1
|
Blosnich JR, Haydinger A, Rhoades H, De Luca SM. Differences in Beliefs About Suicide by Occupation in a Representative Sample of Adults in the United States, General Social Survey 2002-2021. Arch Suicide Res 2024; 28:439-453. [PMID: 36916390 PMCID: PMC10500038 DOI: 10.1080/13811118.2023.2190363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
OBJECTIVE Beliefs about suicide are important aspects of suicide prevention gatekeeper trainings. This study sought to determine if workers in finance- and legal/judicial-related industries have significantly different levels of suicide acceptability compared to the general US population. METHOD Cross-sectional data are from the 2002 to 2021 General Social Survey (GSS). Suicide acceptability was measured with four dichotomous items to which respondents indicated yes/no if they thought someone has the right to end their life in four negative life scenarios. Occupational categories were coded based on U.S. Census Bureau occupation and industry codes. Covariates for multiple logistic regression analyses included age, educational attainment, sex, race, ethnicity, survey year, and religiosity. RESULTS Among the 15,166 respondents, 651 people worked in finance-related occupations and 319 people worked in legal/judicial-related occupations. In adjusted models, people in finance-related occupations had greater odds of endorsing suicide as acceptable if one has an incurable disease (aOR = 1.25, 95%CI = 1.03-1.52) and marginally greater odds of endorsing suicide as acceptable if one dishonors their family (aOR = 1.31, 95%CI = 0.99-1.74) than the general adult population. People in legal/judicial-related occupations were more likely to endorse 3 of the 4 suicide acceptability items compared to the general adult population, however these differences were not statistically significant after accounting for demographic factors. CONCLUSION Workers in non-clinical industries that frequently see clients during negative life events are prime audiences for gatekeeper trainings but may have entrenched beliefs about suicide acceptability. Research is needed to determine how these beliefs may impact gatekeeper training.
Collapse
Affiliation(s)
- John R. Blosnich
- University of Southern California, Suzanne Dworak-Peck School of Social Work, 669 W. 34 Street, Los Angeles, CA, USA 90089
| | - Alexandra Haydinger
- University of Southern California, Suzanne Dworak-Peck School of Social Work, 669 W. 34 Street, Los Angeles, CA, USA 90089
| | - Harmony Rhoades
- University of Southern California, Suzanne Dworak-Peck School of Social Work, 669 W. 34 Street, Los Angeles, CA, USA 90089
| | - Susan M. De Luca
- The MetroHealth System, Population Health Research Institute, Center for Health Care Research and Policy, 2500 MetroHealth Drive, Cleveland, OH, USA 44109
- Case Western Reserve University, School of Medicine, 9501 Euclid Ave., Cleveland OH 44106
| |
Collapse
|
2
|
Park GR. Housing cost burden and external causes of mortality: Variations across housing regimes in high-income countries, 2010-2020. Soc Sci Med 2024; 345:116672. [PMID: 38367338 DOI: 10.1016/j.socscimed.2024.116672] [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: 06/09/2023] [Revised: 12/18/2023] [Accepted: 02/07/2024] [Indexed: 02/19/2024]
Abstract
OBJECTIVES While comparative studies reported that generous welfare state improves population health, they did not take into account the roles of housing as a cornerstone of welfare state. To reduce knowledge gaps, this study aims to estimate (a) the link between housing affordability stress and mortality rate due to external causes and (b) the moderating effects of housing regime on such association. METHODS Using country level panel data from the databases of the Organisation for Economic Co-operation and Development (OECD), fixed effects were performed to estimate the effects of housing costs to income ratio on mortality rates due to external causes (accidents, intentional self-harm, and assault). Also, we tested whether housing regimes moderate the association between housing cost burden and mortality rate. RESULTS An increased level of housing cost burden predicted mortality rates due to accidents and intentional self-harm. Such association was pronounced for countries with higher rates of homeownership and limited access to market self-help. In addition, when homeownership rates and debt-to-income ratios are taken into account as time-varying variables, the elevated mortality risks associated with both increased housing cost burden and higher homeownership are mitigated in countries where debt relative to income increases. CONCLUSION Our findings suggest that different housing systems shape divergent patterns of mortality risks associated with housing affordability stress. Future studies may wish to incorporate housing in macro comparative studies on population health.
Collapse
Affiliation(s)
- Gum-Ryeong Park
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, M5T 3M7, Canada; Department of Health, Aging & Society, McMaster University, Hamilton, Ontario, Canada.
| |
Collapse
|
3
|
Ivey-Stephenson AZ, Ballesteros MF, Trinh E, Stone DM, Crosby AE. CDC Guidance for Community Response to Suicide Clusters, United States, 2024. MMWR Suppl 2024; 73:17-26. [PMID: 38412137 PMCID: PMC10899085 DOI: 10.15585/mmwr.su7302a3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024] Open
Abstract
This is the third of three reports in the MMWR supplement that updates and expands CDC's guidance for assessing, investigating, and responding to suicide clusters based on current science and public health practice. The first report, Background and Rationale - CDC Guidance for Communities Assessing, Investigating, and Responding to Suicide Clusters, United States, 2024, describes an overview of suicide clusters, methods used to develop the supplement guidance, and intended use of the supplement reports. The second report, CDC Guidance for Community Assessment and Investigation of Suspected Suicide Clusters, United States, 2024, describes the potential methods, data sources, and analysis that communities can use to identify and confirm suspected suicide clusters and better understand the relevant issues. This report describes how local public health and community leaders can develop a response plan for suicide clusters. Specifically, the steps for responding to a suicide cluster include preparation, direct response, and action for prevention. These steps are not intended to be explicitly adopted but rather adapted into the local context, culture, capacity, circumstances, and needs for each suicide cluster.
Collapse
|
4
|
Chen YL, Li DJ, Chen YY, Yen CF. The impact of housing-price-related indices on suicide rates in Taiwan. Int J Soc Psychiatry 2024; 70:40-47. [PMID: 37665194 DOI: 10.1177/00207640231194484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
BACKGROUND While certain socioeconomic factors have been studied in relation to suicide, housing-price-related indexes have rarely been investigated. AIMS This article aims to examine the impact of housing-price-related indexes on suicide rates in the general population of Taiwan, a country with high housing costs and suicide rates. METHODS The study utilized three national housing-price-related indexes from 2012 to 2019: (1) housing price index, (2) housing price to income ratio, and (3) housing rental index. Cause of Death Data was employed to calculate suicide rate. A linear regression model with autoregressive errors was used to analyze the association between housing-price-related indexes and suicide rates among different sex and age groups. RESULTS The findings revealed that higher housing rental index values were associated with increased suicide rates in young and middle-aged adults compared to the elderly population, regardless of sex. However, this association was not observed with the other two housing-price-related indexes (i.e. housing price index and housing price to income ratio). CONCLUSION These results offer valuable insights for policymakers, mental health professionals, and housing advocates to improve housing affordability and reduce the burden of suicide in the general population, particularly among younger generations.
Collapse
Affiliation(s)
- Yi-Lung Chen
- Department of Psychology, Asia University, Taichung
- Department of Healthcare Administration, Asia University, Taichung
| | - Dian-Jeng Li
- Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung
- Department of Nursing, Meiho University, Pingtung
| | - Ying-Yeh Chen
- Taipei City Psychiatric Centre, Taipei City Hospital, Taipei City
- Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei City
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung
| |
Collapse
|
5
|
Tang S, Bowen DA, Chadwick L, Madden E, Ghertner R. Are Home Evictions Associated with Child Welfare System Involvement? Empirical Evidence from National Eviction Records and Child Protective Services Data. CHILD MALTREATMENT 2024; 29:66-81. [PMID: 36112918 PMCID: PMC10178375 DOI: 10.1177/10775595221125917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
This study aimed to understand the relationship between home eviction and child welfare system involvement at the county level. Using administrative data, we examined associations of home eviction and eviction filing rates with child abuse and neglect (CAN) reports and foster care entries. We found one additional eviction per 100 renter-occupied homes in a county was associated with a 1.3% increase in the rate of CAN reports and a 1.6% increase in foster care entries. The association between eviction and foster care entries was strongest among Hispanic children with an 8.1% increase. Assisting parents in providing stable housing may reduce the risk of child welfare system involvement, including out-of-home child placement. Primary and secondary prevention strategies could include housing assistance, increasing access to affordable and safe housing, as well as providing economic support for families (e.g., tax credits, childcare subsidies) that reduce parental financial burden to access stable housing.
Collapse
Affiliation(s)
- Shichao Tang
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Daniel A Bowen
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Laura Chadwick
- Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, Washington, DC, USA
| | - Emily Madden
- Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, Washington, DC, USA
| | - Robin Ghertner
- Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, Washington, DC, USA
| |
Collapse
|
6
|
Simon DH, Masters RK. Institutional Failures as Structural Determinants of Suicide: The Opioid Epidemic and the Great Recession in the United States. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2024:221465231223723. [PMID: 38235534 DOI: 10.1177/00221465231223723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
We investigate recent trends in U.S. suicide mortality using a "structural determinants of health" framework. We access restricted-use multiple cause of death files to track suicide rates among U.S. Black, White, American Indian/Alaska Native, and Latino/a men and women between 1990 and 2017. We examine suicide deaths separately by poisonings and nonpoisonings to illustrate that (1) women's suicide rates from poisonings track strongly with increases in prescription drug availability and (2) nonpoisoning suicide rates among all adult Americans track strongly with worsening economic conditions coinciding with the financial crash and Great Recession. These findings suggest that institutional failures elevated U.S. suicide risk between 1990 and 2017 by increasing access to more lethal means of self-harm and by increasing both exposure and vulnerability to economic downturns. Together, these results support calls to scale up to focus on the structural determinants of U.S. suicide.
Collapse
|
7
|
Brown EM, Moineddin R, Hapsari A, Gozdyra P, Durant S, Pinto AD. Eviction filings during bans on enforcement throughout the COVID-19 pandemic: an interrupted time series analysis. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2023; 114:745-754. [PMID: 37581748 PMCID: PMC10485221 DOI: 10.17269/s41997-023-00813-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 07/12/2023] [Indexed: 08/16/2023]
Abstract
OBJECTIVE Bans on evictions were implemented to reduce the spread of COVID-19 and to protect vulnerable populations during a public health crisis. Our objective was to examine how three bans on eviction enforcement impacted eviction filings from March 2020 through January 2022 in Ontario, Canada. METHODS Data were derived from eviction application records kept by the Ontario Landlord and Tenant Board. We used segmented regression analysis to model changes in the average weekly filing rates for evictions due to non-payment of rent (L1 filings) and reasons other than non-payment of rent (L2 filings). RESULTS The average number of weekly L1 and L2 applications dropped by 67.5 (95% CI: 55.2, 79.9) and 31.7 (95% CI: 26.7, 36.6) filings per 100,000 rental dwellings, respectively, following the first ban on eviction enforcement (p < 0.0001). Notably, they did not fall to zero. Level changes during the second and third bans were insubstantial and slope changes for L2 applications varied throughout the study period. The L1 filing rate appeared to increase towards the end of the study period (slope change: 1.3; 95% CI: 0.1, 2.6; p = 0.0387). CONCLUSION Our findings suggest that while the first ban on eviction enforcement appeared to substantially reduce filing rates, subsequent bans were less effective and none of them eliminated eviction filings altogether. Enacting upstream policies that tackle the root causes of displacement would better equip jurisdictions during future public health emergencies.
Collapse
Affiliation(s)
- Erika M Brown
- California Policy Lab, Institute for Research on Labor & Employment, University of California, Berkeley, Berkeley, CA, USA
- Social Interventions Research & Evaluation Network, University of California, San Francisco, San Francisco, CA, USA
| | - Rahim Moineddin
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ayu Hapsari
- Upstream Lab, MAP/Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada
| | - Peter Gozdyra
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - Steve Durant
- Upstream Lab, MAP/Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada
| | - Andrew D Pinto
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- Upstream Lab, MAP/Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada.
