Area-level deprivation and adverse childhood experiences among high school students in Maryland

Szabo Y. Childhood Adversity and Adult Inflammation: Exploring the Mediating Role of Emotion Regulation in the MIDUS II Study

The present study furthers understanding of how childhood adversity connects to inflammation and, in turn, poor health. Using the publicly available Midlife in the United States II (MIDUS II) dataset, we test a recent theoretical model that suggests emotion regulation is a potential mechanism of associations between adversity and inflammation. We examined the indirect effects of various types of adversity (e.g., stressful events, maltreatment, threat, and deprivation) on inflammation via two emotion regulation strategies (i.e., expressive suppression and reappraisal). Participants included 1096 adults without a history of cancer or HIV/AIDS who had completed the initial MIDUS II follow up and a sub-study examining biomarkers. Participants completed self-report measures inquiring about psychosocial factors including stressful life events, childhood trauma, and emotion regulation as well as provided blood samples. Bivariate correlation indicated that multiple forms of childhood adversity were associated with both C-reactive protein and fibrinogen. Deprivation, as measured by a stressful life events scale, was positively associated with both reappraisal and suppression. Tests of indirect effects indicated that deprivation was positively associated with fibrinogen through both emotion regulation strategies, particularly for female participants. Our findings partially support recent theory positing emotion regulation as a pathway through which childhood adversity may impact inflammation in adulthood. Further, deprivation may be particularly critical in understanding how adversity is connected to maladaptive emotion regulation and inflammation. Emotion regulation may be an important treatment target to mitigate the negative impact of childhood adversity on health and well-being.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40653-023-00594-2.

Understanding individual health-related social needs in the context of area-level social determinants of health: The case for granularity

Introduction

Screening for health-related social needs (HRSNs) within health systems is a widely accepted recommendation, however challenging to implement. Aggregate area-level metrics of social determinants of health (SDoH) are easily accessible and have been used as proxies in the interim. However, gaps remain in our understanding of the relationships between these measurement methodologies. This study assesses the relationships between three area-level SDoH measures, Area Deprivation Index (ADI), Social Deprivation Index (SDI) and Social Vulnerability Index (SVI), and individual HRSNs among patients within one large urban health system.

Methods

Patients screened for HRSNs between 2018 and 2019 (N = 45,312) were included in the analysis. Multivariable logistic regression models assessed the association between area-level SDoH scores and individual HRSNs. Bivariate choropleth maps displayed the intersection of area-level SDoH and individual HRSNs, and the sensitivity, specificity, and positive and negative predictive values of the three area-level metrics were assessed in relation to individual HRSNs.

Results

The SDI and SVI were significantly associated with HRSNs in areas with high SDoH scores, with strong specificity and positive predictive values (∼83% and ∼78%) but poor sensitivity and negative predictive values (∼54% and 62%). The strength of these associations and predictive values was poor in areas with low SDoH scores.

Conclusions

While limitations exist in utilizing area-level SDoH metrics as proxies for individual social risk, understanding where and how these data can be useful in combination is critical both for meeting the immediate needs of individuals and for strengthening the advocacy platform needed for resource allocation across communities.

Adverse childhood experiences and living in the socially deprived areas in adulthood: a cross-sectional study of the nationwide data in Japan

OBJECTIVES

This study aimed to examine whether having adverse childhood experiences (ACEs) was associated with living in a deprived area in adulthood.

METHODS

The cross-sectional study was conducted by using nation-wide data in 2022 of the Japan COVID-19 and Society Internet Survey (JACSIS). Participants were community dwelling people 18 years or older. ACEs were assessed by Japanese version of 15-items ACE measurement tool (ACE-J). Living condition was measured by Area Deprived Index (ADI) and Densely Inhabited District (DID) based on zip code. Multivariable logistic regression to analyze the associations between ADI and ACE 4 + was conducted, controlling for individual-level factors, such as age, sex, marital status, and education, as an additional analysis.

RESULTS

The total of 27,916 participants were included in the analysis. The prevalence of emotional neglect, childhood poverty, and school bullying were 38.2%, 26.5%, 20.8%, respectively. 75% of the population had one or more ACE(s). The number of ACEs was associated with significantly higher risk of living in deprived area in the adulthood (p = 0.001). ACEs were not associated with living in density area. The association between ADI and ACEs 4 + was non-significant after controlling the individual-level factors.

CONCLUSION

People with higher number of ACEs tend to live in deprived areas in adulthood. Policy makers in highly deprived areas can apply the trauma-informed approach for the community care and support, which is critical to mitigating deficit perspectives and facilitating comprehensive support for those with ACEs.

Environmental justice and allergic disease: A Work Group Report of the AAAAI Environmental Exposure and Respiratory Health Committee and the Diversity, Equity and Inclusion Committee

Environmental justice is the concept that all people have the right to live in a healthy environment, to be protected against environmental hazards, and to participate in decisions affecting their communities. Communities of color and low-income populations live, work, and play in environments with disproportionate exposure to hazards associated with allergic disease. This unequal distribution of hazards has contributed to health disparities and is largely the result of systemic racism that promotes segregation of neighborhoods, disinvestment in predominantly racial/ethnic minority neighborhoods, and discriminatory housing, employment, and lending practices. The AAAAI Environmental Exposure and Respiratory Health Committee and Diversity, Equity and Inclusion Committee jointly developed this report to improve allergy/immunology specialists' awareness of environmental injustice, its roots in systemic racism, and its impact on health disparities in allergic disease. We present evidence supporting the relationship between exposure to environmental hazards, particularly at the neighborhood level, and the disproportionately high incidence and poor outcomes from allergic diseases in marginalized populations. Achieving environmental justice requires investment in at-risk communities to increase access to safe housing, clean air and water, employment opportunities, education, nutrition, and health care. Through policies that promote environmental justice, we can achieve greater health equity in allergic disease.

