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Zhu F, Yu H, Fan X, Ding Z, Wang Q, Zhou J. Particulate air pollution and cardiovascular disease mortality in Jiangsu Province, China: a time-series analysis between 2015 and 2021. Front Public Health 2023; 11:1218479. [PMID: 38174084 PMCID: PMC10761421 DOI: 10.3389/fpubh.2023.1218479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 11/30/2023] [Indexed: 01/05/2024] Open
Abstract
Introduction Previous time-series studies have revealed a positive association between particulate matter (PM) and acute cardiovascular effects. However, the evidence mostly comes from developed countries and regions, while the majority of air-pollution-related deaths occur in developing countries. To assess the effect of short-term exposure to PM on daily cause-specific cardiovascular disease (CVD) mortality in Jiangsu Province, China, we investigated 1,417,773 CVD deaths from 2015 to 2021 in Jiangsu. Methods The city-specific association was estimated using generalized additive models with quasi-Poisson regression, and then, random effects meta-analysis was performed to estimate the pooled provincial-average associations between acute exposure to PM2.5 and PM10 and cardiovascular disease mortality. To test the independence of PM from gaseous pollutants, we fitted two-pollutant models. Mortality data were also stratified by sex, age, and region to investigate the modification of associations. The exposure-response (E-R) curve from each city was combined using meta-analysis to drive the provincial-level E-R curve. Results The results showed that each 10-μg/m3 increase in the PM2.5 concentration was associated with a 0.723% [95% confidence interval (CI): 0.512, 0.935] increase in daily total CVD mortality, a 0.669% (95% CI: 0.461, 0.878) increase in CHD mortality, a 0.758% (95% CI: 0.584, 0.931) increase in stroke mortality, a 0.512% (95% CI: 0.245, 0.780) increase in ICH mortality, and a 0.876% (95% CI: 0.637, 1.116) increase in CI mortality. The corresponding increases in daily mortality rates for the same increase in the PM10 concentration were 0.424% (95% CI: 0.293, 0.556), 0.415% (95% CI: 0.228, 0.602), 0.444% (95% CI: 0.330, 0.559), 0.276% (95% CI: 0.026, 0.526), and 0.510% (95% CI: 0.353, 0.667), respectively. The association between PM and total CVD mortality remained significant after adjusting for gaseous pollutants. Females, older adults and districts with lower average PM levels are more sensitive, especially for PM10. The E-R curve for PM on CVD mortality is steeper at lower concentrations and flattens out at higher concentrations. The estimates remained generally consistent in sensitivity analyses when excluding the data during the COVID-19 pandemic period. Discussion Our time-series study provides evidence of positive associations between acute exposure to PM2.5 and PM10 and total and cause-specific cardiovascular disease mortality in developing countries.
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Affiliation(s)
- Fangyu Zhu
- Department of Non-communicable Chronic Disease and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Hao Yu
- Department of Non-communicable Chronic Disease and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Xikang Fan
- Department of Non-communicable Chronic Disease and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Zhen Ding
- Department of Environmental Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Qingqing Wang
- Department of Environmental Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Jinyi Zhou
- Department of Non-communicable Chronic Disease and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
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Urbano S, Gobbi E, Florio V, Rughetti A, Ercoli L. Protection of gender health and fight against gender violence during the COVID-19 pandemic: the experience of our street clinic in a disadvantaged suburb of Rome Metropolitan City. BMC Womens Health 2023; 23:434. [PMID: 37587488 PMCID: PMC10428561 DOI: 10.1186/s12905-023-02595-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 08/09/2023] [Indexed: 08/18/2023] Open
Abstract
OBJECT In this study, we evaluated health, social inequalities and risk to gender violence of women living in a disadvantaged degraded suburb of Rome Metropolitan City, during COVID-19 pandemic. METHODS The study included 779 women referring to primary care services of Medicina Solidale Institute for gynecological/breast examinations (209), medical and support aid for the children (383) and COVID-19 test execution (187). RESULTS The data show that most women (68%) were unemployed or had an irregular job. The request of support varied depending on the ethnicity: while healthcare support was requested mostly by African female community, the COVID-19 test, mandatory for public transportation and work, was a need of the east-european community. Both these communities referred to Medical Solidale primary care service for the healthcare and food/clothing support for their children. It is interesting to note that the requests from the Italian women community was elevated in terms of personal healthcare, support for the children and COVID-19 test execution. The access to the national health system (NHS) resulted a complex administrative procedure despite the original social-ethnic communities. The vast majority of women lacked awareness of their crucial role for supporting the family entity, while inadequacy was commonly reported. CONCLUSIONS This study confirms a critical condition for women living in disadvantaged neighborhoods, whose vulnerability is further worsened by the limited access to primary care assistance with serious consequences for health and quality of life. Prevention and treatment, especially for the most vulnerable subjects, should be a priority for the public health system.
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Affiliation(s)
| | | | - Valeria Florio
- Gynecology Department, Fatebenefratelli Hospital, Rome, Italy
| | - Aurelia Rughetti
- Istituto Di Medicina Solidale Onlus, Rome, Italy
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Lucia Ercoli
- Istituto Di Medicina Solidale Onlus, Rome, Italy.
- Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy.
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Azizi Z, Alipour P, Raparelli V, Norris CM, Pilote L. The role of sex and gender in hypertension. J Hum Hypertens 2023; 37:589-595. [PMID: 36509989 DOI: 10.1038/s41371-022-00789-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 11/18/2022] [Accepted: 11/30/2022] [Indexed: 12/14/2022]
Abstract
Hypertension (HTN) is a critical primary modifiable risk factor for the development of cardiovascular diseases, with recognized sex-based differences. While sex refers to one's biological genetic makeup and attributes, gender encompasses the individual's psycho-socio-cultural characteristics, including their environment and living conditions. The impact of each gendered variable may differ amongst men and women with respect to HTN. Applying a sex and gender-based lenses to inform our understanding of HTN has the potential to unveil important contributors of HTN-related cardiovascular outcomes. For instance, increased life stressors, work related anxiety and depression, typically have more pronounced effect on women than men with HTN. The impact of social surrounding including marital status and social support on HTN also differs amongst men and women. While married men are less likely to have higher blood pressure, single women, and those who never married are less likely to have HTN. Additionally, the beneficial role of social support is more pronounced in more historically marginalized cultural groups compared to majority. Finally, socioeconomic status, including education level and income have a linear and inverse relationship in blood pressure control in more resource-rich countries. The aim of this review is to summarize how sex and gender interact in shaping the clinical course of HTN demonstrating the importance of both sex and gender in HTN risk and its treatment. Hence, when investigating the role of gendered factors in HTN it is imperative to consider cultural, and social settings. In this narrative we found that employment and education play a significant role in manifestation and control of HTN particularly in women.
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Affiliation(s)
- Zahra Azizi
- Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montreal, QC, Canada
| | - Pouria Alipour
- Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montreal, QC, Canada
- Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Valeria Raparelli
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
- University Center for Studies on Gender Medicine, University of Ferrara, Ferrara, Italy
- Faculty of Nursing, Medicine, and School of Public Health Sciences University of Alberta, Edmonton, AB, Canada
| | - Colleen M Norris
- Faculty of Nursing, Medicine, and School of Public Health Sciences University of Alberta, Edmonton, AB, Canada
- Heart and Stroke Strategic Clinical Networks-Alberta Health Services, Edmonton, AB, Canada
| | - Louise Pilote
- Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montreal, QC, Canada.
- Divisions of Clinical Epidemiology and General Internal Medicine, McGill University Health Centre Research Institute, Montreal, QC, Canada.
