scholarly journals Combined Effects of Race and Socioeconomic Status on Cancer Beliefs, Cognitions, and Emotions

Healthcare ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 17 ◽  
Author(s):  
Shervin Assari ◽  
Pegah Khoshpouri ◽  
Hamid Chalian
Keyword(s):  
Socioeconomic Status ◽  
Educational Attainment ◽  
Low Income ◽  
Perceived Risk ◽  
Structural Equation ◽  
Structural Equation Models ◽  
The United States ◽  
Racial Gap ◽  
Cancer Beliefs ◽  
Risk Of Cancer

Aim: To determine whether socioeconomic status (SES; educational attainment and income) explains the racial gap in cancer beliefs, cognitions, and emotions in a national sample of American adults. Methods: For this cross-sectional study, data came from the Health Information National Trends Survey (HINTS) 2017, which included a nationally representative sample of American adults. The study enrolled 2277 adults who were either non-Hispanic Black (n = 409) or non-Hispanic White (n = 1868). Race, demographic factors (age and gender), SES (i.e., educational attainment and income), health access (insurance status, usual source of care), family history of cancer, fatalistic cancer beliefs, perceived risk of cancer, and cancer worries were measured. We ran structural equation models (SEMs) for data analysis. Results: Race and SES were associated with perceived risk of cancer, cancer worries, and fatalistic cancer beliefs, suggesting that non-Hispanic Blacks, low educational attainment and low income were associated with higher fatalistic cancer beliefs, lower perceived risk of cancer, and less cancer worries. Educational attainment and income only partially mediated the effects of race on cancer beliefs, emotions, and cognitions. Race was directly associated with fatalistic cancer beliefs, perceived risk of cancer, and cancer worries, net of SES. Conclusions: Racial gap in SES is not the only reason behind racial gap in cancer beliefs, cognitions, and emotions. Racial gap in cancer related beliefs, emotions, and cognitions is the result of race and SES rather than race or SES. Elimination of racial gap in socioeconomic status will not be enough for elimination of racial disparities in cancer beliefs, cognitions, and emotions in the United States.

Disentangling food insecurity and maternal depression: Which comes first?

2021 ◽  
pp. 1-21
Author(s):  
Layton Reesor-Oyer ◽  
Aliye B. Cepni ◽  
Che Young Lee ◽  
Xue Zhao ◽  
Daphne C. Hernandez
Keyword(s):  
Food Insecurity ◽  
Maternal Depression ◽  
Low Income ◽  
Structural Equation ◽  
Structural Equation Models ◽  
Short Form ◽  
Composite International Diagnostic Interview ◽  
The United States ◽  
Time Points ◽  
The Impact

Abstract Objective: To determine the temporal directionality of the association between food insecurity and maternal depression. Design: Food insecurity was measured at two time points using the 18-item USDA Food Security Scale. Maternal depression was measured at two time points using the 15-item Composite International Diagnostic Interview-Short Form. Two structural equation models were utilized to evaluate the impact of food insecurity on maternal depression (model 1) and the impact of maternal depression on food insecurity (model 2). Both models controlled for socio-demographic and parenting characteristics and child behavior problems, along with prior measures of the dependent variable, concurrent measures of the independent variable. Setting: Fragile Families and Child Wellbeing (FFCW) study, 20 cities across the United States Participants: 4,897 mothers who participated in two waves of the FFCW study. Results: On average, 17% (time 1) and 15% (time 2) of mothers experienced food insecurity and 21% (time 1) and 17% (time 2) of mothers experienced depression over time. Maternal depression at time 1 was associated with 53% increased odds (OR=1.53; B=0.43; p <.001) of food insecurity at time 2, controlling for time 1 food insecurity, concurrent depression, and covariates. Food insecurity at time 1 was associated with 36% increased odds (OR=1.36; B=0.31; p <.001) of maternal depression at time 2, controlling for time 1 depression, concurrent food insecurity, and covariates. Conclusions: We found a bidirectional relationship between food insecurity and maternal depression. A holistic approach that combines food assistance and mental health services may be an efficacious approach to reducing both depressive symptoms food insecurity among low-income mothers.

