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Jandaghian-Bidgoli M, Kazemian E, Shaterian N, Abdi F. Focusing attention on the important association between food insecurity and psychological distress: a systematic review and meta-analysis. BMC Nutr 2024; 10:118. [PMID: 39243085 PMCID: PMC11378639 DOI: 10.1186/s40795-024-00922-1] [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: 02/08/2024] [Accepted: 08/20/2024] [Indexed: 09/09/2024] Open
Abstract
BACKGROUND Food insecurity has involved more than 750 million individuals worldwide. The association of food insecurity with socio-economic factors is also undeniable demand more consideration. Food insecurity will become a global priority by 2030. This systematic review and meta-analysis examined current literature concerning the association between food insecurity and psychological distress. METHODS Relevant researches were identified by searching databases including PubMed, EMBASE, Scopus, and Web of Science, ProQuest, and Cochrane Library up to June 2024 without language limitation. Then a snowball search was conducted in the eligible studies. The quality assessment was made through Newcastle-Ottawa Scale. RESULTS Data were available from 44 cross-sectional articles for systematic review and 17 eligible articles for meta-analysis with 2,267,012 and 1,953,636 participants, respectively. Findings support the growing segment of literature on the association between food insecurity and psychological distress. The highly represented groups were households with low income. Psychological and diabetic distress was directly associated with food insecurity as it increased the odds of distress to 329% (OR: 3.29; 95% CI: 2.46-4.40). Sleep problems, anxiety, depression, lower life satisfaction, obesity, and a higher rate of smoking were among the secondary outcomes. CONCLUSION Food insecurity was a common stressor that can have a negative impact on psychological well-being and even physical health. The findings should be considered in the public health and making policy-making process.
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Affiliation(s)
| | - Elham Kazemian
- Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Negin Shaterian
- Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran
| | - Fatemeh Abdi
- Nursing and Midwifery Care Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran.
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2
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Hadavandsiri F, Mohammad nejad S, Mahboobi M, Najafi A, Ebrahimzadeh Mousavi M, Faghihi SH, Abdolmohamadi N, Akbarpour S. Food insecurity and the risk of sleep disorders in people living with HIV/AIDS as a neglected health concern: A national survey in Iran. Heliyon 2024; 10:e33467. [PMID: 39050438 PMCID: PMC11266996 DOI: 10.1016/j.heliyon.2024.e33467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/14/2024] [Accepted: 06/21/2024] [Indexed: 07/27/2024] Open
Abstract
Food insecurity (FI) and sleep problems are major modifiable health issues among people living with HIV/AIDS (PLWH), and there is limited knowledge about their prevalence among this underrepresented population. Our study aimed to assess the relationship between FI and sleep problems as important environmental factors affecting PLWH in Iran. The national survey was conducted on 1185 confirmed HIV-positive patients who attended consulting centers in 15 geographically diverse provinces in Iran, during 2021-2022. Standard questionnaires were used to measure FI and sleep problems (Insomnia, Obstructive Sleep apnea (OSA), Excessive Daytime Sleepiness (EDS), and Poor sleep quality), and a logistic regression model was used to assess the association between FI and the odds of experiencing sleep problems. About 764 (The prevalence of FI = 64.47 %) of the participants had insecure status, with a mean score of 11.73 (SE = 0.34). Those with FI had a higher prevalence of insomnia, EDS, and poor sleep quality (54.84 %, 31.79 %, and 55.17 %, respectively) compared to those without FI (30.69 %, 17.03 %, and 40.42 %, respectively). FI increased the odds of being at risk for Insomnia (OR = 2.39, 95 % CI: 1.81-3.15), EDS (OR = 1.44, 95 % CI: 1.04-2.01), and poor sleep quality (OR = 1.79, 95 % CI: 1.29-2.48) in the multiple regression model. The results highlight the strong association between FI and a broad range of sleep problems in PLWH. Considering the impact of FI and impaired sleep health on PLWH, more attention is needed for at-risk groups for screening and intervention purposes.
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Affiliation(s)
- Fatemeh Hadavandsiri
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Safieh Mohammad nejad
- Sleep Breathing Disorders Research Center (SBDRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Marziyeh Mahboobi
- Center for Communicable Disease Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Arezu Najafi
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Sayed Hassan Faghihi
- Social Determinant of Health Research Center, Yasuj University of Medical Sciences, Iran
| | - Narges Abdolmohamadi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical, Tehran, Iran
| | - Samaneh Akbarpour
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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3
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Green CD, Martinez AC, Becker SP. Examining ADHD and Cognitive Disengagement Syndrome Symptoms in Relation to Food Insecurity in Early Adolescents. Res Child Adolesc Psychopathol 2024:10.1007/s10802-024-01226-5. [PMID: 38967900 DOI: 10.1007/s10802-024-01226-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2024] [Indexed: 07/06/2024]
Abstract
Approximately 13.8 million U.S. households face food insecurity, which severely affects child development, with more than half of these households including children. Research links food insecurity to cognitive deficits and mental health challenges, highlighting the need for thorough understanding and intervention. Although existing studies have explored the association between food insecurity and internalizing symptomatology, less research has examined food insecurity in relation to attention-deficit/hyperactivity disorder (ADHD) symptoms. Further, no studies have explored the connection between food insecurity and cognitive disengagement syndrome (CDS) symptoms, closely related to ADHD symptoms. Despite extant research linking CDS to environmental factors, empirical attention to its potential association with food insecurity is notably lacking. Additionally, adolescents, almost twice as likely as younger children to experience household food insecurity, are likely more aware and respond differently to challenges during this developmental period. Accordingly, this study investigated the unique associations of parent-, teacher-, and youth self-reported ADHD dimensions and CDS symptoms in relation to parent-reported food insecurity in early adolescents (N = 136, ages 10-12). Controlling for age, sex, race, and medication use, no informant's ratings of ADHD symptom dimensions were uniquely related to food insecurity. In contrast, higher parent-, teacher-, and youth self-reported CDS symptoms were uniquely associated with greater food insecurity. This finding was robust to additional control of family income for teacher- and youth self-reported CDS symptoms. These findings highlight the complex link between food insecurity and mental health, suggest a connection with CDS symptoms, and stress the need to address food insecurity as a public health priority, especially in early adolescence.
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Affiliation(s)
- Cathrin D Green
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA.
| | - Andrew C Martinez
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA
| | - Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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4
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Williams CD, Gade S, Johnson K, Peterson RE, Moreno O, Hood KB, Santana A, Vassileva J, Dick DM, Amstadter AB, Chartier KG, Bravo DY. The longitudinal mediating role of sleep in associations between COVID-19 stressors predicting mental and physical health outcomes among emerging adult college students. Stress Health 2024:e3416. [PMID: 38748463 DOI: 10.1002/smi.3416] [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] [Received: 10/22/2023] [Revised: 04/05/2024] [Accepted: 04/18/2024] [Indexed: 06/29/2024]
Abstract
The current study tested a longitudinal mediation model throughout the COVID-19 pandemic focused on whether students' housing instability stress and food/financial instability stress at the beginning of the pandemic in spring 2020 (T1) informed sleep dissatisfaction and duration in fall 2020 (T2) and, in turn, physical and mental health in spring 2021 (T3). Further, we tested whether relations varied based on students' ethnic-racial backgrounds. Participants included 879 Asian, Black, Latine, Multiracial, and White emerging adult college students (Mage = 19.95, SD = 0.33) from a large public university in the mid-Atlantic region of the United States who attended college during the COVID-19 pandemic and completed surveys about their experiences. Findings indicated a significant mediation process, such that T1 housing instability stress predicted greater T2 sleep dissatisfaction and, in turn, less physical health, greater depressive symptoms, and greater anxiety symptoms at T3. Additionally, T1 food/financial instability stress was significantly associated with less T2 sleep duration but was not, in turn, associated with any T3 outcomes. Findings did not vary by students' ethnicity/race. Results highlight that sleep dissatisfaction is an important factor that accounts for relations between COVID-19 stressors predicting mental and physical health outcomes throughout the pandemic.
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Affiliation(s)
| | - Sneha Gade
- Virginia Commonwealth University, Richmond, Virginia, USA
| | | | - Roseann E Peterson
- Virginia Commonwealth University, Richmond, Virginia, USA
- State University of New York Downstate Health Sciences University, Brooklyn, New York, USA
| | - Oswaldo Moreno
- Virginia Commonwealth University, Richmond, Virginia, USA
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5
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Murkey JA, Gaston SA, Alhasan DM, Payne CW, Jackson WB, Jackson CL. Food security status and cardiometabolic health by sex/gender and race/ethnicity among adults in the United States. BMC Public Health 2024; 24:1220. [PMID: 38698385 PMCID: PMC11065684 DOI: 10.1186/s12889-024-18655-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 04/18/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Minoritized racial/ethnic groups and women in the United States (US) are disproportionately burdened by food insecurity, which likely contributes to disparities in cardiovascular health (CVH). Disparities are projected to widen due to the worsening climate crisis that is straining the agricultural system including food supplies. Nonetheless, studies have not investigated the relationship between food security status and 'ideal' CVH in a large, nationally-representative and racially/ethnically diverse US sample. METHODS AND RESULTS We investigated household food security status in relation to 'ideal' CVH among US adults (N = 157,001) using 2014-2018/2020 National Health Interview Survey data. Food security status was defined as very low, low, marginal, or high. A summed score of 4 health behaviors and 3 clinical factors totaling 7 different measures was dichotomized (yes/no) to assess modified 'ideal' CVH (mICVH). Using Poisson regression with robust variance, we estimated prevalence ratios (PRs) and 95% CIs of mICVH by household food security status. We stratified models by sex/gender and race/ethnicity. Very low food security prevalence was higher among non-Hispanic (NH)-Black (8.0%) compared to Hispanic/Latinx (5.1%), NH-White (3.1%) and NH-Asian (1.7%) adults. The association between very low versus high food security and mICVH was stronger among women (PR = 0.23 [95% CI: 0.17-0.31]) than men (PR = 0.48 [95% CI: 0.35-0.66]). Compared to NH-White adults with high food security, racially/ethnically minoritized groups with very low to high food security were generally less likely (range: [PRvery low = 0.25[95% CI: 0.14-0.44] - [PRhigh = 0.88 [95% CI: 0.79-0.97]) to meet mICVH criteria. CONCLUSIONS Food insecurity was associated with lower mICVH prevalence and racially/ethnically minoritized groups were disproportionately burdened.
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Affiliation(s)
- Jamie A Murkey
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, Durham, NC, 27709, USA
| | - Symielle A Gaston
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, Durham, NC, 27709, USA
| | - Dana M Alhasan
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, Durham, NC, 27709, USA
| | - Christopher W Payne
- Social & Scientific Systems, Inc., a DLH Holdings Company, Durham, NC, 27703, USA
| | - W Braxton Jackson
- Social & Scientific Systems, Inc., a DLH Holdings Company, Durham, NC, 27703, USA
| | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, Durham, NC, 27709, USA.
- Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, 20892, USA.
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Flores AC, Sarpong C, Dou N, Na M. Food sufficiency status and sleep outcomes in older adults: the National Health and Aging Trends Study (NHATS). Nutr J 2024; 23:25. [PMID: 38414001 PMCID: PMC10898009 DOI: 10.1186/s12937-024-00918-4] [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: 05/12/2023] [Accepted: 01/19/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Studies investigating the relationship between food insecurity and sleep among older populations are limited. This study aimed to cross-sectionally examine the associations between food sufficiency status and sleep outcomes in a nationally representative sample of older adults. METHODS Our study included 1,665 older adults (≥ 65 years), using data from the 2013 and 2014 National Health and Aging Trends Study (NHATS). Food insufficiency was determined via participants' experience and utilization of food assistance programs (FAP). Sleep outcomes, including nighttime and total sleep hours, sleep latency, and sleep quality, were derived from self-reported data. Multivariable linear regression and logistic regression models were used to estimate the associations between food sufficiency status and sleep outcomes. RESULTS In 2013-2014, 86.1% of older adults were classified as food sufficient without FAP, 9.85% as food sufficient with FAP, and 4.08% as food insufficient. Adjusting for sociodemographic characteristics, food sufficient older adults with FAP reported more total sleep hours (𝛽 = 0.31, 95% CI: -0.02, 0.64) than those participants who are food sufficient without FAP. Further adjusting for health factors, food sufficient participants with FAP had more nighttime sleep hours and greater total sleep hours compared to those participants food sufficient without FAP. Compared to those deemed as food sufficient without FAP, food sufficient participants with FAP had lower odds of having longer sleep latency (OR = 0.50, 95% CI: 0.28, 0.89), after further adjusting for physical function performance. CONCLUSIONS Among older adults, food sufficiency with FAP is associated with greater total sleep hours, greater nighttime sleep hours, and lower odds of longer sleep latency. Our findings may help inform nutrition food assistance programs targeting older populations.