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Shen J, Ma Y, Zhang Y, Zhang C, Wang W, Qin P, Yang L. Temperature modifies the effects of air pollutants on respiratory diseases. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:61778-61788. [PMID: 36933135 DOI: 10.1007/s11356-023-26322-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 03/03/2023] [Indexed: 05/10/2023]
Abstract
Increasing studies have reported temperature modification effects on air pollutants-induced respiratory diseases. In the current study, daily data of respiratory emergency room visits (ERVs), meteorological factors, and concentrations of air pollutants were collected from 2013 to 2016 in Lanzhou, a northwest city in China. Daily average temperature was stratified into low (≤ 25 percentile, P25), medium (25-75 percentile, P25-P75) and high (≥ 75 percentile, P75) to explore how temperature modifies the effects of air pollutants (PM2.5, PM10, SO2, and NO2) on respiratory ERVs by using generalized additive Poisson regression model (GAM). Seasonal modification was also investigated. Results showed that (a) PM10, PM2.5, and NO2 had the strongest effects on respiratory ERVs in low temperature; (b) males and 15-and-younger were more vulnerable in low temperature while females and those older than 46 years were highly affected in high temperature; (c) PM10, PM2.5, and NO2 were mostly associated with the total and both males and females in winter, while SO2 resulted in the highest risk for the total and males in autumn and females in spring. In conclusion, this study found significant temperature modification effects and seasonal differences on the risks of respiratory ERVs due to air pollutants in Lanzhou, China.
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Affiliation(s)
- Jiahui Shen
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Yuxia Ma
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Yifan Zhang
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Caixia Zhang
- First People's Hospital of Dingxi, Dingxi, 743000, China.
| | - Wanci Wang
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Pengpeng Qin
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Lijie Yang
- Qingyang Meteorological Bureau, Qingyang, 745000, China
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Ma H, Liu F, Li J, Chen J, Cao J, Chen S, Liu X, Yang X, Huang K, Shen C, Yu L, Zhao Y, Wu X, Zhao L, Li Y, Hu D, Huang J, Lu X, Gu D. Sex Differences in Associations Between Socioeconomic Status and Incident Hypertension Among Chinese Adults. Hypertension 2023; 80:783-791. [PMID: 36695186 DOI: 10.1161/hypertensionaha.122.20061] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND With rapid socioeconomic development and transition, associations between socioeconomic status (SES) and hypertension remained uncertain in China. We aimed to examine the health effects of SES on hypertension incidence and explore the sex differences among Chinese adults. METHODS We included 53 891 participants without hypertension from the China-PAR (Prediction for Atherosclerotic Cardiovascular Disease Risk in China) project. SES was evaluated by education level, occupation prestige, and household monthly per capita income, and categorized into low, medium, and high groups. Hazard ratios and their 95% CIs were calculated using Cox proportional hazards regression models. RESULTS Compared with high SES, participants with medium SES (hazard ratio, 1.142 [95% CI, 1.068-1.220]) or low SES (hazard ratio, 1.166 [95% CI, 1.096-1.241]) had increased risks of incident hypertension in multivariate analyses. Interactions between SES and sex on hypertension were observed, with more pronounced adverse effects of lower SES among women. The corresponding hazard ratios (95% CIs) for low SES group were 1.270 (1.155-1.397) for women and 1.086 (0.999-1.181) for men. Effects of occupation prestige on hypertension were the strongest among SES factors. CONCLUSIONS Our study provided the compelling evidence from China that lower SES was associated with incident hypertension and women were more susceptible. These findings will have substantial implications on future hypertension prevention and management, especially among women. Sex-specific approaches are warranted to reduce socioeconomic disparities.
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Affiliation(s)
- Han Ma
- Department of Epidemiology, Key Laboratory of Cardiovascular Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China (H.M., F.L., J.L., J. Chen, J. Cao, S.C., K.H., L.Z., Y.L., J.H., X. Lu, D.G.)
| | - Fangchao Liu
- Department of Epidemiology, Key Laboratory of Cardiovascular Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China (H.M., F.L., J.L., J. Chen, J. Cao, S.C., K.H., L.Z., Y.L., J.H., X. Lu, D.G.)
| | - Jianxin Li
- Department of Epidemiology, Key Laboratory of Cardiovascular Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China (H.M., F.L., J.L., J. Chen, J. Cao, S.C., K.H., L.Z., Y.L., J.H., X. Lu, D.G.)
| | - Jichun Chen
- Department of Epidemiology, Key Laboratory of Cardiovascular Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China (H.M., F.L., J.L., J. Chen, J. Cao, S.C., K.H., L.Z., Y.L., J.H., X. Lu, D.G.)
| | - Jie Cao
- Department of Epidemiology, Key Laboratory of Cardiovascular Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China (H.M., F.L., J.L., J. Chen, J. Cao, S.C., K.H., L.Z., Y.L., J.H., X. Lu, D.G.)
| | - Shufeng Chen
- Department of Epidemiology, Key Laboratory of Cardiovascular Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China (H.M., F.L., J.L., J. Chen, J. Cao, S.C., K.H., L.Z., Y.L., J.H., X. Lu, D.G.)
| | - Xiaoqing Liu
- Division of Epidemiology, Guangdong Provincial People's Hospital and Cardiovascular Institute, Guangzhou, China (X. Liu)
| | - Xueli Yang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China (X.Y.)
| | - Keyong Huang
- Department of Epidemiology, Key Laboratory of Cardiovascular Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China (H.M., F.L., J.L., J. Chen, J. Cao, S.C., K.H., L.Z., Y.L., J.H., X. Lu, D.G.)
| | - Chong Shen
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China (C.S.)
| | - Ling Yu
- Department of Cardiology, Fujian Provincial Hospital, Fuzhou, China (L.Y.)
| | - Yingxin Zhao
- Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, China (Y.Z.)
| | - Xianping Wu
- Center for Chronic and Noncommunicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, China (X.W.)
| | - Liancheng Zhao
- Department of Epidemiology, Key Laboratory of Cardiovascular Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China (H.M., F.L., J.L., J. Chen, J. Cao, S.C., K.H., L.Z., Y.L., J.H., X. Lu, D.G.)
| | - Ying Li
- Department of Epidemiology, Key Laboratory of Cardiovascular Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China (H.M., F.L., J.L., J. Chen, J. Cao, S.C., K.H., L.Z., Y.L., J.H., X. Lu, D.G.)
| | - Dongsheng Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China (D.H.).,Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, China (D.H.)
| | - Jianfeng Huang
- Department of Epidemiology, Key Laboratory of Cardiovascular Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China (H.M., F.L., J.L., J. Chen, J. Cao, S.C., K.H., L.Z., Y.L., J.H., X. Lu, D.G.)
| | - Xiangfeng Lu
- Department of Epidemiology, Key Laboratory of Cardiovascular Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China (H.M., F.L., J.L., J. Chen, J. Cao, S.C., K.H., L.Z., Y.L., J.H., X. Lu, D.G.)
| | - Dongfeng Gu
- Department of Epidemiology, Key Laboratory of Cardiovascular Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China (H.M., F.L., J.L., J. Chen, J. Cao, S.C., K.H., L.Z., Y.L., J.H., X. Lu, D.G.).,School of Public Health and Emergency Management, School of Medicine, Southern University of Science and Technology, Shenzhen, China (D.G.)
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Inequities in paid parental leave across industry and occupational class: Drivers and simulated policy remedies. SSM Popul Health 2022; 18:101045. [PMID: 35372660 PMCID: PMC8971637 DOI: 10.1016/j.ssmph.2022.101045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 01/14/2022] [Accepted: 02/07/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction Paid family leave (PFL) has the potential to reduce persistent health disparities. This study aims to characterize differences in access to paid leave by industry sector and occupational class. Methods The Bay Area Parental Leave Survey of Mothers included respondents 18 years of age or older who worked in the San Francisco Bay Area and gave birth from 2016 to 2017. Using linear probability models, we examined differences in five separate measures of PFL by industry sector and occupational class. We extended our regression analysis to simulate the full pay equivalent (FPE) weeks of leave that would have been taken under hypothetical scenarios of increased uptake and wage replacement rates. Results Our study included 806 women in private for-profit or non-profit jobs. In fully adjusted models, blue-collar workers were 10.9% less likely to take 12 weeks of paid parental leave versus white-collar workers (95% CI: -25.9, 4.1). Respondents were 19.2% less likely receive 100% of their regular pay if they worked in education and health services (−29.1, −9.3) and 17.0% less likely if they worked in leisure and hospitality (−29.5, −4.4) versus respondents in professional and financial services. Respondents in leisure and hospitality reported 1.6 fewer FPE weeks of leave versus respondents in professional and financial services (−2.73, −0.42) and blue-collar respondents reported an average of 1.5 fewer FPE weeks versus white-collar workers (−2.66, −0.42). In our simulation analysis, when we manipulated rates of uptake for paid leave, the disparities in FPE by industry sector and occupational class were eliminated. Conclusion We observed substantial inequities in access to paid leave by industry sector and occupational class. These findings underscore the potential importance of universal PFL programs with universal benefits to reduce clear inequities that persist within the labor market today. Paid family leave (PFL) has the potential to reduce persistent health disparities. Many US workers rely on their employers to voluntarily provide leave or go without PFL altogether. We explore PFL access across the labor market among mothers in the SF Bay Area. Access to PFL is limited among blue-collar and leisure and hospitality workers. Further policy interventions aimed at increasing uptake are needed.
