Incidence and Risk Factors for Progression to Diabetes Mellitus: A Retrospective Cohort Study

(1) Objective: This study examined the incidence and risk factors contributing to the progression to diabetes mellitus (DM) in a seven-year follow-up study of non-diabetic National Health Examinees. (2) Methods: For this retrospective observational cohort study, we used two national representative databases: the National Health Screening (HEALS) database 2009 and the National Health Insurance Service (NHIS) database 2009–2015. The eligible subjects without DM with blood sugar levels of <126 mg/dL were selected using the HEALS database. The subsequent follow-up and clinical outcomes were evaluated using the NHIS database. Cox proportional hazard regression was applied to examine the effects of the covariates on progression to diabetes. (3) Results: Among those who took part in the national health screening in 2009, 4,205,006 subjects who met the eligibility criteria were selected. Of these, 587,015 were diagnosed with DM during the follow-up by 2015. The incidence of progression from non-diabetes to DM was 14.0%, whereas that from impaired fasting glucose (IFG) to DM was 21.9%. Compared to the normal group, the newly diagnosed DM group was more likely to comprise older, female, currently smoking, and high-risk drinking participants and participants with IFG, hypertension, dyslipidemia, and metabolic syndrome. (4) Conclusions: This epidemiological study in the Republic of Korea found risk factors similar to those of other studies, but the incidence of progression to DM was 22.8 per 1000 person-years, which is higher than that previously reported. Hence, more care is needed to prevent DM.

Regional Disparity in Adult Obesity Prevalence, and Its Determinants

Objectives: The purpose of this study was to examine the factors affecting regional disparities in the prevalence of adult obesity.Methods: This study is an ecological study in which the unit of analysis were 229 local authorities (si = 78, gun = 82, and gu = 68). The data were obtained from database (ver 1.1) of community health outcomes and health determinants (2015-2017) and Community Health Survey data (2018-2019). Multiple regression analysis was used to identify factors related to the prevalence of obesity in 4 groups (all regions, si, gun, and gu).Results: The prevalence of regional obesity varied 23.5% to 45.15% with a mean of 34.13%. Obesity prevalence was highest in ‘gun’, and lowest in ‘gu’ area. In the overall model, sociodemographic characteristics including sex ratio (β= 0.26), household income over 3 million won (β= -0.23), and the unemployment (β= -0.18)), high-risk drinking (β= 0.18), and satisfaction with public transportation (β= -0.24) were associated with the prevalence of regional obesity. Other than those things, in ‘si’ area, population density, walking practice, in ‘gun’ area, participation in social activity were associated with the prevalence of regional obesity.Conclusions: To reduce obesity prevalence and it’s regional disparities, it is important to make intervention and prevention efforts taking into account the socioeconomic and physical environmental characteristics of the region as well as health behaviors.

Effect of Practicing Health Behaviors on Unmet Needs among Patients with Chronic Diseases: A Longitudinal Study

With the growing prevalence of chronic diseases, the proportion of unmet needs is increasing. In this study, we investigated the effect of practicing health behaviors on unmet needs among patients with chronic diseases, using data from the Korea Health Panel Survey conducted between 2014–2017. Participants (n = 4069) aged 19 or older, with at least one chronic disease (hypertension, diabetes mellitus, dyslipidemia, or arthrosis) and with existing follow up data were selected. Health behaviors combined three variables: not presently smoking, not belonging to high-risk drinking group, and indulging in moderate- or high-intensity exercise. Those who met all three criteria were classified as the practicing health behaviors group. Generalized Estimating Equation analysis was performed to consider correlated data within a subject. Of the participants, 23.9% practiced health behaviors. Participants who did not practice health behaviors were significantly more likely to have unmet needs compared with those who did (OR: 1.24, 95% CI: 1.10–1.39). Further research would be needed to verify the impact of practicing health behavior on unmet needs.

