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Nayak SS, Fraser T, Aldrich DP, Panagopoulos C, Kim D. County-level political group density, partisan polarization, and individual-level mortality among adults in the United States: A lagged multilevel study. SSM Popul Health 2024; 26:101662. [PMID: 38813457 PMCID: PMC11134911 DOI: 10.1016/j.ssmph.2024.101662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/28/2024] [Accepted: 03/18/2024] [Indexed: 05/31/2024] Open
Abstract
Objective To investigate the associations between county-level political group density, partisan polarization, and individual-level mortality from all causes and from coronary heart disease (CHD) in the United States. Methods Using data from five survey waves (1998-2006) of the General Social Survey-National Death Index dataset and the County Presidential Election Return 2000 dataset, we fit weighted Cox proportional hazards models to estimate the associations between (1) political group density and (2) partisan polarization measured at the county level in 2000 (n = 313 counties) categorized into quartiles with individual-level mortality (n = 14,983 participants) from all causes and CHD, controlling for individual- and county-level factors. Maximum follow-up was from one year after the survey up until 2014. We conducted these analyses using two separate measures based on county-level vote share differences and party affiliation ideological extremes. Results In the overall sample, we found no evidence of associations between county-level political group density and individual-level mortality from all causes. There was evidence of a 13% higher risk of dying from heart disease in the highest quartile of county-level polarization (hazards ratio, HR = 1.13; 95% CI = 0.74-1.71). We observed heterogeneity of effects based on individual-level political affiliation. Among those identifying as Democrats, residing in counties with high (vs. low) levels of polarization appeared to be protective against mortality, with an associated 18% lower risk of dying from all causes (HR = 0.82, 95% CI = 0.71-0.94). This association was strongest in areas with the highest concentrations of Democrats. Conclusions Among all study participants, political group density and polarization at the county level in 2000 were not linked to individual-level mortality. At the same time, we found that Democratic party affiliation may be protective against the adverse effects of high polarization, particularly in counties with high concentrations of Democrats. Future research should further explore these associations to potentially identify new structural interventions to address political determinants of population health.
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Affiliation(s)
- Sameera S. Nayak
- Department of Sociology, Anthropology, and Public Health, College of Arts, Humanities, and Social Sciences, University of Maryland, Baltimore County, Baltimore, MD, USA
- Center for Health, Equity, & Aging, University of Maryland, Baltimore County, Baltimore, MD, USA
| | - Timothy Fraser
- Systems Engineering Program, Cornell University, Ithaca, NY, USA
| | - Daniel P. Aldrich
- College of Social Sciences and Humanities, Northeastern University, Boston, MA, USA
- School of Public Policy and Urban Affairs, Northeastern University, Boston, MA, USA
| | - Costas Panagopoulos
- College of Social Sciences and Humanities, Northeastern University, Boston, MA, USA
| | - Daniel Kim
- School of Public Policy and Urban Affairs, Northeastern University, Boston, MA, USA
- School of Community Health & Behavioral Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA
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2
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Leclercq S, Szaffarczyk S, Leptourgos P, Yger P, Fakhri A, Wathelet M, Bouttier V, Denève S, Jardri R. Conspiracy beliefs and perceptual inference in times of political uncertainty. Sci Rep 2024; 14:9001. [PMID: 38637589 PMCID: PMC11026417 DOI: 10.1038/s41598-024-59434-4] [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: 08/11/2023] [Accepted: 04/10/2024] [Indexed: 04/20/2024] Open
Abstract
Sociopolitical crises causing uncertainty have accumulated in recent years, providing fertile ground for the emergence of conspiracy ideations. Computational models constitute valuable tools for understanding the mechanisms at play in the formation and rigidification of these unshakeable beliefs. Here, the Circular Inference model was used to capture associations between changes in perceptual inference and the dynamics of conspiracy ideations in times of uncertainty. A bistable perception task and conspiracy belief assessment focused on major sociopolitical events were administered to large populations from three polarized countries. We show that when uncertainty peaks, an overweighting of sensory information is associated with conspiracy ideations. Progressively, this exploration strategy gives way to an exploitation strategy in which increased adherence to conspiracy theories is associated with the amplification of prior information. Overall, the Circular Inference model sheds new light on the possible mechanisms underlying the progressive strengthening of conspiracy theories when individuals face highly uncertain situations.