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Chantarat T, Enns EA, Hardeman RR, McGovern PM, Myers SL, Dill J. Occupational Segregation And Hypertension Inequity: The Implication Of The Inverse Hazard Law Among Healthcare Workers. JOURNAL OF ECONOMICS, RACE, AND POLICY 2022; 5:267-282. [PMID: 35341024 PMCID: PMC8938730 DOI: 10.1007/s41996-022-00098-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 02/02/2022] [Accepted: 02/03/2022] [Indexed: 01/07/2023]
Abstract
In the United States (US), Black-particularly Black female-healthcare workers are more likely to hold occupations with high job demand, low job control with limited support from supervisors or coworkers and are more vulnerable to job loss than their white counterparts. These work-related factors increase the risk of hypertension. This study examines the extent to which occupational segregation explains the persistent racial inequity in hypertension in the healthcare workforce and the potential health impact of workforce desegregation policies. We simulated a US healthcare workforce with four occupational classes: health diagnosing professionals (i.e., highest status), health treating professionals, healthcare technicians, and healthcare aides (i.e., lowest status). We simulated occupational segregation by allocating 25-year-old workers to occupational classes with the race- and gender-specific probabilities estimated from the American Community Survey data. Our model used occupational class attributes and workers' health behaviors to predict hypertension over a 40-year career. We tracked the hypertension prevalence and the Black-white prevalence gap among the simulated workers under the staus quo condition (occupational segregation) and the experimental conditions in which occupational segregation was eliminated. We found that the Black-white hypertension prevalence gap became approximately one percentage point smaller in the experimental than in the status quo conditions. These findings suggest that policies designed to desegregate the healthcare workforce may reduce racial health inequities in this population. Our microsimulation may be used in future research to compare various desegregation policies as they may affect workers' health differently. Supplementary Information The online version contains supplementary material available at 10.1007/s41996-022-00098-5.
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Affiliation(s)
- Tongtan Chantarat
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN 55455 USA
- Center for Antiracism Research for Health Equity, School of Public Health, University of Minnesota, Minneapolis, MN 55455 USA
| | - Eva A. Enns
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN 55455 USA
| | - Rachel R. Hardeman
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN 55455 USA
- Center for Antiracism Research for Health Equity, School of Public Health, University of Minnesota, Minneapolis, MN 55455 USA
| | - Patricia M. McGovern
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN 55455 USA
| | - Samuel L. Myers
- Hubert H. Humphrey School of Public Affairs, University of Minnesota, Minneapolis, MN 55455 USA
| | - Janette Dill
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN 55455 USA
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Guo J, Lv W, Jiang S, Tang Y, Long Q, Yang J, Wiley JA, Parry M. Biological and sociocultural determinants of increased blood pressure among women with a history of gestational diabetes mellitus in rural China: a retrospective cohort study. BMJ Open 2022; 12:e049625. [PMID: 35063956 PMCID: PMC8785171 DOI: 10.1136/bmjopen-2021-049625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Gestational diabetes mellitus (GDM) increases the risk of hypertension and cardiovascular events among mothers later in life. This risk has not been well recognised by healthcare professionals in rural China. Our objectives were to (1) describe the proportion of rural women with increased blood pressure and a history of GDM; and (2) explore the biological and sociocultural factors associated with increased blood pressure. DESIGN A retrospective cohort study using data from a cross-sectional survey. SETTING Data were collected in two county-level hospitals in the central south of China between November 2017 and June 2018. PARTICIPANTS Postpartum women aged >18 years with a history of GDM (N=397). METHODS Biological and sociocultural variables were examined. We used bivariate analyses to examine the associations between time since delivery and 2-hour postload glucose, and logistic regression to determine the biological and sociocultural factors associated with increased postpartum blood pressure. RESULTS Approximately 20% (n=78) of women had increased blood pressure, defined as a systolic blood pressure ≥130 mm Hg and/or a diastolic blood pressure ≥85 mm Hg. The biological factors of advanced age, family history of hypertension and abnormal 2-hour postload plasma glucose levels were positively associated with increased blood pressure (p<0.05). General self-efficacy was the only sociocultural factor negatively associated with increased blood pressure (p<0.05). CONCLUSIONS One in five rural Chinese postpartum women with a history of GDM were found to have increased blood pressure. Biological and sociocultural factors were associated with increased postpartum blood pressure; women with lower general self-efficacy were more likely to have increased blood pressure. Disseminating knowledge about the high risk of developing increased blood pressure among women with prior GDM in rural China is indicated. Diabetes prevention programmes could consider adding general self-efficacy promotion strategies in this population.
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Affiliation(s)
- Jia Guo
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Wencong Lv
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Shan Jiang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Yujia Tang
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
| | - Qing Long
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Jundi Yang
- School of Nursing, The University of Hong Kong, Hong Kong, Hong Kong
| | - James Allen Wiley
- Department of Family and Community Medicine, University of California, San Francisco, California, USA
| | - Monica Parry
- Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
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Socioeconomic disparities and risk of hypertension among older Americans: the Health and Retirement Study. J Hypertens 2021; 39:2497-2505. [PMID: 34387572 DOI: 10.1097/hjh.0000000000002959] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Reducing hypertension represents a critical point of intervention to lower the burden of cardiovascular disease worldwide. Although the relationship between lower socioeconomic status and higher rates of hypertension is well documented, most of the evidence comes from prevalence studies involving young adult population. AIM To investigate the independent association of wealth, education and income with incident hypertension among older adults living in the United States. METHODS This cohort study included 16 587 individuals aged 50 years and older, free of hypertension and cardiovascular disease at baseline from the Health and Retirement Study over the period 1992-2014. We used Cox proportional hazards models to examine longitudinal associations between wealth, education, and income at baseline and self-reported diagnosis of incident hypertension. RESULTS During a median follow-up of 7.8 years, 6817 participants declared an occurrence of hypertension (incidence rate: 45.3 [95% confidence interval (CI) = 44.2-46.4] per 1000 person-years). Overall, those in low as compared with high socioeconomic status groups had a higher risk of developing hypertension in late life. In particular, adjusted hazard ratios [95% CI] across decreasing wealth quartiles were 1.0 (reference), 0.97 [0.88-1.08], 1.17 [1.05-1.30], and 1.20 [1.07-1.35] in men, and 1.0 (reference), 1.28 [1.17-1.41], 1.21 [1.09-1.33], and 1.28 [1.16-1.42] in women. In multivariate analyses, wealth remained strongly associated with incident hypertension among women after accounting for other socioeconomic, behavioral and anthropometric risk factors. CONCLUSIONS Socioeconomic status, especially wealth, is a strong independent predictor of incident hypertension in older adults. Our findings support population-based interventions tailored to those in disadvantaged socioeconomic groups to reduce the risk of hypertension.
