Childlessness and Health Among Older Adults: Variation Across Five Outcomes and 20 Countries

2019 ◽  
Author(s):  
Nekehia T Quashie ◽  
Bruno Arpino ◽  
Radoslaw Antczak ◽  
Christine A Mair
Keyword(s):  
Health Outcomes ◽  
The United States ◽  
Future Research ◽  
Cross Sectional ◽  
Aging Policy ◽  
Logistic Regression Models ◽  
Wide Range ◽  
The Family ◽  
National Economic ◽  
The Relationship

Abstract Objectives No previous study to the best of our knowledge has examined the association between childlessness and health using a wide range of countries and health outcomes. This study improves previous literature by examining the relationship between “childlessness” (1 = childless for any reason, 0 = parent of biological, step, or adopted child) and health across 20 countries and five health outcomes. Methods Drawing on cross-sectional harmonized data from the family of Health and Retirement Surveys across the United States (HRS, Wave 11), Europe (SHARE, Waves 4 and 5), Mexico (MHAS, Wave 3), and China (CHARLS, Wave 2), we use logistic regression models to estimate the association between childlessness and poor health (poor self-rated health, 1 or more ADL limitations, 1 or more IADL limitations, 1 or more chronic conditions, and depression) in a sample of adults aged 50 and older across 20 countries (N = 109,648). Results Our results point to an absence of associations between childlessness and health, and suggest that childlessness may be associated with better (e.g., Mexico, Hungary) or worse health (e.g., Austria, Estonia, Netherlands, Poland) in certain contexts and for certain measures. Discussion We discuss these findings in light of the meaning of childlessness, as well as cross-national economic, social, and cultural contexts to provide suggestions for aging policy and future research.

scholarly journals A survey of caregiver acculturation and acceptance of silver diamine fluoride treatment for childhood caries

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Anjali Kumar ◽  
Dana Cernigliaro ◽  
Mary E. Northridge ◽  
Yinxiang Wu ◽  
Andrea B. Troxel ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
The United States ◽  
Cross Sectional Study ◽  
Caries Experience ◽  
Cross Sectional ◽  
Silver Diamine Fluoride ◽  
Fluoride Treatment ◽  
Logistic Regression Models ◽  
Health Related ◽  
The Relationship

Abstract Background Interest in aqueous silver diamine fluoride (SDF) has been growing as a treatment for caries arrest. A cross-sectional study was conducted to identify factors associated with caregiver acceptance of SDF treatment for children presenting with caries at 8 Federally Qualified Health Centers. The study purpose was to examine associations between caregiver acceptance of SDF treatment for children with caries and (1) sociodemographic and acculturation characteristics of caregivers and (2) clinical assessments of the children by dentists. Methods A caregiver survey collected information on: sociodemographic characteristics; acculturation characteristics, measured using the validated Short Acculturation Scale for Hispanics (SASH); perceived benefits and barriers of SDF treatment, including caregiver comfort; and perceived health-related knowledge. Chart reviews were conducted to assess: the medical / dental insurance of pediatric patients; cumulative caries experience, measured using decayed, missing, filled teeth total scores (dmft / DMFT); whether operating room treatment was needed; and a record of caregiver acceptance of SDF treatment (the outcome measure). Standard logistic regression models were developed for caregiver acceptance of SDF treatment for their children as the binary outcome of interest (yes / no) to calculate unadjusted odds ratios (OR) and adjusted ORs for covariates of interest. Results Overall, 434 of 546 caregivers (79.5%) accepted SDF treatment for their children. A U-shaped relationship between caregiver odds of accepting SDF treatment and age group of pediatric patients was present, where caregivers were most likely to accept SDF treatment for their children who were either < 6 years or 9–14 years, and least likely to accept SDF treatment for children 6 to < 9 years. The relationship between acculturation and caregiver acceptance of SDF treatment depended upon whether or not caregivers were born in the United States: greater acculturation was associated with caregiver acceptance of SDF treatment among caregivers born in this country, and lower acculturation was associated with caregiver acceptance of SDF treatment among caregivers born elsewhere. Conclusions Caregiver acceptance of SDF treatment is high; child’s age and caregiver comfort are associated with acceptance. Providers need to communicate the risks and benefits of evidence-based dental treatments to increasingly diverse caregiver and patient populations.

scholarly journals Mental Health Outcomes in Barcelona: The Interplay between Gentrification and Greenspace