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Affiliation(s)
- Salomé Leclercq
- INSERM U1172, CHU Lille, Lille Neuroscience and Cognition Centre, CURE Platform, Fontan Hospital, Lille University, 59000, Lille, France.
| | - Sébastien Szaffarczyk
- INSERM U1172, CHU Lille, Lille Neuroscience and Cognition Centre, CURE Platform, Fontan Hospital, Lille University, 59000, Lille, France
| | - Pantelis Leptourgos
- INSERM U1172, CHU Lille, Lille Neuroscience and Cognition Centre, CURE Platform, Fontan Hospital, Lille University, 59000, Lille, France
| | - Pierre Yger
- INSERM U1172, CHU Lille, Lille Neuroscience and Cognition Centre, CURE Platform, Fontan Hospital, Lille University, 59000, Lille, France
| | | | - Marielle Wathelet
- INSERM U1172, CHU Lille, Lille Neuroscience and Cognition Centre, CURE Platform, Fontan Hospital, Lille University, 59000, Lille, France
| | - Vincent Bouttier
- INSERM U1172, CHU Lille, Lille Neuroscience and Cognition Centre, CURE Platform, Fontan Hospital, Lille University, 59000, Lille, France
- LNC, INSERM U-960, Institut de Sciences Cognitives, École Normale Supérieure, 75005, Paris, France
| | - Sophie Denève
- LNC, INSERM U-960, Institut de Sciences Cognitives, École Normale Supérieure, 75005, Paris, France
| | - Renaud Jardri
- INSERM U1172, CHU Lille, Lille Neuroscience and Cognition Centre, CURE Platform, Fontan Hospital, Lille University, 59000, Lille, France.
- LNC, INSERM U-960, Institut de Sciences Cognitives, École Normale Supérieure, 75005, Paris, France.
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3
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Jalali R, Romaszko J, Dragańska E, Gromadziński L, Cymes I, Sokołowski JB, Poterała M, Markuszewski L, Romaszko-Wojtowicz AM, Jeznach-Steinhagen A, Glińska-Lewczuk K. Heat and cold stress increases the risk of paroxysmal supraventricular tachycardia. PLoS One 2024; 19:e0296412. [PMID: 38165960 PMCID: PMC10760728 DOI: 10.1371/journal.pone.0296412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 12/12/2023] [Indexed: 01/04/2024] Open
Abstract
Paroxysmal supraventricular tachycardia (PSVT) is a common arrhythmia in adults. Its occurrence depends on the presence of the reentry circuit and the trigger of the paroxysm. Stress, emotional factors, and comorbidities favour the occurrence of such an episode. We hypothesized that the occurrence of PSVT follows extreme thermal episodes. The retrospective analysis was based on the data collected from three hospital emergency departments in Poland (Olsztyn, Radom, and Wroclaw) involving 816 admissions for PSVT in the period of 2016-2021. To test the hypothesis, we applied the Universal Climate Thermal Index (UTCI) to objectively determine exposure to cold or heat stress. The risk (RR) for PSVT increased to 1.37 (p = 0.006) in cold stress and 1.24 (p = 0.05) in heat stress when compared to thermoneutral conditions. The likelihood of PSVT during cold/heat stress is higher in women (RR = 1.59, p< 0.001 and RR = 1.36, p = 0.024, respectively) than in men (RR = 0.64 at p = 0.088 and RR = 0.78, p = 0.083, respectively). The susceptibility for PSVT was even higher in all groups of women after exclusion of perimenopausal group of women, in thermal stress (RR = 1.74, p< 0.001, RR = 1.56, p = 0.029, respectively). Females, particularly at the perimenopausal stage and men irrespective of age were less likely to develop PSVT under thermal stress as compared to thermoneutral conditions. Progress in climate change requires searching for universal methods and tools to monitor relationships between humans and climate. Our paper confirms that the UTCI is the universal tool describing the impact of thermal stress on the human body and its high usefulness in medical researches.