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Ralli M, Urbano S, Gobbi E, Shkodina N, Mariani S, Morrone A, Arcangeli A, Ercoli L. Health and Social Inequalities in Women Living in Disadvantaged Conditions: A Focus on Gynecologic and Obstetric Health and Intimate Partner Violence. Health Equity 2021; 5:408-413. [PMID: 34235365 PMCID: PMC8237099 DOI: 10.1089/heq.2020.0133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2021] [Indexed: 11/12/2022] Open
Abstract
Purpose: Gynecologic and obstetric health and intimate partner violence are particularly influenced by social determinants of health, such as poverty, low education, and poor nutritional status, and by ethnic and racial factors. In this study, we evaluated health and social inequalities of women living in disadvantaged neighborhoods in the city of Rome, Italy. Methods: The study included 128 women living in socioeconomically disadvantaged neighborhoods. For each woman, a medical record was compiled and a gynecologic examination with screening for cervical cancer was performed. Family network, risk factors for gender-based violence, and psychological abuse were also evaluated. Results: The largest part of the sample, although had adequate schooling, was unemployed or had a low-status job; this was at the basis of intimate partner violence in about one-third of our sample. Nearly 35% of our sample was composed of pregnant women; about half of them were not assisted by the public health system for routine obstetric examinations. Common findings at gynecologic examination for nonpregnant women were infections (n=18, 19.9%), pregnancy planning (n=13, 13.7%), menopause management (n=12, 12.6%), ovarian fibromas (n=6, 6.3%), and post-partum assistance (n=3, 3.2%). Screening for cervical cancer was executed in 62 women; 9 (14.5%) had low- or high-grade squamous intraepithelial lesion or cervical carcinoma. Conclusions: Health and social inequalities are frequent in women living in disadvantaged conditions, with serious consequences for health and quality of life of women and of their children. Prevention and treatment, especially for the most vulnerable subjects, should be a priority for the public health system.
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Affiliation(s)
- Massimo Ralli
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy.,Primary Care Services, Eleemosynaria Apostolica, Vatican City State, Vatican City
| | - Suleika Urbano
- Primary Care Services, Eleemosynaria Apostolica, Vatican City State, Vatican City.,Istituto di Medicina Solidale, Rome, Italy
| | | | - Nataliya Shkodina
- Primary Care Services, Eleemosynaria Apostolica, Vatican City State, Vatican City.,Istituto di Medicina Solidale, Rome, Italy
| | | | - Aldo Morrone
- San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Andrea Arcangeli
- Directorate of Health and Hygiene, Vatican City State, Vatican City.,Department of Anesthesiology, Intensive Care and Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Lucia Ercoli
- Primary Care Services, Eleemosynaria Apostolica, Vatican City State, Vatican City.,Istituto di Medicina Solidale, Rome, Italy.,Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
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11
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A Cumulative Risk Perspective for Occupational Health and Safety (OHS) Professionals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176342. [PMID: 32878292 PMCID: PMC7503320 DOI: 10.3390/ijerph17176342] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/28/2020] [Accepted: 08/19/2020] [Indexed: 12/21/2022]
Abstract
Cumulative risk assessment (CRA) addresses the combined risk associated with chemical and non-chemical exposures. Although CRA approaches are utilized in environmental and ecological contexts, they are rarely applied in workplaces. In this perspectives article, we strive to raise awareness among occupational health and safety (OHS) professionals and foster the greater adoption of a CRA perspective in practice. Specifically, we provide an overview of CRA literature as well as preliminary guidance on when to consider a CRA approach in occupational settings and how to establish reasonable boundaries. Examples of possible workplace co-exposures and voluntary risk management actions are discussed. We also highlight important implications for workplace CRA research and practice. In particular, future needs include simple tools for identifying combinations of chemical and non-chemical exposures, uniform risk management guidelines, and risk communication materials. Further development of practical CRA methods and tools are essential to meet the needs of complex and changing work environments.
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Elser H, Neophytou AM, Tribett E, Galusha D, Modrek S, Noth EM, Meausoone V, Eisen EA, Cantley LF, Cullen MR. Cohort Profile: The American Manufacturing Cohort (AMC) study. Int J Epidemiol 2020; 48:1412-1422j. [PMID: 31220278 DOI: 10.1093/ije/dyz059] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2019] [Indexed: 12/13/2022] Open
Affiliation(s)
- Holly Elser
- Division of Epidemiology, UC Berkeley School of Public Health, Berkeley, CA, USA.,Center for Population Health Sciences, Stanford University, Stanford, CA, USA
| | - Andreas M Neophytou
- Division of Environmental Health Sciences, UC Berkeley School of Public Health, Berkeley, CA, USA.,Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Erika Tribett
- Center for Population Health Sciences, Stanford University, Stanford, CA, USA
| | - Deron Galusha
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Sepideh Modrek
- Department of Economics, San Francisco State University, College of Business, San Francisco, CA, USA
| | - Elizabeth M Noth
- Center for Population Health Sciences, Stanford University, Stanford, CA, USA
| | - Valerie Meausoone
- Center for Population Health Sciences, Stanford University, Stanford, CA, USA
| | - Ellen A Eisen
- Division of Environmental Health Sciences, UC Berkeley School of Public Health, Berkeley, CA, USA
| | - Linda F Cantley
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Mark R Cullen
- Center for Population Health Sciences, Stanford University, Stanford, CA, USA
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Gender differences in the association between socioeconomic status and hypertension in France: A cross-sectional analysis of the CONSTANCES cohort. PLoS One 2020; 15:e0231878. [PMID: 32311000 PMCID: PMC7170232 DOI: 10.1371/journal.pone.0231878] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 04/02/2020] [Indexed: 12/12/2022] Open
Abstract
Background Hypertension prevalence increases when socioeconomic status decreases but gender differences in the relationship between socioeconomic status and hypertension have been less studied. This work aimed to explore the pattern of associations between three indicators of socioeconomic status at individual, household, and municipal levels with hypertension across genders in a large sample of French adults from the CONSTANCES cohort. Methods Using data at inclusion from 59 805 participants (52% women) aged 25–69 years and recruited between 2012 and 2015, multilevel log-Poisson regressions with robust variance estimates were used to assess the associations of Relative Index of Inequality in education, monthly income per consumption unit and residential deprivation with hypertension. Modifying effects of gender and age in those associations were tested. Results Hypertension prevalence was higher in men than in women. Steep socioeconomic gradients of hypertension were observed for the three socioeconomic indicators in both genders and from the youngest to the oldest age class. Socioeconomic inequalities, especially educational inequalities, were larger among women than men: Relative Index of Inequality for highest versus lowest education among the 25–34 years were 0.43 [95%-confidence interval = 0.28–0.67] in women and 0.70 [95%-confidence interval = 0.53–0.92] in men. With increasing age, socioeconomic gradients of hypertension eased in men and even more in women so that gender differences decreased. Conclusions In this cross-sectional analysis of a large sample of adults, prevalence of hypertension was higher in men than in women. Moreover, socioeconomic status and especially education displayed a stronger association with hypertension prevalence in women compared to men. Reducing inequalities in hypertension may require gender-specific approaches.
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14
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Ganguly BB, Kadam NN. Age-related disease burden in Indian population. J Natl Med Assoc 2019; 112:57-73. [PMID: 31759676 DOI: 10.1016/j.jnma.2019.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 04/09/2019] [Accepted: 10/22/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Aging is not just a consequence of wear-and-tear, but it is the inappropriate regenerative mechanism of the stem cells. Aging is directly proportional to increase in health-problems involving all organs and physiological systems - more of non-communicable types. On the other hand, medical advancement and awareness about health-care are increasing the life expectancy, which could outnumber the young generation or the mainstream of work-force gradually. Hence, understanding of disease-prevalence is essential with a view to making necessary medical, environmental and economic arrangements and offering holistic care to the older population. STUDY DESIGN Records of medical consultancies of outpatient departments (OPD) were retrieved from the hospital database and considered for understanding the disease-prevalence in the geriatric population. METHODS Over 47000 subjects of 60 years and above were categorized into eight age-groups and analyzed for age-related disease-prevalence in both males and females. RESULTS Approximately 25% were affected with cardiovascular system followed by 20% with general complication of cold/cough/fever and GI-disorientation. A uniform damage was observed in systems such as gastro-/neuro-/nephro-/ophthalmic and urology in both genders. Males were more prone to cardiac, nephorologic and urologic problems whereas females were more affected with musculo-skeletal problems than men. In general, men were more affected with geriatric diseases. CONCLUSION Cardiovascular disorder after 60 years onwards could be related to stress for transition from 'income-to-no-income' state and lack of financial and other preparedness. Significant osteoarthritis problem in females is undoubtedly associated with ageing of ovaries. An intensive medical intervention following hospital-admission and outcome will guide for building age-friendly, long-stay and isolated accommodation, which could be considered for low- and middle-income countries as a model for handling geriatric disease burden.
