Prevalence, Comorbidity, and Sociodemographic Correlates of Psychiatric Disorders in the All Of Us Biobank

ABSTRACTImportanceAll of Us is a landmark initiative for population-scale research into the etiology of psychiatric disorders and disparities across various sociodemographic categories.ObjectiveTo estimate the prevalence, comorbidity, and demographic covariates of psychiatric and substance use disorders in the All of Us biobank.Design, Setting, and ParticipantsWe estimated prevalence, overlap, and demographic correlates for psychiatric disorders derived from electronic health records in the All of Us biobank (release 5; N = 331,380)ExposuresSocial and demographic covariates.Main Outcome and MeasuresPsychiatric disorders derived from ICD10CM codes and grouped into phecodes across six broad domains: mood disorders, anxiety disorders, substance use disorders, stress-related disorders, schizophrenia, and personality disorders.ResultsThe prevalence of various disorders ranges from approximately 15% to less than 1%, with mood and anxiety disorders being the most common, followed by substance use disorders, stress-related disorders, schizophrenia, and personality disorders. There is substantial overlap among disorders, with a large portion of those with a disorder (~57%) having two or more registered diagnoses and tetrachoric correlations ranging from 0.43 – 0.74. The prevalence of disorders across demographic categories demonstrates that non-Hispanic whites, those of low socioeconomic status, women and those assigned female at birth, and sexual minorities are at greatest risk for most disorders.Conclusions and RelevanceAlthough the rates of disorders in All of Us are lower than rates for disorders in the general population, there is considerable variation, comorbidity, and differences across social groups. Large-scale resources like All of Us will prove to be invaluable for understanding the causes and consequences of psychiatric conditions. As we move towards an era of precision medicine, we must work to ensure it is delivered in an equitable manner.

The Potential for Healthy Checkout Policies to Advance Nutrition Equity

Background: As the only place in a store where all customers must pass through and wait, the checkout lane may be particularly influential over consumer purchases. Because most foods and beverages sold at checkout are unhealthy (e.g., candy, sweets, sugar-sweetened beverages, and salty snacks), policymakers and advocates have expressed growing interest in healthy checkout policies. To understand the extent to which such policies could improve nutrition equity, we assessed the prevalence and sociodemographic correlates of purchasing items found at (i.e., from) checkout. Methods: We assessed self-reported checkout purchasing and sociodemographic characteristics in a national convenience sample of adults (n = 10,348) completing an online survey in 2021. Results: Over one third (36%) of participants reported purchasing foods or drinks from checkout during their last grocery shopping trip. Purchasing items from checkout was more common among men; adults < 55 years of age; low-income consumers; Hispanic, non-Hispanic American Indian or Alaska Native, and non-Hispanic Black consumers; those with a graduate or professional degree; parents; and consumers diagnosed with type 2 diabetes or pre-diabetes (p-values < 0.05). Conclusions: Purchasing foods or beverages from store checkouts is common and more prevalent among low-income and Hispanic, American Indian or Alaska Native, and Black consumers. These results suggest that healthy checkout policies have the potential to improve nutrition equity.

Sociodemographic Correlates of Organized Sports Participation in a Sample of Middle School Students in China

Background: Organized sport participation (OSP) is considered as one method with the potential to increase overall physical activity (PA) levels in young people. It is essential to understand the correlates of OSP to inform future PA interventions.Purpose: This study aimed to explore the sociodemographic correlates of OSP among middle school students from the Nanjing City of China.Methods: A total of 7,097 adolescents (50.1% girls) aged 12–15 years from Nanjing, China, were recruited in this survey. Self-reported data on sex, grade, race, residence areas, proficient sport skills, and parental highest education were obtained. OSP was assessed by the question asked in the questionnaire on whether participants were involved in any “sports club or team” with the binary answer options of “yes” and “no,” for statistical analysis purposes. Generalized linear models were used to determine the correlates of OSP.Results: Only 16.6% reported participating in any organized sport over the past whole year, while boys (OR = 1.34, 95% CI: 1.18–1.53) and 7th graders (OR = 1.40, 95% CI: 1.18–1.65) were more likely to participate in organized sport. Adolescents being Han ethnicity were less likely to either participate in organized sport (OR = 0.60, 95% CI: 0.40–0.92), or masterless (one or two) proficient sport skills [OR (one) = 0.27, 95%CI: 0.20–0.37; OR (two) = 0.43, 95% CI: 0.36–0.50]. Besides, both residence area and parental highest education were not significantly associated with OSP among the participating adolescents.Conclusion: The current study confirmed that only one-sixth of adolescents participate in the organized sport over the past year. At-risk population subgroups include girls, older adolescents, being Han ethnicity, and those proficient in fewer sport skills. Sex, grades, race, and proficient sport skills were significant correlates of OSP. School, community, and families need to provide more resources and support for disadvantaged populations in OSP.