Young Adults’ Physical Distancing Behaviors During the Initial Months of the COVID-19 Pandemic: Adherence to Guidelines and Associations With Alcohol Use Behavior

Throughout the COVID-19 pandemic, the scientific and public health communities have become increasingly focused on understanding young adults’ physical distancing behaviors and the role that young adults have on viral potentiation and community spread. In the present study, we surveyed a group of 560 young adults (ages 22-28) from the greater Seattle area in April 2020, during statewide “shelter-in-place” recommendations, to examine young adults’ self-reported adherence to physical distancing guidelines. Self-report measures were used to identify strong adherers and poor adherers, which we then compared in terms of engagement in specific physical distancing behaviors and alcohol use behaviors pertaining to physical distancing adherence. We found that most young adults are classified as strong adherers, and that poor adherers reported more frequent violations of physical distancing guidelines including having friends over to their residence or going over to other residences. Poor adherers were also significantly more likely to engage in high-risk alcohol use behavior, such as heavy episodic drinking, compared to those young adults who were classified as strong adherers. Our results provide initial evidence that young adults who engage in high-risk drinking may be at greater risk for non-adherence to government recommended physical distancing guidelines. This deeper understanding of young adult behavior during the COVID-19 pandemic can better inform public health outreach to increase physical distancing adherence currently, as well as in preparation for future contagious health crises that may require societal-level adherence to behavioral guidelines.

Increases in Risky Drinking During the COVID-19 Pandemic Assessed via Longitudinal Cohort Design: Associations With Racial Tensions, Financial Distress, Psychological Distress and Virus-Related Fears

Background The COVID-19 pandemic has created disruptions to daily life resulting in wide-spread unemployment and psychological distress. Recent studies have reported high rates of alcohol use during this time; however, longitudinal data remain scarce and factors associated with increases in high-risk drinking observed over time are unknown. Aims The current study examined changes in high-risk drinking patterns across four 7-day observation periods, prior to and following a university wide campus closure. Additionally, factors associated with changes in alcohol use patterns were examined including financial distress, psychological distress, impact of racial tensions and virus-related fears. Method Students (N = 1001) in the Midwestern USA completed repeated assessments between March and June 2020. Each survey included a timeline follow-back measure of alcohol use. Pandemic-related distress spanning several factors was assessed at the final follow-up. Results Risky drinking patterns increased significantly over time. Overall, psychological distress and impact of racial tensions were associated with higher rates of risky drinking, whereas COVID-19-related fears were associated with lower rates. However, only financial-related distress was associated with an increase in risky drinking patterns over time. Conclusions Increased risky drinking patterns observed in the current study may signal problems that are likely to persist even after the direct impact of the COVID-19 pandemic on daily life ends. Individuals experiencing financial distress may represent a particularly high-risk group. Interventions targeting the cross-section of job loss, financial stress and problematic alcohol use will be important to identify.

Mauritian Joint Child Health Project: A Multigenerational Family Study Emerging from a Prospective Birth Cohort Study: Initial Alcohol-related Outcomes in the Offspring Generation

This chapter investigates parental factors in offspring alcohol involvement in the families of the Joint Child Health Project (JCHP), a longitudinal study that has followed a 1969-1970 birth cohort on the east African island nation of Mauritius since 1972. We were particularly interested in whether parent-child gender played a role in these parent-child alcohol relationships. The analytic sample included 1,147 13-24-year-old offspring of the original JCHP birth cohort. Both child-and parent-rated parental drinking norms and behaviors were associated with child alcohol use and binge drinking. Parental predictors of offspring drinking differed for daughters and sons, with daughter alcohol involvement related to both mother and father alcohol-related factors, whereas son alcohol involvement was more associated with paternal factors. These results highlight the value of longitudinal, multi-informant family studies for eludicating how familial factors combine to influence drinking behaviors of younger generations during developmental periods when drinking and high-risk drinking typically emerge.