scholarly journals Educational Attainment, Literacy Skills, Nativity, and Motivation to Learn Among Middle-Aged Adults in the United States

2021 ◽  
pp. 104515952110485
Author(s):  
Shalini Sahoo ◽  
Roberto J. Millar ◽  
Takashi Yamashita ◽  
Phyllis A. Cummins
Keyword(s):  
United States ◽  
Educational Attainment ◽  
Structural Equation ◽  
Structural Equation Models ◽  
The United States ◽  
Literacy Skills ◽  
Motivation To Learn ◽  
Foreign Born ◽  
Middle Aged ◽  
Middle Aged Adults

Research on factors associated with motivation to learn (MtL) is limited, particularly among middle-aged adults and immigrants. This study examines educational attainment, literacy skills, and nativity (foreign-born vs. native-born) as predictors of MtL in middle-aged adults living in the United States. Nationally representative data of middle-aged adults between the ages of 40 and 65 years were obtained from the 2012/2014 Program for International Assessment of Adult Competencies (PIAAC). Structural equation models were used to assess the validity of the latent MtL construct and to examine the associations with the selected determinants in middle-aged adults. Postsecondary education degrees and higher literacy skills were linked with greater MtL. However, foreign-born individuals had lower MtL than their US-born counterparts. Educators and researchers should be aware of lower educational attainment, limited literacy skills, and being an immigrant as possible demoting factors of MtL, and in turn, barriers to lifelong learning participation among middle-aged adults.

Mental distress and its associations with behavioral outcomes during the COVID-19: A national survey of Chinese adults (Preprint)

2020 ◽  
Author(s):  
Lu Ma ◽  
Liwang Gao ◽  
Joseph Tak-Fai Lau ◽  
Rahman Atif ◽  
Blair T. Johnson ◽  
...  
Keyword(s):  
Physical Activity ◽  
Body Weight ◽  
Educational Attainment ◽  
Structural Equation ◽  
Online Survey ◽  
Mental Distress ◽  
Structural Equation Models ◽  
Behavioral Outcomes ◽  
National Sample ◽  
Negative Consequences

BACKGROUND This study primarily aimed to evaluate the associations between mental distress and COVID-19-related changes in behavioral outcomes, and potential modifiers (age, gender, and educational attainment) of such associations. OBJECTIVE The COVID -19 pandemic has led to elevated levels of mental distress attributed to prolonged lockdowns, business closures, and social isolation. Its impact on behavioral outcomes is however less known. This study is designed to primarily evaluate the associations between mental distress and COVID-19-related changes in drinking, smoking, physical activity and body weight, and potential modifiers of such associations including age, gender, and educational attainment. METHODS An online survey using anonymous network sampling was conducted in China during April-May, 2020 using a 74-item questionnaire distributed through social media. A national sample of 10,545 adults in 31 provinces provided data on socio-demographic characteristics, COVID-19-related mental distress, and changes in behavioral outcomes. Structural equation models were used for data analyses. RESULTS About 13% of adults reported experiencing at least one symptom of mental distress. After adjusting for age, education, gender, ethnicity, marital status, residence, and number of chronic conditions, greater mental distress was associated with increased smoking and alcohol consumption (among current smokers and drinkers) and with both increased and decreased physical activity. Underweight adults were more likely to lose body weight (≥1 kg) whereas overweight adults were more likely to gain weight by the same amount. The association between mental distress and change in physical activity was stronger in adults aged 40 and above and those with high education. Mental distress was significantly associated with an increase in smoking in males but not females. CONCLUSIONS Mental distress was associated with increased smoking in males but not females. These findings inform the design of tailored public health interventions aimed to mitigate long-term negative consequences of mental distress on outcomes.

