Racial Discrimination and Uptake of Dental Services among American Adults

This study examined the relationship between racial discrimination and use of dental services among American adults. We used data from the 2014 Behavioral Risk Factor Surveillance System, a health-related telephone cross-sectional survey of a nationally representative sample of adults in the United States. Racial discrimination was indicated by two items, namely perception of discrimination while seeking healthcare within the past 12 months and emotional impact of discrimination within the past 30 days. Their association with dental visits in the past year was tested in logistic regression models adjusting for predisposing (age, gender, race/ethnicity, income, education, smoking status), enabling (health insurance), and need (missing teeth) factors. Approximately 3% of participants reported being discriminated when seeking healthcare in the past year, whereas 5% of participants reported the emotional impact of discrimination in the past month. Participants who experienced emotional impact of discrimination were less likely to have visited the dentist during the past year (Odds Ratios (OR): 0.57; 95% CI 0.44–0.73) than those who reported no emotional impact in a crude model. The association was attenuated but remained significant after adjustments for confounders (OR: 0.76, 95% CI 0.58–0.99). There was no association between healthcare discrimination and last year dental visit in the fully adjusted model. Emotional impact of racial discrimination was an important predictor of use of dental services. The provision of dental health services should be carefully assessed after taking account of racial discrimination and its emotional impacts within the larger context of social inequalities.

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E-cigarette use frequency by smoking status among youth in the United States, 2014-2019

10.1101/2020.05.07.20094185 ◽

2020 ◽

Author(s):

Jamie Tam

Keyword(s):

United States ◽

Smoking Status ◽

The United States ◽

Self Report ◽

Cigarette Use ◽

Cross Sectional Survey ◽

Cross Sectional ◽

The Past ◽

Former Smokers ◽

Never Smokers

AbstractAimsTo report annual 2014-2019 youth estimates of past 30-day e-cigarette use frequency by smoking status in the United States (US).DesignWeighted prevalence estimates of student’s e-cigarette use using the 2014-2019 National Youth Tobacco Surveys (NYTS). For each year, t-tests for significance were used to compare estimates with those from the preceding year; t-tests were not performed on data for 2019 due to the change in survey format from paper to electronic.SettingThe NYTS is an annual school-based cross-sectional survey of US middle school (MS) and high school (HS) students.Participants117,472 students.MeasurementsSelf-report of past 30 day e-cigarette use based on students’ smoking status. Smoking status is assessed by asking if students have ever tried smoking, “even one or two puffs”, with never smokers responding “no”. Former smokers respond “yes” but have not smoked at all in the past 30 days. Current smokers used cigarettes at least once in the past 30 days. Frequent e-cigarette use is defined as use on ≥20 days in the past month.FindingsPast 30-day and frequent e-cigarette use increased among never, former, and current smoker youth from 2014-2019. In 2019, a greater proportion of current smokers used e-cigarettes frequently (HS = 46.1%, 95% CI: 39.1, 53.2; MS = 27.4%, 95% CI: 21.1, 33.6) compared to former smokers (HS = 23.2%, 95% CI: 18.1, 28.2; MS = 10.9%, 95% CI: 6.1, 15.7) and never smokers (HS = 3.7%, 95% CI: 3.0, 4.3; MS = 0.7%, 95% CI: 0.4, 0.9). From 2018 to 2019, the total number of youth using e-cigarettes frequently who were never smokers (2018: 180,000; 2019: 490,000) or former smokers (2018: 260,000; 2019: 640,000) surpassed that of current smokers (2018: 420,000; 2019: 460,000).ConclusionsThe proportion and number of never smoker youth using e-cigarettes frequently increased greatly since 2014.

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Do Socioeconomic Conditions Explain Ethnic Inequalities in Tooth Loss among US Adults?