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Affiliation(s)
- Bani Bandana Ganguly
- MGM Center for Genetic Research & Diagnosis, MGM New Bombay Hospital, Navi Mumbai, India; MGM Institute of Health Sciences, Navi Mumbai, India.
| | - Nitin N Kadam
- MGM Institute of Health Sciences, Navi Mumbai, India
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15
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Gender, Depression, and Blue-collar Work: A Retrospective Cohort Study of US Aluminum Manufacturers. Epidemiology 2019; 30:435-444. [PMID: 30964814 DOI: 10.1097/ede.0000000000000993] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Industrial blue-collar workers face multiple work-related stressors, but evidence regarding the burden of mental illness among today's blue-collar men and women remains limited. METHODS In this retrospective cohort study, we examined health and employment records for 37,183 blue- and white-collar workers employed by a single US aluminum manufacturer from 2003 to 2013. Using Cox proportional hazards regression, we modeled time to first episode of treated depression by gender and occupational class. Among cases, we modeled rates of depression-related service utilization with generalized gamma regression. RESULTS Compared with their white-collar counterparts, blue-collar men were more likely to be treated for depression (hazard ratio [HR] = 1.3; 95% confidence interval [CI] = 1.1, 1.4) as were blue-collar women (HR = 1.4; 1.2, 1.6). Blue-collar women were most likely to be treated for depression as compared with white-collar men (HR = 3.2; 95% CI = 2.1, 5.0). However, blue-collar workers used depression-related services less frequently than their white-collar counterparts among both men (rate ratio = 0.91; 95% CI = 0.84, 0.98) and women (rate ratio = 0.82; 95% CI = 0.77, 0.88). CONCLUSIONS Blue-collar women were more likely to be treated for depression than white-collar workers, and blue-collar women were most likely to be treated for depression compared with white-collar men. However, blue-collar men and women used depression-related healthcare services less frequently than white-collar workers. These findings underscore that blue-collar women may be uniquely susceptible to depression, and suggest that blue-collar workers may encounter barriers to care-seeking related mental illness other than their insurance status.
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Younes N, Atallah M, Alam R, Chehade NH, Gannagé-Yared MH. HbA1c AND BLOOD PRESSURE MEASUREMENTS: RELATION WITH GENDER, BODY MASS INDEX, STUDY FIELD, AND LIFESTYLE IN LEBANESE STUDENTS. Endocr Pract 2019; 25:1101-1108. [PMID: 31241365 DOI: 10.4158/ep-2019-0163] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Objective: The purpose of this study is to determine the prevalence of prediabetes/diabetes in Lebanese university students and to examine the relationship between both hemoglobin A1c (HbA1c) and blood pressure (BP) and gender, body mass index (BMI), study field, and lifestyle factors. Methods: This cross-sectional study was carried out at the Saint-Joseph University of Beirut. A total of 603 students aged 18 to 25 years were recruited from both the medical science campus (MSC) and the social science campus (SSC) between January, 2016, and May, 2018. Waist circumference (WC), BMI, and BP were determined for each student and HbA1c was measured using the Siemens vintage DCA device. Participants completed a self-administered questionnaire about their eating habits and level of physical activity. Results: The mean age of the population was 20.31 ± 1.76 years. The percentage of participants recruited from the MSC was 59.2%. The prevalence of prediabetes was 2.5%. Lower BMI, WC, and HbA1c values, and higher diastolic BP (DBP) were found in MSC students compared to SSC ones. HbA1c, systolic BP (SBP), and DBP were correlated with BMI (P = .02, P<.0001, and P = .017, respectively). HbA1c was not associated with eating habits or physical activity. DBP was inversely associated with physical activity (P = .002), while SBP was positively associated with fast food consumption (P = .003). Conclusion: The present study shows a low prevalence of prediabetes in Lebanese students. BMI and the study field are the main factors predicting HbA1c and BP. Further studies are needed to extrapolate our results to the overall young Lebanese population. Abbreviations: ADA = American Diabetes Association; BMI = body mass index; BP = blood pressure; DBP = diastolic blood pressure; HbA1c = hemoglobin A1c; HTN = hypertension; MSC = medical science campus; SBP = systolic blood pressure; SSC = social science campus; T2D = type 2 diabetes; US = United States; USJ = Saint-Joseph University; WC = waist circumference.
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Chen Z, Zhou D, Zhou S, Jia G. Gender difference in hepatic toxicity of titanium dioxide nanoparticles after subchronic oral exposure in Sprague‐Dawley rats. J Appl Toxicol 2019; 39:807-819. [DOI: 10.1002/jat.3769] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 12/03/2018] [Accepted: 12/07/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Zhangjian Chen
- Department of Occupational and Environmental Health Sciences, School of Public HealthPeking University Beijing 100191 China
| | - Di Zhou
- Department of Occupational and Environmental Health Sciences, School of Public HealthPeking University Beijing 100191 China
| | - Shupei Zhou
- Department of Laboratory Animal Science, Health Science CenterPeking University Beijing 100191 China
| | - Guang Jia
- Department of Occupational and Environmental Health Sciences, School of Public HealthPeking University Beijing 100191 China
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18
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Elser H, Falconi AM, Bass M, Cullen MR. Blue-collar work and women's health: A systematic review of the evidence from 1990 to 2015. SSM Popul Health 2018; 6:195-244. [PMID: 30417066 PMCID: PMC6215057 DOI: 10.1016/j.ssmph.2018.08.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 08/06/2018] [Accepted: 08/13/2018] [Indexed: 01/09/2023] Open
Abstract
Despite the implications of gender and sex differences for health risks associated with blue-collar work, adverse health outcomes among blue-collar workers has been most frequently studied among men. The present study provides a "state-of-the-field" systematic review of the empiric evidence published on blue-collar women's health. We systematically reviewed literature related to the health of blue-collar women published between January 1, 1990 and December 31, 2015. We limited our review to peer-reviewed studies published in the English language on the health or health behaviors of women who were presently working or had previously worked in a blue-collar job. Studies were eligible for inclusion regardless of the number, age, or geographic region of blue-collar women in the study sample. We retained 177 studies that considered a wide range of health outcomes in study populations from 40 different countries. Overall, these studies suggested inferior health among female blue-collar workers as compared with either blue-collar males or other women. However, we noted several methodological limitations in addition to heterogeneity in study context and design, which inhibited comparison of results across publications. Methodological limitations of the extant literature, alongside the rapidly changing nature of women in the workplace, motivate further study on the health of blue-collar women. Efforts to identify specific mechanisms by which blue-collar work predisposes women to adverse health may be particularly valuable in informing future workplace-based and policy-level interventions.