- Department of Family and Community Medicine, St. Michael's Hospital, Toronto, ON, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
| |
Collapse
|
8
|
Bradford AC, Maclean JC. Evictions and psychiatric treatment. JOURNAL OF POLICY ANALYSIS AND MANAGEMENT : [THE JOURNAL OF THE ASSOCIATION FOR PUBLIC POLICY ANALYSIS AND MANAGEMENT] 2023; 43:87-125. [PMID: 38249438 PMCID: PMC10798266 DOI: 10.1002/pam.22522] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
Stable housing is critical for health, employment, education, and other social outcomes. Evictions reflect a form of housing instability that is experienced by millions of Americans each year. Inadequately treated psychiatric disorders have the potential to influence evictions in several ways. For example, these disorders may impede labor market performance and thus the ability to pay rent, or increase the likelihood of risky and/or nuisance behaviors that can lead to a lease violation. We estimate the effect of local access to psychiatric treatment on eviction rates. We combine data on the number of psychiatric treatment centers that offer outpatient and residential care within a county with eviction rates in a two-way fixed-effects framework. Our findings imply that 10 additional psychiatric treatment centers in a county lead to a reduction of 2.1% in the eviction rate.
Collapse
Affiliation(s)
- Ashley C. Bradford
- Georgia Institute of Technology, School of Public Policy, Atlanta, GA, United States
| | | |
Collapse
|
9
|
Montgomery AE, Blosnich JR, deRussy A, Richman JS, Dichter ME, True G. Association between Services to Address Adverse Social Determinants of Health and Suicide Mortality among Veterans with Indicators of Housing Instability, Unemployment, and Justice Involvement. Arch Suicide Res 2023:1-17. [PMID: 37565799 DOI: 10.1080/13811118.2023.2244534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
Suicide among Veterans continues to be a priority issue addressed by the U.S. Department of Veterans Affairs (VA). In addition to a variety of services specifically intended to prevent suicide, VA also offers a number of services to address Veterans' social determinants of health (SDH), several of which may be associated with elevated risk for suicide. For the present study, we assessed whether participation in services to address adverse SDH is associated with a reduction in risk of suicide mortality among Veterans using secondary data from VA datasets (1/1/2014-12/31/2019) for Veterans with an indicator of housing instability, unemployment, or justice involvement. Logistic regressions modeled suicide mortality; use of services to address SDH was the primary predictor. There was not a statistically significant association between services use and suicide mortality; significant correlates included race other than African American, low or no compensation related to disability incurred during military service, and suicidal ideation/attempt during observation period. Suicide is a complex outcome, difficult to predict, and likely the result of many factors; while there is not a consistent association between services use related to adverse SDH and suicide mortality, providers should intervene with Veterans who do not engage in SDH-focused services but have risk factors for suicide mortality.
Collapse
|
10
|
Boen CE, Keister LA, Gibson-Davis CM, Luck A. The Buffering Effect of State Eviction and Foreclosure Policies for Mental Health during the COVID-19 Pandemic in the United States. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2023:221465231175939. [PMID: 37334797 PMCID: PMC10288207 DOI: 10.1177/00221465231175939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
The COVID-19 pandemic spurred an economic downturn that may have eroded population mental health, especially for renters and homeowners who experienced financial hardship and were at risk of housing loss. Using household-level data from the Census Bureau's Household Pulse Survey (n = 805,223; August 2020-August 2021) and state-level data on eviction/foreclosure bans, we estimated linear probability models with two-way fixed effects to (1) examine links between COVID-related financial hardship and anxiety/depression and (2) assess whether state eviction/foreclosure bans buffered the detrimental mental health impacts of financial hardship. Findings show that individuals who reported difficulty paying for household expenses and keeping up with rent or mortgage had increased anxiety and depression risks but that state eviction/foreclosure bans weakened these associations. Our findings underscore the importance of state policies in protecting mental health and suggest that heterogeneity in state responses may have contributed to mental health inequities during the pandemic.
Collapse
|
11
|
Dang LN, Kahsay ET, James LN, Johns LJ, Rios IE, Mezuk B. Research utility and limitations of textual data in the National Violent Death Reporting System: a scoping review and recommendations. Inj Epidemiol 2023; 10:23. [PMID: 37161610 PMCID: PMC10170777 DOI: 10.1186/s40621-023-00433-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 04/26/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Many studies of injury deaths rely on mortality data that contain limited contextual information about decedents. The National Violent Death Reporting System (NVDRS) is unique among such data systems in that each observation includes both quantitative variables and qualitative texts (called "narratives") abstracted from original source documents. These narratives provide rich data regarding salient circumstances that can be used to inform prevention efforts. This review provides a comprehensive summary of peer-reviewed research using NVDRS narratives over the past 20 years, including the limitations of these texts and provides recommendations on utilizing and improving narrative quality for researchers and practitioners. MAIN BODY Studies that used narratives to examine deaths related to suicide, homicide, undetermined intent, accidental firearm, or legal intervention were identified by a title/abstract screening, followed by a full-text review. The search was conducted on English-language, peer-reviewed literature and government reports published from 2002 to 2022 in PubMed, PsycInfo, Scopus, and Google Scholar. Abstracted elements focused on the methodologies used to analyze the narratives, including approaches to explore potential biases in these texts. Articles were abstracted independently by two reviewers, with disagreements resolved through consensus discussion. During the 20-year period, 111 articles used narratives. Two-thirds studied suicide (n = 48, 43%) and homicides (n = 25, 23%). Most studies analyzed the narratives using manual review (n = 81, 73%) and keyword searches (n = 9, 8%), with only 6 (5%) using machine learning tools. Narratives were mainly used for case finding (n = 49, 44%) and characterization of circumstances around deaths (n = 38, 34%). Common challenges included variability in the narratives and lack of relevant circumstantial details for case characterization. CONCLUSION Although the use of narratives has increased over time, these efforts would be enhanced by detailed abstraction of circumstances with greater salience to injury research and prevention. Moreover, researchers and practitioners would benefit from guidance on integrating narratives with quantitative variables and standardized approaches to address variability in the completeness and length of narratives. Such efforts will increase the reliability of findings and set the stage for more widespread applications of data science methods to these texts.
Collapse
Affiliation(s)
- Linh N Dang
- Department of Epidemiology, Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Eskira T Kahsay
- Department of Epidemiology, Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - LaTeesa N James
- Taubman Health Sciences Library, University of Michigan, Ann Arbor, MI, USA
| | - Lily J Johns
- Department of Epidemiology, Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Isabella E Rios
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Briana Mezuk
- Department of Epidemiology, Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
| |
Collapse
|
12
|
Rivera R, Capers T, Chandler M, Matthews E, Rzewinski J, Rees J, Israel S, Lushin V. Socioeconomic Stability Buffers Racial Discrimination Effect on Depression in a Marginalized Community. J Racial Ethn Health Disparities 2023; 10:130-140. [PMID: 35040107 DOI: 10.1007/s40615-021-01203-4] [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: 07/22/2021] [Revised: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 02/03/2023]
Abstract
Depression disproportionately burdens poverty-affected minority communities. Racism and racial discrimination are well-known determinants of depression among members of marginalized minority communities. Less is known about potential buffers of the discrimination effects on depression, particularly those that could serve as targets for efficient community-based policies and interventions. Our secondary analysis of data from a community needs assessment survey (N = 677) in an urban minority neighborhood of low socio-economic status revealed that high school completion and current employment significantly weakened the association between discrimination and depression. Our findings frame community-level efforts to foster high school completion and employment as potential strategies to reduce the footprint of racism on the mental health of marginalized community members. Implications for future research and policy are discussed.
Collapse
Affiliation(s)
- Rebecca Rivera
- Long Island University Brooklyn Campus, Brooklyn, NY, USA
| | - Tracey Capers
- Bedford Stuyvesant Restoration Corporation, Brooklyn, NY, USA
| | | | | | | | - Jo Rees
- School of Health Professions, Long Island University Brooklyn Campus, Brooklyn, NY, USA
| | - Shimonah Israel
- Bedford Stuyvesant Restoration Corporation, Brooklyn, NY, USA
| | - Victor Lushin
- Long Island University Brooklyn Campus, Brooklyn, NY, USA.
| |
Collapse
|
13
|
Park GR, Grignon M, Young M, Dunn JR. The association between housing cost burden and avoidable mortality in wealthy countries: cross-national analysis of social and housing policies, 2000-2017. J Epidemiol Community Health 2023; 77:65-73. [PMID: 36384959 DOI: 10.1136/jech-2022-219545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 11/05/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND It has been shown that the high cost of housing can be detrimental to individual health. However, it is unknown (1) whether high housing costs pose a threat to population health and (2) whether and how social policies moderate the link between housing cost burden and mortality. This study aims to reduce these knowledge gaps. METHODS Country-level panel data from Organisation for Economic Co-operation and Development (OECD) countries are used. Housing cost to income ratio and age-standardised mortality were obtained from the OECD database. Fixed effects models were conducted to estimate the extent to which the housing cost to income ratio was associated with preventable mortality, treatable mortality, and suicides. In order to assess the moderating effects of social and housing policies, different types of social spending per capita as well as housing policies were taken into account. RESULTS Housing cost to income ratio was significantly associated with preventable mortality, treatable mortality, and suicide during the post-global financial crisis (2009-2017) but not during the pre-global financial crisis (2000-2008). Social spending on pensions and unemployment benefits decreased the levels of mortality rate associated with housing cost burden. In countries with higher levels of social housing stock, the link between housing cost burden and mortality was attenuated. Similar patterns were examined for countries with rent control. CONCLUSION Our findings suggest that housing cost burden can be related to population health. Future studies should examine the role of protective measures that alleviate health problems caused by housing cost burden.
Collapse
Affiliation(s)
- Gum-Ryeong Park
- Department of Health, Aging & Society, McMaster University, Hamilton, Ontario, Canada
| | - Michel Grignon
- Department of Health, Aging & Society, McMaster University, Hamilton, Ontario, Canada.,Department of Economics, McMaster University, Hamilton, Ontario, Canada
| | - Marisa Young
- Department of Sociology, McMaster University, Hamilton, Ontario, Canada
| | - James R Dunn
- Department of Health, Aging & Society, McMaster University, Hamilton, Ontario, Canada.,MAP Centre for Urban Health Solutions, St Michael's Hospital, Toronto, Ontario, Canada
| |
Collapse
|
14
|
Johns L, Zhong C, Mezuk B. Understanding Suicide over the Life Course Using Data Science Tools within a Triangulation Framework. JOURNAL OF PSYCHIATRY AND BRAIN SCIENCE 2023; 8:e230003. [PMID: 37168035 PMCID: PMC10168676 DOI: 10.20900/jpbs.20230003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Suicide and suicidal behaviors are important global health concerns. Preventing suicide requires a nuanced understanding of the nature of suicide risk, both acutely during periods of crisis and broader variation over the lifespan. However, current knowledge of the sources of variation in suicide risk is limited due to methodological and conceptual challenges. New methodological approaches are needed to close the gap between research and clinical practice. This review describes the life course framework as a conceptual model for organizing the scientific study of suicide risk across in four major domains: social relationships, health, housing, and employment. In addition, this review discusses the utility of data science tools as a means of identifying novel, modifiable risk factors for suicide, and triangulation as an overarching approach to ensuring rigor in suicide research as means of addressing existing knowledge gaps and strengthening future research.