National Trends of Adolescent Exposure to Tobacco Advertisements: 2012–2020

BACKGROUND AND OBJECTIVES The objective of the current study is to evaluate the temporal trends in the prevalence of cigarette and electronic cigarette (e-cigarette) advertisement exposure by venue and sociodemographic correlates among US adolescents from 2012 to 2020. METHODS We conducted a serial cross-sectional analysis of nationally representative samples of middle and high school youth from the 2012–2020 National Youth Tobacco Survey. Advertisement exposure was defined as self-report of seeing advertisements “sometimes,” “most of the time,” and “always.” The prevalence of cigarette (and other tobacco products) and e-cigarette advertisement exposure, including overall and at specific venues (Internet, press, screen, and retail stores), was estimated by survey year. RESULTS A total of 139 795 adolescents aged 11 to 19 years old were included in the analysis. The prevalence of exposure to combustible cigarette marketing remained high across all years (any venue ranging from 77.0% [2018] to 91.1% [2014]). An increasing trend for cigarette advertisement exposure was observed from 2017 to 2020 after a drop in 2015 (β2012–2015 = 2.8, P for trend &lt; .001; β2017–2020 = .7, P for trend = .03), driven by retail store–based and Internet-based exposure. A similar increasing pattern in the estimated prevalence of e-cigarette marketing was observed (β2014–2016 = 4.6, P for trend &lt; .001; β2017–2020 = 5.1, P for trend &lt; .001). CONCLUSIONS Given the high estimated prevalence of cigarette and e-cigarette marketing exposure among US adolescents, further regulation efforts for both off-line and online tobacco marketing are needed to mitigate adolescent exposure to content regarding these products, reducing susceptibility to uptake.

The Potential for Healthy Checkout Policies to Advance Nutrition Equity

Background: As the only place in a store where all customers must pass through and wait, the checkout lane may be particularly influential over consumer purchases. Because most foods and beverages sold at checkout are unhealthy (e.g., candy/sweets, sugar-sweetened beverages, and salty snacks), policymakers and advocates have expressed growing interest in healthy checkout policies. To understand the extent to which such policies could improve nutrition equity, we as-sessed the prevalence and sociodemographic correlates of purchasing items from checkout. Methods: We assessed self-reported checkout purchasing and sociodemographic characteristics in a national convenience sample of adults (n=10,348) completing an online survey in 2021. Re-sults: Over one-third (36%) of participants reported purchasing foods or drinks from checkout during their last grocery shopping trip. Purchasing items from checkout was more common among men; adults &lt;55 years of age; low-income consumers; Hispanic, non-Hispanic American Indian and Alaska Native, and non-Hispanic Black consumers; those with at least a bachelor&rsquo;s degree; parents; and consumers diagnosed with type 2 diabetes or pre-diabetes (p-values&lt;0.05). Conclusions: Purchasing foods or beverages from store checkouts is common and more prevalent among low-income and racial and ethnic minority groups. These results suggest that healthy checkout policies have the potential to improve nutrition equity.

Telehealth Availability and Use of Related Technologies among Older Cancer Survivors: An early snapshot from the COVID-19 Pandemic (Preprint)

BACKGROUND There has been rapid integration of telehealth into care delivery during the COVID-19 pandemic. However, little is known about technology ownership, internet access and use for communication, and telehealth availability among cancer survivors who are disproportionately older. OBJECTIVE To identify sociodemographic associations with technology ownership, internet access and use for communication, and telehealth availability in a population-based sample of older cancer survivors. METHODS Data are from the Medicare Current Beneficiary Survey COVID-19 Summer 2020 Supplement administered between June 10, 2020–July 15, 2020. Analyses were restricted to beneficiaries who reported a prior (non-skin) cancer diagnosis and a usual source of care (N=2,044). Dichotomous outcomes included: (1) technology ownership, (2) internet access, (3) internet use for communication, and (4) telehealth availability from providers. Sociodemographic correlates included sex, age, race/ethnicity, Medicare/Medicaid dual enrollment, rurality, Census region, and self-reported comorbidities. RESULTS Over half (53%) of cancer survivors reported using the Internet for communication purposes and 62% reported that their usual provider had telehealth services available. Using the internet for communication purposes was reported less frequently for rural compared to urban survivors (adjusted probability of 28% vs. 46%, p<.001), and for Hispanic and Black survivors compared to non-Hispanic Whites (29%, 31%, and 44% respectively, p<.01). Rural survivors reported lower telehealth availability (53% vs. 63% p<.001); no differences in telehealth availability were identified by race/ethnicity (p>.05). CONCLUSIONS During the COVID-19 pandemic, our findings highlight a complex digital divide among Medicare beneficiaries with a history of cancer related to device ownership necessary for telehealth, internet access and use for communication, and reports of providers having telehealth available. Multilevel approaches are needed to increase equitable telehealth availability and use for older cancer survivors. Suggested strategies include increasing broadband internet access to providers and patients in at-risk communities; supporting telehealth implementation among providers that serve populations with known health disparities; raising awareness of providers’ available telehealth services among patients; and screening for technology use and provision of telehealth-related technical assistance among older, Black and Hispanic, dual Medicare/Medicaid enrolled, and rural cancer survivors.