The Oxford Handbook of Integrative Health Science

This handbook signals a paradigm shift in health research. Population-based disciplines have employed large national samples to examine how sociodemographic factors contour rates of morbidity and mortality. Behavioral and psychosocial disciplines have studied the factors that influence these domains using small, nonrepresentative samples in experimental or longitudinal contexts. Biomedical disciplines, drawing on diverse fields, have examined mechanistic processes implicated in disease outcomes. The collection of chapters in this handbook embraces all such prior approaches and, via targeted questions, illustrates how they can be woven together. Diverse contributions showcase how social structural influences work together with psychosocial influences or experiential factors to impact differing health outcomes, including profiles of biological risk across distinct physiological systems. These varied biopsychosocial advances have grown up around the Midlife in the United States (MIDUS) national study of health, begun over 20 years ago and now encompassing over 12,000 Americans followed through time. The overarching principle behind the MIDUS enterprise is that deeper understanding of why some individuals remain healthy and well as they move across the decades of adult life, while others succumb to differing varieties of disease, dysfunction, or disability, requires a commitment to comprehensiveness that attends to the interplay of multiple interacting influences. Put another way, all of the disciplines mentioned have reliably documented influences on health, but in and of themselves, each is inherently limited because it neglects factors known to matter for health outside the discipline’s purview. Integrative health science is the alternative seeking to overcome these limitations.

Author(s):  
Barry T. Radler ◽  
Gayle D. Love

The complexities of managing the data collection and data products in multidisciplinary, population-based longitudinal research on health are not readily apparent to those who use publicly available data. This chapter explores the behind-the-scenes details involved in conducting the Midlife in the United States (MIDUS) study. The objective is to explicate how such a complex investigation involving comprehensive biopsychosocial assessments, obtained on the same individuals followed repeatedly over time, is carried out. The MIDUS study includes multiple data collection projects, covering different domains of science. Such extensive data collection must be carefully sequenced and distributed across different data collection sites, while recognizing that the longitudinal research data life cycle is iterative in nature. The overarching goals are to ensure the integrity of the data collection process while generating data products that are discoverable, understandable, and well documented to promote robust primary and secondary usage of publicly available datasets.


Author(s):  
Robert F. Krueger ◽  
Susan C. South

This chapter focuses on genetically informative research design and strategy in integrative health science (IHS). A feature of IHS is studying individual differences in health outcomes together and in a multidisciplinary manner. The chapter focuses on the advantages of using genetically informative research strategies for IHS. Genetically informative strategies are tools to enrich inferences within the IHS paradigm. They help parse the meaning of observed associations between exposures and outcomes. Two strategies are considered for the Midlife in the United States study : (1) Gene × Environment interactions and (2) correlations between education and allostatic load. A strategy likely to be employed in IHS research involves using segments of RNA to understand mechanisms underlying health and illness, focusing on the conserved transcriptional response to adversity (CTRA). The conclusion is that IHS and genetically informative research strategies are natural allies in understanding origins of health and illness in the population at large.


2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Pablo Vidal-Ribas ◽  
Theemeshni Govender ◽  
Rajeshwari Sundaram ◽  
Roy H. Perlis ◽  
Stephen E. Gilman

AbstractMost suicide research focuses on acute precipitants and is conducted in high-risk populations. Yet, vulnerability to suicide is likely established years prior to its occurrence. In this study, we aimed to investigate the risk of suicide mortality conferred by prenatal sociodemographic and pregnancy-related factors. Offspring of participants (N = 49,853) of the Collaborative Perinatal Project, a U.S. population-based cohort of pregnancies enrolled between 1959 and 1966, were linked to the U.S. National Death Index to determine their vital status by the end 2016. We examined associations between sociodemographic factors during pregnancy, pregnancy complications, labor and delivery complications, and neonatal complications with suicide death coded according to ICD-9/10 criteria. By the end of 2016, 3,555 participants had died. Of these, 288 (214 males, 74 females) died by suicide (incidence rate = 15.6 per 100,000 person-years, 95% Confidence Interval [CI] = 13.9–17.5). In adjusted models, male sex (Hazard Ratio [HR] = 2.98, CI: 2.26–3.93), White race (HR = 2.14, CI = 1.63–2.83), low parental education (HR = 2.23, CI = 1.38–3.62), manual parental occupation (HR = 1.38, CI = 1.05–1.82), being a younger sibling (HR = 1.52, CI = 1.10–2.11), higher rates of pregnancy complications (HR = 2.36, CI = 1.08–5.16), and smoking during pregnancy (HR = 1,28, CI = 0.99–1.66) were independently associated with suicide risk, whereas birth and neonatal complications were not. Consistent with the developmental origins of psychiatric disorders, vulnerability to suicide mortality is established early in development. Both sociodemographic and pregnancy factors play a role in this risk, which underscores the importance of considering life course approaches to suicide prevention, possibly including provision of high-quality prenatal care, and alleviating the socioeconomic burdens of mothers and families.


2019 ◽  
Vol 156 (6) ◽  
pp. S-837-S-838
Author(s):  
Emad Mansoor ◽  
Chiara Maruggi ◽  
Mohannad Abou Saleh ◽  
Gerard A. Isenberg ◽  
Richard C. Wong ◽  
...  

2019 ◽  
Vol 156 (6) ◽  
pp. S-724
Author(s):  
Emad Mansoor ◽  
Mohammed Z. Sheriff ◽  
Mohannad Abou Saleh ◽  
Emi Hayashi ◽  
Maneesh Dave ◽  
...  

2021 ◽  
pp. bmjspcare-2021-002952
Author(s):  
Gabrielle Emanuel ◽  
Julia Verne ◽  
Karen Forbes ◽  
Luke Hounsome ◽  
Katherine E Henson

BackgroundGood end-of-life care is essential to ensure dignity and comfort in death. To our knowledge, there has not been a national population-based study in England of community prescribing of all drugs used in end-of-life care for patients with cancer.Methods57 632 people who died from malignant cancer in their own home or in a care home in 2017 in England were included in this study. National routinely collected data were used to examine community prescriptions dispensed for drugs for symptom control and anticipatory prescribing by key sociodemographic factors in the last 4 months of life.Results94% of people who died received drugs to control their symptoms and 65% received anticipatory prescribing. Prescribing increased for the symptom control drug group (53% to 75%) and the anticipatory prescribing group (4% to 52%) over the 4-month period to death.ConclusionsMost individuals who died of cancer in their own home or a care home were dispensed drugs commonly used to control symptoms at the end of life, as recommended by best-practice guidance. Lower prescribing activity was found for those who died in a care home, highlighting a potential need for improved end-of-life service planning.


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