Collapse
|
15
|
Raifman J, Ettman CK, Dean LT, Abdalla SM, Skinner A, Barry CL, Galea S. Economic precarity, loneliness, and suicidal ideation during the COVID-19 pandemic. PLoS One 2022; 17:e0275973. [PMID: 36383566 PMCID: PMC9668199 DOI: 10.1371/journal.pone.0275973] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 09/27/2022] [Indexed: 11/17/2022] Open
Abstract
The US population faced stressors associated with suicide brought on by the COVID-19 pandemic. Understanding the relationship between stressors and suicidal ideation in the context of the pandemic may inform policies and programs to prevent suicidality and suicide. We compared suicidal ideation between two cross-sectional, nationally representative surveys of adults in the United States: the 2017-2018 National Health and Nutrition Examination Survey (NHANES) and the 2020 COVID-19 and Life Stressors Impact on Mental Health and Well-being (CLIMB) study (conducted March 31 to April 13). We estimated the association between stressors and suicidal ideation in bivariable and multivariable Poisson regression models with robust variance to generate unadjusted and adjusted prevalence ratios (PR and aPR). Suicidal ideation increased from 3.4% in the 2017-2018 NHANES to 16.3% in the 2020 CLIMB survey, and from 5.8% to 26.4% among participants in low-income households. In the multivariable model, difficulty paying rent (aPR: 1.5, 95% CI: 1.2-2.1) and feeling alone (aPR: 1.9, 95% CI: 1.5-2.4) were associated with suicidal ideation but job loss was not (aPR: 0.9, 95% CI: 0.6 to 1.2). Suicidal ideation increased by 12.9 percentage points and was almost 4.8 times higher during the COVID-19 pandemic. Suicidal ideation was more prevalent among people facing difficulty paying rent (31.5%), job loss (24.1%), and loneliness (25.1%), with each stressor associated with suicidal ideation in bivariable models. Difficulty paying rent and loneliness were most associated with suicidal ideation. Policies and programs to support people experiencing economic precarity and loneliness may contribute to suicide prevention.
Collapse
Affiliation(s)
- Julia Raifman
- Boston University School of Public Health, Boston, MA, United States of America
| | - Catherine K. Ettman
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Lorraine T. Dean
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Salma M. Abdalla
- Boston University School of Public Health, Boston, MA, United States of America
| | - Alexandra Skinner
- Brown University School of Public Health, Providence, RI, United States of America
| | - Colleen L. Barry
- Cornell Jeb E. Brooks School of Public Policy, Ithaca, NY, United States of America
| | - Sandro Galea
- Boston University School of Public Health, Boston, MA, United States of America
| |
Collapse
|
16
|
Cutts DB, Ettinger de Cuba S, Bovell-Ammon A, Wellington C, Coleman SM, Frank DA, Black MM, Ochoa E, Chilton M, Lê-Scherban F, Heeren T, Rateau LJ, Sandel M. Eviction and Household Health and Hardships in Families With Very Young Children. Pediatrics 2022; 150:189509. [PMID: 36120757 DOI: 10.1542/peds.2022-056692] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/06/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Families with versus without children are at greater eviction risk. Eviction is a perinatal, pediatric, and adult health concern. Most studies evaluate only formal evictions. METHODS Using cross-sectional surveys of 26 441 caregiver or young child (<48 months) dyads from 2011 to 2019 in emergency departments (EDs) and primary care clinics, we investigated relationships of 5 year history of formal (court-involved) and informal (not court-involved) evictions with caregiver and child health, history of hospitalizations, hospital admission from the ED on the day of the interview, and housing-related and other material hardships. RESULTS 3.9% of 26 441 caregivers reported 5 year eviction history (eviction), of which 57.0% were formal evictions. After controlling for covariates, we found associations were minimally different between formal versus informal evictions and were, therefore, combined. Compared to no evictions, evictions were associated with 1.43 (95% CI: 1.17-1.73), 1.55 (95% confidence interval [CI]: 1.32-1.82), and 1.24 (95% CI: 1.01-1.53) times greater odds of child fair or poor health, developmental risk, and hospital admission from the ED, respectively, as well as adverse caregiver and hardship outcomes. Adjusting separately for household income and for housing-related hardships in sensitivity analyses did not significantly alter results, although odds ratios were attenuated. Hospital admission from the ED was no longer significant. CONCLUSIONS Demonstrated associations between eviction and health and hardships support broad initiatives, such as housing-specific policies, income-focused benefits, and social determinants of health screening and community connections in health care settings. Such multifaceted efforts may decrease formal and informal eviction incidence and mitigate potential harmful associations for very young children and their families.
Collapse
Affiliation(s)
- Diana B Cutts
- Department of Pediatrics, Hennepin County Medical Center, Minneapolis, Minnesota
| | | | | | - Chevaughn Wellington
- Children's HealthWatch, Boston Medical Center, Boston, Massachusetts.,Frank H. Netter M.D. School of Medicine, Quinnipiac University, North Haven, Connecticut
| | - Sharon M Coleman
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, Massachusetts
| | - Deborah A Frank
- Department of Pediatrics, Boston University School of Medicine, Boston, Massachusetts
| | - Maureen M Black
- Department of Pediatrics, Growth and Nutrition Division, University of Maryland School of Medicine, Baltimore, Maryland.,RTI International, Research Triangle Park, North Carolina
| | - Eduardo Ochoa
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | | | - Félice Lê-Scherban
- Epidemiology and Biostatistics.,Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Timothy Heeren
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, Massachusetts
| | - Lindsey J Rateau
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, Massachusetts
| | - Megan Sandel
- Department of Pediatrics, Boston University School of Medicine, Boston, Massachusetts
| |
Collapse
|
17
|
Choi NG, Marti CN, Choi BY. Job loss, financial strain, and housing problems as suicide precipitants: Associations with other life stressors. SSM Popul Health 2022; 19:101243. [PMID: 36203475 PMCID: PMC9530609 DOI: 10.1016/j.ssmph.2022.101243] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 09/23/2022] [Accepted: 09/25/2022] [Indexed: 11/17/2022] Open
Abstract
Previous research has shown that job loss, financial strain, and/or loss of housing (JFH) in midlife elevate suicide risk. In this study based on the 2017–2019 National Violent Death Reporting System, we examined other suicide precipitants and contributors of decedents whose suicide was in part precipitated by JFH and the circumstances under which they died. First, we examined all adult decedents (N = 94,454; 74,042 males [78.4%] and 20,412 females [21.6%]) and then focused on decedents age 45–64 (N = 34,208; 25,640 males [75%] and 8568 females [25.0%]). The 45–64 age group had the highest rate of JFH (22.0% for males and 15.1% for females) as a suicide precipitant. The results of generalized linear models for all adult suicide decedents of both sexes showed that the 45–64 age group (IRR = 2.02, 95% CI = 1.89–2.16), compared to 65+ age group, and relationship problems, mental disorders, and alcohol problems were associated with significantly higher risk of JFH-precipitated suicide. In male decedents age 45–64, JFH was positively associated with depressed mood (IRR = 1.95, 95% CI = 1.85–2.06), alcohol problems (IRR = 1.14, 95% CI = 1.07–1.21), and number of crises (IRR = 1.48, 95% CI = 1.43–1.53). In female decedents age 45–64, JFH was positively associated with relationship problems (IRR = 1.19, 95% CI = 1.05–1.35), legal problems (IRR = 1.27, 95% CI = 1.06–1.54), depressed mood (IRR = 1.78, 95% CI = 1.59–1.99), and number of crises (IRR = 1.58, 95% CI = 1.48–1.68). In both sexes, the risk of JFH was also positively associated with a college education. In female decedents, JFH risk was higher among divorced or never-married individuals. Coroner/medical examiner and law enforcement agency reports show that some experienced depression and started misusing alcohol and/or other substances following a job loss, but others had these problems throughout life, which caused/contributed to JFH. These findings show the significance of suicide prevention approaches at both systemic (generous unemployment insurance, housing subsidies) and individual (treatment of depression and alcohol/substance misuse problems and social support/connection) levels. 16.2% of male and 13.0% of female suicide decedents age 18+ in 2017–2019 had job/finance/housing problems (JFH). Among decedents age 45–64, 22.0% of male and 15.1% of female had JFH. JFH was positively associated with number of crises, depressed mood, and relationship and alcohol problems in both sexes. Suicide prevention approaches are needed at both systemic and individual levels.
Collapse
Affiliation(s)
- Namkee G. Choi
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, 78712, USA
- Corresponding author. UT Steve Hicks School of Social Work, 1925 San Jacinto Blvd, Austin, TX 78712, USA.
| | - C. Nathan Marti
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, 78712, USA
| | - Bryan Y. Choi
- Department of Emergency Medicine, Philadelphia College of Osteopathic Medicine and BayHealth, Dover, DE, 19901, USA
| |
Collapse
|
18
|
Tang J, Chen N, Liang H, Gao X. The Effect of Built Environment on Physical Health and Mental Health of Adults: A Nationwide Cross-Sectional Study in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116492. [PMID: 35682074 PMCID: PMC9180406 DOI: 10.3390/ijerph19116492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 05/20/2022] [Accepted: 05/25/2022] [Indexed: 11/16/2022]
Abstract
At present, there is a lack of research examining the relationships between the built environment and health status from a social epidemiological perspective. With this in mind, the present study aimed to explore the construct validity of housing/neighborhood conditions and evaluate the associations between the built environment and self-rated health among Chinese residents. To conduct the analysis, data from 4906 participants were derived from the 2016 China Labor-force Dynamics Survey (CLDS). Specifically, we used exploratory factor analysis to identify construct of housing/neighborhood factors and performed principal component regression (PCR) to assess the relationship between the built environment and both self-rated physical health and mental health. This process identified five common factors that corresponded to the built environment, including housing affordability, housing quality, neighborhood services, neighborhood physical environment, and perceived environment. The regression results suggested that housing affordability was negatively related to health status. Meanwhile, the services, physical environment, and perceived environment of neighborhoods were related to positive health outcomes. The influence of housing on health exhibits group heterogeneity: respondents in the 41 to 65 age group were most vulnerable to poor built environments. Whilst the results indicated that housing factors and neighborhood conditions were related to health outcomes, their influence varied across different age groups. Future interventions should be intentionally designed to target housing affordability and neighborhood factors, which may include the provision of housing assistance programs and planning layouts.
Collapse
Affiliation(s)
- Jie Tang
- School of Public Administration and Policy, Renmin University of China, Beijing 100872, China; (J.T.); (N.C.)
| | - Nanqian Chen
- School of Public Administration and Policy, Renmin University of China, Beijing 100872, China; (J.T.); (N.C.)
| | - Hailun Liang
- School of Public Administration and Policy, Renmin University of China, Beijing 100872, China; (J.T.); (N.C.)
- Correspondence: (H.L.); (X.G.)
| | - Xu Gao
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100871, China
- Correspondence: (H.L.); (X.G.)
| |
Collapse
|
19
|
Gromis A, Fellows I, Hendrickson JR, Edmonds L, Leung L, Porton A, Desmond M. Estimating eviction prevalence across the United States. Proc Natl Acad Sci U S A 2022; 119:e2116169119. [PMID: 35576463 PMCID: PMC9173767 DOI: 10.1073/pnas.2116169119] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 03/18/2022] [Indexed: 11/18/2022] Open
Abstract
SignificanceSeveral negative effects of forced displacement have been well documented, yet we lack reliable measurement of eviction risk in the national perspective. This prevents accurate estimations of the scope and geography of the problem as well as evaluations of policies to reduce housing loss. We construct a nationwide database of eviction filings in the United States. Doing so reveals that 2.7 million households, on average, are threatened with eviction each year; that the highest eviction filing rates are not concentrated solely in high-cost urban areas; and that state-level housing policies are strongly associated with county-level eviction filing risk. These data facilitate an expanded research agenda on the causes and consequences of eviction lawsuits in the United States.
