Links between obesity, weight stigma and learning in adolescence: a qualitative study

Background Educational attainment is a key social determinant of health. Health and education are linked by multiple pathways, many of which are not well understood. One such pathway is the association between being above a healthy weight and lower academic achievement. While various explanations have been put forward to explain this relationship, evidence for causal pathways is sparse and unclear. This study addresses that evidence gap. Methods We interviewed 19 adults (late 20s; 14 female, 5 male) and one young person (14 years, male) from the UK in 2019/2020. Participants were recruited from the ALSPAC 1990s birth cohort, sampled to ensure diversity in socio-economic status and educational attainment, and a community-based weight management group for young people. Interviews focused on experiences of being above a healthy weight during secondary school and how this may have affected their learning and achievement. Interviews were face-to-face, digitally recorded, and transcribed verbatim. We analysed the data thematically. Results We identified key pathways through which higher body weight may negatively impact educational performance and showed how these are linked within a novel theoretical model. Because larger body size is highly stigmatised, participants engaged in different strategies to minimise their exposure to negative attention. Participants sought to increase their social acceptance or become less socially visible (or a combination of both). A minority navigated this successfully; they often had many friends (or the ‘right’ friends), experienced little or no bullying at school and weight appeared to have little effect on their achievement at school. For most however, the behaviours resulting from these strategies (e.g. disruptive behaviour, truanting, not working hard) or the physical, social or mental impacts of their school experiences (e.g. hungry, tired, self-conscious, depressed) made it difficult to concentrate and/or participate in class, which in turn affected how teachers viewed them. Conclusions Action to combat weight stigma, both within schools and in wider society, is urgently required to help address these educational disparities that in turn can impact health in later life.

Variation in US Drug Overdose Mortality Within and Between Hispanic/Latine Subgroups: A Disaggregation of National Data

This study examined differences across Latine heritage groups (i.e., Mexican, Puerto Rican, Cuban, Dominican, Central American, South American) in rates of US drug overdose mortality. The study utilized 2015-2019 mortality data from the National Center for Health Statistics for 29,137 Hispanic individuals who died of drug overdose. Using population estimates from the American Community Survey, age-standardized drug overdose mortality rates were calculated by specific Latine heritage and sex, nativity, educational attainment, and geographic region. Standardized rate ratios (SRRs), incidence rate ratios (IRRs) from negative binomial regression models, and 95% Confidence Intervals (CIs) were calculated, and multiple imputation was used for missing Latine heritage group in select models. Drug overdose mortality rates in the Puerto Rican heritage population were more than three times as high as in the Mexican heritage population (IRR 3.61 [95% CI 3.02-4.30] in unadjusted model; IRR 3.70 [95% CI 3.31-4.15] in model adjusting for age, sex, nativity, educational attainment, and region; SRR 3.23 [95% CI, 3.15-3.32] in age-standardized model with missing Hispanic heritage imputed). Higher age-standardized rates of drug overdose mortality were observed in males than females across all Latine groups, yet the magnitude of the sex differential varied by Latine heritage. The relationship between drug overdose mortality and nativity differed by Latine heritage; in all groups except Puerto Rican, overdose mortality rates were significantly higher in the US-born than those not US-born. In contrast, overdose mortality rates were significantly lower in US-born Puerto Ricans than in Puerto Ricans who were not US-born (e.g., born in Puerto Rico; SRR, 0.84 [95% CI 0.80-0.88]). The relationship between drug overdose mortality and educational attainment (for ages 25+) also varied between Latine groups. The diverse subgroups comprising the US Latine population vary not only in rates of drug overdose mortality, but also in demographic risk factors for fatal drug overdose.