Adverse Childhood Experiences and Health in Rural Areas of Riyadh Province in Saudi Arabia: A Cross-Sectional Study

Adverse childhood experiences (ACEs) and their consequences are a worldwide problem. ACEs are primary stressors that have a long-term impact on the body and mind during development. They are linked to a variety of chronic illnesses in adults. Information about ACEs and health and risk behaviors is scarce among rural populations. The study aimed to examine ACEs, chronic diseases, and risk behaviors, as well as to explore the relationship between them and number of sociodemographic factors among adults living in rural areas in Riyadh Province, Saudi Arabia. A cross-sectional design and a convenience sampling method were utilized to collect information. A self-reported questionnaire, including an ACEs questionnaire as well as direct health and risk behaviors questions, was used. In total, 68.2% of the respondents reported at least one ACE, and 34.2% reported four or more ACEs. Emotional and physical abuse were the most reported forms. Hypertension and chronic respiratory disease were the most reported chronic diseases. Depression and anxiety were associated with ACEs, indicating that those who reported four or more ACEs were more likely to develop depression and anxiety. ACEs contribute to many negative health outcomes; thus, identifying the prevalence of ACEs among the rural population is essential for future health-related actions. It is also important that chronic diseases and risk behaviors be specifically identified among the rural population in order to prioritize these actions. Future research should further investigate ACEs and other determinants of health among the rural population, taking into consideration the inclusion of more diverse people, such as older adults and those from other rural areas.

An Umbrella Review of the Links Between Adverse Childhood Experiences and Substance Misuse: What, Why, and Where Do We Go from Here?

BACKGROUND AND OBJECTIVES

A wealth of research has identified adverse childhood experiences (ACEs; abuse, neglect, violence or disorder in the home) as a strong risk factor for substance misuse. Synthesis of the existing evidence is critical to shape policy and inform directions for future research. Existing reviews have focused on specific substances or substance use outcomes (eg, disorder), and do not include discussion of the mechanisms that operate between ACEs and substance misuse. The current umbrella review aims to synthesize reviews on the relationship between ACEs and substance misuse, review the evidence on the mechanisms linking these, identify existing gaps in our knowledge, and discuss critical directions for future research, practice, and public policy.

METHODS

Two electronic databases (PsycINFO and Medline) were searched for reviews published between 1998 and 2022 on the link between ACEs and substance misuse. Twenty articles met eligibility criteria and were qualitatively synthesized.

RESULTS

Results overwhelmingly demonstrated an elevated risk of substance misuse or disorder, among adolescents and adults exposed to ACEs. Research on the mechanisms that explain this link highlights a multitude of potential intervention targets, with childhood stress propelling a cascade of effects across neurobiological, endocrine, immune, metabolic, and nervous systems, impacting psychosocial and cognitive functioning. Nonetheless, the literature is subject to limitations surrounding potential unmeasured cofounders and causality, as well as decontextualizing childhood adversity from broader structural issues that influence the link between ACEs and substance misuse. Research, policy, and practice that seek to holistically understand and address the relationship between ACEs and substance misuse within the broader social determinants of health is crucial.

Cross-sectional associations between screen time and the selected lifestyle behaviors in adolescents

Background

In adolescents, excessive screen time leads to many adverse health outcomes and is associated with a variety of lifestyle behaviors. This study was conducted to investigate the associations between the two types of screen time and a variety of lifestyle behaviors in American adolescents.

Methods

Based on the Youth Risk Behavior Surveillance System, this cross-sectional study was conducted. With the help of data collectors, participants self-reported screening time, lifestyle behaviors, and demographic data via well-validated tools.

Results

19% and 43.4% of the participants spent more than two hours a day watching television and using the computer, respectively, while the prevalence of physical inactivity and insufficient sleep was 75.1 and 74.4% respectively. Furthermore, 11.9, 7.3, 14.3, and 21.3% of the participants reported skipping fruits, vegetables, breakfast and milk, respectively. Moreover, the prevalence of alcohol and tobacco consumption and sexual activity was 26.8, 5.3, and 23.5% respectively. More than two hours of television time was significantly associated with high risks of fewer frequency for eating fruit (OR = 1.605, 95%CI: 1.308-1.970), vegetables (OR = 1.389, 95%CI: 1.029-1.873), and smoking (OR = 1.465, 95%CI: 1.088-1.972). Computer/video time for more than two hours was significantly associated with high risks of physical inactivity (OR = 1.724, 95%CI: 1.531-1.941), insufficient sleep (OR = 1.354, 95%CI: 1.151-1.592), and not eating fruit (OR = 1.434, 95%CI: 1.179-1.745).

Conclusion

Increased screen time may be associated with specific unhealthy lifestyle behaviors in adolescents. Furthermore, the associations between different types of screen time and various lifestyle behaviors varied.