Collapse
Affiliation(s)
- Ashley Gromis
- Department of Sociology, Princeton University, Princeton, NJ 08540
| | | | | | - Lavar Edmonds
- Department of Sociology, Princeton University, Princeton, NJ 08540
| | - Lillian Leung
- Department of Sociology, Princeton University, Princeton, NJ 08540
| | - Adam Porton
- Department of Sociology, Princeton University, Princeton, NJ 08540
| | - Matthew Desmond
- Department of Sociology, Princeton University, Princeton, NJ 08540
| |
Collapse
|
20
|
A Qualitative Scoping Review of the Impacts of Economic Recessions on Mental Health: Implications for Practice and Policy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105937. [PMID: 35627474 PMCID: PMC9140450 DOI: 10.3390/ijerph19105937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/12/2022] [Accepted: 05/10/2022] [Indexed: 11/17/2022]
Abstract
In a follow-up to our 2021 scoping review of the quantitative literature on the impacts of economic recessions on mental health, this scoping review summarizes qualitative research to develop a descriptive understanding of the key factors that transmute the socioeconomic stressors of a recession into poorer mental health. The previous study identified 22 qualitative studies from 2008 to 2020, which were updated with search results from six databases for articles published between 2020 and 2021. After inclusion and exclusion criteria were applied to the total 335 identified studies, 13 articles were included. These were peer-reviewed, qualitative studies in developed economies, published from 2008 to 2021, and available online in English. Participants perceived that financial hardship and unemployment during recessions increased stress and led to feelings of shame, loss of structure and identity, and a perceived lack of control, which increased interpersonal conflict, social isolation, maladaptive coping, depression, self-harm, and suicidal behavior. Participants struggled with accessing health and social services and suggested reforms to improve the navigation and efficiency of services and to reduce the perceived harms of austerity measures. Providers should screen for mental distress and familiarize themselves with health and social resources in their community to help patients navigate these complex systems. Policy makers should be aware of the potential protective nature of unemployment safeguards and consider other low-cost measures to bolster mental health supports and informal social networks. Research in this area was limited. Further research would be beneficial given the impacts of the ongoing COVID-19 recession.
Collapse
|
21
|
Chrisinger BW, Springfield S, Whitsel EA, Shadyab AH, Krok-Schoen JL, Garcia L, Sealy-Jefferson S, Stefanick ML. The Association of Neighborhood Changes with Health-Related Quality of Life in the Women's Health Initiative. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5309. [PMID: 35564704 PMCID: PMC9103323 DOI: 10.3390/ijerph19095309] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/08/2022] [Accepted: 04/14/2022] [Indexed: 02/04/2023]
Abstract
Longitudinal studies can help us understand the effects of long-term neighborhood changes, as these can capture individual self-appraisal of current and future circumstances. We analyzed the association between neighborhood changes and health-related quality of life (HRQoL) outcomes among older women from the Women's Health Initiative (WHI) study. We used a subset (n = 49,254) of the longitudinal WHI dataset of female participants, aged 50-79 at baseline, recruited from 40 clinical centers across the U.S. beginning in 1993. Two HRQoL outcomes were explored: self-rated quality of life (SRQoL), and physical functioning-related quality of life (PFQoL). We used U.S. census tract-level changes in median household income between the 2000 census and 2007-2011 American Community Survey to classify neighborhoods as "upgrading," "declining," or "stable." Multi-level models were used to identify significant associations between neighborhood change and HRQoL outcomes over time. Compared to participants residing in upgrading neighborhoods, participants in stable and declining neighborhoods reported significantly lower PFQoL. A significant interaction was observed with income such that the effect of neighborhood change was greater at lower levels of income.
Collapse
Affiliation(s)
- Benjamin W Chrisinger
- Department of Social Policy and Intervention, University of Oxford, Oxford OX1 2ER, UK
| | - Sparkle Springfield
- Department of Public Health Sciences, Loyola University Chicago, Chicago, IL 60660, USA
| | - Eric A Whitsel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC 27599, USA
- Department of Medicine, School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC 27599, USA
| | - Aladdin H Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, CA 92093, USA
| | - Jessica L Krok-Schoen
- School of Health and Rehabilitation Sciences, Ohio State University, Columbus, OH 43210, USA
| | - Lorena Garcia
- Department of Public Health Sciences, School Medicine, University of California, Davis, CA 95616, USA
| | | | - Marcia L Stefanick
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA 94305, USA
| |
Collapse
|
22
|
Abstract
Suicide is a major public health concern in the United States. Between 2000 and 2018, US suicide rates increased by 35%, contributing to the stagnation and subsequent decrease in US life expectancy. During 2019, suicide declined modestly, mostly owing to slight reductions in suicides among Whites. Suicide rates, however, continued to increase or remained stable among all other racial/ethnic groups, and little is known about recent suicide trends among other vulnerable groups. This article (a) summarizes US suicide mortality trends over the twentieth and early twenty-first centuries, (b) reviews potential group-level causes of increased suicide risk among subpopulations characterized by markers of vulnerability to suicide, and (c) advocates for combining recent advances in population-based suicide prevention with a socially conscious perspective that captures the social, economic, and political contexts in which suicide risk unfolds over the life course of vulnerable individuals.
Collapse
Affiliation(s)
- Gonzalo Martínez-Alés
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; ,
- Department of Psychiatry, La Paz University Hospital, Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Tammy Jiang
- Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts, USA;
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; ,
| | - Jaimie L Gradus
- Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts, USA;
- Department of Psychiatry, School of Medicine, Boston University, Boston, Massachusetts, USA;
| |
Collapse
|
23
|
Aquino T, Brand JE, Torche F. Unequal effects of disruptive events. SOCIOLOGY COMPASS 2022; 16:e12972. [PMID: 38895138 PMCID: PMC11185416 DOI: 10.1111/soc4.12972] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 02/07/2022] [Indexed: 06/21/2024]
Abstract
Disruptive events have significant consequences for the individuals and families who experience them, but these effects do not occur equally across the population. While some groups are strongly affected, others experience few consequences. We review recent findings on inequality in the effects of disruptive events. We consider heterogeneity based on socioeconomic resources, race/ethnicity, the likelihood of experiencing disruption, and contextual factors such as the normativity of the event in particular social settings. We focus on micro-level events affecting specific individuals and families, including divorce, job loss, home loss and eviction, health shocks and deaths, and violence and incarceration, but also refer to macro-level events such as recession and natural disasters. We describe patterns of variation that suggest a process of resource disparities and cumulative disadvantage versus those that reflect the impact of non-normative and unexpected shocks. Finally, we review methodological considerations when examining variation in the effect of disruptive events.
Collapse
Affiliation(s)
- Taylor Aquino
- University of California, Los Angeles, California, USA
| | | | | |
Collapse
|
24
|
Biederman DJ, Callejo-Black P, Douglas C, O’Donohue HA, Daeges M, Sofela O, Brown A. Changes in health and health care utilization following eviction from public housing. Public Health Nurs 2022; 39:363-371. [PMID: 34492122 PMCID: PMC9279006 DOI: 10.1111/phn.12964] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/05/2021] [Accepted: 08/06/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This study sought to (1) determine the number of persons evicted from the Durham Housing Authority (DHA) over a 5-year period, (2) explore changes in the number of persons with various medical diagnoses and health care utilization patterns before and after eviction, and (3) examine how many persons evicted from DHA became literally homeless. DESIGN This was a pre/post cross-sectional quantitative study. SAMPLE Heads of households evicted from DHA properties from January 1, 2013 through December 31, 2017 were included in the study. MEASUREMENTS We matched people evicted by the DHA in a university health system electronic health record system to determine changes in diagnoses and health care utilization before and after eviction. We also matched the cohort in the homeless management information system to determine how many persons evicted became literally homeless. RESULTS Findings indicate statistically significant increases in persons with medical diagnoses in five of ten categories, total hospital admissions, and emergency department visits after eviction. Of the 152 people included in the study, 34 (22%) became literally homeless. CONCLUSIONS Health and health care utilization patterns were different before and after eviction. Implications for clinicians are explored.
Collapse
Affiliation(s)
| | | | | | | | - Monica Daeges
- Alumna of Duke University School of Nursing, Durham, NC
| | | | | |
Collapse
|
25
|
Stevenson C, Wakefield JRH. Financial distress and suicidal behaviour during COVID-19: Family identification attenuates the negative relationship between COVID-related financial distress and mental Ill-health. J Health Psychol 2021; 26:2665-2675. [PMID: 34259082 PMCID: PMC8543569 DOI: 10.1177/13591053211014597] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
COVID-19 provides a 'perfect storm' of social and economic suicide risk-factors. Recent research has evidenced an initial impact of the pandemic upon suicide rates, but has yet to understand how elevated financial threat and social isolation may predict suicide ideation/behaviour, or which social factors promote resilience. This study addressed these shortcomings. An online longitudinal survey study (N = 370) which took place from May to September 2020 showed COVID-related financial distress predicts suicidal thoughts and behaviour via increased depression and loneliness. Family identification attenuates these relationships. Our findings reaffirm the importance of social factors in reducing mental ill-health outcomes of economic crises.
Collapse
|
26
|
Leifheit KM, Pollack CE, Raifman J, Schwartz GL, Koehler RD, Rodriguez Bronico JV, Benfer EA, Zimmerman FJ, Linton SL. Variation in State-Level Eviction Moratorium Protections and Mental Health Among US Adults During the COVID-19 Pandemic. JAMA Netw Open 2021; 4:e2139585. [PMID: 34919134 PMCID: PMC8683968 DOI: 10.1001/jamanetworkopen.2021.39585] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 10/25/2021] [Indexed: 11/30/2022] Open
Abstract
Importance Although evictions have been associated with adverse mental health outcomes, it remains unclear which stages of the eviction process are associated with mental distress among renters. Variation in COVID-19 pandemic eviction protections across US states enables identification of intervention targets within the eviction process to improve renters' mental health. Objective To measure the association between the strength of eviction protections (ie, stages blocked by eviction moratoriums) and mental distress among renters during the COVID-19 pandemic. Design, Setting, and Participants This cohort study used individual-level, nationally representative data from the Understanding Coronavirus in America Survey to measure associations between state eviction moratorium protections and mental distress. The sample of 2317 respondents included renters with annual household incomes less than $75 000 who reported a state of residence and completed surveys between March 10 and September 3, 2020, prior to the federal eviction moratorium order by the Centers for Disease Control and Prevention. Exposures Time-varying strength of state moratorium protections as a categorical variable: none, weak (blocking court hearings, judgments, or enforcement without blocking notice or filing), or strong (blocking all stages of the eviction process beginning with notice and filing). Main Outcomes and Measures Moderate to severe mental distress was measured using the 4-item Patient Health Questionnaire. Linear regression models were adjusted for time-varying state COVID-19 incidence and mortality, public health restrictions, and unemployment rates. Models included individual and time fixed effects as well as clustered standard errors. Results The sample consisted of 2317 individuals (20 853 total observations) composed largely (1788 [78%] weighted) of middle-aged adults (25-64 years of age) and women (1538 [60%]); 640 respondents (23%) self-reported as Hispanic or Latinx, 314 respondents (20%) as non-Hispanic Black, and 1071 respondents (48%) as non-Hispanic White race and ethnicity. Relative to no state-level eviction moratorium protections, strong protections were associated with a 12.6% relative reduction (risk ratio, 0.87; 95% CI, 0.76-0.99) in the probability of mental distress, whereas weak protections were not associated with a statistically significant reduction (risk ratio, 0.96; 95% CI, 0.86-1.06). Conclusions and Relevance This analysis of the Understanding Coronavirus in America Survey data found that strong eviction moratoriums were associated with protection against mental distress, suggesting that distress begins early in the eviction process with notice and filing. This finding is consistent with the idea that to reduce mental distress among renters, policy makers should focus on primary prevention of evictions.