2021 ◽  
Vol 18 (17) ◽  
pp. 9314
Author(s):  
Montserrat Zayas-Costa ◽  
Helen V. S. Cole ◽  
Isabelle Anguelovski ◽  
James Connolly ◽  
Xavier Bartoll ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Health Benefits ◽  
Mental Health Outcomes ◽  
Future Research ◽  
Effect Modifier ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Health Association ◽  
Mental Health Association

Greenspace is widely related to mental health benefits, but this relationship may vary by social group. Gentrification, as linked to processes of unequal urban development and conflict, potentially impacts health outcomes. This study explores the relationships between greenspace and mental health and between gentrification and mental health associations. It also further examines gentrification as an effect modifier in the greenspace–mental health association and SES as an effect modifier in the gentrification-mental health association. We used cross-sectional Barcelona (Spain) data from 2006, which included perceived mental health status and self-reported depression/anxiety from the Barcelona Health Survey. Greenspace exposure was measured as residential access to (1) all greenspace, (2) greenways and (3) parks in 2006. Census-tract level gentrification was measured using an index including changes in sociodemographic indicators between 1991 and 2006. Logistic regression models revealed that only greenways were associated with better mental health outcomes, with no significant relationship between mental health and parks or all greenspace. Living in gentrifying neighborhoods was protective for depression/anxiety compared to living in non-gentrifying neighborhoods. However, only residents of gentrifiable census tracts benefited from the exposure to greenways. SES was not found to be an effect modifier in the association between gentrification and mental health. Future research should tackle this study’s limitations by incorporating a direct measure of displacement in the gentrification status indicator, accounting for qualitative aspects of greenspace and user’s perceptions. Gentrification may undermine the health benefits provided by greenspace interventions.

CANNABIS USE AMONG MILITARY VETERANS: A GREAT DEAL TO GAIN OR LOSE?

2020 ◽  
Author(s):  
James MacKillop ◽  
Jasmine Turna
Keyword(s):  
Substance Use ◽  
Health Outcomes ◽  
The United States ◽  
Cannabis Use ◽  
Future Research ◽  
Therapeutic Effects ◽  
Medical Cannabis ◽  
Cross Sectional ◽  
Physical Health Outcomes ◽  
Male Veterans

Policy changes have resulted in dramatic increases in access to cannabis for medical purposes. Veterans are disproportionately affected by conditions for which medical cannabis is often pursued, making an evidence-based perspective on risks versus benefits of high priority. The current review sought to examine the state of the evidence on consequences and correlates of cannabis use among veterans. Using a comprehensive search strategy, 501 articles were identified and 86 studies met criteria for inclusion. The literature was predominated by cross-sectional studies (67%) of male veterans (71.4%-100% male) from the United States (93.0%). Three overarching themes emerged, comprising cannabis associations with other substance use, mental health, and physical health outcomes. The balance of the evidence associated cannabis use with negative health outcomes, with consistent positive associations with other substance use, psychiatric disorders, and self-harm/suicidality. Few studies examined the therapeutic effects of cannabis, thus limiting the potential to evaluate evidence of efficacy. Priority areas for future research are studies using designs that can examine the directionality of links between cannabis and health in veterans more conclusively, and studies directly examining therapeutic efficacy of cannabis-based therapies in veterans. Methodologically rigorous design will be essential to inform clinical recommendations and practices guidelines in an era of burgeoning access to cannabis.

scholarly journals The Association of E-cigarette Flavors With Satisfaction, Enjoyment, and Trying to Quit or Stay Abstinent From Smoking Among Regular Adult Vapers From Canada and the United States: Findings From the 2018 ITC Four Country Smoking and Vaping Survey

2020 ◽  
Vol 22 (10) ◽  
pp. 1831-1841 ◽  
Author(s):  
Shannon Gravely ◽  
K Michael Cummings ◽  
David Hammond ◽  
Eric Lindblom ◽  
Danielle M Smith ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Cross Sectional Study ◽  
Future Research ◽  
Cross Sectional ◽  
Quit Attempt ◽  
Quit Smoking ◽  
Wide Range ◽  
The Us ◽  
Former Smokers

