Evaluating sociodemographic, behavioral and psychologic disparities in 918 head and neck cancer survivors.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e17541-e17541
Author(s):  
Andrew T Day ◽  
Anupama Vasudevan ◽  
Erin Wynings ◽  
Sanjana Balachandra ◽  
Saad A. Khan ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Psychological Distress ◽  
Depressive Symptoms ◽  
Tobacco Use ◽  
Low Income ◽  
Serious Psychological Distress ◽  
Poverty Threshold ◽  
Income Status ◽  
Current Tobacco ◽  
Age And Sex

e17541 Background: Minority race, low-income status, tobacco dependence, alcohol abuse, and depression negatively impact overall survival among head and neck cancer (HNC) survivors. Understanding the prevalence and associations of these factors will inform the development of targeted HNC survivorship interventions. Methods: We pooled cross-sectional samples of HNC patients participating in the National Health Interview Survey from 1997-2016. Descriptive statistics were used to compare: 1) HNC survivors to age- and sex-matched adults without cancer (1:4) and 2) behavioral and psychologic conditions in HNC survivors by income status. Results: Mean age of the 918 HNC survivors was 64.8 years and 65.2% were male. Most HNC survivors were non-Hispanic white (85.3%); 7.6% were non-Hispanic black, 4.9% were Hispanic, and 2.2% were of other race and ethnicity. A substantial portion reported income below the poverty threshold (13.9%) and 5.0% consumed > 14 alcoholic drinks per week. Compared to adults without cancer (n = 3,612), a higher proportion (p < 0.05) of HNC survivors (n = 903) exhibited: current tobacco use (21.3% vs 17.4%); serious psychological distress (Kessler-6 score of ≥13; 6.9% vs 3.9%); depressive symptoms most or all of the time (14.1% vs 8.9%). There were particularly striking differences in the prevalence of these factors among HNC survivors by income. Specifically, a higher proportion of HNC survivors with income below the poverty threshold (n = 133) were non-Hispanic black (15.5% vs 5.8%) and exhibited current tobacco use (42.9% vs 18.6%), serious psychological distress (17.4% vs 5.7%) and depressive symptoms most or all of the time (25.3% vs 12.7%) compared to those at or above the poverty threshold (n = 646; all p < 0.05). Conclusions: HNC survivors experience a disproportionate burden of behavioral and psychologic health conditions compared to age- and sex-matched adults without cancer. Low-income status exacerbates these disparities. HNC survivors, especially those in low-income settings, require comprehensive survivorship care targeting these needs.

scholarly journals Factors associated with serious psychological distress during the COVID-19 pandemic in Japan: a nationwide cross-sectional internet-based study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e051115
Author(s):  
Takashi Yoshioka ◽  
Ryo Okubo ◽  
Takahiro Tabuchi ◽  
Satomi Odani ◽  
Tomohiro Shinozaki ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Low Income ◽  
Income Level ◽  
Economic Situation ◽  
Serious Psychological Distress ◽  
Sampling Weights ◽  
Cross Sectional ◽  
Caregiving Burden ◽  
Targeted Interventions ◽  
Factors Associated

ObjectiveTo investigate the factors associated with serious psychological distress (SPD) during the COVID-19 pandemic in Japan.DesignNationwide cross-sectional study using survey data.SettingInternet survey using sampling weights for national estimates conducted between 25 August and 30 September 2020 in Japan.ExposuresDemographics (age, gender), socioeconomic status (income level, employment type, educational attainment, marital status, family composition and caregiving burden); the experience of domestic violence (DV), the state of emergency and fear of and stigma related to COVID-19.Main outcome measuresPrevalence of SPD, defined as Kessler 6 Scale score ≥13.ResultsAmong 25 482 respondents, 10.0% met the criteria of SPD. Overall, women (adjusted OR (aOR) 1.59; 95% CI 1.17 to 2.16; p=0.003), ages 15–29 (aOR 2.35 compared with ages 45–59 years; 95% CI 1.64 to 3.38; p<0.001), low-income level (aOR 1.70 compared with intermediate income; 95% CI 1.16 to 2.49; p=0.007), providing caregiving to family members (aOR 5.48; 95% CI 3.51 to 8.56; p<0.001), experiencing DV (aOR 5.72; 95% CI 3.81 to 8.59; p<0.001) and fear of COVID-19 (aOR 1.96; 95% CI 1.55 to 2.48; p<0.001) were associated with SPD. Among women aged 15–29 years, who have a higher risk of suicide during the COVID-19 pandemic in Japan, caregiving, DV, fear of COVID-19 and COVID-19-related stigma were associated with SPD.ConclusionsEconomic situation, caregiving burden, DV and fear of COVID-19 were independently associated with SPD during the COVID-19 pandemic. Among young women, similar factors, except economic situation, were associated with SPD. Targeted interventions based on age and gender may be more effective in mitigating the negative impact of the COVID-19 pandemic on the population’s mental health.

