Intimate Partner Relationships and Health

Author(s):  
Deborah Carr ◽  
Dawne M. Mouzon

The linkages between intimate relationships and superior physical and mental health are well documented. Contemporary scholars explore under what conditions, for which outcomes, for whom, and through which pathways marriage and other intimate partnerships affect health. The chapter summarizes conceptual frameworks for understanding marriage and health, and contemporary empirical studies yielding four main discoveries: Relationship status is powerfully linked to health in cross-sectional studies, yet weaker associations are found in longitudinal studies that account for social selection; the protective effects of romantic partnerships vary based on characteristics of the union; the marriage–health nexus varies based on gender, race, and age; and (d) integrative science approaches have advanced understanding of the pathways linking social relationships to health. The review draws on population-based longitudinal studies, notably the Midlife in the United States (MIDUS) study. Implications of contemporary research on marriage and health for policy and practice are highlighted.

Author(s):  
Hui Liu ◽  
Ning Hsieh ◽  
Zhenmei Zhang ◽  
Yan Zhang ◽  
Kenneth M Langa

Abstract Objectives We provide the first nationally representative population-based study of cognitive disparities among same-sex and different-sex couples in the United States. Methods We analyzed data from the Health and Retirement Study (2000–2016). The sample included 23,669 respondents (196 same-sex partners and 23,473 different-sex partners) aged 50 and older who contributed to 85,117 person-period records (496 from same-sex partners and 84,621 from different-sex partners). Cognitive impairment was assessed using the modified version of the Telephone Interview for Cognitive Status. Mixed-effects discrete-time hazard regression models were estimated to predict the odds of cognitive impairment. Results The estimated odds of cognitive impairment were 78% (p < .01) higher for same-sex partners than for different-sex partners. This disparity was mainly explained by differences in marital status and, to a much lesser extent, by differences in physical and mental health. Specifically, a significantly higher proportion of same-sex partners than different-sex partners were cohabiting rather than legally married (72.98% vs. 5.42% in the study sample), and cohabitors had a significantly higher risk of cognitive impairment than their married counterparts (odds ratio = 1.53, p < .001). Discussion The findings indicate that designing and implementing public policies and programs that work to eliminate societal homophobia, especially among older adults, is a critical step in reducing the elevated risk of cognitive impairment among older same-sex couples.


Rheumatology ◽  
2020 ◽  
Vol 59 (9) ◽  
pp. 2556-2562 ◽  
Author(s):  
Raúl Cortés Verdú ◽  
José M Pego-Reigosa ◽  
Daniel Seoane-Mato ◽  
Mercedes Morcillo Valle ◽  
Deseada Palma Sánchez ◽  
...  

Abstract Objectives Prevalence of SLE varies among studies, being influenced by study design, geographical area and ethnicity. Data about the prevalence of SLE in Spain are scarce. In the EPISER2016 study, promoted by the Spanish Society of Rheumatology, the prevalence estimate of SLE in the general adult population in Spain has been updated and its association with sociodemographic, anthropometric and lifestyle variables has been explored. Methods Population-based multicentre cross-sectional study, with multistage stratified and cluster random sampling. Participants were contacted by telephone to carry out a questionnaire for the screening of SLE. Investigating rheumatologists evaluated positive results (review of medical records and/or telephone interview, with medical visit if needed) to confirm the diagnosis. To calculate the prevalence and its 95% CI, the sample design was taken into account and weighing was calculated considering age, sex and geographic origin. Multivariate logistic regression models were defined to analyse which sociodemographic, anthropometric and lifestyle variables included in the telephone questionnaire were associated with the presence of SLE. Results 4916 subjects aged 20 years or over were included. 16.52% (812/4916) had a positive screening result for SLE. 12 cases of SLE were detected. The estimated prevalence was 0.21% (95% CI: 0.11, 0.40). SLE was more prevalent in the rural municipalities, with an odds ratio (OR) = 4.041 (95% CI: 1.216, 13.424). Conclusion The estimated prevalence of SLE in Spain is higher than that described in most international epidemiological studies, but lower than that observed in ethnic minorities in the United States or the United Kingdom.


2019 ◽  
Vol 33 (8) ◽  
pp. 1123-1133 ◽  
Author(s):  
Liana DesHarnais Bruce ◽  
Joshua S. Wu ◽  
Stuart L. Lustig ◽  
Daniel W. Russell ◽  
Douglas A. Nemecek