Collapse
Affiliation(s)
- Kathryn M. Leifheit
- Department of Health Policy and Management, University of California, Los Angeles Fielding School of Public Health, Los Angeles
| | - Craig E. Pollack
- Department of Health Policy and Management, Johns Hopkins School of Public Health, Baltimore, Maryland
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Johns Hopkins School of Nursing, Baltimore, Maryland
| | - Julia Raifman
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, Massachusetts
| | - Gabriel L. Schwartz
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco
| | | | | | - Emily A. Benfer
- Wake Forest University School of Law, Winston-Salem, North Carolina
| | - Frederick J. Zimmerman
- Department of Health Policy and Management, University of California, Los Angeles Fielding School of Public Health, Los Angeles
| | - Sabriya L. Linton
- Department of Mental Health, Johns Hopkins University School of Public Health, Baltimore, Maryland
| |
Collapse
|
27
|
Reed J, Quinlan K, Labre M, Brummett S, Caine ED. The Colorado National Collaborative: A public health approach to suicide prevention. Prev Med 2021; 152:106501. [PMID: 34538367 DOI: 10.1016/j.ypmed.2021.106501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 02/26/2021] [Accepted: 02/27/2021] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Suicide rates in the United States have risen dramatically during the 21st century despite national, state and local level commitments to prevention, improvements in the development and delivery of evidence-informed prevention approaches, and advances in epidemiological capacity to identify areas for targeted intervention. Complex problems require comprehensive solutions. In Colorado, that solution is a comprehensive, integrated public health collaboration that aligns diverse community and programmatic efforts across the prevention continuum. The Colorado National Collaborative (CNC) is pursuing a real-world test of the public health approach to suicide prevention by helping community coalitions deliver a package of evidence-informed activities in geographically defined community systems. METHODS The CNC began by identifying six diverse Colorado counties with high suicide rates or number of deaths. Working closely with community, state, and national partners, CNC identified existing community-level risk and protective factors, programs, and policies. This process provided insight on the overlay between existing efforts and identified burden centers and drivers. RESULTS The CNC team identified six components for strategic implementation: (1) connectedness, (2) economic stability and supports, (3) education and awareness, (4) access to suicide safer care, (5) lethal means safety, and (6) postvention. Evaluation is being conducted through a collaborative, participatory, and empowerment approach that incorporates stakeholders as leaders in all aspects of the process. CONCLUSION The CNC includes data-driven identification of populations at risk of suicide, community identification of protective factors, and true collaboration between prevention experts at the national, state, and local level in implementing a comprehensive approach to prevention. Lessons learned are discussed.
Collapse
Affiliation(s)
- Jerry Reed
- Education Development Center, 43 Foundry Avenue, Waltham, MA 02453, United States of America.
| | - Kristen Quinlan
- Education Development Center, 43 Foundry Avenue, Waltham, MA 02453, United States of America
| | - Magdala Labre
- Education Development Center, 43 Foundry Avenue, Waltham, MA 02453, United States of America
| | - Sarah Brummett
- Colorado Department of Public Health and the Environment, 4300 Cherry Creek Drive South, Denver, CO 80246, United States of America
| | - Eric D Caine
- University of Rochester Medical Center, 300 Crittenden Blvd., Rochester, NY 14642, United States of America
| |
Collapse
|
28
|
Choi M, Lim J, Chang SS, Hwang M, Kim CS, Ki M. Financial hardship and suicide ideation: Age and gender difference in a Korean panel study. J Affect Disord 2021; 294:889-896. [PMID: 34375217 DOI: 10.1016/j.jad.2021.07.102] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 07/18/2021] [Accepted: 07/26/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUNDS Socioeconomic factors influence suicide risk but a systematic understanding of the role of financial hardship is unclear. We examined whether financial hardship had cumulative or contemporaneous impacts on suicide ideation and any gender and age differences in a large Korean sample. METHODS Data of 67,728 observations from 14,321 individuals were extracted from seven waves of Korean Welfare Panel Study. The association of financial hardship at baseline and its change over two years with suicide ideation was investigated using generalized estimation equation to account for repeated measurements within an individual, adjusting for other socioeconomic factors. RESULTS Financial hardship was associated with suicide ideation but the magnitude of association varied across age and gender groups. Specifically, the impact of financial hardship was persistent over two years presenting a cumulative effect among men aged 50-64 years and ≥65 years; e.g., adjusted OR (adjusted odds ratio) = 3.87, 95 % CI = 2.71-5.54 for emergent hardship group vs adjusted OR = 4.22, 95 %CI = 3.00-5.93 for persistent group in those aged ≥65 years. Financial hardship increased the risk of suicide ideation incrementally with age, although the pattern was less clear among women. LIMITATIONS Financial hardship was identified as having changing nature, though it was assumed to occur over two years. CONCLUSION In general, financial hardship plays a role in amplifying suicide ideation in a contemporaneous way but also in a cumulative way, predominantly among late-middle-aged and elderly men. Monitoring and intervention for financial hardship would be a promising strategy for suicide prevention.
Collapse
Affiliation(s)
- Minjae Choi
- Program in Public Health, Graduate School, Korea University, Seoul, 73 Goryeodae-ro, Seongbuk-gu, Seoul, Republic of Korea
| | - Jiseun Lim
- Department of Preventive Medicine, Eulji University, 77 Gyeryong-ro 771beon-gil, Yongdu-dong, Jung-gu, Daejeon, Republic of Korea
| | - Shu-Sen Chang
- Institute of Health Behaviors and Community Sciences and Global Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Minji Hwang
- Program in Public Health, Graduate School, Korea University, Seoul, 73 Goryeodae-ro, Seongbuk-gu, Seoul, Republic of Korea; BK21FOUR R&E Center for Learning Health Systems, Korea University, 145, Anam-ro, Seongbuk-gu, Seoul, Republic of Korea
| | - Cheong-Seok Kim
- Department of Sociology, Dongguk University, 30 Pildong-ro, Jung-gu, Seoul, Republic of Korea
| | - Myung Ki
- Program in Public Health, Graduate School, Korea University, Seoul, 73 Goryeodae-ro, Seongbuk-gu, Seoul, Republic of Korea; Department of Preventive Medicine, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul, Republic of Korea; BK21FOUR R&E Center for Learning Health Systems, Korea University, 145, Anam-ro, Seongbuk-gu, Seoul, Republic of Korea.
| |
Collapse
|
29
|
Tsai J, Jones N, Szymkowiak D, Rosenheck RA. Longitudinal study of the housing and mental health outcomes of tenants appearing in eviction court. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1679-1686. [PMID: 32926182 DOI: 10.1007/s00127-020-01953-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 09/01/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE Millions of people are evicted from rental properties in the U.S. annually, but little is known about them and their mental health. This study followed a cohort of eviction court participants over time and assessed their housing and mental health outcomes. METHODS One hundred and twenty-one tenants were recruited from an eviction court in New Haven, Connecticut, and their housing, mental health, and psychosocial status were assessed at baseline, 1, 3, 6, and 9 months following their encounter with the court. Inverse probability weighting was used for missing data. RESULTS At baseline, 42% of participants had appeared in eviction court before, 28% had experienced eviction, and 44% had been previously homeless. In addition, 39% screened positive for generalized anxiety disorder, 37% for posttraumatic stress disorder, 33% for major depressive disorder, and 17% reported suicidal ideation. At follow-up, participants experienced increased days of housing instability and homelessness over time with some persistent mental health symptoms. Less than one-quarter of participants received any mental health treatment during the 9-month follow-up period. About 54% of participants followed reported that they had to change their residence after their court appearance consistent with court records. Participants who had an eviction-related move experienced greater housing instability over time than participants who did not. CONCLUSION Together, these findings suggest that there is a sizable subgroup of adults who present to eviction court with persistent housing and mental health issues who do not receive adequate assistance in addressing these issues.
Collapse
Affiliation(s)
- Jack Tsai
- National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs Central Office, Tampa, FL, USA. .,School of Public Health, University of Texas Health Science Center at Houston, San Antonio Regional Campus, 7411 John Smith Drive, Suite 1100, San Antonio, TX, 7822, USA. .,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
| | - Natalie Jones
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Dorota Szymkowiak
- National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs Central Office, Tampa, FL, USA
| | - Robert A Rosenheck
- National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs Central Office, Tampa, FL, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| |
Collapse
|
30
|
Guerra O, Eboreime E. The Impact of Economic Recessions on Depression, Anxiety, and Trauma-Related Disorders and Illness Outcomes-A Scoping Review. Behav Sci (Basel) 2021; 11:119. [PMID: 34562956 PMCID: PMC8464685 DOI: 10.3390/bs11090119] [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] [Received: 07/20/2021] [Revised: 08/20/2021] [Accepted: 08/25/2021] [Indexed: 11/30/2022] Open
Abstract
In the wake of a global economic recession secondary to the COVID-19 pandemic, this scoping review seeks to summarize the current quantitative research on the impact of economic recessions on depression, anxiety, traumatic disorders, self-harm, and suicide. Seven research databases (PsycINFO, MEDLINE, Embase, Web of Science: Core Collection, National Library of Medicine PubMed, PubMed Central, and Google Scholar) were searched for keywords returning 3412 preliminary results published since 2008 in Organisation for Economic Coordination and Development (OECD)nations. These were screened by both authors for inclusion/exclusion criteria resulting in 127 included articles. Articles included were quantitative studies in OECD countries assessing select mental disorders (depression, anxiety, and trauma-/stress-related disorders) and illness outcomes (self-harm and suicide) during periods of economic recession. Articles were limited to publication from 2008 to 2020, available online in English, and utilizing outcome measures specific to the disorders and outcomes specified above. A significant relationship was found between periods of economic recession and increased depressive symptoms, self-harming behaviour, and suicide during and following periods of recession. Results suggest that existing models for mental health support and strategies for suicide prevention may be less effective than they are in non-recession times. It may be prudent to focus public education and medical treatments on raising awareness and access to supports for populations at higher risk, including those vulnerable to the impacts of job or income loss due to low socioeconomic status preceding the recession or high levels of financial strain, those supporting others financially, approaching retirement, and those in countries with limited social safety nets. Policy makers should be aware of the potential protective nature of unemployment safeguards and labour program investment in mitigating these negative impacts. Limited or inconclusive data were found on the relationship with traumatic disorders and symptoms of anxiety. In addition, research has focused primarily on the working-age adult population with limited data available on children, adolescents, and older adults, leaving room for further research in these areas.
Collapse
Affiliation(s)
- Olivia Guerra
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada;
| | | |
Collapse
|
31
|
Austin AE, Shanahan ME. Material hardship and suicidal behavior: Associations among parents and non-parents. Suicide Life Threat Behav 2021; 51:646-656. [PMID: 33280153 PMCID: PMC8179931 DOI: 10.1111/sltb.12723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 06/30/2020] [Accepted: 10/20/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Material hardship is unique facet of economic distress and may be a risk factor for suicidal behavior. Parents are more likely to experience both material hardship and suicidal behavior than non-parents. The aims of this study were to (a) examine the association of material hardship with suicidal behavior and (b) assess whether associations differed for parents and non-parents. METHODS We used data from Waves IV and V of the National Longitudinal Study of Adolescent to Adult Health (N = 10,685). We conducted logistic regression to examine the association of one and two or more material hardships at Wave IV with suicidal behavior at Wave V. RESULTS Overall, 38.8% of participants reported material hardship at Wave IV and 7.5% reported suicidal ideation or attempts at Wave V. In the total sample, one material hardship (OR = 1.57, 95% CI 1.20, 2.06) and two or more material hardships (OR = 1.52, 95% CI 1.04, 2.21) were associated with an increased likelihood of suicidal behavior. Among parents, two or more material hardships (OR = 1.86, 95% CI 1.17, 2.94) were associated with an increased likelihood of suicidal behavior. Among non-parents, one material hardship (OR = 1.81, 95% CI 1.26, 2.59) was associated with an increased likelihood of suicidal behavior. CONCLUSIONS Programs and policies aimed at addressing material hardship, particularly accumulating material hardships among parents, may be an effective suicide prevention strategy.
Collapse
Affiliation(s)
- Anna E. Austin
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Meghan E. Shanahan
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| |
Collapse
|
32
|
Suicide Distribution and Trends Among Male Older Adults in the U.S., 1999-2018. Am J Prev Med 2021; 60:802-811. [PMID: 33653647 DOI: 10.1016/j.amepre.2020.12.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 12/06/2020] [Accepted: 12/09/2020] [Indexed: 01/07/2023]
Abstract
INTRODUCTION This study examines the distribution and trends in suicide death rates among male adults aged ≥65 years in the U.S. from 1999 to 2018. METHODS Suicide mortality data were derived from Multiple Cause of Death from the Center for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research database. Suicides were identified from the underlying causes of death. Joinpoint regression examined the distribution and shift in suicide age-adjusted death rates overall and by age groups, race/ethnicity, method of suicide, and urbanicity. Analyses were conducted in 2020. RESULTS Between 1999 and 2018, a total of 106,861 male adults aged ≥65 years died of suicide (age-adjusted rate=31.4 per 100,000 population, 95% CI=31.2, 31.6). Suicide rates showed a V-shaped trend. They were declining annually by 1.8% (95% CI= -2.4, -1.2); however, starting in 2007, there was a shift upward, increasing significantly by 1.7% per year for the next decade (95% CI=1.0, 1.6). Suicide rates were highest among those aged ≥85 years (48.8 per 100,000 population with an upward shift in 2008), Whites (35.3 per 100,000 population with an upward shift in trend in 2007), and the most rural communities (39.0 per 100,000 population). Most suicides were due to firearms (78.3% at a rate of 24.7 per 100,000 population), especially in rural areas, and shifted upward after 2007. CONCLUSIONS Increases in suicide rates among male older adults in the U.S., particularly after the 2007-2008 economic recession, are concerning. Tailored suicide prevention intervention strategies are needed to address suicide-related risk factors.