Suicidal Ideation Among International Students: The Role of Cultural, Academic, and Interpersonal Factors

2021 ◽  
pp. 001100002110024
Author(s):  
Andrés E. Pérez Rojas ◽  
Na-Yeun Choi ◽  
Minji Yang ◽  
Theodore T. Bartholomew ◽  
Giovanna M. Pérez
Keyword(s):  
International Students ◽  
Suicidal Ideation ◽  
Structural Equation ◽  
Structural Equation Models ◽  
The United States ◽  
Cross Cultural ◽  
Thwarted Belongingness ◽  
Perceived Burdensomeness ◽  
Using Data

We examined two structural equation models of international students’ suicidal ideation using data from 595 international students in two public universities in the United States. The models represented competing hypotheses about the relationships among discrimination, cross-cultural loss, academic distress, thwarted belongingness, perceived burdensomeness, and suicidal ideation. The findings indicated there were direct, positive links between discrimination, cross-cultural loss, and academic distress to perceived burdensomeness; a direct, positive link between perceived burdensomeness and suicidal ideation; and indirect, positive links between discrimination, cross-cultural loss, and academic distress to suicidal ideation via perceived burdensomeness. The only predictors that related to thwarted belongingness were cross-cultural loss and academic distress, and there were no indirect links to suicidal ideation via thwarted belongingness. In fact, with all other variables in the model, thwarted belongingness was unrelated to suicidal ideation. Finally, academic distress was directly related to suicidal ideation. We discuss implications of the findings.

Predictors of Unmet Dental Health Needs in US Adults in 2018: A Cross-Sectional Analysis

2021 ◽  
pp. 238008442110356
Author(s):  
D.J. Gaskin ◽  
H. Zare ◽  
R. McCleary ◽  
O. Kanwar ◽  
A.L. Davis
Keyword(s):  
Socioeconomic Status ◽  
Oral Health ◽  
Low Socioeconomic Status ◽  
Low Income ◽  
The United States ◽  
Permanent Teeth ◽  
Dental Visit ◽  
Low Socioeconomic ◽  
The Past ◽  
Dental Needs

Objective: To identify predictors of unmet dental needs for adults 18 y of age or older in the United States. Method: Using the Aday and Andersen framework and data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS), we ran logistic regression to estimate predictors for adults of not having a dental visit within 5 y and having lost any teeth using a national sample of 155,060 survey respondents. Results: Results showed that predisposing factors (age, race/ethnicity, gender, and educational attainment) and enabling factors (income and health insurance status) are important predictors for losing teeth due to decay or gum disease. Men, the elderly, and less educated and low-income residents were less likely to have seen a dentist within the past 5 y and more likely to have lost their permanent teeth. Compared to non-Hispanic White adults, Hispanics adults were more likely to have had a dental visit within the past 5 y. Unmet dental needs varied across states. People living in states with extensive Medicaid dental care benefit coverage were less likely to lose their teeth and more likely to have had a dental visit within the past 5 y. Conclusion: Efforts to improve oral health should address unmet dental needs of men and adults with low socioeconomic status. Studying the variation between state oral health care programs could further our understanding of how public policy can improve population oral health. Knowledge Transfer Statement: Men, non-Hispanic Blacks, mixed and other race minorities, and low socioeconomic status adults are most at risk of unmet dental needs. States can address these needs by expanding Medicaid coverage for adults.

scholarly journals Patient Engagement in Health Management as a Mediator Between Perceived Risk and COVID-19 Related Distress in Patients With IBD: A Structural Equation Model

2021 ◽  
Vol 12 ◽  
Author(s):  
Greta Castellini ◽  
Lorenzo Palamenghi ◽  
Mariarosaria Savarese ◽  
Serena Barello ◽  
Salvatore Leone ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Perceived Stress ◽  
Patient Engagement ◽  
Perceived Risk ◽  
Structural Equation ◽  
Structural Equation Models ◽  
Health Management ◽  
Equation Model ◽  
Online Questionnaire ◽  
The Impact