Ethnicity & Disease ◽

10.18865/ed.28.3.201 ◽

2018 ◽

Vol 28 (3) ◽

pp. 201

Author(s):

Fatma W. Nazer ◽

Wael Sabbah

Keyword(s):

Ethnic Differences ◽

Tooth Loss ◽

Family Income ◽

The United States ◽

Outcome Variable ◽

Behavioral Risk ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Logistic Regression Models ◽

Ethnic Inequalities

Objective: To assess whether there are ethnic differences in tooth loss among adult Americans aged <40 years and whether socioeconomic position attenuates these differences if they exist.Methods: Data were from the 2014 Behavioral Risk Factor Surveillance System, a health-related telephone cross-sectional survey of a nationally representative sample of US adults. Tooth loss (one tooth or more) was used as the outcome variable. Ethnicity was the main explanatory variable. Family income, education and health insurance were also used in the analysis. Logistic regression models for tooth loss were constructed adjusting for demographic (age, sex, and ethnicity), socioeconomic indicators (income and education), health insurance, dental visits, smoking and diabetes.Results: A total of 76,273 participants were included in the analysis. The prevalence of tooth loss was highest among Blacks (33.7%). Hispanics and other ethnic groups had a higher prevalence of tooth loss than Whites, 29.1% (95%CI: 27.7-30.6), 22.0% (95%CI: 20.3-23.8), and 20.8% (95%CI: 20.2-21.4), respectively. Blacks had odds ratios (OR) 1.98 (95%CI: 1.81-2.16) for tooth loss compared with Whites. After adjusting for socioeconomic positions (SEP), the relationship attenuated but remained significant with OR 1.71 (95%CI: 1.55-1.90).Conclusions: Despite recent changes in the health care system in the United States, ethnic inequalities in tooth loss still exist. Income and education partially explained ethnic differences in tooth loss among Americans aged <40 years.Ethn Dis. 2018;28(3):201-206; doi:10.18865/ ed.28.3.201

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E-Cigarette Advice to Patients From Physicians and Dentists in the United States

American Journal of Health Promotion ◽

10.1177/0890117117710876 ◽

2017 ◽

Vol 32 (5) ◽

pp. 1228-1233 ◽

Cited By ~ 5

Author(s):

Olivier Drouin ◽

Robert C. McMillen ◽

Jonathan D. Klein ◽

Jonathan P. Winickoff

Keyword(s):

United States ◽

The United States ◽

Fisher Exact Test ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Exact Test ◽

The Past ◽

Random Digit Dialing ◽

Potential Benefits ◽

Nationally Representative

Purpose: To report on adults’ recall of discussion by physicians and dentists about e-cigarettes. Design: A nationally representative cross-sectional survey (Internet and random digit dialing) in the United States. Participants: Adults who ever used e-cigarettes. Measures: Participant-reported discussion about the potential benefits and harms of e-cigarettes with their doctor, dentist, or child’s doctor in the past 12 months. Analysis: Fisher exact test for the analysis between benefits and harms for each type of provider and for rates of advice between provider types. Results: Among the 3030 adults who completed the survey, 523 (17.2%) had ever used e-cigarettes. Of those who had seen their doctor, dentist, or child’s doctor in the last year, 7.3%, 1.7%, and 10.1%, respectively, reported discussing potential harms of e-cigarettes. Conversely, 5.8%, 1.7%, and 9.3% of patients who had seen their doctor, dentist, or child’s doctor in the last year reported that the clinician discussed the potential benefits of e-cigarettes. Each clinician type was as likely to discuss harms as benefits. Rates of advice were similar between doctors and child’s doctors but lower for dentists. Rates were comparable when the analysis was limited to current e-cigarette users, participants with children, or those who reported using both e-cigarettes and combusted tobacco. Conclusions: Few physicians and dentists discuss either the harms or benefits of e-cigarettes with their patients. These data suggest an opportunity to educate, train, and provide resources for physicians and dentists about e-cigarettes and their use.