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Affiliation(s)
- Ashley C Flores
- Department of Nutritional Sciences, 108C Chandlee Laboratory, The Pennsylvania State University, University Park, University Park, PA, 16802, USA
| | - Christopher Sarpong
- Department of Biology, The Pennsylvania State University, University Park, PA, USA
| | - Nan Dou
- Department of Nutritional Sciences, 108C Chandlee Laboratory, The Pennsylvania State University, University Park, University Park, PA, 16802, USA
| | - Muzi Na
- Department of Nutritional Sciences, 108C Chandlee Laboratory, The Pennsylvania State University, University Park, University Park, PA, 16802, USA.
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Marçal K. Housing hardship and maternal mental health among renter households with young children. Psychiatry Res 2024; 331:115677. [PMID: 38113812 DOI: 10.1016/j.psychres.2023.115677] [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] [Received: 09/07/2023] [Revised: 12/11/2023] [Accepted: 12/14/2023] [Indexed: 12/21/2023]
Abstract
Maternal mental health is crucial to healthy family functioning and child well-being. Housing hardship may increase risk for mood disorders among mothers of young children in renter households. The present study used latent class analysis to investigate manifestations of housing hardship during the postpartum year in a sample of renter mothers in the United States (N = 2,329), as well as whether housing hardship types were associated with subsequent maternal depression and anxiety. The majority of mothers were relatively stably housed ("Stable"), one in six made do with governmental rental assistance ("Rent-Assisted"), and more than one in ten struggled to afford or maintain stable housing ("Cost-Burdened" or "Housing Insecure"). The most severe housing hardship was associated with the greatest depression risk, whereas the best determinant of anxiety risk was whether rent was paid each month; mothers whose rent was paid with government assistance did not differ on anxiety risk compared to those who paid their rent independently. Findings suggest that different types of housing hardship are linked with distinct mental health sequelae. Widely available housing assistance may reduce cost burden and prevent displacement, with the potential to reduce mental disorder among low-income mothers of young children.
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Affiliation(s)
- Katherine Marçal
- School of Social Work, Rutgers University, New Brunswick, NJ, USA.
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8
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Akhlaghi M, Kohanmoo A. Sleep deprivation in development of obesity, effects on appetite regulation, energy metabolism, and dietary choices. Nutr Res Rev 2023:1-21. [PMID: 37905402 DOI: 10.1017/s0954422423000264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Sleep deprivation, which is a decrease in duration and quality of sleep, is a common problem in today's life. Epidemiological and interventional investigations have suggested a link between sleep deprivation and overweight/obesity. Sleep deprivation affects homeostatic and non-homoeostatic regulation of appetite, with the food reward system playing a dominant role. Factors such as sex and weight status affect this regulation; men and individuals with excess weight seem to be more sensitive to reward-driven and hedonistic regulation of food intake. Sleep deprivation may also affect weight through affecting physical activity and energy expenditure. In addition, sleep deprivation influences food selection and eating behaviours, which are mainly managed by the food reward system. Sleep-deprived individuals mostly crave for palatable energy-dense foods and have low desire for fruit and vegetables. Consumption of meals may not change but energy intake from snacks increases. The individuals have more desire for snacks with high sugar and saturated fat content. The relationship between sleep and the diet is mutual, implying that diet and eating behaviours also affect sleep duration and quality. Consuming healthy diets containing fruit and vegetables and food sources of protein and unsaturated fats and low quantities of saturated fat and sugar may be used as a diet strategy to improve sleep. Since the effects of sleep deficiency differ between animals and humans, only evidence from human subject studies has been included, controversies are discussed and the need for future investigations is highlighted.
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Affiliation(s)
- Masoumeh Akhlaghi
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Kohanmoo
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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McCurley JL, Fung V, Levy DE, McGovern S, Vogeli C, Clark CR, Bartels S, Thorndike AN. Assessment of the Massachusetts Flexible Services Program to Address Food and Housing Insecurity in a Medicaid Accountable Care Organization. JAMA HEALTH FORUM 2023; 4:e231191. [PMID: 37266960 PMCID: PMC10238945 DOI: 10.1001/jamahealthforum.2023.1191] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 04/03/2023] [Indexed: 06/03/2023] Open
Abstract
Importance Health systems are increasingly addressing health-related social needs. The Massachusetts Flexible Services program (Flex) is a 3-year pilot program to address food insecurity and housing insecurity by connecting Medicaid accountable care organization (ACO) enrollees to community resources. Objective To understand barriers and facilitators of Flex implementation in 1 Medicaid ACO during the first 17 months of the program. Design, Setting, and Participants This mixed-methods qualitative evaluation study from March 2020 to July 2021 used the Reach, Efficacy, Adoption, Implementation, Maintenance/Practical, Robust Implementation, and Sustainability Model (RE-AIM/PRISM) framework. Two Mass General Brigham (MGB) hospitals and affiliated community health centers were included in the analysis. Quantitative data included all MGB Medicaid ACO enrollees. Qualitative interviews were conducted with 15 members of ACO staff and 17 Flex enrollees. Main Outcomes and Measures Reach was assessed by the proportion of ACO enrollees who completed annual social needs screening (eg, food insecurity and housing insecurity) and the proportion and demographics of Flex enrollees. Qualitative interviews examined other RE-AIM/PRISM constructs (eg, implementation challenges, facilitators, and perceived effectiveness). Results Of 67 098 Medicaid ACO enrollees from March 2020 to July 2021 (mean [SD] age, 28.8 [18.7] years), 38 442 (57.3%) completed at least 1 social needs screening; 10 730 (16.0%) screened positive for food insecurity, and 7401 (11.0%) screened positive for housing insecurity. There were 658 (1.6%) adults (mean [SD] age, 46.6 [11.8] years) and 173 (0.7%) children (<21 years; mean [SD] age, 10.1 [5.5]) enrolled in Flex; of these 831 people, 613 (73.8%) were female, 444 (53.4%) were Hispanic/Latinx, and 172 (20.7%) were Black. Most Flex enrollees (584 [88.8%] adults; 143 [82.7%] children) received the intended nutrition or housing services. Implementation challenges identified by staff interviewed included administrative burden, coordination with community organizations, data-sharing and information-sharing, and COVID-19 factors (eg, reduced clinical visits). Implementation facilitators included administrative funding for enrollment staff, bidirectional communication with community partners, adaptive strategies to identify eligible patients, and raising clinician awareness of Flex. In Flex enrollee interviews, those receiving nutrition services reported increased healthy eating and food security; they also reported higher program satisfaction than Flex enrollees receiving housing services. Enrollees who received nutrition services that allowed for selecting food based on preferences reported higher satisfaction than those not able to select food. Conclusions and Relevance This mixed-methods qualitative evaluation study found that to improve implementation, Medicaid and health system programs that address social needs may benefit from providing funding for administrative costs, developing bidirectional data-sharing platforms, and tailoring support to patient preferences.
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Affiliation(s)
- Jessica L. McCurley
- Division of General Internal Medicine, Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, Massachusetts
- Department of Psychology, San Diego State University, San Diego, California
| | - Vicki Fung
- Harvard Medical School, Boston, Massachusetts
- Mongan Institute Health Policy Research Center, Massachusetts General Hospital, Boston
| | - Douglas E. Levy
- Harvard Medical School, Boston, Massachusetts
- Mongan Institute Health Policy Research Center, Massachusetts General Hospital, Boston
| | - Sydney McGovern
- Division of General Internal Medicine, Massachusetts General Hospital, Boston
| | - Christine Vogeli
- Harvard Medical School, Boston, Massachusetts
- Mongan Institute Health Policy Research Center, Massachusetts General Hospital, Boston
| | - Cheryl R. Clark
- Harvard Medical School, Boston, Massachusetts
- Division of General Internal Medicine & Primary Care, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Stephen Bartels
- Harvard Medical School, Boston, Massachusetts
- Mongan Institute Health Policy Research Center, Massachusetts General Hospital, Boston
| | - Anne N. Thorndike
- Division of General Internal Medicine, Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, Massachusetts
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10
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Koob C, Luo Y, Mobley C, Baxter S, Griffin S, Hossfeld C, Hossfeld L. Food Insecurity and Stress Among Rural Residents in South Carolina: The Moderating Influences of Household Characteristics, Neighborhood Social Environment and Food Environment. J Community Health 2023; 48:367-380. [PMID: 36469166 PMCID: PMC10765493 DOI: 10.1007/s10900-022-01176-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2022] [Indexed: 12/08/2022]
Abstract
Food insecurity is linked with poor physical and mental health outcomes, including anxiety, depression and stress. Rural residents in particular face unique challenges obtaining healthy food; the COVID-19 pandemic exacerbated the relationship between food insecurity and mental health outcomes. This study examines the relationship between food insecurity and stress, and the moderating influence of household characteristics, neighborhood social environment and food environment on this relationship, using a sample of 630 rural South Carolina (SC) residents during COVID-19. Two measures of stress were used in this study: current levels of stress and changes in stress since COVID-19. Results showed a gradient pattern between food insecurity and stress: rural residents with high food insecurity were 6.1 times more likely and those with moderate food insecurity were 3.4 times more likely to report higher level of general stress than those with low food insecurity; rural residents with high food insecurity were 3.3 times more likely and those with moderate food insecurity were 2.0 times more likely to report greater increase in stress after COVID-19 than those with low food insecurity. Neighborhood social environment and food environment provided a buffering effect on the relationship between food insecurity and stress. A stronger social environment after COVID-19 and higher levels of easiness in food access mitigated the negative impacts of food insecurity on stress. Efforts to ameliorate food insecurity should address these broader contextual variables, involving community-level factors.
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Affiliation(s)
- Caitlin Koob
- Department of Public Health Sciences, Clemson University, 29634, Clemson, SC, USA.
| | - Ye Luo
- Department of Sociology, Anthropology and Criminal Justice, Clemson University, 29634, Clemson, SC, USA
| | - Catherine Mobley
- Department of Sociology, Anthropology and Criminal Justice, Clemson University, 29634, Clemson, SC, USA
| | - Samuel Baxter
- Department of Public Health Sciences, Clemson University, 29634, Clemson, SC, USA
| | - Sarah Griffin
- Department of Public Health Sciences, Clemson University, 29634, Clemson, SC, USA
| | - Cassius Hossfeld
- Department of Public Health Sciences, Clemson University, 29634, Clemson, SC, USA
| | - Leslie Hossfeld
- Dean of College of Behavioral, Social and Health Sciences, Clemson University, 29634, Clemson, SC, USA
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11
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Ehlers CL, Karriker-Jaffe KJ, Bernert R. Poor self-reported sleep quality associated with suicide risk in a community sample of American Indian adults. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2023; 4:zpad024. [PMID: 37293513 PMCID: PMC10246582 DOI: 10.1093/sleepadvances/zpad024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/18/2023] [Indexed: 06/10/2023]
Abstract
Study Objectives Although American Indian/Alaska Native (AI/AN) have high suicide rates few studies have systematically investigated sleep quality and its association with suicidal behaviors in AI/AN. This study is a cross-sectional investigation of self-reported sleep quality and suicidal behaviors in an adult AI population. Methods A semi-structured interview was used to collect data on suicidal ideation, suicidal plans, and suicidal attempts and the Pittsburgh Sleep Quality Index (PSQI) was collected to assess sleep quality in American Indian adults. Results In this sample (n = 477), 91 (19%) of the participants endorsed suicidal ideation (thoughts and plans), and 66 (14%) reported suicidal attempts, including four who subsequently died by suicide. More women reported suicidal thoughts or acts than men. Those endorsing suicidal thoughts slept fewer hours during the night, reported more nocturnal awakenings, and showed poorer subjective sleep quality according to PSQI total scores compared to those with no suicidal thoughts or acts. Participants with suicidal acts (n = 66) reported more bad dreams and higher PSQI total scores compared to those with no suicidal thoughts or acts. When those with any suicidal thoughts or acts (n = 157, 33%) were compared to those without, they were more likely to endorse nocturnal awakenings and bad dreams and demonstrated significantly higher PSQI total scores. Conclusions Although additional research is needed to evaluate sleep disturbances as a proximal, causal risk factor for suicidal behaviors in AI, findings highlight need for further study of sleep as a warning sign and intervention tool for suicide prevention among American Indian adults.