Abstract 070: Community-based, Cluster Randomized Controlled Trial Increases Physical Activity In Diverse, Low Income Older Adults Over 2-year Period

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Katie Crist ◽  
Fatima Tuz Zahra ◽  
Kelsie M Full ◽  
Marta M Jankowska ◽  
Loki Natarajan
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Randomized Controlled Trial ◽  
Depressive Symptoms ◽  
Low Income ◽  
Controlled Trial ◽  
Community Based ◽  
Randomized Controlled ◽  
Income Status ◽  
Cluster Randomized

Objective: Older adults are the least active population group in the U.S. Low income and ethnically diverse communities have fewer physical activity (PA) related resources and facilities, which contributes to lower PA levels and disparities in cardiovascular (CVD) risk factors and disease outcomes. This study assessed the hypothesis that low income and diverse older adults participating in the multilevel Peer Empowerment Program 4 Physical Activity (PEP4PA) would increase moderate-to-vigorous PA (MVPA), improve blood pressure (BP), perceived quality of life (PQoL), and depressive symptoms to a greater extent than older adults receiving usual senior center programming. Methods: In a cluster-randomized controlled trial (RCT) in 12 senior centers, 476 older adults (mean age 71.4 years, 76% female, 60% low income, 38% minority) were assigned to a PA intervention (n=267) or control (n=209) condition. The peer-led intervention included individual self-monitoring and counseling, group walks and social support, and community advocacy to improve walking conditions. Outcomes included minutes of MVPA per day (7-day accelerometer), systolic and diastolic BP (automatic cuff), PQoL (PQoL-20) and depressive symptoms (CES-D 10) at baseline, 6, 12, 18 and 24 months. To account for multiple measurement days and clustering of participants within senior centers, mixed effects regression models with random effects estimated the intervention effects on all outcomes between groups over time. Models were adjusted for imbalanced baseline covariates. A three-way interaction term assessed whether intervention effects differed by income status. Results: Compared to the control group, intervention participants significantly increased MVPA from baseline at 6, 12, 18 and 24 months by 8, 11, 9 and 9 minutes/day respectively (p<0.001), with increases remaining statistically significant across the 2-year period. The intervention group significantly increased mean PQoL scores from 7.2 at baseline to 7.6 (p<0.001), 7.8 (p=0.008) and 7.7 (p<0.001) at 12, 18 and 24 months, compared to control participants. No significant effects were observed for BP or depressive symptoms. Low income participants decreased minutes of MVPA, compared to higher income participants, at 12 and 24 months (β=-7.9, p=0.008 and β=-10.8, p=0.001). Conclusions: The multilevel RCT achieved sustained increases in MVPA and QoL in a diverse cohort of older adults across 2 years of follow up. The peer-led, community-based intervention provides a sustainable model to improve health behaviors related to CVD in an at-risk and often difficult to reach aging population. Further exploration is needed to understand what components of the intervention may be modified to address the differential effects by income status.