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Affiliation(s)
- Rakesh Jalali
- Department of Emergency Medicine, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Jerzy Romaszko
- Department of Family Medicine and Infectious Diseases, School of Medicine, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Ewa Dragańska
- Department of Water Management and Climatology, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Leszek Gromadziński
- Department of Cardiology and Internal Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Iwona Cymes
- Department of Water Management and Climatology, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | | | - Magdalena Poterała
- Department of Medicine, Faculty of Medical Sciences and Health Science, Kazimierz Pulaski University of Technology and Humanities in Radom, Radom, Poland
| | - Leszek Markuszewski
- Department of Medicine, Faculty of Medical Sciences and Health Science, Kazimierz Pulaski University of Technology and Humanities in Radom, Radom, Poland
| | - Anna Maria Romaszko-Wojtowicz
- Department of Pulmonology, School of Public Health, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | | | - Katarzyna Glińska-Lewczuk
- Department of Water Management and Climatology, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
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Kyriopoulos I, Vandoros S, Kawachi I. State-level economic uncertainty and cardiovascular disease deaths: evidence from the United States. Eur J Epidemiol 2023; 38:1175-1183. [PMID: 37966544 PMCID: PMC10663230 DOI: 10.1007/s10654-023-01076-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/31/2023] [Indexed: 11/16/2023]
Abstract
The relationship between economic recessions and cardiovascular mortality has been widely explored. However, there is limited evidence on whether economic uncertainty alone is linked to cardiovascular disease deaths. This study examines the association between economic uncertainty and mortality from diseases of the circulatory system in the United States. We obtained monthly state-level mortality data from 2008 to 2017 and used indices capturing economic uncertainty from national/international sources and local sources. Panel data modelling was used to account for unobserved time-invariant differences between the states. Our findings suggest that economic uncertainty is independently linked to cardiovascular mortality. Uncertainty arising from national/international sources is associated with cardiovascular deaths, whereas the respective index capturing uncertainty from state/local sources is not. Deaths respond asymmetrically with respect to uncertainty fluctuations - with high levels of uncertainty driving the association. One- and two-month lagged uncertainty levels are also associated with mortality. Several robustness checks further validate the baseline findings. Overall, economic uncertainty is an independent predictor of cardiovascular mortality which appears to act as a psychosocial stressor and a short-term trigger. Public health strategies for cardiovascular disease need to consider factors driving economic uncertainty. Preventive measures and raising awareness can intensify in periods of economic uncertainty.
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Affiliation(s)
- Ilias Kyriopoulos
- Department of Health Policy, The London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK.
| | - Sotiris Vandoros
- UCL Global Business School for Health, University College London, London, UK
- Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, UK
| | - Ichiro Kawachi
- Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, UK
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5
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Kawachi I, Kyriopoulos I, Vandoros S. Economic uncertainty and cardiovascular disease mortality. HEALTH ECONOMICS 2023; 32:1550-1560. [PMID: 36952311 DOI: 10.1002/hec.4678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 02/24/2023] [Accepted: 03/06/2023] [Indexed: 06/04/2023]
Abstract
Previous studies have found a link between economic conditions, such as recessions and unemployment, and cardiovascular disease as well as other health outcomes. More recent research argues that economic uncertainty-independently of unemployment-can affect health outcomes. Using data from England and Wales, we study the association between fluctuations in economic uncertainty and cardiovascular disease mortality in the short term for the period 2001-2019. Controlling for several economic indicators (including unemployment), we find that economic uncertainty alone is strongly associated with deaths attributed to diseases of the circulatory system, ischemic heart disease and cerebrovascular disease. Our findings highlight the short-term link between economic conditions and cardiovascular health and reveal yet another health outcome that is associated with uncertainty.
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Affiliation(s)
- Ichiro Kawachi
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Ilias Kyriopoulos
- Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Sotiris Vandoros
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
- Department of Economics, King's Business School, King's College London, London, UK
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6
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Wołowiec Ł, Grześk G, Osiak J, Wijata A, Mędlewska M, Gaborek P, Banach J, Wołowiec A, Głowacka M. Beta-blockers in cardiac arrhythmias-Clinical pharmacologist's point of view. Front Pharmacol 2023; 13:1043714. [PMID: 36699057 PMCID: PMC9868422 DOI: 10.3389/fphar.2022.1043714] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/30/2022] [Indexed: 01/11/2023] Open
Abstract
β-blockers is a vast group of antiarrhythmic drugs which differ in their pharmacokinetic and chemical properties. Some of them block β-adrenergic receptors selectively while the others work non-selectively. Consequently, they reduce the influence of the sympathetic nervous system on the heart, acting negatively inotropic, chronotropic, bathmotropic and dromotropic. Although they have been present in medicine since the beginning of the 1960s, they still play a crucial role in the treatment of cardiac arrhythmias. They are also first-line group of drugs used to control the ventricular rate in patients with the most common arrhythmia-atrial fibrillation. Previous reports indicate that infection with SARS-CoV-2 virus may constitute an additional risk factor for arrhythmia. Due to the aging of the population in developed countries and the increase in the number of patients with cardiac burden, the number of people suffering from cardiac arrhythmias will increase in the upcoming years. As a result the role of above-mentioned beta-blockers will remain significant. Particularly noteworthy is propranolol-the oldest beta adrenergic antagonist, which in recent years has found additional applications due to its unique properties. In this article, we reviewed the accessible literature and summarized the current guidelines on the use of beta-blockers in the treatment of cardiac arrhythmias.