Educational attainment, health outcomes and mortality: a within-sibship Mendelian randomization study

Previous Mendelian randomization (MR) studies using population samples (population-MR) have provided evidence for beneficial effects of educational attainment on health outcomes in adulthood. However, estimates from these studies may have been susceptible to bias from population stratification, assortative mating and indirect genetic effects due to unadjusted parental genotypes. Mendelian randomization using genetic association estimates derived from within-sibship models (within-sibship MR) can avoid these potential biases because genetic differences between siblings are due to random segregation at meiosis. Applying both population and within-sibship MR, we estimated the effects of genetic liability to educational attainment on body mass index (BMI), cigarette smoking, systolic blood pressure (SBP) and all-cause mortality. MR analyses used individual-level data on 72,932 siblings from UK Biobank and the Norwegian HUNT study and summary-level data from a within-sibship Genome-wide Association Study including over 140,000 individuals. Both population and within-sibship MR estimates provided evidence that educational attainment influences BMI, cigarette smoking and SBP. Genetic variant-outcome associations attenuated in the within-sibship model, but genetic variant-educational attainment associations also attenuated to a similar extent. Thus, within-sibship and population MR estimates were largely consistent. The within-sibship MR estimate of education on mortality was imprecise but consistent with a putative effect. These results provide evidence of beneficial individual-level effects of education (or liability to education) on adulthood health, independent of potential demographic and family-level confounders.

Depression symptoms and associated factors among thalassemia patients in the Palestinian Territories: a cross-sectional study

Background Thalassemia is a condition that causes the human body to destroy red blood cells faster than they can be made. It causes physical symptomology as well as psychological distress. The current study aimed to identify the prevalence of depression symptoms among individuals with moderate to severe thalassemia. A quantitative descriptive cross-sectional design was applied utilizing the Beck Depression Inventory to assess the level of depression in the sample. Results Some significant relationships were demonstrated in the sample: males reporting severe depression symptoms than females by 6.0 times (95% CI 0.07–0.62, p 0.014), and reporting moderate depression symptoms (95% CI 0.00–0.47, p 0.05). Additionally, income was found to be a predictor of level of depression symptoms with low income reported higher incidence of severe depression symptoms than those whose monthly income was > 400$ by 18.4 times (95% CI 0.38–1.03, p ≤ 0.001), but not reporting a significant association between moderate depressive symptoms and monthly income (95% CI − 012–1.47, P 0.225). A significant association was found between the educational attainment and level of depression symptoms with lower levels of education predicting higher levels of severe depression symptoms (95% CI 0.069–0.89, p 0.022), but no significant association was reported between moderate depression symptoms and educational attainment (95% CI − 0.49–0.01, p 0.81). Related to disease characteristics a relationship was confirmed between severe depressive symptoms and medication level such as the individual needing tablets or pumps (95% CI 0.189–1.05, p 0.005 and 95% CI 0.52–1.44, p 0.001) respectively. Other disease related variables showed no significant correlation with depressive symptom levels. Additional significant relationships were found in environment whereas increased moderate depressive symptoms were experienced by individuals residing in rural areas as opposed to those living in IDP camps or cities by 4 times (95% CI − 0.30–0.01, p 0.04), but no significant association was found between severe depression and the place of residence. The other independent variables had no significant correlation with severe or moderate depressive symptoms. Conclusion In light of these findings addressing symptoms of depression directly and supporting patients with thalassemia with basic life needs unrelated to their disease maybe mitigating depressive symptoms which may negatively affect recovery.

Effects of Educational Attainment and Housing Condition on Self-Rated Health in Old Age: Heterogeneity and Tendency in China

In China, the health of the elderly has long been discussed, but few have investigated the diversity of the aging pattern in later life of this population. Although a large body of literature has approved the positive association between socioeconomic status (SES) and health, it still remains controversial regarding whether the association becomes convergent or divergent in old ages. Using data from China's 2010 and 2015 Inter-census Survey (1‰ sample), this paper explored the role of two key SES indicators, educational attainment and housing condition in modifying the self-rated health of Chinese elders aged 60 and above. We observed the diversified patterns of how educational attainment and housing condition have made an impact on the health of these elders in their old age and the temporal changes of the two SES indicators. We found higher educational attainment and better housing condition can lead to higher self-rated health. This positive significance however diminished with age over time, as we observed from 2010 to 2015, indicating the convergent effects of SES on health in old age. We also found that although educational attainment and housing condition were both positively correlated with health, their effects were differentiated. The influence of educational attainment on health waxed, whereas on housing conditions waned over time. These findings suggested the heterogeneity of health and SES effects among Chinese elders.