Prevalence and Risk Factors for Food Insecurity Among Low-Income US Military Veterans

2021 ◽  
pp. 003335492097466
Author(s):  
Jennifer A. Pooler ◽  
Mithuna Srinivasan ◽  
Zachary Miller ◽  
Paula Mian
Keyword(s):  
Psychological Distress ◽  
Food Insecurity ◽  
Low Income ◽  
Well Being ◽  
Veterans Health ◽  
Health Providers ◽  
Participation Rates ◽  
Serious Psychological Distress ◽  
Poverty Level ◽  
Assistance Program

Objective Ensuring access to sufficient foods at all times is critical to veterans’ health and well-being. Food insecurity has not been well explored in the veteran population. We examined the prevalence and predictors of food insecurity among low-income veterans, because the highest rates of food insecurity are among low-income households. We also examined rates of Supplemental Nutrition Assistance Program (SNAP) participation among subgroups at the highest risk of food insecurity. Methods We used univariate analyses and 2011-2017 National Health Interview Survey (NHIS) data on veterans aged ≥21 with family incomes <200% of the federal poverty level to estimate the prevalence of food insecurity. We used bivariate analyses to identify correlates of food insecurity and estimate SNAP participation rates among subgroups of low-income veterans. Percentages were weighted using NHIS survey weights. Results Of 5146 low-income veterans, 22.5% reported being food insecure in the previous month. Food insecurity was significantly associated with being aged <65 (33.0% aged 45-64 and 29.7% aged 21-44) compared with 15.0% and 6.4% among veterans aged 65-74 and ≥75, respectively ( P < .001); unemployed compared with employed or not in the labor force (39.4%, 22.7%, and 20.2%, respectively; P < .001); in fair or poor health compared with good, very good, or excellent heath (31.8% vs 18.2%; P < .001); and having experienced serious psychological distress in the past month (56.3%) compared with not having experienced such distress (19.7%; P < .001). Although overall SNAP participation among low-income veterans was estimated to be 27.0%, participation rates were highest among veterans who had experienced serious psychological distress (44.1%), were unemployed (39.2%), and were renting their home (39.0%). Conclusions Some low-income veterans are at greater risk of food insecurity than other veterans. Postseparation programs, civilian support services, and veterans’ health providers should be aware of the characteristics that place veterans at highest risk of food insecurity.

scholarly journals Depressive and Anxiety Symptom Assessment in Adults with Polycystic Ovarian Syndrome

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Wadha K. Almeshari ◽  
Alanoud K. Alsubaie ◽  
Reham I. Alanazi ◽  
Yara A. Almalki ◽  
Nazish Masud ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Low Income ◽  
Anxiety Symptom ◽  
Polycystic Ovarian Syndrome ◽  
Anxiety Symptoms ◽  
Reproductive Age ◽  
Depression And Anxiety ◽  
Cross Sectional ◽  
Income Status ◽  
Ovarian Syndrome

Background. Polycystic ovarian syndrome (PCOS) is an endocrinopathic disorder commonly affecting women in the reproductive age. These women have a possibility of developing depression and anxiety due to biochemical changes, concerns regarding physical appearance, and social pressure from infertility. Thus, the connection between PCOS, anxiety, and depression has a possible impact on patients’ quality of life. This study is aimed at assessing depression and anxiety symptoms among PCOS patients and their association with different socioeconomic aspects. Methods. A cross-sectional study was conducted to assess depression and anxiety symptoms on 250 PCOS patients which were selected through consecutive sampling technique. Arabic versions of the HAM-A and HAM-D questionnaires were used alongside a demographic sheet to determine the socioeconomic and fertility status. Results. Prevalence of anxiety symptoms was reported among 100 (40%) of women and was found to be significantly higher in single women with a prevalence of 59 (48%) ( χ 2 = 5.8 , p value <0.01). Also, lower-income status and unemployment were associated with a significantly higher prevalence of anxiety 18 (67%) ( χ 2 = 10.3 , p value =0.03) and 71 (45%) ( χ 2 = 4.5 , p value =0.03) women, respectively. Depressive symptoms were reported among 122 (49%) participants. Conclusion. Single marital status, low income, and unemployment were predictors of anxiety. Tension was noted to be the most common anxiety symptom among participants while depressed mood and psychological anxiety were the most reported depressive symptoms. It is important to note the link between anxiety, PCOS, and depression when deciding treatment plans for affected women.