Collapse
|
33
|
Hoke MK, Boen CE. The health impacts of eviction: Evidence from the national longitudinal study of adolescent to adult health. Soc Sci Med 2021; 273:113742. [PMID: 33607393 PMCID: PMC8045672 DOI: 10.1016/j.socscimed.2021.113742] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 01/28/2021] [Accepted: 01/30/2021] [Indexed: 11/22/2022]
Abstract
Eviction represents an urgent social and economic issue in the United States, with nearly two million evictions occurring annually in the U.S. Still, the population health impacts of evictions, as well as the pathways linking eviction to health, are not well documented or understood, particularly among young adults. Using nationally-representative, longitudinal data from the National Longitudinal Study of Adolescent to Adult Health (1994-2008) (n = 9029), the present study uses a combination of analytic methods-including prospective lagged dependent variable regression models, inverse probabilities of treatment weighting, longitudinal first difference models, causal mediation techniques-to comprehensively assess whether and how evictions relate to depressive risk and self-rated health across early adulthood, paying particular attention to the stress-related pathways linking eviction and health. Results provide robust evidence of positive longitudinal associations between eviction and depressive risk, in particular. In the prospective regression models, young adults who experienced recent eviction had more depressive symptoms and worse self-rated health than those who were not evicted, net a host of background characteristics. Using treatment weighting techniques, results showed that young adults who experienced eviction had more depressive symptoms than those who were not evicted (5.921 vs. 4.998 depressive symptoms, p = 0.003). Perceived social stress mediated nearly 18 percent of the associations between eviction and the depressive symptoms (p < 0.001). In the first difference models, young people who experienced eviction between survey waves experienced greater increases in depressive symptoms over time compared to those who were not evicted, net of changes in other indicators of socioeconomic status and residential instability. Taken together, our results suggest that the recent surges in evictions in the U.S. serve as a potent threat to population health during the emerging adult period, with especially devastating consequences for low-income individuals and communities of color.
Collapse
Affiliation(s)
- Morgan K Hoke
- Population Studies Center, University of Pennsylvania, USA; Department of Anthropology, University of Pennsylvania, USA.
| | - Courtney E Boen
- Population Studies Center, University of Pennsylvania, USA; Department of Sociology, Population Aging Research Center, University of Pennsylvania, USA
| |
Collapse
|
34
|
Wasserman D, Iosue M, Wuestefeld A, Carli V. Adaptation of evidence-based suicide prevention strategies during and after the COVID-19 pandemic. World Psychiatry 2020; 19:294-306. [PMID: 32931107 PMCID: PMC7491639 DOI: 10.1002/wps.20801] [Citation(s) in RCA: 163] [Impact Index Per Article: 40.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Suicide is preventable. Nevertheless, each year 800,000 people die of suicide in the world. While there is evidence indicating that suicide rates de-crease during times of crises, they are expected to increase once the immediate crisis has passed. The COVID-19 pandemic affects risk and pro-tective factors for suicide at each level of the socio-ecological model. Economic downturn, augmented barriers to accessing health care, increased access to suicidal means, inappropriate media reporting at the societal level; deprioritization of mental health and preventive activities at the community level; interpersonal conflicts, neglect and violence at the relationship level; unemployment, poverty, loneliness and hopelessness at the individual level: all these variables contribute to an increase of depression, anxiety, post-traumatic stress disorder, harmful use of alcohol, substance abuse, and ultimately suicide risk. Suicide should be prevented by strengthening universal strategies directed to the entire population, including mitigation of unemployment, poverty and inequalities; prioritization of access to mental health care; responsible media reporting, with information about available support; prevention of increased alcohol intake; and restriction of access to lethal means of suicide. Selective interventions should continue to target known vulnerable groups who are socio-economically disadvantaged, but also new ones such as first responders and health care staff, and the bereaved by COVID-19 who have been deprived of the final contact with loved ones and funerals. Indicated preventive strategies targeting individuals who display suicidal behaviour should focus on available pharmacological and psychological treatments of mental disorders, ensuring proper follow-up and chain of care by increased use of telemedicine and other digital means. The scientific community, health care professionals, politicians and decision-makers will find in this paper a systematic description of the effects of the pandemic on suicide risk at the society, community, family and individual levels, and an overview of how evidence-based suicide preventive interventions should be adapted. Research is needed to investigate which adaptations are effective and in which con-texts.
Collapse
Affiliation(s)
- Danuta Wasserman
- National Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institutet, Stockholm, Sweden
| | - Miriam Iosue
- National Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institutet, Stockholm, Sweden
| | - Anika Wuestefeld
- National Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institutet, Stockholm, Sweden
| | - Vladimir Carli
- National Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
35
|
Damon W, McNeil R, Milloy MJ, Nosova E, Kerr T, Hayashi K. Residential eviction predicts initiation of or relapse into crystal methamphetamine use among people who inject drugs: a prospective cohort study. J Public Health (Oxf) 2020; 41:36-45. [PMID: 29425315 DOI: 10.1093/pubmed/fdx187] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 11/30/2017] [Accepted: 12/20/2017] [Indexed: 02/03/2023] Open
Abstract
Reports of increasing methamphetamine use among vulnerable populations may be attributed in part to the adaptive use of stimulants in response to the loss of stable housing through residential eviction. We employed multivariable recurrent event extended Cox regression to examine the independent association between recent evictions and initiation of or relapse into crystal methamphetamine use among people who inject drugs in Vancouver, Canada enrolled in two prospective cohort studies. In a multivariable analysis, eviction remained independently associated with methamphetamine initiation or relapse (adjusted hazard ratio = 1.90; 95% confidence interval: 1.31-2.75). Findings demonstrate the need to secure tenancies for drug-using populations to reduce harms.
Collapse
Affiliation(s)
- William Damon
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, British Columbia, Canada
| | - Ryan McNeil
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, British Columbia, Canada.,Faculty of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, British Columbia, Canada
| | - M-J Milloy
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, British Columbia, Canada.,Faculty of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, British Columbia, Canada
| | - Ekaterina Nosova
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, British Columbia, Canada
| | - Thomas Kerr
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, British Columbia, Canada.,Faculty of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, British Columbia, Canada
| | - Kanna Hayashi
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, British Columbia, Canada.,Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, British Columbia, Canada
| |
Collapse
|
36
|
Zheng Z, Yabroff KR. The Long Shadow of Childhood Cancer: Lasting Risk of Medical Financial Hardship. J Natl Cancer Inst 2020; 111:105-106. [PMID: 30085202 DOI: 10.1093/jnci/djy122] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 06/13/2018] [Indexed: 01/11/2023] Open
Affiliation(s)
- Zhiyuan Zheng
- Surveillance and Health Services Research Program, American Cancer Society, Atlanta, GA
| | | |
Collapse
|
37
|
Abstract
OBJECTIVE To assess the relationship between county-level eviction rates and drug and alcohol mortality rates. DATA SOURCES Eviction rates from 2003 to 2016 provided by the Princeton University Eviction Lab were merged with Multiple Cause-of-Death Mortality Files and aggregated to the county-year level. STUDY DESIGN All opioid (prescription and heroin), cocaine, psychostimulant, benzodiazepine, antidepressant, and alcohol poisoning-related deaths per 100 000 people, eviction rates, and socioeconomic indicators were merged at the county-year level from 2003 to 2016. We estimated a series of mortality rate models with county and year fixed effects and used a control function (2SRI) method to adjust for the endogeneity of eviction rates. DATA COLLECTION/EXTRACTION METHODS We matched retrospectively collected datasets. PRINCIPAL FINDINGS Higher levels of eviction rates were consistently associated with higher rates of mortality across six of nine substance categories studied when all counties were combined. Subanalysis by USDA population density measures indicated this positive association was almost entirely driven by urban counties; few systematic associations between the eviction rate levels and mortality were observed for suburban or rural counties. CONCLUSIONS Risk of eviction appears to exacerbate the current "deaths of despair" crisis associated with substance use. Proposed changes to Housing and Urban Development policy that are expected to substantially increase the risk of eviction may worsen an already-acute mortality crisis.
Collapse
Affiliation(s)
- Ashley C. Bradford
- Paul H. O'Neill School of Public and Environmental AffairsIndiana UniversityBloomingtonIndiana
| | - W. David Bradford
- Department of Public Administration and PolicyUniversity of GeorgiaAthensGeorgia
| |
Collapse
|
38
|
Risk of suicide in households threatened with eviction: the role of banks and social support. BMC Public Health 2019; 19:1250. [PMID: 31510963 PMCID: PMC6737669 DOI: 10.1186/s12889-019-7548-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 08/26/2019] [Indexed: 11/10/2022] Open
Abstract
Background One of the greatest effects of the financial crisis in Spain has been the enormous increase in the number of evictions. Several studies have shown the association of evictions with different aspects of the physical and mental health. Furthermore, evictions have been associated with an increased risk of suicide. Our objective was to evaluate the risk of suicide among victims of eviction and investigate whether it is associated with specific characteristics of households and interviewees, the eviction process and social support, and health needs. Methods A total of 205 participants from households threatened with eviction in Granada, Spain, and 673 being the total number of members of these households, were interviewed in one-on-one sessions between April 2013 and May 2014. Through a questionnaire, information was obtained on physical and mental health, characteristics of their eviction process and support networks, and the use of health services. Results Almost half of the sample (46.7%) were at low (11.8%), moderate (16.9%), or high suicide risk (17.9%). Household and interviewee features had a limited association with suicide risk. On the contrary, the risk of suicide is greater with a longer exposure to the eviction process. In addition, threatening phone calls from banks increased significantly the risk of suicide, especially among men. Suicide risk was also associated with low social support, especially among women. Interviewees at risk of suicide received more help from nongovernmental organizations than those who were not at risk. In interviewees at risk, the main unmet needs were emotional and psychological help, especially in men. A high percentage of those at risk of suicide declare having large unmeet health needs. Finally, there was a tendency among the evicted at risk of suicide to visit emergency room and primary care more often than those not at risk, especially among women. Conclusions To our knowledge, this is the first study showing that when banks adopt a threatening attitude, suicide risk increases among the evicted. As hypothesized, when the evicted felt socially supported, suicide risk decreased. Emotional help was the main mediator of suicide risk and the main unmet need, especially among men.
Collapse
|
39
|
Jiménez-Picón N, García-Reposo A, Romero-Martín M. [Biopsychosocial consequences in Spanish population affected by an eviction process]. GACETA SANITARIA 2019; 34:289-296. [PMID: 31474382 DOI: 10.1016/j.gaceta.2019.03.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 03/26/2019] [Accepted: 03/29/2019] [Indexed: 10/26/2022]
Abstract
The biopsychosocial consequences in Spanish population affected by an eviction process were described in this paper. A scoping review was conducted, consulting the following databases: PubMed, Scopus, PsycINFO, CINAHL, LILACS, CSIC, MEDES, Scielo, Dialnet, Cuiden Plus and Cochrane. The search strategy was (Eviction OR "Home eviction" OR "Housing eviction" OR "Households at risk of eviction" OR Foreclosure) AND ("Health" OR "Mental Health" OR "Psychosocial impact" OR "Impacts on health" OR "Social impact indicators" OR "Social Determinants of Health" OR "Social Indicators").Eleven articles published between 2008 and September 2018 were selected. They followed a quantitative or qualitative methodology. The research quality was measured, and the results were organized according to the biopsychosocial model. From the physical perspective, results described a poor self-perception of health, as well as an increase of chronic diseases, pain, drug consumptions. From the psychological perspective, it was found negative thoughts, recurrent emotions and increased anxiety, depression, mental disorder and post-traumatic stress. From the social perspective, it was found that family, the offspring and the guarantor were affected, as well as the health system with greater medical visits and emergencies. This review showed worse health indicators among women, such as a headache, smoking habits, worse self-perception of health and more mental health disorders (depression, anxiety and other types of psychological distress). Daughters revealed worse self-perception of health than sons. It is necessary an approach from public health, epidemiological surveillance, action protocols and health programs, to advise, diagnose, prevent, protect and promote the health of the Spanish population affected.