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Affiliation(s)
- Cindy L Ehlers
- Neurosciences Department, The Scripps Research Institute, La Jolla, CA, USA
| | | | - Rebecca Bernert
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, CAUSA
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12
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Alhasan DM, Riley NM, Jackson II WB, Jackson CL. Food insecurity and sleep health by race/ethnicity in the United States. J Nutr Sci 2023; 12:e59. [PMID: 37252683 PMCID: PMC10214135 DOI: 10.1017/jns.2023.18] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 02/02/2023] [Accepted: 02/06/2023] [Indexed: 05/31/2023] Open
Abstract
Food insecurity, poised to increase with burgeoning concerns related to climate change, may influence sleep, yet few studies examined the food security-sleep association among racially/ethnically diverse populations with multiple sleep dimensions. We determined overall and racial/ethnic-specific associations between food security and sleep health. Using National Health Interview Survey data, we categorised food security as very low, low, marginal and high. Sleep duration was categorised as very short, short, recommended and long. Sleep disturbances included trouble falling/staying asleep, insomnia symptoms, waking up feeling unrested and using sleep medication (all ≥3 d/times in the previous week). Adjusting for socio-demographic characteristics and other confounders, we used Poisson regression with robust variance to estimate prevalence ratios (PRs) and 95 % confidence intervals (95 % CIs) for sleep dimensions by food security. Among 177 435 participants, the mean age of 47⋅2 ± 0⋅1 years, 52⋅0 % were women, and 68⋅4 % were non-Hispanic (NH)-White. A higher percent of NH-Black (7⋅9 %) and Hispanic/Latinx (5⋅1 %) lived in very low food security households than NH-White (3⋅1 %) participants. Very low v. high food security was associated with a higher prevalence of very short (PR = 2⋅61 [95 % CI 2⋅44-2⋅80]) sleep duration as well as trouble falling asleep (PR = 2⋅21 [95 % CI 2⋅12-2⋅30]). Very low v. high food security was associated with a higher prevalence of very short sleep duration among Asian (PR = 3⋅64 [95 % CI 2⋅67-4⋅97]) and NH-White (PR = 2⋅73 [95 % CI 2⋅50-2⋅99]) participants compared with NH-Black (PR = 2⋅03 [95 % CI 1⋅80-2⋅31]) and Hispanic/Latinx (PR = 2⋅65 [95 % CI 2⋅30-3⋅07]) participants. Food insecurity was associated with poorer sleep in a racially/ethnically diverse US sample.
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Affiliation(s)
- Dana M. Alhasan
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | - Nyree M. Riley
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | | | - Chandra L. Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
- Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
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13
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Kim B, Troxel WM, Dubowitz T, Hunter GP, Ghosh-Dastidar B, Chaix B, Rudolph KE, Morrison CN, Branas CC, Duncan DT. Neighborhood Built Environment and Sleep Health: A Longitudinal Study in Low-Income and Predominantly African-American Neighborhoods. Am J Epidemiol 2023; 192:736-747. [PMID: 36691683 PMCID: PMC10423630 DOI: 10.1093/aje/kwad016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 11/10/2022] [Accepted: 01/18/2023] [Indexed: 01/25/2023] Open
Abstract
In the present study, we examined the associations between physical characteristics of neighborhoods and sleep health outcomes and assessed the mediating role of physical activity in these associations. A longitudinal study (the Pittsburgh Hill/Homewood Research on Eating, Shopping, and Health (PHRESH) Zzz Study; n = 1,051) was conducted in 2 low-income, predominately African-American neighborhoods in Pittsburgh, Pennsylvania, with repeated measures of neighborhood characteristics and sleep health outcomes from 2013 to 2018. Built environment measures of walkability, urban design, and neighborhood disorder were captured from systematic field observations. Sleep health outcomes included insufficient sleep, sleep duration, wakefulness after sleep onset, and sleep efficiency measured from 7-day actigraphy data. G-computations based on structural nested mean models were used to examine the total effects of each built environment feature, and causal mediation analyses were used to evaluate direct and indirect effects operating through physical activity. Urban design features were associated with decreased wakefulness after sleep onset (risk difference (RD) = -1.26, 95% confidence interval (CI): -4.31, -0.33). Neighborhood disorder (RD = -0.46, 95% CI: -0.86, -0.07) and crime rate (RD = -0.54, 95% CI: -0.93, -0.08) were negatively associated with sleep efficiency. Neighborhood walkability was not associated with sleep outcomes. We did not find a strong and consistent mediating role of physical activity. Interventions to improve sleep should target modifiable factors, including urban design and neighborhood disorder.
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Affiliation(s)
- Byoungjun Kim
- Correspondence to Dr. Byoungjun Kim, Department of Population Health, Grossman School of Medicine, New York University, 180 Madison Avenue, 5th Floor, New York, NY 10016 (e-mail: )
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14
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Jacob L, Smith L, Kostev K, Oh H, Gyasi RM, López Sánchez GF, Song TJ, Tully MA, Haro JM, Yon DK, Shin JI, Koyanagi A. Food insecurity and insomnia-related symptoms among adults from low- and middle-income countries. J Sleep Res 2023:e13852. [PMID: 36808652 DOI: 10.1111/jsr.13852] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 01/31/2023] [Accepted: 02/02/2023] [Indexed: 02/23/2023]
Abstract
Little is known about the relationship between food insecurity and sleep problems in low- and middle-income countries, while the mediators of this association are largely unknown. Therefore, we investigated the association between food insecurity and insomnia-related symptoms in six low- and middle-income countries (i.e., China, Ghana, India, Mexico, Russia, South Africa), and the potential mediators of this relationship. Cross-sectional, nationally representative data from the Study on Global AGEing and Adult Health (2007-2010) were analysed. Past 12-month food insecurity was assessed with two questions on the frequency of eating less, and on hunger owing to a lack of food. Insomnia-related symptoms referred to severe or extreme sleep problems in the past 30 days. Multivariable logistic regression and mediation analysis were conducted. Data on 42,489 adults aged ≥18 years were analysed (mean [standard deviation] age 43.8 [14.4] years; 50.1% females). The prevalence of any food insecurity and insomnia-related symptoms was 11.9% and 4.4%, respectively. After adjustment, compared with no food insecurity, moderate (odds ratio = 1.53, 95% confidence interval = 1.11-2.10) and severe food insecurity (odds ratio = 2.35, 95% confidence interval = 1.56-3.55) were significantly associated with insomnia-related symptoms. Anxiety, perceived stress, and depression mediated 27.7%, 13.5%, and 12.5% of the relationship between any food insecurity and insomnia-related symptoms, respectively (total percentage = 43.3%). Food insecurity was positively associated with insomnia-related symptoms in adults from six low- and middle-income countries. Anxiety, perceived stress, and depression explained a substantial proportion of this relationship. Addressing food insecurity itself or the identified potential mediators among people with food insecurity may lead to a reduction in sleep problems among adults in low- and middle-income countries, pending confirmation with longitudinal studies.
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Affiliation(s)
- Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Barcelona, Spain.,Department of Physical Medicine and Rehabilitation, Lariboisière-Fernand Widal Hospital, AP-HP, University Paris Cité, Paris, France.,Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Lee Smith
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | | | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Razak M Gyasi
- Aging and Development Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Guillermo F López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain
| | - Tae-Jin Song
- Department of Neurology, Seoul Hospital, Ewha Womans University, Seoul, South Korea
| | - Mark A Tully
- School of Medicine, Ulster University, Londonderry, UK
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Barcelona, Spain
| | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Barcelona, Spain.,Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
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15
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Khot SP, Taylor BL, Longstreth WT, Brown AF. Sleep Health as a Determinant of Disparities in Stroke Risk and Health Outcome. Stroke 2023; 54:595-604. [PMID: 36345822 PMCID: PMC9870956 DOI: 10.1161/strokeaha.122.039524] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Sleep is essential to human survival and overall vascular health. Sleep health encompasses the objective and subjective qualities associated with one's daily pattern of sleep and wakefulness and has become a growing clinical and public health concern. Impaired sleep duration and quality can increase stroke risk and mediate the relationship between the physical aspects of an individual's environment and disparities in stroke incidence. Here, we review observational studies evaluating the association between sleep health and cerebrovascular disease. We assess the influence on sleep of the physical environment, including the ambient environment with noise levels and the built environment. We also describe the influences on sleep health and stroke risk of social determinants of health, including the chronic stressor of racial discrimination. Finally, we discuss how changes in historical neighborhood characteristics or societal policies can influence the social factors affecting sleep health and stroke risk among socioeconomically disadvantaged groups or ethnic and racial minorities. Given the regional and racial or ethnic differences in stroke risk across the United States, an understanding of novel vascular risk factors, such as the multifaceted role of sleep health, will be critical to develop effective public policies to improve population health.
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Affiliation(s)
- Sandeep P Khot
- Department of Neurology (S.P.K., B.L.T., W.T.L.), University of Washington, Seattle
| | - Breana L Taylor
- Department of Neurology (S.P.K., B.L.T., W.T.L.), University of Washington, Seattle
| | - W T Longstreth
- Department of Neurology (S.P.K., B.L.T., W.T.L.), University of Washington, Seattle
- Department of Epidemiology (W.T.L.), University of Washington, Seattle
| | - Arleen F Brown
- Department of Medicine, University of California, Los Angeles (A.F.B.)
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Dong L, D'Amico EJ, Dickerson DL, Brown RA, Palimaru AI, Johnson CL, Troxel WM. Food insecurity, sleep, and cardiometabolic risks in urban American Indian/Alaska Native youth. Sleep Health 2023; 9:4-10. [PMID: 36328921 PMCID: PMC9991968 DOI: 10.1016/j.sleh.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 09/13/2022] [Accepted: 10/02/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Food insecurity contributes to racial/ethnic disparities in health. This is the first study to examine associations among food insecurity, sleep, and cardiometabolic outcomes in urban American Indian/Alaska Native (AI/AN) youth. DESIGN Participants were 142 urban AI/AN youth (mean age = 14 years, 58% female). Food insecurity and self-reported sleep disturbance were measured using validated surveys. A multi-dimensional sleep health composite was derived using questionnaires (ie, satisfaction, alertness) and actigraphy-derived indices (ie, duration, efficiency, regularity, timing). Cardiometabolic measures included body mass index, blood pressure, glycosylated hemoglobin, waist circumference, cholesterol, and triglycerides. Covariates were sex, age, and single-parent household. RESULTS Greater food insecurity was significantly associated with greater body mass index (b = 0.12, p = .015), higher systolic blood pressure (b = 0.93, p = .03), and greater sleep disturbance (b = 1.49, p < .001), and marginally associated with lower sleep health composite scores (b = -0.09, p = .08). There was a significant indirect path from greater food insecurity to greater waist circumference through poorer sleep health (0.11, 95% bootstrapping CI: [0.01, 0.30]). CONCLUSION Food insecurity is an important correlate of sleep and cardiometabolic health among urban AI/AN youth and should be addressed to reduce emerging health risks during this important developmental period. Policies to reduce food insecurity and increase access to healthy foods as well as sleep interventions for these youth could help, as preliminary findings suggest that sleep health may mediate the negative impact of food insecurity on cardiometabolic risks.