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Family Role towards Smoking Behaviour among Children in Jakarta

Kesmas National Public Health Journal ◽

10.21109/kesmas.v9i1.457 ◽

2014 ◽

Vol 9 (1) ◽

pp. 58 ◽

Cited By ~ 1

Author(s):

Wahyu Septiono ◽

Dan Wolf Meyrowitsch

Keyword(s):

Smoking Status ◽

Parental Control ◽

Smoking Habit ◽

Total Sample ◽

Smoking Behaviour ◽

Intervention Programs ◽

Cross Sectional Survey ◽

Cross Sectional ◽

The Past ◽

Parental Approval

In Indonesia, the prevalence of smoking among 5 – 9 years old children has increased from 0.4% in 2001 to 2% in 2007. Among present adults smokers (>20 years), 17% started to smoke before the age of 13 years. This study identified factors related to smoking behaviour among 8 – 12 years old children in Jakarta, Indonesia using a questionnaire based cross sectional survey to obtain smoking status and possible predictors towards smoking habit. The total sample size was 1,097 students among 3rd - 7th grade students from schools in Jakarta. Self-reported smoking status was defined as whether the child had smoked tobacco within the past two months prior to the interview. The prevalence of smoking was 13.4%. Logistic regression analysis showed that high parental approval on tobacco use (OR=13.4; CI 95%: 5.1 – 35.1) was the strongest predictor on children smoking status, followed by low parental control (OR=12.1; CI 95%: 6.9 – 21.2), being a male compared to a female (OR=10.7; CI 95%: 5.3 – 21.7), mother (OR=10.58; CI 95%: 3.96 – 28.28), father (OR=7.69; CI 95%: 3.59 – 16.47), sibling (OR=7.91; CI 95%: 4.41 – 14.17) smoking status. Smoking parents and siblings, low parental control, and high parental approval on smoking were related to higher odds of smoking among children. The results were used as a rationale for suggestions and recommendations of relevance for future intervention programs and tobacco related research with specific focus on children.Prevalensi anak perokok umur 5-9 tahun di Indonesia meningkat dari 0,4% di tahun 2001 menjadi 2% di tahun 2007. Tujuh belas persen perokok dewasa menyatakan mulai merokok ketika berumur di bawah 13 tahun. Penelitian ini bertujuan untuk menentukan faktor terkait perilaku merokok anak umur 8-12 tahun di Jakarta dengan menggunakan pendekatan potong lintang untuk menjaring perokok anak dan faktor yang mungkin menyebabkan perilaku tersebut. Kuesioner digunakan untuk menjaring status perilaku merokok anak dalam dua bulan terakhir sebelum survei. Total 1.097 murid kelas 3 sampai 7 di Jakarta menjadi sampel penelitian dengan 13,4% responden merokok dalam 2 bulan terakhir. Analisis regresi logistik menunjukkan bahwa pembolehan merokok di dalam rumah oleh orang tua (OR=13,4; CI 95%: 5,1 – 35,1) menjadi penyebab terkuat, diikuti dengan rendahnya kontrol orang tua (OR=12,1; CI 95%: 6,9 – 21,2), siswa laki-laki (OR=10,7; CI 95%: 5,3 – 21,7), ibu (OR=10.58; CI 95%: 3.96 – 28.28), ayah (OR=7,69; CI 95%: 3,59 – 16,47), dan saudara kandung yang perokok (OR=7,91; CI 95%: 4,41 – 14,17). Orang tua dan saudara kandung yang merokok, rendahnya pengawasan orang tua, dan tingginya pembolehan merokok di dalam rumah menjadi penyebab perilaku merokok anak umur 8- 12 tahun. Hasil penelitian dapat dimanfaatkan sebagai rekomendasi untuk program intervensi di masa depan dan penelitian terkait tembakau dengan fokus kepada anak-anak.

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Is Racial Discrimination Associated with Number of Missing Teeth Among American Adults?