Collapse
Affiliation(s)
- Nerea Jiménez-Picón
- Centro Universitario de Enfermería Cruz Roja de Sevilla, Universidad de Sevilla, Sevilla, España.
| | - Alicia García-Reposo
- Centro Universitario de Enfermería Cruz Roja de Sevilla, Universidad de Sevilla, Sevilla, España
| | - Macarena Romero-Martín
- Centro Universitario de Enfermería Cruz Roja de Sevilla, Universidad de Sevilla, Sevilla, España
| |
Collapse
|
40
|
Zewde N, Eliason E, Allen H, Gross T. The Effects of the ACA Medicaid Expansion on Nationwide Home Evictions and Eviction-Court Initiations: United States, 2000-2016. Am J Public Health 2019; 109:1379-1383. [PMID: 31415189 DOI: 10.2105/ajph.2019.305230] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. To evaluate the effect of the Affordable Care Act (ACA) Medicaid expansions on national rates of home eviction and eviction initiation in the United States.Methods. Using nationally representative administrative data from The Eviction Lab at Princeton University, we estimated the effects of the ACA Medicaid expansions on county-level evictions and filings from 2000 to 2016 with a difference-in-difference regression design.Results. We found that Medicaid expansions were associated with an annual reduction in the rate of evictions by 1.15 per 1000 renter-occupied households (P < .001), a reduction of 1.59 eviction filings per 1000 renter-occupied households (P < .001), and a reduction in the average number of evictions by 46 (P < .05). We found additional evidence that increasing rates of African American residents in a county was associated with a greater rate of evictions filed, and increased rates of poverty and rent burdens relative to income were associated with more evictions both filed and completed.Conclusions. Evictions decreased after Medicaid expansion, demonstrating further evidence of the substantive financial protections afforded by this coverage. The reduction in the eviction filing rate suggests that Medicaid expansion could be reducing evictions by preventing the court proceeding entirely.
Collapse
Affiliation(s)
- Naomi Zewde
- Naomi Zewde, Erica Eliason, and Heidi Allen are with Columbia University School of Social Work, New York, NY. Tal Gross is with Boston University Questrom School of Business, Boston, MA
| | - Erica Eliason
- Naomi Zewde, Erica Eliason, and Heidi Allen are with Columbia University School of Social Work, New York, NY. Tal Gross is with Boston University Questrom School of Business, Boston, MA
| | - Heidi Allen
- Naomi Zewde, Erica Eliason, and Heidi Allen are with Columbia University School of Social Work, New York, NY. Tal Gross is with Boston University Questrom School of Business, Boston, MA
| | - Tal Gross
- Naomi Zewde, Erica Eliason, and Heidi Allen are with Columbia University School of Social Work, New York, NY. Tal Gross is with Boston University Questrom School of Business, Boston, MA
| |
Collapse
|
41
|
Paes-Sousa R, Schramm JMDA, Mendes LVP. Fiscal austerity and the health sector: the cost of adjustments. CIENCIA & SAUDE COLETIVA 2019; 24:4375-4384. [PMID: 31778488 DOI: 10.1590/1413-812320182412.23232019] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 07/12/2019] [Indexed: 12/30/2022] Open
Abstract
Fiscal austerity policies have been used as responses to economic crises and fiscal deficits in both developed and developing countries. While they vary in regard to their content, intensity and implementation, such models recommend reducing public expenses and social investments, retracting the public service and substituting the private sector in lieu of the State to provide certain services tied to social policies. The present article discusses the main effects of the recent economic crisis on public health based on an updated review with consideration for three dimensions: health risks, epidemiological profiles of different populations, and health policies. In Brazil, the combination of economic crisis and fiscal austerity policies is capable of producing a direr situation than those experienced in developed countries. The country is characterized by historically high levels of social inequality, an under-financed health sector, highly prevalent chronic degenerative diseases and persisting preventable infectious diseases. It is imperative to develop alternatives to mitigate the effects of the economic crisis taking into consideration not only the sustainability of public finance but also public well-being.
Collapse
Affiliation(s)
- Romulo Paes-Sousa
- Centro de Pesquisas René Rachou, Fiocruz Minas. Av. Augusto de Lima 1715, Barro Preto. 30190-002 Belo Horizonte MG Brasil.
| | | | | |
Collapse
|
42
|
Anguelovski I, Triguero-Mas M, Connolly JJT, Kotsila P, Shokry G, Pérez Del Pulgar C, Garcia-Lamarca M, Argüelles L, Mangione J, Dietz K, Cole H. Gentrification and health in two global cities: a call to identify impacts for socially-vulnerable residents. ACTA ACUST UNITED AC 2019. [DOI: 10.1080/23748834.2019.1636507] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Isabelle Anguelovski
- UAB - Universitat Autònoma de Barcelona, Barcelona, Spain
- ICTA - Institute for Environmental Science and Technology, Barcelona, Spain
- IMIM - Medical Research Institute, Hospital del Mar, Barcelona, Spain
- ICREA - Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain
| | - Margarita Triguero-Mas
- UAB - Universitat Autònoma de Barcelona, Barcelona, Spain
- ICTA - Institute for Environmental Science and Technology, Barcelona, Spain
- IMIM - Medical Research Institute, Hospital del Mar, Barcelona, Spain
| | - James JT Connolly
- UAB - Universitat Autònoma de Barcelona, Barcelona, Spain
- ICTA - Institute for Environmental Science and Technology, Barcelona, Spain
- IMIM - Medical Research Institute, Hospital del Mar, Barcelona, Spain
| | - Panagiota Kotsila
- UAB - Universitat Autònoma de Barcelona, Barcelona, Spain
- ICTA - Institute for Environmental Science and Technology, Barcelona, Spain
- IMIM - Medical Research Institute, Hospital del Mar, Barcelona, Spain
| | - Galia Shokry
- UAB - Universitat Autònoma de Barcelona, Barcelona, Spain
- ICTA - Institute for Environmental Science and Technology, Barcelona, Spain
- IMIM - Medical Research Institute, Hospital del Mar, Barcelona, Spain
| | - Carmen Pérez Del Pulgar
- UAB - Universitat Autònoma de Barcelona, Barcelona, Spain
- ICTA - Institute for Environmental Science and Technology, Barcelona, Spain
- IMIM - Medical Research Institute, Hospital del Mar, Barcelona, Spain
| | - Melissa Garcia-Lamarca
- UAB - Universitat Autònoma de Barcelona, Barcelona, Spain
- ICTA - Institute for Environmental Science and Technology, Barcelona, Spain
- IMIM - Medical Research Institute, Hospital del Mar, Barcelona, Spain
| | - Lucia Argüelles
- UAB - Universitat Autònoma de Barcelona, Barcelona, Spain
- ICTA - Institute for Environmental Science and Technology, Barcelona, Spain
- IMIM - Medical Research Institute, Hospital del Mar, Barcelona, Spain
| | - Julia Mangione
- UAB - Universitat Autònoma de Barcelona, Barcelona, Spain
- ICTA - Institute for Environmental Science and Technology, Barcelona, Spain
- IMIM - Medical Research Institute, Hospital del Mar, Barcelona, Spain
| | - Kaitlyn Dietz
- UAB - Universitat Autònoma de Barcelona, Barcelona, Spain
- ICTA - Institute for Environmental Science and Technology, Barcelona, Spain
- IMIM - Medical Research Institute, Hospital del Mar, Barcelona, Spain
| | - Helen Cole
- UAB - Universitat Autònoma de Barcelona, Barcelona, Spain
- ICTA - Institute for Environmental Science and Technology, Barcelona, Spain
- IMIM - Medical Research Institute, Hospital del Mar, Barcelona, Spain
| |
Collapse
|
43
|
Mazeikaite G, O'Donoghue C, Sologon DM. The Great Recession, financial strain and self-assessed health in Ireland. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2019; 20:579-596. [PMID: 30564918 PMCID: PMC6517350 DOI: 10.1007/s10198-018-1019-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 12/04/2018] [Indexed: 06/09/2023]
Abstract
In this paper, we study the effects of the 2008 economic crisis on general health in one of the most severely affected EU economies-Ireland. We examine the relationship between compositional changes in demographic and socio-economic factors, such as education, income, and financial strain, and changes in the prevalence of poor self-assessed health over a 5-year period (2008-2013). We apply a generalised Oaxaca-Blinder decomposition approach for non-linear regression models proposed by Fairlie (1999, 2005). Results show that the increased financial strain explained the largest part of the increase in poor health in the Irish population and different sub-groups. Changes in the economic activity status and population structure also had a significant positive effect. The expansion of education had a significant negative effect, preventing further increases in poor health. Wealthier and better educated individuals experienced larger relative increases in poor health, which led to reduced socio-economic health inequalities.
Collapse
Affiliation(s)
- Gintare Mazeikaite
- Luxembourg Institute of Socio-Economic Research (LISER), Esch-Sur-Alzette, Luxembourg.
- Maastricht University/UNU-MERIT, Maastricht, Netherlands.
| | | | - Denisa M Sologon
- Luxembourg Institute of Socio-Economic Research (LISER), Esch-Sur-Alzette, Luxembourg
| |
Collapse
|
44
|
Housing insecurity and health among people in South Korea: focusing on tenure and affordability. Public Health 2019; 171:116-122. [PMID: 31125867 DOI: 10.1016/j.puhe.2019.02.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 01/08/2019] [Accepted: 02/16/2019] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Housing is one of the social determinants of health, and the evidence of its impact in this area has been increasingly expanded. However, in spite of its importance, there have been few studies to investigate an association between housing and health in Korea. Our study aimed to investigate housing tenure and affordability and their effects on health outcomes in Korea. STUDY DESIGN We selected 9456 participants from the 10-11th wave of the Korea Welfare Panel Study, after excluding missing variables. Housing tenure and affordability were chosen as independent variables, and depressive symptoms and self-rated health were selected as dependent variables. METHODS Logistic regression was implemented to investigate the association between housing tenure/affordability and health outcome, and all covariates such as sex, age, and household income were adjusted. RESULTS Compared with homeowners, renters are more likely to have depressive symptoms (odds ratio [OR]: 1.26, 95% confidence interval [CI]: 1.08, 1.47) and poor self-rated health (OR: 1.38, 95% CI: 1.19-1.61). Also, health effects of housing unaffordability were observed differently by tenure, showing that the likelihood of having depressive symptoms (OR: 1.56, 95% CI: 1.15, 2.13) and poor self-rated health (OR: 1.51, 95% CI: 1.10, 2.06) is significantly high among renters who reported unaffordability. CONCLUSION This study could provide evidence of housing as a determinant of health by showing that both housing tenure and affordability are significantly related to health outcomes.