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Affiliation(s)
- Lu Dong
- RAND Corporation, Santa Monica, California, USA.
| | | | - Daniel L Dickerson
- UCLA Integrated Substance Abuse Program, Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA
| | | | | | - Carrie L Johnson
- Sacred Path Indigenous Wellness Center, Los Angeles, California, USA
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17
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Mazloomi SN, Talebi S, Kazemi M, Ghoreishy SM, Moosavian SP, Amirian P, Mohammadi H, Nouri-Majd S, Marx W, Hojjati Kermani MA, Moradi S. Food insecurity is associated with the sleep quality and quantity in adults: a systematic review and meta-analysis. Public Health Nutr 2022; 26:1-11. [PMID: 36416108 PMCID: PMC10131157 DOI: 10.1017/s1368980022002488] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/14/2022] [Accepted: 11/07/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVE We evaluated associations between food insecurity (FI) and the quality and quantity of sleep in adults (≥18 years). DESIGN The current study represented a systematic review and meta-analysis of observational studies. SETTING Databases of PubMed, Scopus, Embase and Web of Science were searched from inception until 6 June 2022. Meta-analyses were conducted using random-effects models, and effect sizes were reported as OR and 95 % CI. PARTICIPANTS Data from ten eligible observational studies, including 83 764 participants, were included. RESULTS FI was associated with an increased risk of poor sleep quality (OR = 1·45; 95 % CI (1·24, 1·70), I2 = 95, P < 0·001, n 7). Besides, subgroup analysis showed increased risk of poor sleep quality corresponding to the severity of FI across mild (OR = 1·31; 95 % CI (1·16, 1·48), I2 = 0 %, P < 0·001, n 5), moderate (OR = 1·49; 95 % CI (1·32, 1·68), I2 = 0 %, P < 0·001, n 5) and severe (OR = 1·89; 95 % CI (1·63, 2·20), I2 = 0 %, P < 0·001, n 5) levels. Similarly, subgroup analysis by sleep problems showed that FI was associated with an increased the risk of trouble falling asleep (OR = 1·39; 95 % CI (1·05, 1·83), I2 = 91 %, P = 0·002, n 3) and trouble staying asleep (OR = 1·91; 95 % CI (1·37, 2·67), I2 = 89 %, P < 0·001, n 3). Moreover, FI was associated with the odds of shorter (OR = 1·14; 95 % CI (1·07, 1·21), I2 = 0 %, P < 0·001, n 4) and longer sleep duration (OR = 1·14; 95 % CI (1·03, 1·26), I2 = 0 %, P = 0·010, n 4). CONCLUSIONS Collective evidence supports that FI is associated with poor sleep quality and quantity in adults. Preventative and management strategies that address FI may provide health benefits beyond improving nutritional status per se.
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Affiliation(s)
- Seyadeh Narges Mazloomi
- The Health of Plant and Livestock Products Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Food and Drug Administration, Mazandaran University of Medical Sciences, Sari, Iran
| | - Sepide Talebi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Kazemi
- Hilda and J. Lester Gabrilove Division of Endocrinology, Diabetes, and Bone Disease, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Seyed Mojtaba Ghoreishy
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyedeh Parisa Moosavian
- Department of Community Nutrition, Vice-Chancellery for Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parsa Amirian
- General Practitioner, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
| | - Hamed Mohammadi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeedeh Nouri-Majd
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Wolfgang Marx
- Deakin University, IMPACT – the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Mohammad Ali Hojjati Kermani
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sajjad Moradi
- Nutritional Sciences Department, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
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18
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Aborode AT. Sleep-wake disorder: A silent health crisis in USA. Ann Med Surg (Lond) 2022; 82:104727. [PMID: 36176380 PMCID: PMC9513085 DOI: 10.1016/j.amsu.2022.104727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/11/2022] [Accepted: 09/11/2022] [Indexed: 11/29/2022] Open
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19
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Role of social determinants in anxiety and depression symptoms during COVID-19: A longitudinal study of adults in North Carolina and Massachusetts. Behav Res Ther 2022; 154:104102. [PMID: 35561644 PMCID: PMC9056067 DOI: 10.1016/j.brat.2022.104102] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 04/12/2022] [Accepted: 04/21/2022] [Indexed: 12/15/2022]
Abstract
Trajectory studies of the COVID-19 pandemic have described patterns of symptoms over time. Yet, few have examined whether social determinants of health predict the progression of depression and anxiety symptoms during COVID-19 or identified which social determinants worsen symptom trajectories. Using a racially, ethnically, and linguistically diverse sample of adults participating in a randomized clinical trial with pre-existing moderate to severe depression and/or anxiety symptoms, we compare symptom patterns before and during COVID-19; characterize symptom trajectories over a 20-week follow-up period; and evaluate whether social determinants are associated with within- and between- person differences in symptom trajectories. Data were collected before and during COVID-19 in Massachusetts and North Carolina. On average, depression and anxiety symptoms did not seem to worsen during the pandemic compared to pre-pandemic. During COVID-19, anxiety scores at follow-up were higher for participants with baseline food insecurity (vs no food insecurity). Depression scores at follow-up were higher for participants with food insecurity and for those with utilities insecurity (vs no insecurity). Participants with child or family care responsibilities at baseline had depression symptoms decreasing at a slower rate than those without these responsibilities. We discuss the important implications of these findings.
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20
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Williams PC, Alhasan DM, Krafty R, Coutts C, Miles-Richardson S, Jackson CL. A mixed methods approach to understand greenspace redevelopment in relation to objectively- and subjectively-measured sleep health among Black adults in Southwest Atlanta. Health Place 2022; 76:102812. [PMID: 35640375 DOI: 10.1016/j.healthplace.2022.102812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 04/14/2022] [Accepted: 04/23/2022] [Indexed: 12/26/2022]
Affiliation(s)
- Patrice C Williams
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institute of Health, Department of Health and Human Services, Research Triangle Park, NC, USA; Department of Urban Studies and Planning, School of Architecture & Planning, Massachusetts Institute of Technology, Cambridge, MA, USA.
| | - Dana M Alhasan
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institute of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | - Robert Krafty
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, USA
| | - Christopher Coutts
- Department of Urban and Regional Planning, Florida State University, Tallahassee, FL, USA
| | | | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institute of Health, Department of Health and Human Services, Research Triangle Park, NC, USA; Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
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21
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The Psychological Distress of Food Insecurity: A Qualitative Study of the Emotional Experiences of Parents and Their Coping Strategies. J Acad Nutr Diet 2022; 122:1903-1910.e2. [DOI: 10.1016/j.jand.2022.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 05/06/2022] [Accepted: 05/10/2022] [Indexed: 10/18/2022]
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22
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Kobulsky JM, Yoon D, Villodas MT, Schuler BR, Wildfeuer R, Reyes JN. Neglect, Abuse, and Adaptive Functioning: Food Security and Housing Stability as Protective Factors for Adolescents. CHILDREN 2022; 9:children9030390. [PMID: 35327762 PMCID: PMC8946869 DOI: 10.3390/children9030390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 03/02/2022] [Accepted: 03/08/2022] [Indexed: 11/16/2022]
Abstract
This study addresses gaps in knowledge of protective factors that support adaptive functioning among maltreated adolescents. The sample included 1003 high-risk youths participating in the Longitudinal Studies of Child Abuse and Neglect (53% female, 56% Black, and 82% living in poverty). Adolescent neglect (Exposure to Risky Situations, Lack of Monitoring, Inattention to Basic Needs, Permitting Misbehavior, Lack of Support) and physical, sexual, and emotional abuse were self-reported at age 16. Age 18 adaptive functioning measures included healthcare receipt (medical, dental, and mental health), self-rated global health, high school graduation or enrollment, prosocial activities, peer relationships (Companionship, Conflict, Satisfaction, and Intimacy), and independent living skills. Previous childhood maltreatment, demographics, and earlier prosocial activities and peer relationships were controls. Structural equation modeling showed that adolescent neglect and abuse were associated with lower adaptive functioning. Multigroup models showed protective effects for food security on the relationships between sexual abuse and self-rated health and between Inadequate Monitoring and Companionship. Housing stability buffered relationships between Inadequate Support and high school graduation or enrollment and between Permitting Misbehavior and independent living skills. Findings imply the need for adolescent-focused prevention, including the promotion of food security and housing stability to support adaptive functioning in maltreated adolescents. However, notable mixed findings show the need for additional research.
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Affiliation(s)
- Julia M. Kobulsky
- School of Social Work, College of Public Health, Temple University, Philadelphia, PA 19122, USA;
- Correspondence: ; Tel.: +1-215-204-2843
| | - Dalhee Yoon
- Department of Social Work, Binghamton University-State University of New York, Binghamton, NY 13902, USA;
| | - Miguel T. Villodas
- Department of Psychology, College of Sciences, San Diego State University, San Diego, CA 92121, USA;
| | - Brittany R. Schuler
- School of Social Work, College of Public Health, Temple University, Philadelphia, PA 19122, USA;
| | - Rachel Wildfeuer
- Department of Sociology, Temple University, Philadelphia, PA 19122, USA;
| | - José N. Reyes
- Department of Health Services Administration and Policy, College of Public Health, Temple University, Philadelphia, PA 19122, USA;
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23
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Brown MJ, Joseph C, James T, Haider MR, Zahnd WE, Cohen SA. Gender and Racial/Ethnic Disparities in Social Determinants of Health and Subjective Cognitive Decline: The Mediating Role of Depression. J Gerontol Nurs 2022; 48:13-22. [PMID: 35103521 PMCID: PMC9003396 DOI: 10.3928/00989134-20220110-01] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Social determinants of health (SDOH) may be associated with subjective cognitive decline (SCD), which is a precursor for Alzheimer's disease. The main aims of the current study were to examine the association between SDOH and SCD; to determine if there is an indirect pathway among SDOH, depression, and SCD; and to examine the related gender and racial/ethnic disparities. Cross-sectional data were obtained from the 2017 Behavioral Risk Factor Surveillance System Survey (N = 6,509; 2,530 men and 3,978 women aged ≥45 years). Path analyses (stratified by gender and race) were used to determine the relationship between a SDOH index, depression, and SCD. After controlling for gender, age, income, education, employment, and other health-related behaviors, SDOH were positively associated with SCD among the overall population, men, and White populations. SDOH were associated with depression, and depression was associated with SCD among men, women, and White and Black populations. After adjustment for confounders, the indirect pathway among SDOH, depression, and SCD was statistically significant for men (β = 0.035, p < 0.001), women (β = 0.040, p < 0.001), White populations (β = 0.034, p < 0.001), and Black populations (β = 0.036, p = 0.026). Gender and racial/ethnic disparities existed in the relationship among SDOH, depression, and SCD. Future research should assess alternative mediational pathways between SDOH and SCD. [Journal of Gerontological Nursing, 48(2), 13-22.].
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Affiliation(s)
- Monique J. Brown
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina,South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina,Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina,Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Chantaezia Joseph
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Titilayo James
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Mohammad Rifat Haider
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, Georgia
| | - Whitney E. Zahnd
- Department of Health Management and Policy, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Steven A. Cohen
- Department of Health Studies, University of Rhode Island, Kingston, Rhode Island
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24
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Assessing the Determinants of Quality of Life and the Impact on HIV Prevention Measures among HIV-Negative and Status-Unknown Young Men Who Have Sex with Men: A Study in Two U.S. Metropolitan Areas. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020726. [PMID: 35055548 PMCID: PMC8776199 DOI: 10.3390/ijerph19020726] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/02/2022] [Accepted: 01/04/2022] [Indexed: 12/17/2022]
Abstract
Young men who have sex with men (YMSM) in the United States (U.S.) are disproportionally burdened by HIV and experience adverse social determinants of health. Minimal research has examined quality of life (QoL) and psychosocial/behavioral determinants among HIV-negative or status-unknown YMSM. We conducted a study with YMSM from two U.S. cities to assess their QoL scores, and whether specific QoL domains (e.g., physical, psychological, social, and environment) were associated with their demographics, psychosocial determinants, behavioral risk factors, and HIV prevention measures. Black YMSM, YMSM of low socioeconomic status (below high school education, income < $20,000, and lack of health insurance), and YMSM who did not disclose their sexual orientation had the lowest QoL scores across all domains. Substance use and unprotected anal intercourse were negatively associated with men’s physical/psychosocial health. Housing/food instability and perceived stress were among the strongest predictors of lower QoL in all domains. Higher physical/psychological and environment QoL scores were associated with a higher likelihood of HIV testing and PrEP use. The identification of YMSM within these demographic, behavioral, and psychosocial sub-groups is important for targeted intervention to enhance their well-being and engagement with HIV prevention.
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Sances MW, Campbell AL. State Policy and Mental Health Outcomes under COVID-19. JOURNAL OF HEALTH POLITICS, POLICY AND LAW 2021; 46:811-830. [PMID: 33765132 DOI: 10.1215/03616878-9155991] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
CONTEXT The COVID-19 pandemic has caused enormous damage to physiological health and economic security, especially among racial and ethnic minorities. We examined downstream effects on mental health, how effects vary by race and ethnicity, and the role of existing state-level social policies in softening the pandemic's impact. METHODS We analyze an online, multi-wave Census Bureau survey fielded to nearly a million respondents between late April and July 2020. The survey includes questions measuring psychological distress as well as indirect measures of experience with the pandemic. We combined these data with state-level measures of COVID-19 cases, lockdown orders, unemployment filings, and safety net policy. FINDINGS We find significant mental stress among all respondents and a sizeable gap between nonwhite and white respondents. Adjusting for pandemic experiences eliminates this gap. The effect of losing work as a result of the pandemic is slightly offset by state policies such as unemployment benefit size and Medicaid expansion. The magnitude of these offsetting effects is similar across racial/ethnic groups. CONCLUSIONS The racialized impacts of the pandemic are exacerbated by inequalities in state policy exemplifying structural racism. If the least generous states matched the policies of the most generous, inequalities caused by the pandemic would be diminished.