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Affiliation(s)
- Holly Elser
- School of Public Health, Division of Epidemiology, University of California, Berkeley, 50 University Hall, Berkeley, CA 94720, United States
| | - April M. Falconi
- Stanford Center for Population Health Sciences, Stanford University, 1070 Arastradero Road, Palo Alto, CA 94304, United States
| | - Michelle Bass
- Population Research Librarian, Lane Medical Library & Knowledge Management Center, Stanford University School of Medicine, 300 Pasteur Dr L109, Stanford, CA 94305, United States
| | - Mark R. Cullen
- Stanford Center for Population Health Sciences, Stanford University, 1070 Arastradero Road, Palo Alto, CA 94304, United States
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Estrella ML, Rosenberg NI, Durazo-Arvizu RA, Gonzalez HM, Loop MS, Singer RH, Lash JP, Castañeda SF, Perreira KM, Eldeirawi K, Daviglus ML. The association of employment status with ideal cardiovascular health factors and behaviors among Hispanic/Latino adults: Findings from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). PLoS One 2018; 13:e0207652. [PMID: 30481192 PMCID: PMC6258516 DOI: 10.1371/journal.pone.0207652] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 11/05/2018] [Indexed: 12/04/2022] Open
Abstract
Background The American Heart Association’s 2020 Impact Goals propose to improve cardiovascular health (CVH) and reduce deaths from cardiovascular diseases and stroke in the US. Targeted health promotion efforts in workplaces and communities are needed to achieve these population-level changes. The present study examined the sex-specific cross-sectional associations between employment status and ideal CVH among Hispanics/Latinos, and whether these associations were modified by age (i.e., younger adults [aged 18–44] compared to middle-aged and older adults [aged 45–74]). Methods This study included 4,797 males and 7,043 females (aged 18–74) from the Hispanic Community Health Study / Study of Latinos. Employment status was categorized as employed full-time (FT), employed part-time (PT), employed (FT or PT) and homemakers, homemakers only, and unemployed. CVH metrics, operationalized as ‘ideal’ versus ‘less than ideal,’ included health factors (i.e., blood pressure, cholesterol, and fasting glucose) and health behaviors (i.e., body mass index, smoking, physical activity [PA], and diet). A total CVH score was derived based on the seven CVH metrics, and dichotomized as ideal vs. less than ideal (score of 11–14 vs. 0–10). Survey-based generalized linear regression models with Gaussian binomial distribution were used to estimate adjusted prevalence differences (APDs) and their 95% confidence intervals (CIs) for the associations between employment status (with employed FT as referent) and ideal CVH (total score and each metric), adjusting for socio-demographic characteristics. Effect modification by age was examined. Results Among males, compared to their employed FT counterparts, those who were employed PT had a higher prevalence of ideal CVH score (APD = 6.8, 95% CI = 1.7, 11.8), ideal BMI (APD = 8.5, 95% CI = 3.0, 14.0), and ideal PA (APD = 4.8, 95% CI = 0.9, 8.7). Age modified the associations of employment type with ideal CVH score and ideal BMI, i.e., younger males who were employed PT had a higher prevalence of ideal CVH score and ideal BMI. Among females, employment status was not associated with ideal CVH score. Compared to females employed FT, females who were homemakers had a lower prevalence of ideal (non-) smoking (APD = -4.7, 95% CI = -8.5, -1.0) and ideal PA (APD = -7.9, 95% CI = -12.7, -3.0), and females who were unemployed had a lower prevalence of ideal PA (APD = -10.4, 95% CI = -16.7, -4.1). Age modified the associations of employment type with ideal fasting glucose and ideal PA, i.e., middle-aged and older females who were homemakers or unemployed had a lower prevalence of ideal fasting glucose and ideal PA. Conclusions Hispanic/Latino males who were employed PT had the most favorable CVH profiles but these associations were mostly driven by better CVH (total score and metrics) among younger males. Hispanic/Latino females who were homemakers or unemployed had lower rates of ideal CVH metrics.
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Affiliation(s)
- Mayra L. Estrella
- Institute for Minority Health Research, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States of America
- * E-mail:
| | - Natalya I. Rosenberg
- Institute for Minority Health Research, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Ramon A. Durazo-Arvizu
- Institute for Minority Health Research, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States of America
- Department of Public Health Sciences, Loyola University Medical Center, Maywood, IL, United States of America
| | - Hector M. Gonzalez
- Department of Neurosciences, University of California San Diego, San Diego, CA, United States of America
| | - Matthew S. Loop
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Richard H. Singer
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States of America
| | - James P. Lash
- Division of Nephrology, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Sheila F. Castañeda
- Graduate School of Public Health, San Diego State University, San Diego, CA, United States of America
| | - Krista M. Perreira
- Department of Social Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Kamal Eldeirawi
- Department of Health Systems Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Martha L. Daviglus
- Institute for Minority Health Research, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States of America
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Milner A, King T, LaMontagne AD, Bentley R, Kavanagh A. Men’s work, Women’s work, and mental health: A longitudinal investigation of the relationship between the gender composition of occupations and mental health. Soc Sci Med 2018; 204:16-22. [DOI: 10.1016/j.socscimed.2018.03.020] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 03/07/2018] [Accepted: 03/10/2018] [Indexed: 01/22/2023]
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Beltrán-Sánchez H, Pebley A, Goldman N. Links between Primary Occupation and Functional Limitations among Older Adults in Mexico. SSM Popul Health 2017; 3:382-392. [PMID: 29085879 PMCID: PMC5659182 DOI: 10.1016/j.ssmph.2017.04.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 03/31/2017] [Accepted: 04/03/2017] [Indexed: 10/27/2022] Open
Abstract
Social inequalities in health and disability are often attributed to differences in childhood adversity, access to care, health behavior, residential environments, stress, and the psychosocial aspects of work environments. Yet, disadvantaged people are also more likely to hold jobs requiring heavy physical labor, repetitive movement, ergonomic strain, and safety hazards. We investigate the role of physical work conditions in contributing to social inequality in mobility among older adults in Mexico, using data from the Mexican Health and Aging Survey (MHAS) and an innovative statistical modeling approach. We use data on categories of primary adult occupation to serve as proxies for jobs with more or less demanding physical work requirements. Our results show that more physically demanding jobs are associated with mobility limitations at older ages, even when we control for age and sex. Inclusion of job categories attenuates the effects of education and wealth on mobility limitations, suggesting that physical work conditions account for at least part of the socioeconomic differentials in mobility limitations in Mexico.
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Affiliation(s)
- Hiram Beltrán-Sánchez
- Department of Community Health Sciences, Fielding School of Public Health, California Center for Population Research, University of California, Los Angeles, 650 Charles E. Young Dr, 41-257 CHS, Los Angeles, CA 90095-1772, USA
| | - Anne Pebley
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, 650 Charles E. Young Dr, Los Angeles, CA 90095-1772, USA
| | - Noreen Goldman
- Office of Population Research, Princeton University, 243 Wallace Hall, Princeton, NJ 08544, USA
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22
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Caswell JM. Prevalence of reported high blood pressure in Canada: investigation of demographic and spatial trends. J Public Health (Oxf) 2017. [DOI: 10.1007/s10389-016-0761-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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23
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Rineer JR, Truxillo DM, Bodner TE, Hammer LB, Kraner MA. The moderating effect of perceived organizational support on the relationships between organizational justice and objective measures of cardiovascular health. EUROPEAN JOURNAL OF WORK AND ORGANIZATIONAL PSYCHOLOGY 2017. [DOI: 10.1080/1359432x.2016.1277207] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Jennifer R. Rineer
- Social Policy, Health, and Economics Research, RTI International, Durham, NC, USA
| | | | - Todd E. Bodner
- Department of Psychology, Portland State University, Portland, OR, USA
| | - Leslie B. Hammer
- Department of Psychology, Portland State University, Portland, OR, USA
| | - Mariah A. Kraner
- Department of Psychology, Portland State University, Portland, OR, USA
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Changing work stressors and coping resources influence blood pressure and hypertension incidence in a large OHSPIW cohort. J Hum Hypertens 2016; 31:313-319. [DOI: 10.1038/jhh.2016.79] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 08/27/2016] [Accepted: 09/19/2016] [Indexed: 11/08/2022]
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Shvedova AA, Kisin ER, Yanamala N, Farcas MT, Menas AL, Williams A, Fournier PM, Reynolds JS, Gutkin DW, Star A, Reiner RS, Halappanavar S, Kagan VE. Gender differences in murine pulmonary responses elicited by cellulose nanocrystals. Part Fibre Toxicol 2016; 13:28. [PMID: 27278671 PMCID: PMC4898310 DOI: 10.1186/s12989-016-0140-x] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 06/02/2016] [Indexed: 12/31/2022] Open
Abstract
Background Cellulose-based materials have been used for centuries to manufacture different goods derived from forestry and agricultural sources. In the growing field of nanocellulose applications, its uniquely engineered properties are instrumental for inventive products coming to competitive markets. Due to their high aspect ratio and stiffness, it is speculated that cellulose nanocrystals (CNC) may cause similar pulmonary toxicity as carbon nanotubes and asbestos, thus posing a potential negative impact on public health and the environment. Methods The present study was undertaken to investigate the pulmonary outcomes induced by repeated exposure to respirable CNC. C57BL/6 female and male mice were exposed by pharyngeal aspiration to CNC (40 μg/mouse) 2 times a week for 3 weeks. Several biochemical endpoints and pathophysiological outcomes along with gene expression changes were evaluated and compared in the lungs of male and female mice. Results Exposure to respirable CNC caused pulmonary inflammation and damage, induced oxidative stress, elevated TGF-β and collagen levels in lung, and impaired pulmonary functions. Notably, these effects were markedly more pronounced in females compared to male mice. Moreover, sex differences in responses to pulmonary exposure to CNC were also detected at the level of global mRNA expression as well as in inflammatory cytokine/chemokine activity. Conclusions Overall, our results indicate that there are considerable differences in responses to respirable CNC based on gender with a higher pulmonary toxicity observed in female mice. Electronic supplementary material The online version of this article (doi:10.1186/s12989-016-0140-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anna A Shvedova
- Health Effects Laboratory Division, NIOSH, Exposure Assessment Branch, 1095 Willowdale Road, Morgantown, WV, 26505, USA. .,Department of Physiology & Pharmacology, School of Medicine/WVU, Morgantown, WV, USA.