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Affiliation(s)
- Łukasz Wołowiec
- Department of Cardiology and Clinical Pharmacology, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland,*Correspondence: Łukasz Wołowiec,
| | - Grzegorz Grześk
- Department of Cardiology and Clinical Pharmacology, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland
| | - Joanna Osiak
- Department of Cardiology and Clinical Pharmacology, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland
| | - Aleksandra Wijata
- Department of Cardiology and Clinical Pharmacology, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland
| | - Martyna Mędlewska
- Department of Cardiology and Clinical Pharmacology, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland
| | - Patryk Gaborek
- Department of Cardiology and Clinical Pharmacology, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland
| | - Joanna Banach
- Department of Cardiology and Clinical Pharmacology, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland
| | - Anna Wołowiec
- Department of Geriatrics, Division of Biochemistry and Biogerontology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland
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7
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Nelson MH. Resentment Is Like Drinking Poison? The Heterogeneous Health Effects of Affective Polarization. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2022; 63:508-524. [PMID: 35148647 PMCID: PMC9716484 DOI: 10.1177/00221465221075311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Affective polarization-the tendency for individuals to exhibit animosity toward those on the opposite side of the partisan divide-has increased in the United States in recent years. This article presents evidence that this trend may have consequences for Americans' health. Structural equation model analyses of nationally representative survey data from Pew Research Center's American Trends Panel (n = 4,685) showed heterogeneous relationships between affectively polarized attitudes and self-rated health. On one hand, such attitudes were directly negatively associated with health such that the polarized political environment was proposed to operate as a sociopolitical stressor. Simultaneously, affective polarization was positively associated with political participation, which in turn was positively associated with health, although the direct negative effect was substantially larger than the indirect positive one. These results suggest that today's increasingly hostile and pervasive form of partisanship may undermine Americans' health even as it induces greater political engagement.
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Affiliation(s)
- Micah H. Nelson
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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8
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Hwang AY, Cardel MI, Smith SM. Racial and ethnic differences in blood pressure before and after the 2016 United States general election. Am J Hum Biol 2022; 34:e23785. [PMID: 35856295 DOI: 10.1002/ajhb.23785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 05/23/2022] [Accepted: 07/05/2022] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES The 2016 U.S. presidential election was a major source of stress among many adults. Psychosocial stress can manifest physiologically in elevated blood pressure (BP). Little is known regarding the association of macro-level sociopolitical events with BP changes at the population-level. This study sought to characterize population-level changes in BP following the 2016 U.S. presidential election. METHODS Using 2015-2018 National Health and Nutrition Examination Survey, we included participants aged ≥18 years during the same periods prior to (May to October 2015/2016) and after (May to October 2017/2018) the election. Survey-weighted data were analyzed to compare population-level systolic BP (SBP) and diastolic BP (DBP) pre- and post-election, stratified by race/ethnicity. Sex differences were also investigated. RESULTS We observed significant increases in SBP among non-Hispanic (NH) Asian participants (+3.4 mmHg; p = .046), but not among other racial/ethnic participants. DBP increased among NH Black participants (+2.3 mmHg; p = .049) and Mexican American participants (+2.9 mmHg; p = .007), but not among other racial/ethnic participants. These changes appeared attributable to differential BP changes by sex. CONCLUSIONS At the population-level, variable changes in BP were observed by race/ethnicity following the 2016 U.S. presidential election, possibly driven by SBP elevations among women.