Objective: This study aimed to evaluate the impact of the COVID-19 emergency on patients with IBD's psychological distress, understanding the role of patient engagement as a mediator.Methods: An online questionnaire was created, measuring perceived risk susceptibility toward COVID-19, perceived stress, and patient engagement. The questionnaire was distributed to a purposive sample of IBD patients who belonged to the Italian Association for patients with IBD (AMICI Onlus) in April 2020. Structural equation models were implemented.Results: The effect of the perceived risk susceptibility toward COVID-19 contagion on the perceived stress is fully mediated by patient engagement (β = 0.306, p &lt; 0.001). Moreover, the patient engagement mitigates the perceived stress (β = −0.748, p &lt; 0.001) in our sample of IBD patients, and it is negatively influenced by the perceived risk susceptibility toward COVID-19 (β = −0.410, p &lt; 0.001).Conclusion: Patient engagement is the key factor that explains how the perceived risk susceptibility toward COVID-19 affects the perceived psychological distress in patients with IBD, underlining that the perceived risk of contagion increases their perceived level of stress through a decrease of patient engagement.

Constraints in the Demand for Education: What Can we Learn from Subjective Assessments?

2012 ◽  
Vol 12 (1) ◽  
Author(s):  
Olga V. Sorokina
Keyword(s):  
United States ◽  
Socioeconomic Status ◽  
Educational Attainment ◽  
Family Background ◽  
Credit Constraints ◽  
The United States ◽  
Economic Literature ◽  
Demand For Education ◽  
Subjective Assessments

Abstract While the large disparities in educational attainment by socioeconomic status in the United States point towards the importance of credit constraints, there is no consensus in the economic literature regarding their pervasiveness. To evaluate how subjective information can enhance our understanding of the role of credit constraints in education, I focus on NLSY79 respondents' assessments of financial obstacles to schooling. About 12 percent of young adults in the data expect to underinvest in education because of financial reasons or the need to work. Using this information in a regression model of educational attainment shows that it provides valuable behavioral insights, above and beyond standard measures of income and family background.

scholarly journals Impact of Socioeconomic Status and Race on Sepsis Epidemiology and Outcomes

2020 ◽  
Author(s):  
Emi Minejima ◽  
Annie Wong-Beringer
Keyword(s):  
Socioeconomic Status ◽  
Low Income ◽  
Formal Education ◽  
Geographic Location ◽  
The United States ◽  
Risk Scores ◽  
Low Ses ◽  
The Relationship ◽  
Poor Health Literacy ◽  
Hispanic White

Abstract Background Socioeconomic status (SES) is a complex variable that is derived primarily from an individual’s education, income, and occupation and has been found to be inversely related to outcomes of health conditions. Sepsis is the sixth most common admitting diagnosis and one of the most costly conditions for in-hospital spending in the United States. The objective of this review is to report on the relationship between SES and sepsis incidence and associated outcomes. Content Sepsis epidemiology varies when explored by race, education, geographic location, income, and insurance status. Sepsis incidence was significantly increased in individuals of Black race compared with non-Hispanic white race; in persons who have less formal education, who lack insurance, and who have low income; and in certain US regions. People with low SES are likely to have onset of sepsis significantly earlier in life and to have poorly controlled comorbidities compared with those with higher SES. Sepsis mortality and hospital readmission is increased in individuals who lack insurance, who reside in low-income or medically underserved areas, who live far from healthcare, and who lack higher level education; however, a person’s race was not consistently found to increase mortality. Summary Interventions to minimize healthcare disparity for individuals with low SES should target sepsis prevention with increasing measures for preventive care for chronic conditions. Significant barriers described for access to care by people with low SES include cost, transportation, poor health literacy, and lack of a social network. Future studies should include polysocial risk scores that are consistently defined to allow for meaningful comparison across studies.

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