scholarly journals Alcohol Use and Misuse Among School-Going Adolescents in Thailand: Results of a National Survey in 2015

2019 ◽  
Vol 16 (11) ◽  
pp. 1898 ◽  
Author(s):  
Supa Pengpid ◽  
Karl Peltzer
Keyword(s):  
Psychological Distress ◽  
Alcohol Use ◽  
Tobacco Use ◽  
Parental Support ◽  
Older Age ◽  
The Past ◽  
Physical Fight ◽  
School Truancy ◽  
Current Tobacco ◽  
Current Alcohol

The aim of this study was to assess the prevalence of alcohol use and misuse, and to identify its associated factors among in-school adolescents in the 2015 Thailand Global School-based Student Health Survey (GSHS). The sample included 5994 school-going adolescents (mean age 14.5 years, SD = 1.7) from Thailand that responded to the 2015 GSHS. Overall, 22.2% were current alcohol users, 24.3% had ever been drunk, 12.1% had drunk two or more alcoholic drinks in a day in the past 30 days and 10.8% had gotten into trouble because of drinking alcohol. In adjusted Poisson regression analysis, older age, psychological distress, current tobacco use, the consumption of one or more soft drinks a day, school truancy, having been in a physical fight in the past 12 months, and having been seriously injured in the past 12 months were associated with current alcohol use. Older age, psychological distress, current tobacco use and injury also increased the odds for lifetime drunkenness, having two or more drinks in a day and trouble resulting from drinking. Soft drink consumption and having been in a physical fight also increased the odds for lifetime drunkenness and having two or more drinks in a day and school truancy also increased the odds for lifetime drunkenness and trouble resulting from drinking. In addition. Parental tobacco use was associated with lifetime drunkenness and trouble resulting from drinking, cannabis use with trouble resulting from drinking, and parental support was protective from trouble resulting from drinking. There were no significant sex differences regarding any of the four alcohol use indicators. More than one in five school-going adolescents in Thailand use and misuse alcohol, and strategies to prevent alcohol misuse, including a cluster of risk behaviours, are needed.

scholarly journals Hispanics/Latinos' Cigarette and E-cigarette Use: Behavioral and Self-rated Health

2021 ◽  
Vol 45 (1) ◽  
pp. 95-110
Author(s):  
Virmarie Correa-Fernández ◽  
Niloofar Tavakoli ◽  
Marshall Motsenbocker ◽  
Hanjoe Kim
Keyword(s):  
Multinomial Logistic Regression ◽  
Vulnerable Groups ◽  
Cigarette Use ◽  
Serious Psychological Distress ◽  
Dual Use ◽  
Self Rated Health ◽  
Tobacco Cigarette ◽  
Current Tobacco ◽  
Dual User ◽  
Age And Sex

Objectives: In this paper, we examine if serious psychological distress (SPD), binge drinking, and self-rated health predict dual-use of tobacco cigarette and e-cigarette compared with no use or the use of only one product among Hispanics/Latinos (H/L). By increasing our understanding of determinants of dual-use, we can identify the most vulnerable groups and intervention targets. Methods: We used data from H/L who were current tobacco/nicotine users in the Houston Health Survey 2018 (N = 188; representing 158,369 individuals). We conducted descriptive, bi-variate, and multinomial logistic regression analyses, and moderation by age and sex. Results: H/L with SPD were more likely to be dual-users than non-users (Odds Ratio [OR] = 1.97), cigarette users (OR = 1.12), or e-cigarette users (OR = 2.44). Individuals who binge drank were more likely to be dual-users than non-users (OR = 2.66) or e-cigarette users (OR = 9.30), but more likely to be cigarette users compared to dual-users (OR = 2.05). Poorer self-rated health predicted an increased likelihood of being a non-user (OR = 1.19), cigarette user (OR = 1.36), and e-cigarette user compared to a dual-user (OR = 1.04). Conclusions: Behavioral health and self-rated health are important predictors of tobacco cigarette, e-cigarette, and dual-use among H/L. These relationships differ by age and sex.

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