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Wang Q. Food Insecurity and Sleep Disturbance Among 223,561 Adolescents: A Multi-Country Analysis of Cross-Sectional Surveys. Front Public Health 2021; 9:693544. [PMID: 34660509 PMCID: PMC8517446 DOI: 10.3389/fpubh.2021.693544] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 09/06/2021] [Indexed: 12/13/2022] Open
Abstract
This study was to investigate the association between food insecurity (FI) and sleep disturbance among adolescents. Based on the cross-sectional data of the Global School-based Student Health Survey, this study analyzed self-reported data from adolescents in 68 countries. Multivariate logistic regression and meta-analysis were used to evaluate the association between FI and sleep disturbance. The final sample included 223,561 adolescents. The prevalence of severe FI and sleep disturbance was 6.4% and 8.0%, respectively. Severe FI was significantly associated with a higher risk of sleep disturbance in 48 of the 68 countries after adjusting for covariates, with a pooled OR (95% CI) of 1.94 (1.79-2.09). Overall, the association between FI and sleep disturbance was similar across countries and gender, though a large level of heterogeneity existed across upper- and middle-income countries. Identifying adolescents suffering from FI and remedying the FI severity may be important to improve sleep quality in global adolescents.
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Affiliation(s)
- Qiuying Wang
- Educational Science Research Institute of Shenzhen, Shenzhen, China
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Chung J, Goodman M, Huang T, Wallace ML, Johnson DA, Bertisch S, Redline S. Racial-ethnic Differences in Actigraphy, Questionnaire, and Polysomnography Indicators of Healthy Sleep: The Multi-Ethnic Study of Atherosclerosis. Am J Epidemiol 2021; 193:kwab232. [PMID: 34498675 DOI: 10.1093/aje/kwab232] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 08/11/2021] [Accepted: 09/02/2021] [Indexed: 11/14/2022] Open
Abstract
A paradigm shift in sleep science argues for a systematic, multidimensional approach to investigate sleep's association with disease and mortality and to address sleep disparities. We utilized the comprehensive sleep assessment of the Multi-Ethnic Study of Atherosclerosis (2010- 2013), a cohort of U.S. White, Black, Chinese, and Hispanic adults and older adults (n=1,736; mean age=68.3), to draw 13 sleep dimensions and create composite Sleep Health Scores to quantify multidimensional sleep health disparities. After age and sex adjustment in linear regression, compared to White participants, Black participants showed the greatest global sleep disparity, then Hispanic and Chinese participants. We estimated relative 'risk' of obtaining favorable sleep compared to White adults at the component level by race/ethnicity (lower is worse). The largest disparities were in objectively-measured sleep timing regularity (RRBlack [95% CI]: 0.37 [0.29,0.47], RRHispanic: 0.64 [0.52,0.78], RRChinese: 0.70 [0.54,0.90]) and duration regularity (RRBlack: 0.55 [0.47,0.65], RRHispanic: 0.76 [0.66,0.88], RRChinese: 0.74 [0.61,0.90]), after sex and age adjustment. Disparities in duration and continuity were also apparent, and Black adults were additionally disadvantaged in %N3 (slow wave sleep), sleepiness, and sleep timing (24-hour placement). Sleep timing regularity, duration regularity, duration, and continuity may comprise a multidimensional cluster of targets to reduce racial-ethnic sleep disparities.
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Affiliation(s)
- Joon Chung
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Matthew Goodman
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Tianyi Huang
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Meredith L Wallace
- Department of Psychiatry, University of Pittsburgh, PA
- Department of Biostatistics, University of Pittsburgh, PA
| | - Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Suzanne Bertisch
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA
- Harvard Medical School, Boston, MA
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Graupensperger S, Cadigan JM, Einberger C, Lee CM. Multifaceted COVID-19-Related Stressors and Associations with Indices of Mental Health, Well-being, and Substance Use Among Young Adults. Int J Ment Health Addict 2021; 21:418-431. [PMID: 34377106 PMCID: PMC8336528 DOI: 10.1007/s11469-021-00604-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/01/2021] [Indexed: 02/07/2023] Open
Abstract
Alongside direct health concerns pertaining to the SARS-CoV-2 virus, the stressors and life disruptions associated with the COVID-19 pandemic may provoke secondary concerns for health and well-being. The implications of COVID-19-related stressors may be particularly salient for young adults, who are at higher-risk for mental health concerns and substance use behaviors. We developed a multifaceted scale that assessed distinct domains of COVID-19-related stressors and examined associations between these stressors and indices of mental health, well-being, and substance use (alcohol and marijuana use). In April-June of 2020, 1181 young adults were recruited from two- and four-year colleges to participate in this study (M age = 20.40; 59.95% women). Exploratory factor analysis identified five domains of COVID-19-related stressors: job insecurity, social/relational, financial, illness-related, and school-related. The overall pattern of results indicated that COVID-19-related stressors were related to poorer mental health and well-being. Social/relational stressors emerged as a primary concern most strongly associated with indices of mental health and alcohol use, relative to other stressors. However, illness-related stressors and school-related stressors were associated with less alcohol use. Stressors associated with the COVID-19 pandemic may impact young adults' health and well-being but disentangling various stressor domains informs more tailored intervention and prevention strategies. Supplementary Information The online version contains supplementary material available at 10.1007/s11469-021-00604-0.
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Affiliation(s)
- Scott Graupensperger
- Department of Psychiatry and Behavioral Sciences, University of Washington, 1100 NE 45th St., Suite 300, Seattle, WA 98105 USA
| | - Jennifer M. Cadigan
- Department of Psychiatry and Behavioral Sciences, University of Washington, 1100 NE 45th St., Suite 300, Seattle, WA 98105 USA
| | - Clare Einberger
- School of Medicine, University of Washington, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Christine M. Lee
- Department of Psychiatry and Behavioral Sciences, University of Washington, 1100 NE 45th St., Suite 300, Seattle, WA 98105 USA
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Health Effects of Housing Insecurity and Unaffordability in the General Population in Barcelona, Spain. J Urban Health 2021; 98:496-504. [PMID: 34231119 PMCID: PMC8382804 DOI: 10.1007/s11524-021-00546-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/04/2021] [Indexed: 10/20/2022]
Abstract
While the negative effects of housing insecurity and unaffordability on health are well known, most of the studies in Spain have focused on very specific social groups so their findings cannot be extrapolated to the general population. The aim of this study is to assess the effects of housing stress and risk of displacement due to economic reasons, and their combined effect, on the mental and physical health of the general population from a middle-income neighborhood of Barcelona. We conducted a cross-sectional study using a household health survey which included respondents from a representative sample of 1202 non-institutionalized residents (> 18 years old) of the Horta neighborhood. We carried out a descriptive analysis, estimated the prevalence of poor mental and self-rated health (stratifying by the independent variables) and fitted robust Poisson regression models to estimate the effects of housing stress (HS) and the risk of forced displacement (RD) on self-rated health and mental health (GHQ-12). All analyses were stratified by sex. We found a higher likelihood of poor general and mental health among people affected by HS and/or RD compared to those not affected by HS and/or RD. A graded effect of HS and RD emerged mainly on mental health, even after adjusting by socioeconomic variables and housing tenure. The serious problem of housing insecurity and unaffordability in Spain is a widespread public health issue. Evidence-based public policies to improve well-being and health of people under this threat are urgently needed.
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Banks AR, Bell BA, Ngendahimana D, Embaye M, Freedman DA, Chisolm DJ. Identification of factors related to food insecurity and the implications for social determinants of health screenings. BMC Public Health 2021; 21:1410. [PMID: 34271906 PMCID: PMC8284017 DOI: 10.1186/s12889-021-11465-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 07/05/2021] [Indexed: 11/16/2022] Open
Abstract
Background Food insecurity and other social determinants of health are increasingly being measured at routine health care visits. Understanding the needs and behaviors of individuals or families who screen positive for food insecurity may inform the types of resources they need. The goal of this research was to identify modifiable characteristics related to endorsement of two food insecurity screener questions to better understand the resources necessary to improve outcomes. Methods Analysis was conducted focusing on cross-sectional survey data collected in 2015–2016 from participants (N = 442) living in urban neighborhoods in Ohio with limited access to grocery stores. Food insecurity was assessed by the endorsement of at least one of two items. These were used to categorize participants into two groups: food insecure(N = 252) or food secure (N = 190). Using logistic regression, we estimated the association between several variables and the food insecure classification. Results Those that used their own car when shopping for food had lower odds of reporting food insecurity, as did those with affirmative attitudes related to the convenience of shopping for and ease of eating healthy foods. As shopping frequency increased, the odds of food insecurity increased. Food insecurity also increased with experience of a significant life event within the past 12 months. There was an 81% increase in the odds of reporting food insecurity among participants who received Supplemental Nutrition Assistance Program benefits compared to those not receiving Supplemental Nutrition Assistance Program benefits. Conclusions Along with referrals to SNAP, clinicians can further address screening-identified food insecurity through provision of transportation supports and linkages to other social services while collaborating on community initiatives to promote convenient and easy access to healthy foods. The needs and behaviors associated with screens indicating food insecurity also have implications for impacting other SDH, and thus, health outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11465-6.
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Affiliation(s)
- Ashley R Banks
- Center for Child Health Equity and Outcomes Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA.
| | - Bethany A Bell
- School of Education and Human Development, University of Virginia, Charlottesville, VA, USA
| | - David Ngendahimana
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Milen Embaye
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Darcy A Freedman
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Deena J Chisolm
- Center for Child Health Equity and Outcomes Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA.,Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
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Jia J, Fung V, Meigs JB, Thorndike AN. Food Insecurity, Dietary Quality, and Health Care Utilization in Lower-Income Adults: A Cross-Sectional Study. J Acad Nutr Diet 2021; 121:2177-2186.e3. [PMID: 34247978 DOI: 10.1016/j.jand.2021.06.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 05/20/2021] [Accepted: 06/01/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Food insecurity and poor nutrition are prevalent in the United States and associated with chronic diseases. Understanding relationships among food insecurity, diet, and health care utilization can inform strategies to reduce health disparities. OBJECTIVE Our aim was to determine associations between food security status and inpatient and outpatient health care utilization and whether they differed by dietary quality in lower-income adults. DESIGN This was a cross-sectional study of data from the 2009-2016 National Health and Nutrition Examination Survey. PARTICIPANTS/SETTING Participants were 13,956 lower-income (<300% federal poverty level) adults 18 years and older in the United States. MAIN OUTCOME MEASURES Self-reported health care utilization in the past 12 months included no usual source of care, any outpatient visit, any mental health service use, and any hospitalization. STATISTICAL ANALYSES Multiple logistic regression was used to study the association between food insecurity and health care utilization. Analyses were stratified by diet-related comorbidities to account for potential confounding and mediation of health care utilization, and by dietary quality. RESULTS In a sample of lower-income adults <300% federal poverty level, 4,319 participants (27.4%) were food insecure, 2,208 (15.0%) were marginally food secure, and 7,429 (57.6%) were food secure. Food insecurity was associated with having no usual source of care (adjusted odds ratio [aOR] 1.30; 95% CI 1.11 to 1.52), any mental health service use (aOR 2.02; 95% CI 1.61 to 2.52), and any hospitalization (aOR 1.19; 95% CI 1.01 to 1.41). Food-insecure adults were more likely to report no outpatient visits if they had diet-related comorbidities (aOR 1.45; 95% CI 1.10 to 1.92) or the lowest dietary quality (aOR 1.53; 95% CI 1.06 to 2.23). Marginal food security was associated with having no usual source of care (aOR 1.22; 95% CI 1.04 to 1.44). CONCLUSIONS Adults with food insecurity were more likely to be hospitalized, use mental health services, and have no usual source of care. Food-insecure participants with diet-related comorbidities or poor diet were less likely to have outpatient visits. Hospitalizations and mental health visits represent underused opportunities to identify and address food insecurity and dietary intake in lower-income patients.
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Affiliation(s)
- Jenny Jia
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA.
| | - Vicki Fung
- Health Policy Research Center, Mongan Institute, Massachusetts General Hospital, Boston, MA
| | - James B Meigs
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Anne N Thorndike
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Harvard University, Boston, MA
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Joseph C, Feiner C, Leung CW. Food insecurity is associated with serious psychological distress among low-income California adults. J Health Psychol 2021; 27:2249-2260. [PMID: 34213360 DOI: 10.1177/13591053211028913] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study examined differences in the associations between food insecurity and serious psychological distress (SPD) by key sociodemographic factors in a population-based sample of low-income adults from the 2017 California Health Interview Survey (n = 6266). After adjusting for sociodemographic characteristics, low food security, and very low food security were both positively associated with SPD among all low-income adults. Upon stratification, these associations were most pronounced among adults under age 50, males, and in adults with children. Understanding disparities in the associations between food insecurity and psychological distress is critical in developing effective programs or policies to target the most vulnerable sub-groups.