| | - Elena R Kisin
- Health Effects Laboratory Division, NIOSH, Exposure Assessment Branch, 1095 Willowdale Road, Morgantown, WV, 26505, USA
| | - Naveena Yanamala
- Health Effects Laboratory Division, NIOSH, Exposure Assessment Branch, 1095 Willowdale Road, Morgantown, WV, 26505, USA
| | - Mariana T Farcas
- Health Effects Laboratory Division, NIOSH, Exposure Assessment Branch, 1095 Willowdale Road, Morgantown, WV, 26505, USA
| | - Autumn L Menas
- Health Effects Laboratory Division, NIOSH, Exposure Assessment Branch, 1095 Willowdale Road, Morgantown, WV, 26505, USA
| | - Andrew Williams
- Environmental and Radiation Health Sciences Directorate, Health Canada, Ottawa, ON, K1A 0 K9, Canada
| | - Philip M Fournier
- Department of Chemistry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jeffrey S Reynolds
- Engineering and Controls Technology Branch, NIOSH/CDC, Morgantown, WV, USA
| | - Dmitriy W Gutkin
- Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Alexander Star
- Department of Chemistry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Richard S Reiner
- Forest Products Laboratory, USDA Forest Service, Madison, WI, USA
| | - Sabina Halappanavar
- Environmental and Radiation Health Sciences Directorate, Health Canada, Ottawa, ON, K1A 0 K9, Canada
| | - Valerian E Kagan
- Free Radical Center, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Environmental & Occupational Health, University of Pittsburgh, Pittsburgh, PA, USA
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Morton JS, Cooke CL, Davidge ST. In Utero Origins of Hypertension: Mechanisms and Targets for Therapy. Physiol Rev 2016; 96:549-603. [DOI: 10.1152/physrev.00015.2015] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The developmental origins of health and disease theory is based on evidence that a suboptimal environment during fetal and neonatal development can significantly impact the evolution of adult-onset disease. Abundant evidence exists that a compromised prenatal (and early postnatal) environment leads to an increased risk of hypertension later in life. Hypertension is a silent, chronic, and progressive disease defined by elevated blood pressure (>140/90 mmHg) and is strongly correlated with cardiovascular morbidity/mortality. The pathophysiological mechanisms, however, are complex and poorly understood, and hypertension continues to be one of the most resilient health problems in modern society. Research into the programming of hypertension has proposed pharmacological treatment strategies to reverse and/or prevent disease. In addition, modifications to the lifestyle of pregnant women might impart far-reaching benefits to the health of their children. As more information is discovered, more successful management of hypertension can be expected to follow; however, while pregnancy complications such as fetal growth restriction, preeclampsia, preterm birth, etc., continue to occur, their offspring will be at increased risk for hypertension. This article reviews the current knowledge surrounding the developmental origins of hypertension, with a focus on mechanistic pathways and targets for therapeutic and pharmacologic interventions.
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Affiliation(s)
- Jude S. Morton
- Departments of Obstetrics and Gynaecology and of Physiology, University of Alberta, Edmonton, Canada; Women and Children's Health Research Institute, Edmonton, Canada; and Cardiovascular Research Centre, Edmonton, Canada
| | - Christy-Lynn Cooke
- Departments of Obstetrics and Gynaecology and of Physiology, University of Alberta, Edmonton, Canada; Women and Children's Health Research Institute, Edmonton, Canada; and Cardiovascular Research Centre, Edmonton, Canada
| | - Sandra T. Davidge
- Departments of Obstetrics and Gynaecology and of Physiology, University of Alberta, Edmonton, Canada; Women and Children's Health Research Institute, Edmonton, Canada; and Cardiovascular Research Centre, Edmonton, Canada
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Valenty M, Homère J, Lemaitre A, Plaine J, Ruhlman M, Cohidon C, Imbernon E. Surveillance programme for uncompensated work-related diseases in France. Occup Med (Lond) 2015; 65:642-50. [DOI: 10.1093/occmed/kqv104] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Rehkopf DH, Eisen EA, Modrek S, Mokyr Horner E, Goldstein B, Costello S, Cantley LF, Slade MD, Cullen MR. Early-Life State-of-Residence Characteristics and Later Life Hypertension, Diabetes, and Ischemic Heart Disease. Am J Public Health 2015; 105:1689-95. [PMID: 26066927 DOI: 10.2105/ajph.2014.302547] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVES We examined how state characteristics in early life are associated with individual chronic disease later in life. METHODS We assessed early-life state of residence using the first 3 digits of social security numbers from blue- and white-collar workers from a US manufacturing company. Longitudinal data were available from 1997 to 2012, with 305 936 person-years of observation. Disease was assessed using medical claims. We modeled associations using pooled logistic regression with inverse probability of censoring weights. RESULTS We found small but statistically significant associations between early-state-of-residence characteristics and later life hypertension, diabetes, and ischemic heart disease. The most consistent associations were with income inequality, percentage non-White, and education. These associations were similar after statistically controlling for individual socioeconomic and demographic characteristics and current state characteristics. CONCLUSIONS Characteristics of the state in which an individual lives early in life are associated with prevalence of chronic disease later in life, with a strength of association equivalent to genetic associations found for these same health outcomes.