Abstract Aims This study examined whether nontobacco flavors are more commonly used by vapers (e-cigarette users) compared with tobacco flavor, described which flavors are most popular, and tested whether flavors are associated with: vaping satisfaction relative to smoking, level of enjoyment with vaping, reasons for using e-cigarettes, and making an attempt to quit smoking by smokers. Methods This cross-sectional study included 1603 adults from Canada and the United States who vaped at least weekly, and were either current smokers (concurrent users) or former smokers (exclusive vapers). Respondents were categorized into one of seven flavors they used most in the last month: tobacco, tobacco–menthol, unflavored, or one of the nontobacco flavors: menthol/mint, fruit, candy, or “other” (eg, coffee). Results Vapers use a wide range of flavors, with 63.1% using a nontobacco flavor. The most common flavor categories were fruit (29.4%) and tobacco (28.7%), followed by mint/menthol (14.4%) and candy (13.5%). Vapers using candy (41.0%, p &lt; .0001) or fruit flavors (26.0%, p = .01) found vaping more satisfying (compared with smoking) than vapers using tobacco flavor (15.5%) and rated vaping as very/extremely enjoyable (fruit: 50.9%; candy: 60.9%) than those using tobacco flavor (39.4%). Among concurrent users, those using fruit (74.6%, p = .04) or candy flavors (81.1%, p = .003) were more likely than tobacco flavor users (63.5%) to vape in order to quit smoking. Flavor category was not associated with the likelihood of a quit attempt (p = .46). Among exclusive vapers, tobacco and nontobacco flavors were popular; however, those using tobacco (99.0%) were more likely than those using candy (72.8%, p = .002) or unflavored (42.5%, p = .005) to vape in order to stay quit. Conclusions A majority of regular vapers in Canada and the US use nontobacco flavors. Greater satisfaction and enjoyment with vaping are higher among fruit and candy flavor users. While it does not appear that certain flavors are associated with a greater propensity to attempt to quit smoking among concurrent users, nontobacco flavors are popular among former smokers who are exclusively vaping. Future research should determine the likely impact of flavor bans on those who are vaping to quit smoking or to stay quit. Implications Recent concerns about the attractiveness of e-cigarette flavors among youth have resulted in flavor restrictions in some jurisdictions of the United States and Canada. However, little is known about the possible consequences for current and former smokers if they no longer have access to their preferred flavors. This study shows that a variety of nontobacco flavors, especially fruit, are popular among adult vapers, particularly among those who have quit smoking and are now exclusively vaping. Limiting access to flavors may therefore reduce the appeal of e-cigarettes among adults who are trying to quit smoking or stay quit.

scholarly journals Assessing the impact of health system organizational structure on hospital electronic data sharing

2018 ◽  
Vol 25 (9) ◽  
pp. 1147-1152 ◽  
Author(s):  
A Jay Holmgren ◽  
Eric W Ford
Keyword(s):  
Health System ◽  
Data Sharing ◽  
Health Systems ◽  
The United States ◽  
Future Research ◽  
Organizational Forms ◽  
Hospital Industry ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
The Impact

Abstract Objective Horizontal consolidation in the hospital industry has gained momentum in the United States despite concerns over rising costs and lower quality. Hospital systems frequently point to potential gains in interoperability and electronic exchange of patient information as consolidation benefits. We sought to assess whether hospitals in different health system structures varied in their interoperable data sharing. Materials and methods We created a cross-sectional national hospital sample from the 2014 AHA Annual Survey and 2015 IT Supplement. We combined the existing taxonomy of health system organizational forms and the ONC’s functionality-based, technology-agnostic definition of interoperability. We used logistic regression models to assess the relationship between health systems’ organizational forms and interoperability engagement, controlling for hospital characteristics. Results We found that interoperability engagement varied greatly across hospitals in different health system structures, with facilities in more centralized health systems more likely to be interoperable. Hospitals in one system type, featuring centralized insurance product development but diverse service offerings across member organizations, had significantly higher odds of being engaged in interoperable data sharing in our multivariate regression results. Discussion The heterogeneity in health system interoperability engagement indicates that incentives to share data vary greatly across organizational strategies and structures. Our results suggest that horizontal consolidation in the hospital industry may not bring significant gains in interoperability progress unless that consolidation takes a specific business alignment form. Conclusion Policymakers should be wary of claims that horizontal consolidation will lead to interoperability gains. Future research should explore the specific mechanisms that lead to greater interoperability in certain health system organizational structures.

