extend previous research by demonstrating that exposure to both direct and cross-contextual indirect violence influences externalizing behaviors in children. Additionally, the findings suggest that community and household social environments are both important targets for interventions designed to decrease externalizing behaviors and improve long-term outcomes for youth at risk of exposure to violence.
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Affiliation(s)
- Julia M Fleckman
- Department of Global Community Health and Behavioral Sciences, Tulane School of Public Health and Tropical Medicine, 1440 Canal St., Suite 2300, New Orleans, LA, 70112, USA.
| | - Stacy S Drury
- Department of Psychiatry and Behavioral Sciences, Tulane School of Medicine, 1440 Canal St., Suite 1000, New Orleans, LA, 70112, USA
| | - Catherine A Taylor
- Department of Global Community Health and Behavioral Sciences, Tulane School of Public Health and Tropical Medicine, 1440 Canal St., Suite 2300, New Orleans, LA, 70112, USA
| | - Katherine P Theall
- Department of Global Community Health and Behavioral Sciences, Tulane School of Public Health and Tropical Medicine, 1440 Canal St., Suite 2300, New Orleans, LA, 70112, USA
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