Educational Attainment, Race, and Ethnicity as Predictors for Ideal Cardiovascular Health: From the National Health and Nutrition Examination Survey

Background Educational attainment is protective for cardiovascular health (CVH), but the benefits of education may not persist across racial and ethnic groups. Our objective was to determine whether the association between educational attainment and ideal CVH differs by race and ethnicity in a nationally representative sample. Methods and Results Using the National Health and Nutrition Examination Survey, we determined the distribution of ideal CVH, measured by Life’s Simple 7, across levels of educational attainment. We used multivariable ordinal logistic regression to assess the association between educational attainment (less than high school, high school graduate, some college, college graduate) and Life’s Simple 7 category (ideal, intermediate, poor), by race and ethnicity (Asian, Black, Hispanic, White). Covariates were age, sex, history of cardiovascular disease, health insurance, access to health care, and income–poverty ratio. Of 7771 National Health and Nutrition Examination Survey participants with complete data, as level of educational attainment increased, the criteria for ideal health were more often met for most metrics. After adjustment for covariates, effect of education was attenuated but remained significant ( P <0.01). Those with at least a college degree had 4.12 times the odds of having an ideal Life’s Simple 7 compared with less than high school (95% CI, 2.70–5.08). Among all racial and ethnic groups, as level of educational attainment increased, so did Life’s Simple 7. The magnitude of the association between education and CVH varied by race and ethnicity (interaction P <0.01). Conclusions Our findings demonstrate that educational attainment has distinct associations with ideal CVH that differs by race and ethnicity. This work demonstrates the need to elucidate barriers preventing individuals from racial and ethnic minority groups from achieving equitable CVH.

Modifiable risk factors for intracranial aneurysms: Evidence from genetic studies

Background: Intracranial aneurysm (IA) is a crucial health concern with limited strategies for prevention and treatment. Aim: To identify potentially modifiable risk factors, such as socioeconomic, behaviors, dietary, and cardiometabolic factors, for IA and its subtypes. Methods: Summary statistics for IA were derived from a genome-wide association study with an overall 79,429 participants. Single nucleotide polymorphisms associated with modifiable risk factors at genome-wide significance ( P = 5 × 10–8) were used as instrumental variables. The inverse-variance-weighted method, weighted-median method, Mendelian randomization (MR)-Egger regression, MR-Pleiotropy RESidual Sum and Outlier, and multivariable MR analyses were performed to evaluate the effect estimates. Results: Genetically predicted educational attainment, insomnia, smoking, and systolic and diastolic blood pressure (SBP and DBP) were significantly associated with the risk of IA. The odds ratios (ORs) were 0.44 (95% confidence interval (CI): 0.37–0.52) for educational attainment, 1.15 (95% CI: 1.08–1.23) for insomnia, 1.56 (95% CI: 1.38–1.75) for smoking initiation, 2.69 (95% CI: 1.77–4.07) for cigarette per day, 2.65 (95% CI: 1.72–4.08) for lifetime smoking, 1.07 (95% CI: 1.06–1.09), and 1.06 (95% CI: 1.04–1.10) for SBP and DBP, respectively. Similar effect estimates were observed for unruptured IAs and aneurysmal subarachnoid hemorrhage. Conclusions: This study provided genetic evidence that several modifiable risk factors, including blood pressure, smoking, educational attainment, and insomnia were associated with the risk of IA.