Interpersonal Discrimination and Physical Health

2017 ◽  
Author(s):  
Laura Smart Richman ◽  
Elizabeth A. Pascoe ◽  
Micah Lattanner
Keyword(s):  
Health Outcomes ◽  
Physical Health ◽  
Meta Analysis ◽  
Well Being ◽  
Future Research ◽  
Cross Sectional ◽  
Respiratory Problems ◽  
Wide Range ◽  
Interpersonal Discrimination ◽  
Measurement Practices

Interpersonal discrimination contributes to health inequalities for disadvantaged groups across numerous stigmatized identities. This effect has been found using cross-sectional, prospective, and experimental designs. Interpersonal discrimination has been associated with poor health across a wide range of mental health outcomes, including greater rates of depression, psychological distress, anxiety, and negative well-being, and also physical health outcomes such as hypertension, diabetes, respiratory problems, self-reported ill health, low birth weight, and cardiovascular disease. This chapter examines the relationship between interpersonal discrimination and health. It first reviews the literature, focusing on current best measurement practices, and then provides support for the theoretical model of the pathways by which interpersonal discrimination impacts health outcomes. The chapter then presents an updated meta-analysis that further supports the model and expands on types of discrimination and outcomes. It concludes with a discussion of directions for future research.

scholarly journals The association of urine osmolality with decreased kidney function and/or albuminuria in the United States

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Boonsong K. Kitiwan ◽  
Sarinnapha M. Vasunilashorn ◽  
Heather J. Baer ◽  
Kenneth Mukamal ◽  
Stephen P. Juraschek
Keyword(s):  
Kidney Function ◽  
Positive Association ◽  
Urine Osmolality ◽  
The United States ◽  
Sensitivity Analyses ◽  
Future Research ◽  
Cross Sectional ◽  
Lower Egfr ◽  
The Mean ◽  
The Relationship

Abstract Background Decreased kidney function is commonly caused by hypovolemia. When hypovolemic, the kidney reabsorbs water resulting in concentrated urine. Osmolality is a measure of urine concentration which is more objective than self-reported fluid intake. It has a positive association with hypovolemia. However, it remains controversial whether osmolality is associated with decreased kidney function and/or albuminuria. Methods We conducted a cross-sectional analysis of the 2009–2012 National Health and Nutrition Examination Survey, a standardized survey in the U.S. population. Participants aged 18–70 years old with random urine osmolality were included. Osmolality was categorized as quartiles. Decreased kidney function was defined by estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m2 and albuminuria was defined by albumin-to-creatinine ratio ≥ 30 mg/gm. We performed multivariable regression via four sequential models. Results Our study sample included 7,373 participants. The mean age was 42.9 ± 0.4 years. Overall, 51.4% were male and 67.3% were white. The mean osmolality was 603.8 mOsm/kg and 629.1 mOsm/kg in those with and without decreased eGFR and/or albuminuria, respectively. The number of cases was 610 (6.7%). The prevalence from the lowest to highest quartiles of osmolality was 116 (6.2%), 213 (8.6%), 179 (7.5%), and 102 (4.3%), respectively (p-value for trend = 0.02). The relationship between osmolality and eGFR appeared nonlinear. After adjustment for demographic, social, cardiovascular, and dietary risk factors, there was no significant association of osmolality quartiles with decreased eGFR and/or albuminuria (odds ratio [OR] 0.77, 95% confidence interval [CI] 0.56, 1.07). In sensitivity analyses, osmolality ≥ 500 mOsm/kg was associated with lower eGFR (adjusted ß -1.13, 95% CI -1.98, -0.28). In pre-specified subgroup analyses, osmolality had a statistically significant negative correlation with eGFR among individuals with eGFR ≥ 60 mL/min/1.73m2, but a positive correlation among those with eGFR < 60 mL/min/1.73m2 (adjusted ß -0.19, 95% CI -0.36, -0.01 versus adjusted ß 0.50, 95% CI 0.05, 0.96; p-value for interaction = 0.016). Conclusions Higher osmolality was significantly associated with lower eGFR among adults with eGFR ≥ 60 mL/min/1.73m2 Future research should examine the relationship between osmolality and change in kidney function over time among adults with normal eGFR.

scholarly journals DISCRIMINATION AND DEPRESSION IN MID- TO LATE LIFE: THE ROLE OF OPTIMISM