Journal of Racial and Ethnic Health Disparities ◽

10.1007/s40615-020-00891-8 ◽

2020 ◽

Author(s):

Malini Muralikrishnan ◽

Wael Sabbah

Keyword(s):

Racial Discrimination ◽

Ethnic Differences ◽

Tooth Loss ◽

Healthcare Facility ◽

Emotional Impact ◽

Missing Teeth ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Risk Factor Surveillance ◽

Nationally Representative

Abstract Objective The objectives of this study are to assess the association of racial discrimination with tooth loss among American adults and whether this relationship, if existed, explains ethnic differences in tooth loss. Methods Data is from the Behavioural Risk Factor Surveillance System (BRFSS) 2014, a cross-sectional survey of a nationally representative sample of American adults. The survey included data on sociodemographic characteristics, behaviour, health insurance and number of missing teeth. The survey also included questions on whether a person was treated differently because of his/her race. Logistic regression analysis was conducted to assess the relationship between tooth loss and indicators of discrimination. We also examined the relation between ethnicity and indicators of discrimination. Results The analysis included 4858 participants aged 18 to 44 years. Tooth loss (> one tooth) was reported by 26% of participants. Among those reporting discrimination at healthcare facility, there was 141% increase in tooth loss compared to those not reporting discrimination. Discrimination at work and emotional impact of discrimination were both significantly associated with tooth loss in the partially adjusted models. Accounting for discrimination slightly attenuated ethnic differences in too loss. Black Americans had significantly higher odds for reporting all types of discrimination used here. Conclusion This study demonstrated a potential role for discrimination in tooth loss among American adults. Discrimination could also explain part of ethnic inequalities in oral health.

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Anxiety is associated with undesirable eating behaviors in university students during the COVID-19 pandemic

10.21203/rs.3.rs-148637/v1 ◽

2021 ◽

Author(s):

Kathryn E Coakley ◽

Huyen Le ◽

Spirit Rae Silva ◽

Aspen Wilks

Keyword(s):

Eating Behaviors ◽

The United States ◽

Eating Attitudes ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Professional Students ◽

The Past ◽

Severe Anxiety ◽

Satiety Responsiveness ◽

Food Fussiness

Abstract Background COVID-19 has impacted mental health globally, however, relationships between anxiety and eating behaviors during the pandemic have not been explored. This study evaluated anxiety, eating attitudes and behaviors, and associations between anxiety and eating behaviors in students at a large public University in the United States during the COVID-19 pandemic. Methods Current undergraduate and graduate/professional students completed a cross-sectional survey in fall 2020. Demographic information, indicators of anxiety in the past two weeks assessed by the Generalized Anxiety Disorder Screener (GAD-7), and eating behaviors assessed by the Adult Eating Behavior Questionnaire (AEBQ) were evaluated. A score ≥ 10 on the GAD-7 indicated anxiety (≥ 15 indicated severe anxiety). Eating behaviors were reported via Likert scale and combined into eight AEBQ subscales; subscale mean and standard deviation were reported. Differences in mean AEBQ subscale scores were examined between participants with and without anxiety via Mann-Whitney U tests. Multivariate linear regression was utilized to examine associations between GAD-7 score and individual AEBQ subscale scores, adjusting for age, gender, race/ethnicity, and student status. Results The final sample included 1243 students (57% undergraduates). In the full sample, 51.9% experienced anxiety in the past two weeks; 24.6% had severe anxiety. Subgroups with the highest prevalence of anxiety included non-cisgender participants (73.6%), the youngest age group [18–20 years of age (62%)], undergraduate students (60.7%), and Hispanic/Latino participants (57.5%). Participants with anxiety had significantly lower AEBQ scores for enjoyment of food and significantly higher scores for emotional over and under-eating, food fussiness, food and satiety responsiveness, and hunger than those with no anxiety (p < 0.01). In adjusted analyses, GAD-7 score was significantly and positively associated with hunger, food responsiveness, emotional over-eating, satiety responsiveness, and food fussiness and negatively associated with enjoyment of food. Conclusions The prevalence of anxiety is overwhelming in undergraduate and graduate/professional students amidst the COVID-19 pandemic. Eating behaviors differ significantly in those with anxiety; increasing anxiety severity was associated with undesirable eating behaviors including hunger and emotional over-eating. Universities and health professionals must consider strategies to address anxiety, particularly in younger students, non-cis-gender students, and across race/ethnicities keeping in mind associations between anxiety and eating behaviors.