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Affiliation(s)
- David H Rehkopf
- At the time of the study, David H. Rehkopf, Sepideh Modrek, Elizabeth Mokyr Horner, Benjamin Goldstein, and Mark R. Cullen were with the Division of General Medical Disciplines, School of Medicine, Stanford University, Stanford, CA. Ellen A. Eisen and Sadie Costello are with the Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley. Linda F. Cantley and Martin D. Slade are with the Occupational and Environmental Medicine Program, School of Medicine, Yale University, New Haven, CT
| | - Ellen A Eisen
- At the time of the study, David H. Rehkopf, Sepideh Modrek, Elizabeth Mokyr Horner, Benjamin Goldstein, and Mark R. Cullen were with the Division of General Medical Disciplines, School of Medicine, Stanford University, Stanford, CA. Ellen A. Eisen and Sadie Costello are with the Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley. Linda F. Cantley and Martin D. Slade are with the Occupational and Environmental Medicine Program, School of Medicine, Yale University, New Haven, CT
| | - Sepideh Modrek
- At the time of the study, David H. Rehkopf, Sepideh Modrek, Elizabeth Mokyr Horner, Benjamin Goldstein, and Mark R. Cullen were with the Division of General Medical Disciplines, School of Medicine, Stanford University, Stanford, CA. Ellen A. Eisen and Sadie Costello are with the Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley. Linda F. Cantley and Martin D. Slade are with the Occupational and Environmental Medicine Program, School of Medicine, Yale University, New Haven, CT
| | - Elizabeth Mokyr Horner
- At the time of the study, David H. Rehkopf, Sepideh Modrek, Elizabeth Mokyr Horner, Benjamin Goldstein, and Mark R. Cullen were with the Division of General Medical Disciplines, School of Medicine, Stanford University, Stanford, CA. Ellen A. Eisen and Sadie Costello are with the Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley. Linda F. Cantley and Martin D. Slade are with the Occupational and Environmental Medicine Program, School of Medicine, Yale University, New Haven, CT
| | - Benjamin Goldstein
- At the time of the study, David H. Rehkopf, Sepideh Modrek, Elizabeth Mokyr Horner, Benjamin Goldstein, and Mark R. Cullen were with the Division of General Medical Disciplines, School of Medicine, Stanford University, Stanford, CA. Ellen A. Eisen and Sadie Costello are with the Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley. Linda F. Cantley and Martin D. Slade are with the Occupational and Environmental Medicine Program, School of Medicine, Yale University, New Haven, CT
| | - Sadie Costello
- At the time of the study, David H. Rehkopf, Sepideh Modrek, Elizabeth Mokyr Horner, Benjamin Goldstein, and Mark R. Cullen were with the Division of General Medical Disciplines, School of Medicine, Stanford University, Stanford, CA. Ellen A. Eisen and Sadie Costello are with the Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley. Linda F. Cantley and Martin D. Slade are with the Occupational and Environmental Medicine Program, School of Medicine, Yale University, New Haven, CT
| | - Linda F Cantley
- At the time of the study, David H. Rehkopf, Sepideh Modrek, Elizabeth Mokyr Horner, Benjamin Goldstein, and Mark R. Cullen were with the Division of General Medical Disciplines, School of Medicine, Stanford University, Stanford, CA. Ellen A. Eisen and Sadie Costello are with the Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley. Linda F. Cantley and Martin D. Slade are with the Occupational and Environmental Medicine Program, School of Medicine, Yale University, New Haven, CT
| | - Martin D Slade
- At the time of the study, David H. Rehkopf, Sepideh Modrek, Elizabeth Mokyr Horner, Benjamin Goldstein, and Mark R. Cullen were with the Division of General Medical Disciplines, School of Medicine, Stanford University, Stanford, CA. Ellen A. Eisen and Sadie Costello are with the Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley. Linda F. Cantley and Martin D. Slade are with the Occupational and Environmental Medicine Program, School of Medicine, Yale University, New Haven, CT
| | - Mark R Cullen
- At the time of the study, David H. Rehkopf, Sepideh Modrek, Elizabeth Mokyr Horner, Benjamin Goldstein, and Mark R. Cullen were with the Division of General Medical Disciplines, School of Medicine, Stanford University, Stanford, CA. Ellen A. Eisen and Sadie Costello are with the Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley. Linda F. Cantley and Martin D. Slade are with the Occupational and Environmental Medicine Program, School of Medicine, Yale University, New Haven, CT
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Karatzias T, Yan E, Jowett S. Adverse life events and health: a population study in Hong Kong. J Psychosom Res 2015; 78:173-7. [PMID: 25498319 DOI: 10.1016/j.jpsychores.2014.11.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 11/28/2014] [Accepted: 11/30/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Although the effects of adverse life events on mental health have been well documented in the literature, there has never been a population based study that investigated systematically the association between history of adverse life events and physical health (objective and subjective) in adults. METHOD Cross-sectional, face-to-face household population based survey of adults (18+) in Hong Kong (N=1147). Participants were asked if they had a diagnosis of six health conditions including hypertension, heart disease, arthritis, diabetes, eyesight degeneration, and hearing loss. They were also asked if they had experienced five adverse life events including death of a partner or spouse, abuse, natural disaster, life threatening illness or injury, and family disruption. Interviews also included the Short-Form 12 Health Survey (SFHS-12) and the short version of the Centre for Epidemiologic Studies Depression Scale (CES-D). RESULTS Overall, results indicate that specific adverse life events may be associated with specific health conditions. However, all tested life events were associated with subjective physical and mental health. Death of partner or parent and life threatening illness or injury were found to have the strongest association with physical health problems. A dose-response relationship between adverse life events and physical health in general was evident but more so for heart disease and eyesight degeneration. CONCLUSION Considering the high prevalence of traumatic events and how common the conditions associated with such events are in the general population, screening for adverse life events as part of comprehensive assessment will allow a deeper understanding of patients' needs.
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Affiliation(s)
- Thanos Karatzias
- Edinburgh Napier University, Faculty of Health, Life and Social Sciences, Edinburgh UK; NHS Lothian, Rivers Centre, Edinburgh, UK.
| | - Elsie Yan
- Hong Kong University, Department of Social Work and Social Administration, Hong Kong
| | - Sally Jowett
- Edinburgh Napier University, Faculty of Health, Life and Social Sciences, Edinburgh UK
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Jackson B, Richman LS, LaBelle O, Lempereur MS, Twenge JM. Experimental Evidence That Low Social Status is Most Toxic to Well-being When Internalized. SELF AND IDENTITY 2014; 14:157-172. [PMID: 25620889 DOI: 10.1080/15298868.2014.965732] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
What makes low social status toxic to well-being? To internalize social status is to believe the self is responsible for it. We hypothesized that the more people internalize low subjective social status, the more their basic psychological needs are thwarted. Experiment 1 randomly assigned participants to imagine themselves in low, middle, or high social status and assessed their subjective social status internalization by independent ratings. The more participants internalized low status, the more they reported their basic psychological needs were thwarted. This effect did not appear among their higher status counterparts. Experiment 2 replicated and extended these findings using a behavioral manipulation of subjective social status and a self-report measure of internalization. We discuss implications for basic and action research.
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Bell ML, Zanobetti A, Dominici F. Evidence on vulnerability and susceptibility to health risks associated with short-term exposure to particulate matter: a systematic review and meta-analysis. Am J Epidemiol 2013; 178:865-76. [PMID: 23887042 DOI: 10.1093/aje/kwt090] [Citation(s) in RCA: 218] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Although there is strong evidence that short-term exposure to particulate matter is associated with health risks, less is known about whether some subpopulations face higher risks. We identified 108 papers published after 1995 and summarized the scientific evidence regarding effect modification of associations between short-term exposure to particulate matter and the risk of death or hospitalization. We performed a meta-analysis of estimated mortality associations by age and sex. We found strong, consistent evidence that the elderly experience higher risk of particular matter--associated hospitalization and death, weak evidence that women have higher risks of hospitalization and death, and suggestive evidence that those with lower education, income, or employment status have higher risk of death. Meta-analysis showed a statistically higher risk of death of 0.64% (95% confidence interval (CI): 0.50, 0.78) for older populations compared with 0.34% (95% CI: 0.25, 0.42) for younger populations per 10 μg/m3 increase of particulate matter with aerodynamic diameter ≤10 μm. Women had a slightly higher risk of death of 0.55% (95% CI: 0.41, 0.70) compared with 0.50% (95% CI: 0.34, 0.54) for men, but these 2 risks were not statistically different. Our synthesis on modifiers for risks associated with particulate matter can aid the design of air quality policies and suggest directions for future research. Studies of biological mechanisms could be informed by evidence of differential risks by population, such as by sex and preexisting conditions.
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Extricating sex and gender in air pollution research: a community-based study on cardinal symptoms of exposure. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:3801-17. [PMID: 23975108 PMCID: PMC3799513 DOI: 10.3390/ijerph10093801] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 07/25/2013] [Accepted: 08/09/2013] [Indexed: 11/17/2022]
Abstract
This study investigated sex and gender differences in cardinal symptoms of exposure to a mixture of ambient pollutants. A cross sectional population-based study design was utilized in Sarnia, ON, Canada. Stratified random sampling in census tracts of residents aged 18 and over recruited 804 respondents. Respondents completed a community health survey of chronic disease, general health, and socioeconomic indicators. Residential concentrations of NO2, SO2, benzene, toluene, ethylbenzene and o/m/p-xylene were estimated by land use regression on data collected through environmental monitoring. Classification and Regression Tree (CART) analysis was used to identify variables that interacted with sex and cardinal symptoms of exposure, and a series of logistic regression models were built to predict the reporting of five or more cardinal symptoms (5+ CS). Without controlling for confounders, higher pollution ranks increased the odds ratio (OR) of reporting 5+ CS by 28% (p < 0.01; Confidence Interval (CI): 1.07–1.54). Females were 1.52 (p < 0.05; CI: 1.03–2.26) times more likely more likely to report 5+ CS after controlling for income, age and chronic diseases. The CART analysis showed that allergies and occupational exposure classified the sample into the most homogenous groups of males and females. The likelihood of reporting 5+ CS among females was higher after stratifying the sample based on occupational exposure. However, stratifying by allergic disease resulted in no significant sex difference in symptom reporting. The results confirmed previous research that found pre-existing health conditions to increase susceptibility to ambient air pollution, but additionally indicated that stronger effects on females is partly due to autoimmune disorders. Furthermore, gender differences in occupational exposure confound the effect size of exposure in studies based on residential levels of air pollution.
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