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S315-S316
Author(s):  
Elliottnell Perez ◽  
Joseph Dzierzewski ◽  
Scott Ravyts
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Positive Association ◽  
Late Life ◽  
The United States ◽  
Future Research ◽  
Cross Sectional ◽  
Life Orientation Test ◽  
The Impact ◽  
The Relationship

Abstract he positive association between discrimination and depression is well-supported throughout the literature. Previous evidence exploring potential mechanisms suggest discrimination is associated with depression via changes in social cognition. The goal of the current study was to investigate whether optimism explained the relationship between discrimination and depressive symptoms in mid-to-late life. Furthermore, the study assessed whether this mediated relationship was moderated by race or sex. This study included cross-sectional and longitudinal secondary data analysis of 2453 middle-aged and older adults (M age=68.30,SD=8.93) from the Midlife in the United States study. Discrimination was measured using an 11-item count of the number of discriminatory events experienced. Optimism was measured using the 6-item Life Orientation Test. Depressive symptoms were assessed using a 7-item count of the number of symptoms experienced. Optimism mediated the relationship between discrimination and depressive symptoms cross-sectionally, 95% CI:[.012, .034], and longitudinally, 95% CI:[.008, .024]. There was no evidence of moderated mediation; however, sex did moderate the direct relationship between discrimination and depressive symptoms cross-sectionally, b=.10, 95% CI:[.001, .194], and longitudinally, b=.03, 95% CI:[.01, .05]. The current study extends the literature by providing cross-sectional and longitudinal support for optimism as a mechanism through which discrimination leads to depressive symptoms in older adults. Evidence also suggests that women experience greater depressive symptoms than men in response to discrimination. Future research may wish to examine the developmental course of observed relationships and the impact of multiple marginalized identities on these relationships.

scholarly journals A Quantitative Comparison of Social Interactions of Older Adults Pre-COVID-19 Between the United States and Japan

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 453-453
Author(s):  
Mariko Nishikitani
Keyword(s):  
Older Adults ◽  
Social Interaction ◽  
Social Interactions ◽  
Senior Citizens ◽  
International Study ◽  
The United States ◽  
Future Research ◽  
The Social ◽  
The Family ◽  
The Relationship

Abstract Using the Study on the Lifestyle and Values of Senior Citizens (The Eighth International Study by the Japan Cabinet Office), the social interactions were assessed in the context of health and life satisfaction of the older adults of the U.S and Japan to confirm the relationship between ICT usage and social interactions. The less social interaction was defined as those who answered that they had no “role in the family,” “working,” or “social activities such as volunteering.” The proportion of less-social interaction people and non-use of ICT increased with age, but the proportions of Japanese were higher than that in Americans. The adjusted odds ratio for non-use of ICT to the risk of isolation of the older adults in Japan was 2.43 (95% CI: 1.59-3.73), but no significant relationship was observed in American older adults. Future research will examine the use of ICT by older adults in each country.

A Silenced Population

Crisis ◽  
2017 ◽  
Vol 38 (6) ◽  
pp. 433-442 ◽  
Author(s):  
Kim Gryglewicz ◽  
Melanie Bozzay ◽  
Brittany Arthur-Jordon ◽  
Gabriela D. Romero ◽  
Melissa Witmeier ◽  
...  
Keyword(s):  
At Risk ◽  
Depressive Symptomatology ◽  
The United States ◽  
Future Research ◽  
At Risk Youth ◽  
Peer Relationship ◽  
Student Records ◽  
Cross Sectional ◽  
Increased Risk ◽  
Method Student

Abstract. Background: Given challenges that exceed the normal developmental requirements of adolescence, deaf and hard-of-hearing (DHH) youth are believed to be at elevated risk for engaging in suicide-related behavior (SRB). Unfortunately, little is known about the mechanisms that put these youth potentially at risk. Aims: To determine whether peer relationship difficulties are related to increased risk of SRB in DHH youth. Method: Student records (n = 74) were retrieved from an accredited educational center for deaf and blind students in the United States. Results: Peer relationship difficulties were found to be significantly associated with engagement in SRB but not when accounting for depressive symptomatology. Limitations: The restricted sample limits generalizability. Conclusions regarding risk causation cannot be made due to the cross-sectional nature of the study. Conclusion: These results suggest the need for future research that examines the mechanisms of the relationship between peer relationship difficulties, depression, and suicide risk in DHH youth and potential preventive interventions to ameliorate the risks for these at-risk youth.

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