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Differential Effects of Personal-Level vs Group-Level Racial Discrimination on Health among Black Americans

Ethnicity & Disease ◽

10.18865/ed.26.3.453 ◽

2016 ◽

Vol 26 (3) ◽

pp. 453 ◽

Cited By ~ 9

Author(s):

Nao Hagiwara ◽

Courtney J. Alderson ◽

Briana Mezuk

Keyword(s):

Mental Health ◽

Physical Health ◽

Racial Discrimination ◽

Black Americans ◽

The United States ◽

Group Level ◽

Physical And Mental Health ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Personal Level

Objective: Racial/ethnic minorities in the United States not only experience discrimination personally but also witness or hear about fellow in-group members experiencing discrimination (ie, group-level discrimination). The objective of our study was to examine whether the effects of group-level discrimination on mental and physical health are different from those of personal level discrimination among Black Americans by drawing upon social psychology research of the Personal/Group Discrimination Discrepancy. Design and Setting: We conducted a secondary analysis of cross-sectional survey data from a larger study. Participants: One hundred and twenty participants, who self-identified as Black/ African Americans during the laboratory sessions (57.5% women, mean age = 48.97, standard deviation = 8.58) in the parent study, were included in our analyses. Main Predictor Measures: Perceived personal- level discrimination was assessed with five items that were taken from two existing measures, and group-level racial discrimination was assessed with three items. Main Outcome Measures: Self-reported physical and mental health were assessed with a modified version of SF-8. Results: Perceived personal-level racial discrimination was associated with worse mental health. In contrast, perceived group-level racial discrimination was associated with better mental as well as physical health. Conclusions: Perceived group-level racial discrimination may serve as one of several health protective factors even when individuals perceive personal-level racial discrimination. The present findings demonstrate the importance of examining both personal- and group-level experiences of racial discrimination as they independently relate to health outcomes for Black Americans. Ethn Dis. 2016;26:453-460; doi:10.18865/ ed.26.3.453

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Acculturation and Cancer Risk Behaviors among Pacific Islanders in Hawaii

Ethnicity & Disease ◽

10.18865/ed.30.4.593 ◽

2020 ◽

Vol 30 (4) ◽

pp. 593-602

Author(s):

Kevin Cassel ◽

Mark Willingham ◽

Hye-ryeon Lee ◽

Lilnabeth P. Somera ◽

Grazyna Badowski ◽

...

Keyword(s):

Cancer Risk ◽

Risk Behaviors ◽

Information Seeking ◽

The United States ◽

Pacific Islanders ◽

Behavioral Risk ◽

Cancer Knowledge ◽

Cross Sectional Survey ◽

Cross Sectional ◽

And Behaviors

Background: To communicate research to the public, the National Cancer Institute developed the Health Information National Trends Survey (HINTS). However, as with most national health surveillance, including the Behavioral Risk Factor Surveillance System, HINTS data are not sufficient to address unique demographic subpopulations such as US Pacific Islanders (PIs). National sampling methods do not adequately reach participants from small, medically underserved populations.Aim: This study aims to document the cancer-relevant knowledge, attitudes, behaviors, and information-seeking practices of PIs in Hawaii (HI).Methods: We conducted a cross-sectional survey during 2017-2018 of Native Hawaiians, Chuukese, and Marshallese in HI using Respondent Driven Sampling (RDS) to recruit these geographically diffuse groups. The modified HINTS survey included questions about cancer knowledge, attitudes and behaviors, health communications, and cultural practices.Results: A total of 515 Native Hawaiians, 305 Chuukese, and 180 Marshallese completed the survey. Differences were found across a variety of cancer-related attitudes, knowledge, and behaviors. These groups also differed regarding acculturation, health locus of control, and trust in medical professionals. Native Hawaiians were significantly more acculturated (P=.0001) than Chuukese or Marshallese and more likely to smoke cigarettes (P=.0001). Among participants aged >50 years, we found no significant differences across ethnic groups (P=.30) for those completing a colon cancer screening (37%). However, only 27% were referred to screening by a physician.Conclusions: Cancer prevention programs are greatly needed for PIs in HI. This study provides knowledge concerning the efficiency of RDS to recruit participants, and the role of culture in communications influencing cancer risk behaviors, which may be generalizable to migrant PIs in the United States. Ethn Dis. 2020;30(4):593- 602; doi:10.18865/ed.30.4.593