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Willie TC, Linton SL, Whittaker S, Martinez I, Sharpless L, Kershaw T. "There's no place like home": Examining the associations between state eviction defense protections and indicators of biopsychosocial stress among survivors of intimate partner violence. Soc Sci Med 2021; 279:113957. [PMID: 34022678 PMCID: PMC8208584 DOI: 10.1016/j.socscimed.2021.113957] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/15/2021] [Accepted: 04/17/2021] [Indexed: 11/18/2022]
Abstract
Housing instability is prevalent among intimate partner violence (IPV) survivors and a source of biopsychosocial stress among this population. Eviction policies play an important role in determining housing instability of IPV survivors. However, few studies have investigated whether state-level policies that prevent evictions lessen vulnerability to biopsychosocial stress among IPV survivors. This study examined the relationship between state eviction defense policy and indicators of biopsychosocial stress among 6577 IPV survivors. State-level data on IPV-related housing policies were from a compendium on homelessness and violence. Individual-level data were collected from the National Intimate Partner and Sexual Violence Survey (NISVS), a nationally representative study of noninstitutionalized U.S. women and men from Wave 1 (2010). Multilevel regression models were conducted to investigate associations between the presence of an eviction defense policy and indicators of biopsychosocial stress (i.e., headaches, sleeping, safety concerns and PTSD symptoms). Stratified multilevel modeling was conducted to examine differences in the policy-stress associations across racial and ethnic groups and gender. Nearly 26% of states had an eviction defense policy for IPV survivors. Overall, residing in a state with an eviction defense policy (vs. none) was associated with no reports of frequent headaches (B [95% CI] = -0.21 [-0.41, -0.01], p < .05). For non-Hispanic Black survivors, residing in a state with an eviction defense policy (vs. none) was associated with reduced likelihood of reporting safety concerns (B [95% CI] = -1.36 [-2.16, -0.56], p < .001) and PTSD symptoms (B [SE] = -1.91 [-2.82, -1.01], p < .000). Among men survivors, residing in a state with an eviction defense policy was associated with reduced likelihood of reporting safety concerns (B [95% CI] = -0.63 [-1.26, -0.01], p < .05). State housing policies are important protective policies for IPV survivors. For IPV survivors, the eviction defense policy may interrupt the psychological sequeale of IPV and housing instability.
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Affiliation(s)
- Tiara C Willie
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Sabriya L Linton
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Shannon Whittaker
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Isabel Martinez
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Laurel Sharpless
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Trace Kershaw
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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Daundasekara SS, Schuler BR, Hernandez DC. RETRACTED: Independent and combined associations of intimate partner violence and food insecurity on maternal depression and generalized anxiety disorder. J Anxiety Disord 2021; 81:102409. [PMID: 33932633 DOI: 10.1016/j.janxdis.2021.102409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 12/28/2020] [Accepted: 04/21/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Sajeevika Saumali Daundasekara
- Department of Health, & Health Performance, University of Houston, 3875 Holman Street, Garrison Gymnasium, Room 104, Houston, TX, 77204-6015, United States.
| | - Brittany R Schuler
- School of Social Work, Temple University, Ritter Annex 549, 1301 Cecil B. Moore Ave., Philadelphia, PA, 19122, United States.
| | - Daphne C Hernandez
- University of Texas Health Science Center, Cizik School of Nursing, 6901 Bertner Avenue, Houston, TX, 77030-3901, United States.
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Lee S, Deason K, Rancourt D, Gray HL. Disentangling the Relationship between Food Insecurity and Poor Sleep Health. Ecol Food Nutr 2021; 60:580-595. [PMID: 34032535 DOI: 10.1080/03670244.2021.1926245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The COVID-19 pandemic has created disruptions in global and national food supply chains. Along with an increase in the unemployment rate, this resulted in a rise in food insecurity at the community-level, threatening individual and family well-being. Food insecurity is associated with inadequate nutrient intakes, weight gain, and psychological distress, including anxiety and depressive symptoms, all of which are known to affect sleep. Yet, little is known about whether and how food insecurity is associated with sleep health, a critical but underrecognized health outcome. This paper reviews literature describing associations between food insecurity and sleep, summarizes key findings based on proposed mechanisms, and discusses directions for future research.
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Affiliation(s)
- Soomi Lee
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
| | - Karley Deason
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
| | - Diana Rancourt
- Department of Psychology, University of South Florida, Tampa, Florida, USA
| | - Heewon L Gray
- College of Public Health, University of South Florida, Tampa, Florida, USA
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Abstract
PURPOSE OF REVIEW Food insecurity is the lack of sufficient food in quantity and/or quality. Psychological distress includes mental health issues such as depression and anxiety. This review provides current information on research examining the association between food insecurity and psychological distress. RECENT FINDINGS Among studies published in the previous 5 years, food insecurity was significantly and positively associated with multiple indicators of psychological distress. This included cross-sectional and longitudinal studies, as well as primary data collection and secondary data analyses, from countries of varying income levels. Articles also provided evidence within various populations, such as adults of all ages, college students, those living with chronic disease, and parents. Food insecurity and psychological distress are interconnected health issues. Future research should consider a number of important gaps in the literature, with the most important being the development of interventions to improve food insecurity and psychological health concurrently.
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Affiliation(s)
- Candice A Myers
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA.
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37
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Williams PC, Krafty R, Alexander T, Davis Z, Gregory AV, Proby R, Troxel W, Coutts C. Greenspace redevelopment, pressure of displacement, and sleep quality among Black adults in Southwest Atlanta. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2021; 31:412-426. [PMID: 33714980 PMCID: PMC8134046 DOI: 10.1038/s41370-021-00313-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 02/10/2021] [Accepted: 02/19/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Little is known on how greenspace redevelopment-creating or improving existing parks and trails-targeted for low-income and/or majority Black neighborhoods could amplify existing social environmental stressors, increase residents' susceptibility to displacement, and impact their sleep quality. OBJECTIVE To examine the relationship between social environmental stressors associated with displacement and sleep quality among Black adults. METHODS Linear regression models were employed on survey data to investigate the association between social environmental stressors, independently and combined, on sleep quality among Black adults residing in block groups targeted for greenspace redevelopment (i.e., exposed) and matched with block groups that were not (i.e., unexposed). RESULTS The independent associations between everyday discrimination, heightened vigilance, housing unaffordability, and subjective sleep quality were not modified by greenspace redevelopment, controlling for other factors. The association between financial strain and subjective sleep quality was different for exposed and unexposed participants with exposed participants having a poorer sleep quality. The combined model revealed that the association between financial strain and sleep quality persisted. However, for different financial strain categories exposed participants slept poorer and/or better than unexposed participants. SIGNIFICANCE Our findings suggest a nuanced relationship between social environmental stressors, pressure of displacement related to greenspace redevelopment, and sleep quality among Black adults.
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Affiliation(s)
- Patrice C Williams
- Department of Urban & Regional Planning, Florida State University, Tallahassee, FL, USA.
| | - Robert Krafty
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Terrence Alexander
- Master of Public Health Program, Morehouse School of Medicine, Atlanta, GA, USA
| | - Zipporah Davis
- Master of Public Health Program, Morehouse School of Medicine, Atlanta, GA, USA
| | - Akil-Vuai Gregory
- Master of Public Health Program, Morehouse School of Medicine, Atlanta, GA, USA
| | - Raven Proby
- Master of Public Health Program, Morehouse School of Medicine, Atlanta, GA, USA
| | | | - Christopher Coutts
- Department of Urban & Regional Planning, Florida State University, Tallahassee, FL, USA
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Redline B, Semborski S, Madden DR, Rhoades H, Henwood BF. Examining Sleep Disturbance Among Sheltered and Unsheltered Transition Age Youth Experiencing Homelessness. Med Care 2021; 59:S182-S186. [PMID: 33710093 PMCID: PMC7958980 DOI: 10.1097/mlr.0000000000001410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The estimated 3.5-million transition age youth (TAY) who experience homelessness in the United States annually are routinely exposed to inadequate sleep environments and other psychosocial risk factors for deficient sleep. Although staying in a shelter versus being unsheltered may facilitate sleep, research suggests that perceived safety wherever one sleeps may be just as important. In this study, which is the first known study to investigate sleep disturbances among TAY experiencing homelessness, we examine associations of sleep disturbances with sheltered status and perceived safety of usual sleep environment. METHODS We surveyed TAY (aged 18-25) experiencing homelessness in Los Angeles, CA about their sleep, psychosocial health, and living situations. Participants (n=103; 60% sheltered) self-reported sleep disturbances using the Patient-Reported Outcomes Measurement Information System Sleep Disturbance short form, while individual items assessed sheltered status and perceived safety where they usually slept. Regression analyses examined associations of sheltered status and perceived sleep environment safety with sleep disturbance, adjusting for age, sex, race, self-rated health, depression symptoms, serious mental illness, high-risk drinking, and severe food insecurity. RESULTS Twenty-six percent of participants reported moderate-severe sleep disturbances. Sleep disturbance was not associated with sheltered status, but was positively associated with feeling unsafe in one's sleep environment, depression symptoms, severe food insecurity, and decreased age. CONCLUSIONS Our findings suggest that sleep disturbances among TAY experiencing homelessness are associated more closely with how safe one feels rather than one's sheltered status. This highlights the importance of providing safe places to live for sheltered and unsheltered TAY.
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Affiliation(s)
- Brian Redline
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California
| | - Sara Semborski
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California
| | - Danielle R. Madden
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California
| | - Harmony Rhoades
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California
| | - Benjamin F. Henwood
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California
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Do EK, Bowen GA, Ksinan AJ, Adams EL, Fuemmeler BF. Sleep, Food Insecurity, and Weight Status: Findings from the Family Life, Activity, Sun, Health, and Eating Study. Child Obes 2021; 17:125-135. [PMID: 33493402 PMCID: PMC7984656 DOI: 10.1089/chi.2020.0259] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: Shorter sleep duration and lower sleep quality have been previously associated with greater obesity risk among adult samples. Food insecurity has also been found to impact sleep patterns and obesity. Yet few studies have explored associations between sleep, food insecurity, and obesity in adolescent populations, who may have more irregular sleep patterns. Thus, the objectives of this study were to determine associations between measures of sleep, food insecurity, and weight status. Methods: Data were obtained from the Family Life, Activity, Sun, Health, and Eating (FLASHE) Study, an online cross-sectional study of parent and adolescent (12-17-year old) dyads. Participants were drawn from a Consumer Opinion Panel representative of the general population of the United States with respect to sex, education, income, age, household size, and region. First, multinomial logistic regression analyses were conducted to determine associations between sleep measures (adolescent-reported average nighttime sleep duration, having a regular bedtime, and having difficulty staying asleep), food insecurity (a validated two-item parent-reported measure), and weight status (being underweight, of healthy weight, overweight, and obese). Weight status was based upon adolescent BMI z-scores using Centers for Disease Control and Prevention growth charts using information from parent report of adolescent height and weight and adolescent-reported age and sex among adolescents (N = 1544). Conditional process models were also fitted to the data to determine whether food insecurity moderates the associations between sleep measures and weight status, and to determine whether the association between food insecurity and weight status is mediated by average sleep duration. Results: Compared to those with food security, a greater percentage of those with food insecurity reported having difficulties staying asleep and a longer average sleep duration. Multinomial logistic regression models demonstrated that having a regular bedtime was associated with lower odds of having obesity, having difficulties staying asleep was associated with greater odds of being underweight, and having food insecurity was associated with greater odds of being overweight. Conditional process models demonstrated that food insecurity did not moderate associations between sleep measures and weight status and that average nighttime sleep duration did not mediate the association between food insecurity and weight status. Conclusions: This is one of the first studies to examine associations between sleep, food insecurity, and weight status among adolescents. Results provide additional support for the need to uncover mechanisms for how sleep and food insecurity affect pediatric obesity using longitudinal data.