Purpose: To inform health behavior intervention design, we sought to quantify loneliness and its correlates, including social media use, among adults in the United States. Design: Cross-sectional research panel questionnaire. Setting: Responses were gathered from individuals in all 50 states surveyed via Internet from February 2018 to March 2018. Participants: A total of 20 096 US panel respondents aged 18+. Measures: The University of California at Los Angeles (UCLA) Loneliness Scale (theoretical score range = 20-80) was administered along with demographic, structural, cognitive, and behavioral items. Analysis: After calibrating the sample to population norms, we conducted multivariable linear regression analysis. Results: The overall mean survey-weighted loneliness score was 44.03 (standard error = 0.09). Social support (standardized β [sβ] = −0.19) and meaningful daily interactions (sβ = −0.14) had the strongest associations with lower loneliness, along with reporting good relationships, family life, physical and mental health, friendships, greater age, being in a couple, and balancing one’s daily time. Social anxiety was most strongly associated with greater loneliness (sβ = +0.20), followed by self-reported social media overuse (sβ = +0.05) and daily use of text-based social media (sβ = +0.03). Conclusion: Our findings confirm that loneliness decreases with age, and that being in a relationship as well as everyday behavioral factors in people’s control are most strongly related to loneliness. Population health promotion efforts to reduce loneliness should focus on improving social support, decreasing social anxiety, and promoting healthy daily behaviors.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Nigel Teo ◽  
Pei Shi Yeo ◽  
Qi Gao ◽  
Ma Shwe Zin Nyunt ◽  
Jie Jing Foo ◽  
...  

Abstract Background Few empirical studies support a bio-psycho-social conceptualization of frailty. In addition to physical frailty (PF), we explored mental (MF) and social (SF) frailty and studied the associations between multidimensional frailty and various adverse health outcomes. Methods Cross-sectional and longitudinal analyses were conducted using data from a population-based cohort (SLAS-1) of 2387 community-dwelling Singaporean Chinese older adults. Outcomes examined were functional and severe disability, nursing home referral and mortality. PF was defined by shrinking, weakness, slowness, exhaustion and physical inactivity, 1–2 = pre-frail, 3–5 = frail; MF was defined by ≥1 of cognitive impairment, low mood and poor self-reported health; SF was defined by ≥2 of living alone, no education, no confidant, infrequent social contact or help, infrequent social activities, financial difficulty and living in low-end public housing. Results The prevalence of any frailty dimension was 63.0%, dominated by PF (26.2%) and multidimensional frailty (24.2%); 7.0% had all three frailty dimensions. With a few exceptions, frailty dimensions share similar associations with many socio-demographic, lifestyle, health and behavioral factors. Each frailty dimension varied in showing independent associations with functional (Odds Ratios [ORs] = 1.3–1.8) and severe disability prevalence at baseline (ORs = 2.2–7.3), incident functional disability (ORs = 1.1–1.5), nursing home referral (ORs = 1.5–3.4) and mortality (Hazard Ratios = 1.3–1.5) after adjusting for age, gender, medical comorbidity and the two other frailty dimensions. The addition of MF and SF to PF incrementally increased risk estimates by more than 2 folds. Conclusions This study highlights the relevance and utility of PF, MF and SF individually and together. Multidimensional frailty can better inform policies and promote the use of targeted multi-domain interventions tailored to older adults’ frailty statuses.


Author(s):  
Shervin Assari ◽  
Mohsen Bazargan

Background: Although other mechanisms are also involved, at least one reason high educational attainment (EA) is associated with better health is lower employment stress in individuals with high EA. Minorities’ Diminished Returns, however, refer to the smaller protective health effects of EA for racial- and ethnic-minority individuals, particularly African Americans (AAs) and Hispanics, as compared to Whites. We are, however, not aware of many studies that have explored differential associations between EA and work-related stress across racial and ethnic groups. Aims: We aimed to compare racial and ethnic groups for the association between EA and occupational stress in a national sample of American adults. Methods: The National Health Interview Survey (NHIS 2015), a cross-sectional survey, included 15,726 employed adults. Educational attainment was the independent variable. Occupational stress was the outcome. Race and ethnicity were the moderators. Age, gender, number of jobs, and years in the job were the covariates. Results: Overall, higher EA was associated with lower levels of occupational stress. Race and ethnicity both interacted with EA, suggesting that the association between high EA and reduced occupational stress is systemically smaller for AAs and Hispanics than it is for Whites. Conclusions: In the United States, race and ethnicity limit the health gains that follow EA. While EA helps individuals avoid environmental risk factors, such as occupational stress, this is more valid for non-Hispanic Whites than AAs and Hispanics. The result is additional physical and mental health risks in highly educated AAs and Hispanics. The results are important, given racial and ethnic minorities are the largest growing section of the US population. We should not assume that EA is similarly protective across all racial and ethnic groups. In this context, EA may increase, rather than reduce, health disparities.


2020 ◽  
Vol 11 ◽  
Author(s):  
Isabel Hurtado ◽  
Aníbal García-Sempere ◽  
Salvador Peiró ◽  
Gabriel Sanfélix-Gimeno

Background: The opioid epidemic has been extensively documented in the United States and Canada, but fewer data are available for Europe.Aim: To describe the trends in opioid use—volume of prescriptions, dosage and number of patients treated—in a Spanish population with more than 4.2 million inhabitants aged 18 years and older.Patients and Methods: Population-based cross-sectional analysis of opioid prescription in adults (≥18 years) from January 1, 2010 to December 31, 2018 in the region of Valencia, Spain. Outcomes were estimated on an annual basis: number of prescriptions, prescription rate per 100 inhabitants, dosage per capita (morphine mg equivalents, MME/c) and volume of patients treated (overall and by drug).Results: Over the study period, 2,107,756 unique patients were prescribed more than 35 million total treatments. The yearly number of treatments doubled, and total MME/c showed almost a threefold increase. Fentanyl MME/c more than tripled, accounting for 34.4% of the total MME/c in 2018. Oxycodone MME/c showed a 10-fold increase, while tapentadol, launched in 2011, showed the highest growth rates. The annual number of patients receiving at least one opioid prescription more than doubled, from 335,379 in 2010 to 722,838 in 2018.Conclusions: Even if proportions still seem far from epidemic, urgent research is warranted on the observed patterns of use, their appropriateness and their association with health and safety outcomes, especially for high-use and high-strength drugs.