Collapse
|
45
|
Nazarov O, Guan J, Chihuri S, Li G. Research utility of the National Violent Death Reporting System: a scoping review. Inj Epidemiol 2019; 6:18. [PMID: 31245267 PMCID: PMC6582674 DOI: 10.1186/s40621-019-0196-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 04/01/2019] [Indexed: 11/26/2022] Open
Abstract
Background To better understand and prevent suicide and homicide, the National Center for Injury Prevention and Control of the US Centers for Disease Control and Prevention launched the National Violent Death Reporting System (NVDRS) in six states in 2002. As of 2018, the NVDRS has been expanded to include all 50 states, the District of Columbia and Puerto Rico. The purpose of this review was to assess the research utility of the NVDRS based on studies indexed in major bibliographical databases. Methods We performed a scoping review of published studies that were based on data from the NVDRS, identified by searching six electronic databases: PubMed, EMBASE, Google Scholar, OVID, Scopus, and Web of Science. We examined the time trend of annual NVDRS-based research output, generated a word cloud using the keywords listed in the publications, and mapped the knowledge domains covered by NVDRS-based studies. Results Our review included a total of 150 studies published between 2005 and 2018. There was a marked increase in the annual number of NVDRS-based publications, with 120 (80.0%) of the 150 studies published between 2011 and 2018. Overall, 104 (69.3%) studies focused on suicide and 39 (26.0%) on homicide. Of the included studies, 100 (66.7%) were descriptive epidemiology, 31 (20.7%) were risk factor analyses, 9 (6.0%) were evaluations, 7 (4.7%) were trend analyses, and 4 (2.7%) were data quality assessments. Knowledge domain mapping identified two major clusters of studies, one on suicide and the other on homicide. The cluster on suicide was commonly linked to “circumstance,” “alcohol” and “substance abuse” and the cluster on homicide was commonly linked to “firearm,” “injury,” and “gang.” The two clusters were interlinked to overlapping networks of keywords, such as “firearm” and “mental health problem.” Conclusions Research utility of the NVDRS has increased considerably in recent years. Studies based on data from the NVDRS are clustered in two knowledge domains – suicide and homicide. The vast potential of the NVDRS for violence research and prevention remains to be fully exploited.
Collapse
Affiliation(s)
- Oybek Nazarov
- 1Department of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY USA.,3Center for Injury Epidemiology and Prevention, Columbia University Irving Medical Center, 622 West 168th St, PH5-534, New York, NY 10032 USA
| | | | - Stanford Chihuri
- 1Department of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY USA.,3Center for Injury Epidemiology and Prevention, Columbia University Irving Medical Center, 622 West 168th St, PH5-534, New York, NY 10032 USA
| | - Guohua Li
- 1Department of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY USA.,4Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY USA
| |
Collapse
|
46
|
Associations between Home Foreclosure and Health Outcomes in a Spanish City. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16060981. [PMID: 30893804 PMCID: PMC6466329 DOI: 10.3390/ijerph16060981] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 03/17/2019] [Accepted: 03/17/2019] [Indexed: 11/16/2022]
Abstract
The financial crisis has caused an exponential increase of home foreclosures in Spain. Recent studies have shown the effects that foreclosures have on mental and physical health. This study explores these effects on a sample of adults in the city of Granada (Spain), in terms of socio-demographic, socio-economic and process characteristics. A cross-sectional survey was administered to obtain information on self-perceived changes in several indicators of physical and mental health, consumption of medications, health-related behaviors and use of health services. A total of 205 persons, going through a foreclosure process, participated in the study. 85.7% of the sample reported an increase of episodes of anxiety, depression, and stress; 82.6% sleep disturbances; 42.8% worsening of previous chronic conditions, and 40.8% an increase in consumption of medication. Women, married persons and persons already in the legal stage of the foreclosure process reported higher probability of worsening health according to several indicators, in comparison with men, not married, and individuals in the initial stages of the foreclosure process. The results of this study reveal a general deterioration of health associated with the foreclosure process. These results may help to identify factors to prevent poor health among populations going through a foreclosure process.
Collapse
|
47
|
Schaff K, Dorfman L. Local Health Departments Addressing the Social Determinants of Health: A National Survey on the Foreclosure Crisis. Health Equity 2019; 3:30-35. [PMID: 30793093 PMCID: PMC6382054 DOI: 10.1089/heq.2018.0066] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: To examine local health department (LHD) engagement in addressing the social determinants of health by using the foreclosure crisis as an example. Methods: National survey of 166 LHD staff on the foreclosure crisis (2006–2014). Results: About one quarter (28%) of respondents reported that their LHD had engaged in work related to the foreclosure crisis, 7% planned to engage, and 65% did not or were not planning to engage. Views about the role of LHDs in addressing the foreclosure crisis varied: 30% stated that LHDs should work on foreclosure. Conclusions: A substantial number of respondents reported that their LHD addressed foreclosure, or supported engagement, yet there are divergent perceptions of appropriate LHD roles. LHDs follow a pattern described by the diffusion of innovations theory: Innovative LHDs can share their work on foreclosure and housing, early adopters are poised to act, and others may follow if they have support.
Collapse
Affiliation(s)
- Katherine Schaff
- Alameda County Public Health Department, Oakland, California
- Berkeley Media Studies Group—A Project of Public Health Institute, Berkeley, California
- Address correspondence to: Katherine Schaff, DrPH, MPH, Berkeley Media Studies Group—A Project of Public Health Institute, 2130 Center Street, Suite 302, Berkeley, CA 94607,
| | - Lori Dorfman
- Berkeley Media Studies Group—A Project of Public Health Institute, Berkeley, California
| |
Collapse
|
48
|
Petrosky E, Harpaz R, Fowler KA, Bohm MK, Helmick CG, Yuan K, Betz CJ. Chronic Pain Among Suicide Decedents, 2003 to 2014: Findings From the National Violent Death Reporting System. Ann Intern Med 2018; 169:448-455. [PMID: 30208405 PMCID: PMC6913029 DOI: 10.7326/m18-0830] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND More than 25 million adults in the United States have chronic pain. Chronic pain has been associated with suicidality, but previous studies primarily examined nonfatal suicidal behaviors rather than suicide deaths associated with chronic pain or the characteristics of such deaths. OBJECTIVE To estimate the prevalence of chronic pain among suicide decedents in a large multistate sample and to characterize suicide decedents with and without chronic pain. DESIGN Retrospective analysis of National Violent Death Reporting System (NVDRS) data. The NVDRS links death certificate, coroner or medical examiner, and law enforcement data collected by investigators, who often interview informants who knew the decedent to gather information on precipitating circumstances surrounding the suicide. Information is abstracted by using standard coding guidance developed by the Centers for Disease Control and Prevention. SETTING 18 states participating in the NVDRS. PARTICIPANTS Suicide decedents with and without chronic pain who died during 1 January 2003 to 31 December 2014. MEASUREMENTS Demographic characteristics, mechanism of death, toxicology results, precipitating circumstances (mental health, substance use, interpersonal problems, life stressors), and suicide planning and intent. RESULTS Of 123 181 suicide decedents included in the study, 10 789 (8.8%) had evidence of chronic pain, and the percentage increased from 7.4% in 2003 to 10.2% in 2014. More than half (53.6%) of suicide decedents with chronic pain died of firearm-related injuries and 16.2% by opioid overdose. LIMITATION The results probably underrepresent the true percentage of suicide decedents who had chronic pain, given the nature of the data and how they were captured. CONCLUSION Chronic pain may be an important contributor to suicide. Access to quality, comprehensive pain care and adherence to clinical guidelines may help improve pain management and patient safety. PRIMARY FUNDING SOURCE None.
Collapse
Affiliation(s)
- Emiko Petrosky
- Centers for Disease Control and Prevention, Atlanta, Georgia (E.P., R.H., K.A.F., M.K.B., C.G.H., K.Y., C.J.B.)
| | - Rafael Harpaz
- Centers for Disease Control and Prevention, Atlanta, Georgia (E.P., R.H., K.A.F., M.K.B., C.G.H., K.Y., C.J.B.)
| | - Katherine A Fowler
- Centers for Disease Control and Prevention, Atlanta, Georgia (E.P., R.H., K.A.F., M.K.B., C.G.H., K.Y., C.J.B.)
| | - Michele K Bohm
- Centers for Disease Control and Prevention, Atlanta, Georgia (E.P., R.H., K.A.F., M.K.B., C.G.H., K.Y., C.J.B.)
| | - Charles G Helmick
- Centers for Disease Control and Prevention, Atlanta, Georgia (E.P., R.H., K.A.F., M.K.B., C.G.H., K.Y., C.J.B.)
| | - Keming Yuan
- Centers for Disease Control and Prevention, Atlanta, Georgia (E.P., R.H., K.A.F., M.K.B., C.G.H., K.Y., C.J.B.)
| | - Carter J Betz
- Centers for Disease Control and Prevention, Atlanta, Georgia (E.P., R.H., K.A.F., M.K.B., C.G.H., K.Y., C.J.B.)
| |
Collapse
|
49
|
Kalesan B, Mobily ME, Vasan S, Siegel M, Galea S. The Role of Interpersonal Conflict as a Determinant of Firearm-Related Homicide-Suicides at Different Ages. JOURNAL OF INTERPERSONAL VIOLENCE 2018; 33:2335-2351. [PMID: 26843182 DOI: 10.1177/0886260516629387] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Although firearm-related homicide-suicides and firearm-related suicides are tragic and catastrophic events, there is increasing evidence that the two events have different precipitants and that understanding these precipitants may help prevention efforts. We aimed to assess the role of interpersonal conflict (IPC) and recent crises in firearm-related homicide-suicides as compared with firearm-related suicides alone. We also assessed whether these differences were consistent across young and old perpetrators. Using an unmatched case-control study, we compared firearm-related homicide-suicides andsuicides alone from 2003 to 2011 in the National Violent Death Registry data to assess the risk associated with IPC and crisis. Survival analysis was performed to compare time-to-incident of homicide-suicide versus suicide only. We derived odds ratios (ORs) and 95% confidence intervals (95%CI) due to IPC and recent crisis from mixed logistic regression models. Stratified analysis by age on the effect of IPC and recent crisis, and type of incident was also performed. After adjusting for relevant covariates, homicide-suicides were more likely than suicide alone following IPC (OR = 20.6, 95%CI = [16.6, 25.7]) and recent crisis (OR = 14.5, 95%CI = [12.4, 16.9]). The risk of firearm homicide-suicide compared with suicide associated with IPC was twice greater among those >30 years compared with those ≤30 years ( p-interaction = .033), and no differential by age associated with recent crisis ( p-interaction = .64). IPC and recent crisis are risk factors for committing homicide-suicides compared with suicides alone, with the risk doubly greater among older than younger perpetrators.
Collapse
Affiliation(s)
| | | | | | | | - Sandro Galea
- 3 Boston University School of Public Health, MA, USA
| |
Collapse
|
50
|
Evicted children and subsequent placement in out-of-home care: A cohort study. PLoS One 2018; 13:e0195295. [PMID: 29668737 PMCID: PMC5905888 DOI: 10.1371/journal.pone.0195295] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 03/20/2018] [Indexed: 11/21/2022] Open
Abstract
Background Evictions may have serious consequences for individuals’ health and wellbeing. Even though an eviction may be experienced as a significant crisis for the family, there is little previous knowledge on consequences for evicted children. This study represents the first attempt to examine to what extent children from evicted households were separated from their parents and placed in out-of-home care (foster family or residential care) using population-based data, net of observed confounding factors related to the socioeconomic and psychosocial circumstances of their parents. Methods This study takes advantage of information from a Swedish national database, consisting of about 8 000 evicted individuals and a random sample of 770 000 individuals from the national population, linked to individual-level, longitudinal data from Swedish national registers. Our analytical sample consists of information for more than 250 000 children born in 1995–2008, including 2 224 children from evicted households. We used binary logistic regression based on the Karlson/Holm/Breen method to account for observed imbalances at baseline between evicted and non-evicted children. Results Compared to non-evicted children, the crude odds ratio for placement in out-of-home care in evicted children was 12.10 (95% CI 8.54–17.14). Net of observed confounding factors related to the socioeconomic and psychosocial circumstances of the parents, evicted children had a twofold elevated risk of being placed in out-of-home care (odds ratio 2.26, 95% CI 1.55–3.27). Crude OR for evicted children in comparison with children under threat of eviction (eviction not formally executed) was 1.71 (95% CI 1.17–2.49) and adjusted OR 1.58 (95% CI 1.06–2.35). Conclusion Children who experience eviction constitute a disadvantaged group and are at significant risk of being separated from their parents and placed in out-of-home care. These results demonstrate the importance of providing support for these children and their parents. Strategies to prevent households with children from being evicted seem to be an important and viable intervention path.
Collapse
|