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Affiliation(s)
- Elizabeth K. Do
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA
| | - Gabrielle A. Bowen
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA.,Department of Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA
| | - Albert J. Ksinan
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA
| | - Elizabeth L. Adams
- Department of Pediatrics, Virginia Commonwealth University, Richmond, VA, USA
| | - Bernard F. Fuemmeler
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA.,Department of Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA.,Address correspondence to: Bernard F. Fuemmeler, PhD, MPH, Department of Health Behavior and Policy, Virginia Commonwealth University, Box 980430, Richmond, VA 23298, USA
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40
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Affiliation(s)
- Melissa Hawkins
- Department of Health Studies, College of Arts & Sciences, American University, 4400 Massachusetts Avenue NW, Washington, DC 20016, United States of America.
| | - Anthony Panzera
- Department of Health Studies, College of Arts & Sciences, American University, 4400 Massachusetts Avenue NW, Washington, DC 20016, United States of America.
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Malek Rivan NF, Yahya HM, Shahar S, Ajit Singh DK, Ibrahim N, Mat Ludin AF, Mohamed Sakian NI, Mahadzir H, Subramaniam P, Kamaruddin MZA. The Impact of Poor Nutrient Intakes and Food Insecurity on the Psychological Distress among Community-Dwelling Middle-Aged and Older Adults during the COVID-19 Pandemic. Nutrients 2021; 13:353. [PMID: 33503860 PMCID: PMC7911207 DOI: 10.3390/nu13020353] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/12/2021] [Accepted: 01/15/2021] [Indexed: 11/17/2022] Open
Abstract
This study aimed to investigate the impact of food insecurity and poor nutrient intake on the psychological health of middle-aged and older adults during the COVID-19 pandemic. A sub-sample of 535 individuals aged 52 years and above, from the earlier cohort and interventional studies (n = 4) from four selected states in Peninsular Malaysia, were recruited during the COVID-19 outbreak (April to June 2020). Telephone interviews were conducted by trained interviewers with a health sciences background to obtain participants' information on health status, physical activity, food security, and psychological health (General Health Questionnaire-12; normal and psychological distress). Univariate analyses were performed for each variable, followed by a logistic regression analysis using SPSS Statistics version 25.0. Results revealed food insecurity (OR = 17.06, 95% CI: 8.24-35.32, p < 0.001), low protein (OR = 0.981, 95% CI: 0.965-0.998, p < 0.05), and fiber intakes (OR = 0.822, 95% CI: 0.695-0.972, p < 0.05) were found to be significant factors associated with the psychological distress group after adjusting for confounding factors. The findings suggested that food insecurity and insufficiencies of protein and fiber intakes heightened the psychological distress during the COVID-19 pandemic. Optimal nutrition is vital to ensure the physical and psychological health of the older population, specifically during the current pandemic.
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Affiliation(s)
- Nurul Fatin Malek Rivan
- Nutritional Sciences Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Hanis Mastura Yahya
- Nutritional Sciences Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Suzana Shahar
- Dietetics Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Devinder Kaur Ajit Singh
- Physiotherapy Programme and Centre for Healthy Ageing and Wellness (H-CARE), Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Norhayati Ibrahim
- Health Psychology Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia; (N.I.); (P.S.)
| | - Arimi Fitri Mat Ludin
- Biomedical Science Programme and Centre for Healthy Ageing and Wellness (H-CARE), Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Noor Ibrahim Mohamed Sakian
- Occupational Therapy Programme, Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Hazlina Mahadzir
- Internal Medicine and Geriatric Department, Pusat Perubatan Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Batu 9 Cheras, Kuala Lumpur 56000, Malaysia;
| | - Ponnusamy Subramaniam
- Health Psychology Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia; (N.I.); (P.S.)
| | - Mohd Zul Amin Kamaruddin
- Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
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Jackson CL, Walker JR, Brown MK, Das R, Jones NL. A workshop report on the causes and consequences of sleep health disparities. Sleep 2020; 43:zsaa037. [PMID: 32154560 PMCID: PMC7420527 DOI: 10.1093/sleep/zsaa037] [Citation(s) in RCA: 113] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 01/16/2020] [Indexed: 01/10/2023] Open
Abstract
Sleep deficiencies, which include insufficient or long sleep duration, poor sleep quality, and irregular timing of sleep, are disproportionately distributed among populations that experience health disparities in the United States. Sleep deficiencies are associated with a wide range of suboptimal health outcomes, high-risk health behaviors, and poorer overall functioning and well-being. This report focuses on sleep health disparities (SHDs), which is a term defined as differences in one or more dimensions of sleep health on a consistent basis that adversely affect designated disadvantaged populations. SHDs appear to share many of the same determinants and causal pathways observed for health outcomes with well-known disparities. There also appears to be common behavioral and biological mechanisms that connect sleep with poorer health outcomes, suggesting a link between SHDs and other health disparities observed within these designated populations. In 2018, the National Institute on Minority Health and Health Disparities, the National Heart, Lung, and Blood Institute, and the Office of Behavioral and Social Sciences Research convened a workshop with experts in sleep, circadian rhythms, and health disparities to identify research gaps, challenges, and opportunities to better understand and advance research to address SHDs. The major strategy to address SHDs is to promote integration between health disparity causal pathways and sleep and circadian-related mechanisms in research approaches and study designs. Additional strategies include developing a comprehensive, integrative conceptual model, building transdisciplinary training and research infrastructure, and designing as well as testing multilevel, multifactorial interventions to address SHDs.
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Affiliation(s)
- Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC
- Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD
| | - Jenelle R Walker
- Center for Translation Research and Implementation Science, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Marishka K Brown
- Division of Lung Diseases, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Rina Das
- Division of Extramural Scientific Programs, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD
| | - Nancy L Jones
- Division of Extramural Scientific Programs, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD
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Rich JA, Corbin TJ, Jacoby SF, Webster JL, Richmond TS. Pathways to Help-Seeking Among Black Male Trauma Survivors: A Fuzzy Set Qualitative Comparative Analysis. J Trauma Stress 2020; 33:528-540. [PMID: 32516470 PMCID: PMC7719085 DOI: 10.1002/jts.22517] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 10/26/2019] [Accepted: 11/26/2019] [Indexed: 11/06/2022]
Abstract
Many Black men suffer symptoms of traumatic stress in the aftermath of traumatic injury, and they also often carry social concerns, including experiences of discrimination and stigma, and a lack of financial resources. The objective of the present study was to understand how traumatic symptoms and social factors combine in complex ways toward the outcome of psychological help-seeking. We analyzed qualitative and quantitative data from 32 injured Black men admitted to a Level 1 trauma center. Qualitative interviews explored their attitudes toward seeking professional psychological help. We analyzed quantitative data, collected using validated instruments, on posttraumatic stress and depression symptoms, financial worry, and discrimination/stigma. Fuzzy set qualitative comparative analysis (fsQCA) was conducted by calibrating each condition to fuzzy set membership scores based on our knowledge of the causal conditions and the cases. We then constructed truth tables for QCA analysis using fsQCA software. Three causal pathways for psychological help-seeking were identified: Two pathways showed that severe trauma symptoms in the absence of financial worry were sufficient for seeking help, whereas the third showed that financial worry and discrimination in the absence of trauma symptoms were sufficient for help-seeking. We identified two causal pathways for negated help-seeking, in which low posttraumatic symptom severity and low levels of discrimination or financial worry were sufficient for not seeking psychological help. The QCA analysis revealed multiple pathways for psychological help-seeking among Black men who suffer trauma. These findings highlight the need for further research to understand complex pathways toward psychological help-seeking in this population.
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Affiliation(s)
- John A. Rich
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA,Department of Emergency Medicine, College of Medicine, Drexel University, Philadelphia, Pennsylvania, USA,Center for Nonviolence and Social Justice, Drexel University, Philadelphia, Pennsylvania, USA
| | - Theodore J. Corbin
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA,Department of Emergency Medicine, College of Medicine, Drexel University, Philadelphia, Pennsylvania, USA,Center for Nonviolence and Social Justice, Drexel University, Philadelphia, Pennsylvania, USA
| | - Sara F. Jacoby
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA,Penn Injury Science Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jessica L. Webster
- Department of Biobehavioral Sciences, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Therese S. Richmond
- Penn Injury Science Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA,Department of Biobehavioral Sciences, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Schwartz AR, Cohen-Zion M, Pham LV, Gal A, Sowho M, Sgambati FP, Klopfer T, Guzman MA, Hawks EM, Etzioni T, Glasner L, Druckman E, Pillar G. Brief digital sleep questionnaire powered by machine learning prediction models identifies common sleep disorders. Sleep Med 2020; 71:66-76. [PMID: 32502852 DOI: 10.1016/j.sleep.2020.03.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 02/17/2020] [Accepted: 03/05/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION We developed and validated an abbreviated Digital Sleep Questionnaire (DSQ) to identify common societal sleep disturbances including insomnia, delayed sleep phase syndrome (DSPS), insufficient sleep syndrome (ISS), and risk for obstructive sleep apnea (OSA). METHODS The DSQ was administered to 3799 community volunteers, of which 2113 were eligible and consented to the study. Of those, 247 were interviewed by expert sleep physicians, who diagnosed ≤2 sleep disorders. Machine Learning (ML) trained and validated separate models for each diagnosis. Regularized linear models generated 15-200 features to optimize diagnostic prediction. Models were trained with five-fold cross-validation (repeated five times), followed by robust validation testing. ElasticNet models were used to classify true positives and negatives; bootstrapping optimized probability thresholds to generate sensitivities, specificities, accuracies, and area under the receiver operating curve (AUC). RESULTS Compared to reference subgroups, physician-diagnosed sleep disorders were marked by DSQ evidence of sleeplessness (insomnia, DSPS, OSA), sleep debt (DSPS, ISS), airway obstruction during sleep (OSA), blunted circadian variability in alertness (DSPS), sleepiness (DSPS and ISS), increased alertness (insomnia) and global impairment in sleep-related quality of life (all sleep disorders). ElasticNet models validated each diagnosis with high sensitivity (80-83%), acceptable specificity (63-69%), high AUC (0.80-0.85) and good accuracy (agreement with physician diagnoses, 68-73%). DISCUSSION A brief DSQ readily engaged and efficiently screened a large population for common sleep disorders. Powered by ML, the DSQ can accurately classify sleep disturbances, demonstrating the potential for improving the sleep, health, productivity and safety of populations.
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Affiliation(s)
- Alan R Schwartz
- Johns Hopkins Sleep Disorders Center, Baltimore, MD, USA; Johns Hopkins Center for Interdisciplinary Sleep Research and Education, Baltimore, MD, USA(1); University of Pennsylvania Perelman School of Medicine, USA.
| | - Mairav Cohen-Zion
- The Academic College of Tel Aviv-Jaffa, Tel Aviv, Israel; DayZz Live Well Ltd, Herzeliya, Israel
| | - Luu V Pham
- Johns Hopkins Sleep Disorders Center, Baltimore, MD, USA; Johns Hopkins Center for Interdisciplinary Sleep Research and Education, Baltimore, MD, USA(1)
| | - Amit Gal
- The Open University, Raanana, Israel
| | - Mudiaga Sowho
- Johns Hopkins Sleep Disorders Center, Baltimore, MD, USA
| | - Francis P Sgambati
- Johns Hopkins Sleep Disorders Center, Baltimore, MD, USA; Johns Hopkins Center for Interdisciplinary Sleep Research and Education, Baltimore, MD, USA(1)
| | - Tracy Klopfer
- Johns Hopkins Sleep Disorders Center, Baltimore, MD, USA
| | | | - Erin M Hawks
- Johns Hopkins Sleep Disorders Center, Baltimore, MD, USA
| | - Tamar Etzioni
- Carmel Medical Center, Haifa, Israel; Technion School of Medicine, Haifa, Israel
| | - Laura Glasner
- DayZz Live Well Ltd, Herzeliya, Israel; Sheba Medical Center, Ramat Gan, Israel
| | - Eran Druckman
- Druckman Research and Statistics, Rishon Lezion, Israel
| | - Giora Pillar
- Carmel Medical Center, Haifa, Israel; Technion School of Medicine, Haifa, Israel
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Abstract
PURPOSE OF REVIEW Food insecurity is the lack of sufficient food in quantity and/or quality. Psychological distress includes mental health issues such as depression and anxiety. This review provides current information on research examining the association between food insecurity and psychological distress. RECENT FINDINGS Among studies published in the previous 5 years, food insecurity was significantly and positively associated with multiple indicators of psychological distress. This included cross-sectional and longitudinal studies, as well as primary data collection and secondary data analyses, from countries of varying income levels. Articles also provided evidence within various populations, such as adults of all ages, college students, those living with chronic disease, and parents. Food insecurity and psychological distress are interconnected health issues. Future research should consider a number of important gaps in the literature, with the most important being the development of interventions to improve food insecurity and psychological health concurrently.