2013 ◽  
Vol 21 (2) ◽  
pp. 119-139 ◽  
Author(s):  
Sachiko Inoue ◽  
Takashi Yorifuji ◽  
Masumi Sugiyama ◽  
Toshiki Ohta ◽  
Kazuko Ishikawa-Takata ◽  
...  

Few epidemiological studies have examined the potential protective effects of physical activity on insomnia. The authors thus evaluated the association between physical activity and insomnia in a large population-based study in Shizuoka, Japan. Individual data were obtained from participants in an ongoing cohort study. A total of 14,001 older residents who completed questionnaires were followed for 3 yr. Of these, 10,211 and 3,697 participants were eligible for the cross-sectional and longitudinal analyses, respectively. The authors obtained information about the frequency of physical activity and insomnia. Then, the adjusted odds ratios and 95% confidence intervals between physical activity and insomnia were estimated. Habitual physical activity was related to lower prevalence of insomnia. Frequent physical activity also reduced the incidence of insomnia, especially difficulty maintaining sleep. For elderly people with sufficient mobility and no preexisting disease, high-frequency physical activity (e.g., 5 or more days/wk) may help reduce insomnia.


PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261059
Author(s):  
Zarintaj Malihi ◽  
Janet L. Fanslow ◽  
Ladan Hashemi ◽  
Pauline Gulliver ◽  
Tracey McIntosh

Background There is limited information about what influences help-seeking following experience of intimate partner violence (IPV). This study investigated determinants of formal and informal help-seeking by those who had experienced lifetime physical, sexual or psychological IPV. Methods A cross-sectional population-based New Zealand study conducted from 2017 to 2019 recruited 2,887 participants (1,464 women and 1,423 men) aged 16 years and older. Face-to-face interviews were conducted. Of these, 1,373 participants experienced physical, sexual or psychological IPV. Two series of logistic regressions were conducted: 1) comparing those who sought help with those who did not, and 2) comparing those who had not sought help with those who sought informal help only, or with those who also sought formal help. Results Of the 1,373 participants who reported experience of physical, sexual or psychological IPV 835 participants (71.3% of women and 49.0% of men) sought some form of help. In both genders self-reported physical and mental health or work-related IPV impacts were significantly associated with help-seeking. Experiencing only one form of IPV was associated with lower odds of seeking formal help by women (Adjusted odds ratio = 0.38; 95%CI = 0.15, 0.92 for physical/sexual only and AOR = 0.37, 95%CI = 0.22, 0.64 for psychological only) compared to those experiencing concurrent types of IPV. Conclusion and implications Although there were gender differences in help-seeking, for both women and men the experience of greater impacts associated with IPV exposure increased the likelihood of help-seeking. Agencies providing services for people who are experiencing IPV need to be equipped to identify and respond to multiple forms of IPV, and prepared to address the suite of impacts experienced.


2019 ◽  
Vol 4 (3) ◽  
pp. 86-91 ◽  
Author(s):  
Shervin Assari ◽  
Mohsen Bazargan

Background: As suggested by the Minorities’ Diminished Returns (MDRs) theory, educational attainment shows a weaker protective effect for racial and ethnic minority groups compared to non-Hispanic Whites. This pattern, however, is never shown for hospitalization risk. Objectives: This cross-sectional study explored racial and ethnic variations in the association between educational attainment and hospitalization in the United States. Methods: Data came from the National Health Interview Survey (NHIS 2015). The total sample was 28,959 American adults. Independent variable was educational attainment. The main outcome was hospitalization during the last 12 months. Age, gender, employment, marital status, region, obesity, and number of cardiovascular conditions were covariates. Race and ethnicity were the effect modifiers. Logistic regression models were utilized to analyze the data. Results: From all participants, 16.2% were Black and 11.6% were Hispanic with a mean age of 51 years. Overall, higher education levels were associated with lower odds of hospitalization, independent of all confounders. Educational attainment showed significant interactions with race (odds ratio [OR] =1.04, 95% CI = 1.01-1.08) and ethnicity (OR = 1.04, 95% CI =1.01-1.07) on hospitalization, indicating smaller protective effects of educational attainment on hospitalization of Hispanics and Blacks than nonHispanic Whites. Conclusion: The protective effects of educational attainment on population health are smaller for Blacks and Hispanics compared to non-Hispanic Whites. To prevent health disparities, the diminished returns of educational attainment should be minimized for racial and ethnic minorities. To do so, there is a need for innovative and bold economic, public, and social policies that do not limit themselves to equalizing socioeconomic status, but also help minorities leverage their available resources and gain tangible outcomes.


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