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The Impact of COVID-19 Safety Recommendations on Adults Age 60 and Older: A Qualitative Study

Innovation in Aging ◽

10.1093/geroni/igaa057.3506 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 959-959

Author(s):

Kerstin Emerson ◽

Deborah Kim ◽

George Mois ◽

Jenay Beer

Keyword(s):

Older Adults ◽

Qualitative Study ◽

Positive Emotions ◽

The United States ◽

Coping Mechanisms ◽

Emotional Impact ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Social Distancing ◽

The Impact

Abstract In March 2020, the United States Centers for Disease Control (CDC) began recommending social distancing and sheltering in place, in particular for older adults. This resulted in many older adults staying at home for long periods of time in relative isolation. Because there is little prior evidence of the emotional impact that this has on older adults, we conducted an exploratory qualitative study on how older adults felt during the first three to five weeks of the CDC recommendations. We fielded a web-based cross-sectional survey. Our analytic sample consisted of 673 respondents aged 60 and older who respondent to the prompt: “How are you feeling during this time of social distancing?”. We used a thematic bottom-up qualitative analysis, via MAXQDA, to analyze segments into general affect codes and detailed emotion subcodes, as well as coping mechanisms. Results showed that while many older adults reported neutral (9%) or positive (9%) affect, a larger proportion reported negative affect (42%) or reported mixed affect (35%). The most common negative emotions mentioned were anxiety and loneliness/boredom, while the most common positive emotions mentioned were optimism and feeling grateful. The most common coping mechanisms reported by participants included making life adjustments, keeping busy, prayer/spirituality, and mediation/mindfulness. This study provides an initial understanding into how older adults experienced and coped with the first stages of restricting social interactions. If social distancing continues to be a recommended disease-containment strategy, information about how older adults are coping can be critical for public health interventions. Implications will be discussed.

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Effect of depression on health behavior among myocardial infarction survivors in the United States

Mental Health Clinician ◽

10.9740/mhc.2020.07.222 ◽

2020 ◽

Vol 10 (4) ◽

pp. 222-231

Author(s):

Brooke Nicholson ◽

Shawn Morse ◽

Terra Lundgren ◽

Nina Vadiei ◽

Sandipan Bhattacharjee

Keyword(s):

Physical Activity ◽

United States ◽

Myocardial Infarction ◽

Health Behavior ◽

Health Behaviors ◽

Smoking Status ◽

The United States ◽

Blood Cholesterol ◽

Behavioral Risk ◽

Cross Sectional

Abstract Introduction The purpose of this study was to evaluate the effect of depression on health behavior among myocardial infarction (MI) survivors. Methods This retrospective, cross-sectional study used publicly available 2015 Behavioral Risk Factor Surveillance System (BRFSS) data. Our study sample includes adults aged 50 years or older who completed the 2015 BRFSS survey and reported having MI. The BRFSS participants with a yes response to the question, Has a doctor, nurse, or other health care professional ever told you that you had a heart attack, also called a myocardial infarction? were identified as MI survivors. The presence or absence of depression among MI survivors was identified using a similar question. Health behaviors, the dependent variable of this study, included physical activity, smoking status, alcohol use, body mass index, last flu immunization, last physical checkup, last blood cholesterol check, heavy drinking, and vegetable and fruit consumption. Univariate (χ2 tests) and multivariable (binomial logistic regression) analyses were used to assess the differences in health behaviors between MI survivors with or without depression. Results Our final study sample consists of 20 483 older adults with MI among whom 5343 (26.19%) reported having depression. Multivariable analyses reveal MI survivors with depression are more overweight, have less physical activity, and have higher likelihood of smoking but less odds of consuming alcohol compared to MI survivors without depression. Discussion In this nationally representative sample of adults aged over 50 years in the United States, MI survivors with depression exhibited poorer health behaviors compared to those without depression.

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