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Affiliation(s)
- Candice A. Myers
- Pennington Biomedical Research Center, Baton Rouge, 70808, Louisiana, USA,Corresponding author at: Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA 70808, USA, , Tel: (225) 763-2849
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46
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Leung CW, Zhou MS. Household Food Insecurity and the Association with Cumulative Biological Risk among Lower-Income Adults: Results from the National Health and Nutrition Examination Surveys 2007-2010. Nutrients 2020; 12:nu12051517. [PMID: 32456138 PMCID: PMC7285083 DOI: 10.3390/nu12051517] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/20/2020] [Accepted: 05/20/2020] [Indexed: 01/24/2023] Open
Abstract
Household food insecurity has been associated with adverse health outcomes; however, the mechanisms underlying these associations are not well-defined. Using data from 5005 adults from the 2007-2010 National Health and Nutrition Examination Surveys (NHANES), we examined associations between household food insecurity and cumulative biological risk, a measure of the body's physiological response to chronic stress. Household food security was assessed using the 18-item Household Food Security Survey Module. Marginal food security refers to 1-2 positive responses, and food insecurity refers to ≥3 positive responses. The cumulative biological risk scores were calculated based on the distributions of ten biomarkers from the cardiovascular, metabolic, and immune systems. Elevated biological risk was defined as a risk score of ≥3. Multivariable regression models were used to examine associations between food security and cumulative biological risk scores, adjusting for sociodemographic characteristics. After multivariable adjustment, food insecurity was associated with a 0.14-unit higher cumulative biological risk score (95% CI 0.05-0.22, p-trend = 0.003) and higher odds of elevated biological risk (OR 1.20, 95% CI 1.05-1.37, p-trend = 0.003). These associations differed by gender. Among women, food insecurity was associated with 0.30-unit higher cumulative biological risk score (95% CI 0.14-0.45, p-trend = 0.0004) and higher odds of elevated biological risk (OR 1.61, 95% CI 1.29-2.00, p-trend < 0.0001). These associations were not observed in men. Women experiencing food insecurity demonstrated elevated levels of biological risk. These findings support the hypothesis that food insecurity may be associated with women's chronic health outcomes through the pathway of chronic stress. Further research is needed to understand why these associations were not observed in men.
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Na M, Dou N, Ji N, Xie D, Huang J, Tucker KL, Gao X. Food Insecurity and Cognitive Function in Middle to Older Adulthood: A Systematic Review. Adv Nutr 2020; 11:667-676. [PMID: 31711095 PMCID: PMC7231583 DOI: 10.1093/advances/nmz122] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 09/10/2019] [Accepted: 10/16/2019] [Indexed: 01/10/2023] Open
Abstract
Food insecurity (FI) may limit cognitive functioning during aging. The goal of this systematic review was to summarize existing evidence linking FI and general or specific cognitive functions in middle and older adulthood. A systematic search of human studies published between 1 January 2000 and 30 April 2018 was conducted in PubMed, PsycINFO, and CAB Direct. Four independent reviewers assessed the eligibility of identified articles and conducted data extraction and data quality assessment. Ten studies were included in the review, including 1 cluster-randomized controlled trial, 2 longitudinal studies, and 7 cross-sectional studies. Three studies reported the association between early-life FI experience and a global cognitive function measure. Nine studies reported later-life FI experience in relation to global or specific cognitive functions. The results suggest an adverse association between FI experienced in early or later life and global cognitive function; and between later-life FI and executive function and memory. Findings from the review are preliminary because of sparse data, heterogeneity across study populations, exposure and outcome assessments, and potential risk of bias across studies. Future studies are recommended to better understand the role of FI in cognitive function, with the goal of identifying possible critical windows for correction of FI in vulnerable subpopulations to prevent neurocognitive deficit in adulthood.
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Affiliation(s)
- Muzi Na
- Department of Nutritional Sciences, College of Health and Human Development, The Pennsylvania State University, University Park, PA, USA,Address correspondence to MN (e-mail: )
| | - Nan Dou
- Department of Nutritional Sciences, College of Health and Human Development, The Pennsylvania State University, University Park, PA, USA
| | - Naiwen Ji
- Department of Nutritional Sciences, College of Health and Human Development, The Pennsylvania State University, University Park, PA, USA
| | - Dixin Xie
- Department of Nutritional Sciences, College of Health and Human Development, The Pennsylvania State University, University Park, PA, USA
| | - Jie Huang
- Department of Nutritional Sciences, College of Health and Human Development, The Pennsylvania State University, University Park, PA, USA
| | - Katherine L Tucker
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA
| | - Xiang Gao
- Department of Nutritional Sciences, College of Health and Human Development, The Pennsylvania State University, University Park, PA, USA
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Lachaud J, Mejia-Lancheros C, Wang R, Wiens K, Nisenbaum R, Stergiopoulos V, Hwang SW, O'Campo P. Mental and substance use disorders and food insecurity among homeless adults participating in the At Home/Chez Soi study. PLoS One 2020; 15:e0232001. [PMID: 32324795 PMCID: PMC7179857 DOI: 10.1371/journal.pone.0232001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 04/03/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Few studies have examined how food insecurity changes over time when living with severe mental disorders or substance use disorders. This study identifies food insecurity trajectories of homeless adults participating in a trial of a housing intervention and examines whether receiving the intervention and having specific mental and substance disorders predict food insecurity trajectories. MATERIALS AND METHODS We studied 520 participants in the Toronto site of the At Home/Chez-Soi project. Food insecurity data were collected at seven times during a follow-up period of up to 5.5 years. Mental and substance use disorders were assessed at baseline. Food insecurity trajectories were identified using group based-trajectory modeling. Multinomial logistic regression was used to examine the effects of the intervention and mental and substance use disorders on food insecurity trajectories. RESULTS Four food insecurity trajectories were identified: persistently high food insecurity, increasing food insecurity, decreasing food insecurity, and consistently low food insecurity. Receiving the intervention was not a predictor of membership in any specific food insecurity trajectory group. Individuals with major depressive episode, mood disorder with psychotic features, substance disorder, and co-occurring disorder (defined as having at least one alcohol or other substance use disorder and at least one non-substance related mental disorder] were more likely to remain in the persistently high food insecurity group than the consistently low food insecurity group. CONCLUSION A persistently high level of food insecurity is common among individuals with mental illness who have experienced homelessness, and the presence of certain mental health disorders increases this risk. Mental health services combined with access to resources for basic needs, and re-adaptation training are required to enhance the health and well-being of this population.
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Affiliation(s)
- James Lachaud
- MAP|Centre for Urban Health Solutions, Li Ka-Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Cilia Mejia-Lancheros
- MAP|Centre for Urban Health Solutions, Li Ka-Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Ri Wang
- MAP|Centre for Urban Health Solutions, Li Ka-Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Kathryn Wiens
- MAP|Centre for Urban Health Solutions, Li Ka-Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Rosane Nisenbaum
- MAP|Centre for Urban Health Solutions, Li Ka-Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada
- Applied Health Research Centre, St Michael’s Hospital, Li Ka Shing Knowledge Institute, Toronto, ON, Canada
| | - Vicky Stergiopoulos
- MAP|Centre for Urban Health Solutions, Li Ka-Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Stephen W. Hwang
- MAP|Centre for Urban Health Solutions, Li Ka-Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada
- Division of General Internal Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Patricia O'Campo
- MAP|Centre for Urban Health Solutions, Li Ka-Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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Tsuchiya K, Leung CW, Jones AD, Caldwell CH. Multiple financial stressors and serious psychological distress among adults in the USA. Int J Public Health 2020; 65:335-344. [PMID: 32239257 DOI: 10.1007/s00038-020-01354-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 02/09/2020] [Accepted: 03/16/2020] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES Financial stress has adverse consequences for health. However, the association between individual and cumulative associations of multiple financial stressors and serious psychological distress (SPD) is unclear. METHODS Using data from the 2017 National Health Interview Survey, we examined cross-sectional associations between perceived financial worries, healthcare insecurity, food insecurity, and SPD among 23,317 US adults. Associations were examined using logistic regression. RESULTS Among US adults in 2017, the overall prevalence of SPD was 3.6%. Among those with SPD, 85.5% were financially worried, 50.3% were food insecure, and 51.2% were healthcare insecure. Financial worries (OR 4.27; CI 3.31, 5.52), food insecurity (OR 2.34; CI 1.92, 2.85), and healthcare insecurity (OR 2.26; CI 1.85, 2.76) were each associated with higher odds of SPD. A dose-response association was found between the number of stressors and SPD. CONCLUSIONS Each financial stressor was adversely associated with SPD both individually and cumulatively, indicating the adverse effects of the accumulation of these stressors. Additional studies are needed to understand the longitudinal effects of multiple financial stressors on mental health outcomes.
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Affiliation(s)
- Kazumi Tsuchiya
- Minnesota Population Center, University of Minnesota, Minneapolis, MN, USA.
| | - Cindy W Leung
- Department of Nutritional Sciences, University of Michigan, School of Public Health, Ann Arbor, MI, USA
| | - Andrew D Jones
- Department of Nutritional Sciences, University of Michigan, School of Public Health, Ann Arbor, MI, USA
| | - Cleopatra H Caldwell
- Department of Health Behavior and Health Education, University of Michigan, School of Public Health, Ann Arbor, MI, USA
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Troxel WM, Haas A, Ghosh-Dastidar B, Holliday SB, Richardson AS, Schwartz H, Gary-Webb TL, Hale L, Buysse DJ, Buman MP, Dubowitz T. Broken Windows, Broken Zzs: Poor Housing and Neighborhood Conditions Are Associated with Objective Measures of Sleep Health. J Urban Health 2020; 97:230-238. [PMID: 31993870 PMCID: PMC7101456 DOI: 10.1007/s11524-019-00418-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
African Americans and socioeconomically disadvantaged individuals have higher rates of a variety of sleep disturbances, including short sleep duration, poor sleep quality, and fragmented sleep. Such sleep disturbances may contribute to pervasive and widening racial and socioeconomic (SES) disparities in health. A growing body of literature demonstrates that over and above individual-level SES, indicators of neighborhood disadvantage are associated with poor sleep. However, there has been scant investigation of the association between sleep and the most proximal environments, the home and residential block. This is the first study to examine the association between objective and self-reported measures of housing and block conditions and sleep. The sample included 634 adults (mean age = 58.7 years; 95% African American) from two low-income urban neighborhoods. Study participants reported whether they experienced problems with any of seven different housing problems (e.g., broken windows) and rated the overall condition of their home. Trained data collectors rated residential block quality. Seven days of wrist actigraphy were used to measure average sleep duration, efficiency, and wakefulness after sleep onset (WASO), and a sleep diary assessed sleep quality. Multivariate regression analyses were conducted for each sleep outcome with housing or block conditions as predictors in separate models. Participants reporting "fair" or "poor" housing conditions had an adjusted average sleep duration that was 15.4 min shorter than that of participants reporting "good" or "excellent" conditions. Those reporting any home distress had 15.9 min shorter sleep and .19 units lower mean sleep quality as compared with participants who did not report home distress. Poor objectively measured block quality was associated with 14.0 min shorter sleep duration, 1.95% lower sleep efficiency, and 10.7 additional minutes of WASO. Adverse housing and proximal neighborhood conditions are independently associated with poor sleep health. Findings highlight the importance of considering strategies that target upstream determinants of sleep health disparities.
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Affiliation(s)
- Wendy M Troxel
- Behavior and Policy Sciences, RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA, 15213, USA.
| | - Ann Haas
- Economics, Sociology and Statistics, RAND Corporation, Pittsburgh, PA, 15213, USA
| | | | - Stephanie Brooks Holliday
- Behavior and Policy Sciences, RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA, 15213, USA
| | - Andrea S Richardson
- Behavior and Policy Sciences, RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA, 15213, USA
| | - Heather Schwartz
- Economics, Sociology and Statistics, RAND Corporation, Pittsburgh, PA, 15213, USA
| | - Tiffany L Gary-Webb
- Departments of Behavioral and Community Health Sciences and Epidemiology, University of Pittsburgh, Pittsburgh, PA, 15261, USA
| | - Lauren Hale
- Department of Family, Population, and Preventive Medicine, Program in Public Health, Stony Brook University, Stony Brook, NY, 11794-8338, USA
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Matthew P Buman
- College of Health Solutions, Arizona State University, Phoenix, AZ, 85004, USA
| | - Tamara Dubowitz
- Behavior and Policy Sciences, RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA, 15213, USA
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