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Affiliation(s)
- Andrew Y Hwang
- Department of Clinical Sciences, Fred Wilson School of Pharmacy, High Point University, High Point, North Carolina, USA
| | - Michelle I Cardel
- Department of Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA.,Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, Florida, USA.,WW International, Inc, New York, New York State, USA
| | - Steven M Smith
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, Florida, USA.,Department of Pharmacotherapy & Translational Research, College of Pharmacy, University of Florida, Gainesville, Florida, USA
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Mefford MT, Rana JS, Reynolds K, Ranasinghe O, Mittleman MA, Liu JY, Qian L, Zhou H, Harrison TN, Geller AC, Sloan RP, Mostofsky E, Williams DR, Sidney S. Association of the 2020 US Presidential Election With Hospitalizations for Acute Cardiovascular Conditions. JAMA Netw Open 2022; 5:e228031. [PMID: 35442454 PMCID: PMC9021908 DOI: 10.1001/jamanetworkopen.2022.8031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Prior studies found a higher risk of acute cardiovascular disease (CVD) around population-wide psychosocial or environmental stressors. Less is known about acute CVD risk in relation to political events. OBJECTIVE To examine acute CVD hospitalizations following the 2020 presidential election. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study examined acute CVD hospitalizations following the 2020 presidential election. Participants were adult members aged 18 years or older at Kaiser Permanente Southern California and Kaiser Permanente Northern California, 2 large, integrated health care delivery systems. Statistical analysis was performed from March to July 2021. EXPOSURE 2020 US presidential election. MAIN OUTCOMES AND MEASURES Hospitalizations for acute CVD around the 2020 presidential election were examined. CVD was defined as hospitalizations for acute myocardial infarction (AMI), heart failure (HF), or stroke. Rate ratios (RR) and 95% CIs were calculated comparing rates of CVD hospitalization in the 5 days following the 2020 election with the same 5-day period 2 weeks prior. RESULTS Among 6 396 830 adults (3 970 077 [62.1%] aged 18 to 54 years; 3 422 479 [53.5%] female; 1 083 128 [16.9%] Asian/Pacific Islander, 2 101 367 [32.9%] Hispanic, and 2 641 897 [41.3%] White), rates of hospitalization for CVD following the election (666 hospitalizations; rate = 760.5 per 100 000 person-years [PY]) were 1.17 times higher (95% CI, 1.05-1.31) compared with the same 5-day period 2 weeks prior (569 hospitalizations; rate = 648.0 per 100 000 PY). Rates of AMI were significantly higher following the election (RR, 1.42; 95% CI, 1.13-1.79). No significant difference was found for stroke (RR, 1.02; 95% CI, 0.86-1.21) or HF (RR, 1.18; 95% CI, 0.98-1.42). CONCLUSIONS AND RELEVANCE Higher rates of acute CVD hospitalization were observed following the 2020 presidential election. Awareness of the heightened risk of CVD and strategies to mitigate risk during notable political events are needed.
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Affiliation(s)
- Matthew T. Mefford
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
| | - Jamal S. Rana
- Department of Cardiology, Kaiser Permanente Oakland Medical Center, Oakland, California
- Division of Research, Kaiser Permanente Northern California, Oakland
| | - Kristi Reynolds
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
| | - Omesh Ranasinghe
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
| | - Murray A. Mittleman
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Jennifer Y. Liu
- Division of Research, Kaiser Permanente Northern California, Oakland
| | - Lei Qian
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
| | - Hui Zhou
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
| | - Teresa N. Harrison
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
| | - Alan C. Geller
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Richard P. Sloan
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Elizabeth Mostofsky
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - David R. Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of African and African American Studies, Harvard University, Cambridge, Massachusetts
| | - Stephen Sidney
- Division of Research, Kaiser Permanente Northern California, Oakland
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10
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Symbolic disempowerment and Donald Trump's 2016 presidential election: Mental health responses among Latinx and white populations. Soc Sci Med 2021; 289:114417. [PMID: 34656819 DOI: 10.1016/j.socscimed.2021.114417] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 08/25/2021] [Accepted: 09/19/2021] [Indexed: 11/23/2022]
Abstract
The 2016 election of United States (U.S.) President Donald Trump was a political event that may have affected population-level mental health. A prominent theme in the Trump election was anti-immigrant policy that contributed to a racist and xenophobic sociopolitical climate. Applying a symbolic dis/empowerment framework, this study examines whether there was an effect of the Trump election on the mental health of the U.S. population that differed by race/ethnicity, language of interview, and state-level support for Trump or Clinton. We used data from the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System 2011-2018 to examine trends in poor mental health days in the five months after the U.S Presidential election (November 2016 to March 2017) compared to all other survey months. We conducted difference-in-differences analyses using negative binomial regression models to examine the effect of the five post-election months on the rate of poor mental health days, comparing six population categories: 1) non-Latinx white populations in Trump states, 2) non-Latinx white populations in Clinton states, 3) English-speaking Latinx populations in Trump states, 4) English-speaking Latinx populations in Clinton states, 5) Spanish-speaking Latinx populations in Trump states, and 6) Spanish-speaking Latinx populations in Clinton states. White populations in Clinton states reported more poor mental health days in response to the five months post-election period compared to white populations in Trump states. English-speaking Latinx people living in Trump states experienced higher than expected poor mental health days in November 2016 and February 2017. Spanish-speaking Latinx people, by contrast, reported fewer poor mental health days in the post-election period. The 2016 U.S. presidential election preceded population-level changes in mental health that support a symbolic dis/empowerment framework. We discuss possible explanations and the mental health implications for future major political events.
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