Preparedness for Natural Disasters Among Older US Adults: A Nationwide Survey

Objectives. We sought to determine natural disaster preparedness levels among older US adults and assess factors that may adversely affect health and safety during such incidents.Methods. We sampled adults aged 50 years or older (n = 1304) from the 2010 interview survey of the Health and Retirement Study. The survey gathered data on general demographic characteristics, disability status or functional limitations, and preparedness-related factors and behaviors. We calculated a general disaster preparedness score by using individual indicators to assess overall preparedness.Results. Participant (n = 1304) mean age was 70 years (SD = 9.3). Only 34.3% reported participating in an educational program or reading materials about disaster preparation. Nearly 15% reported using electrically powered medical devices that might be at risk in a power outage. The preparedness score indicated that increasing age, physical disability, and lower educational attainment and income were independently and significantly associated with worse overall preparedness.Conclusions. Despite both greater vulnerability to disasters and continuous growth in the number of older US adults, many of the substantial problems discovered are remediable and require attention in the clinical, public health, and emergency management sectors of society.Each of the past few years has witnessed more natural disasters than any year on record, costing billions of dollars, according to the US National Climatic Data Center.1 President Obama declared a record number of federally designated natural disasters in 2011, more in the first 3 years of his presidency than almost any other presidents in their full 4-year terms.2 In 2012, insured economic losses from severe weather-related catastrophes in the United States totaled $57.9 billion.2 We continue to experience aberrant climatic and geologic phenomena that can jeopardize older adults and disproportionately affect them.3 Three quarters of those who perished in Hurricane Katrina in 2005 were aged older than 60 years.4 Natural disasters, such as the earthquake and tsunami in Japan in 2011 and Hurricane Sandy in 2012, continue to occur and impose serious aftermaths on older persons.5,6Having the highest prevalence rates for multiple chronic conditions, limitations in activities of daily living (ADLs) and instrumental activities of daily living (IADLs), physical and cognitive disabilities, and sensory impairments makes older adults particularly vulnerable to physiological stresses during natural disasters.7 However, most fatalities, injuries, and damage caused by natural disasters, such as floods, tornadoes, hurricanes, and earthquakes, are preventable.8 Preparing older adults for disasters by following certain precautionary measures and designing comprehensive disaster management plans can alleviate some proportion of the physical, social, and emotional damage that occurs in these situations. But an important public health question is, How prepared are older US adults for natural disasters? We report the results of a survey of older Americans, part of the Health and Retirement Study (HRS), an ongoing nationwide panel study of the health, social, and economic status among persons, conducted by the University of Michigan.9     

Sociodemographic and Anthropometric Factors Associated With Screen-Based Sedentary Behavior Among Japanese Adults: A Population-Based Cross-Sectional Study

Background

Concern over the health risks of sedentary behavior has highlighted the need to examine factors associated with screen-based (television/computer) sedentary behavior. The present study examined the association of screen-based sedentary behavior with body weight and sociodemographic attributes among Japanese adults.

Methods

A population-based cross-sectional study enrolled 1034 Japanese adults aged 40 to 69 years who lived in 2 Japanese cities. Sociodemographic variables, height, weight, and time spent on screen-based sedentary behavior were collected by self-administered questionnaire. Differences in screen time in relation to body mass index and weight gain since age 20 years were assessed by the Mann-Whitney U test. Independent associations of each variable with screen time were examined by forced-entry logistic regression analyses.

Results

Mean (SD) age and median (interquartile range) duration of screen time per week were 55.6 (8.4) years and 832.0 (368.8–1263.1) minutes, respectively, for men, and 55.3 (8.4) years and 852.6 (426.0–1307.5) minutes, respectively, for women. Screen time among participants with weight gain was longer than among those with a weight gain of less than 10 kg (P = 0.08). Unmarried and unemployed participants had longer screen times. Participants aged 40 to 49 years were less likely than older age groups to spend time on screen-based sedentary behavior during leisure hours.

Conclusions

The present findings imply that strategies are necessary to discourage screen-based sedentary behavior among all demographic groups, especially among adults who are elderly, unmarried, or unemployed.Key words: weight status, Japanese, sedentary behavior, sociodemographic     

Peer Reviewed: Smoking and Visual Impairment Among Older Adults With Age-Related Eye Diseases

Introduction

Tobacco use is the leading preventable cause of death in the United States. Visual impairment, a common cause of disability in the United States, is associated with shorter life expectancy and lower quality of life. The relationship between smoking and visual impairment is not clearly understood. We assessed the association between smoking and visual impairment among older adults with age-related eye diseases.

Methods

We analyzed Behavioral Risk Factor Surveillance System data from 2005 through 2008 on older adults with age-related eye diseases (cataract, glaucoma, age-related macular degeneration, and diabetic retinopathy; age ≥50 y, N = 36,522). Visual impairment was defined by self-reported difficulty in recognizing a friend across the street or difficulty in reading print or numbers. Current smokers were respondents who reported having smoked at least 100 cigarettes ever and still smoked at the time of interview. Former smokers were respondents who reported having ever smoked at least 100 cigarettes but currently did not smoke. We used multivariate logistic regressions to examine the association and to adjust for potential confounders.

Results

Among respondents with age-related eye diseases, the estimated prevalence of visual impairment was higher among current smokers (48%) than among former smokers (41%, P < .05) and respondents who had never smoked (42%, P < .05). After adjustment for age, sex, race/ethnicity, education, and general health status, current smokers with age-related eye diseases were more likely to have visual impairment than respondents with age-related eye diseases who had never smoked (odds ratio, 1.16, P < .05). Furthermore, respondents with cataract who were current smokers were more likely to have visual impairment than respondents with cataract who had never smoked (predictive margin, 44% vs 40%, P = .03), and the same was true for respondents with age-related macular degeneration (65% of current smokers vs 57% of never smokers, P = .02). This association did not hold true among respondents with glaucoma or diabetic retinopathy.

Conclusion

Smoking is linked to self-reported visual impairment among older adults with age-related eye diseases, particularly cataract and age-related macular degeneration. Longitudinal evaluation is needed to assess smoking cessation''s effect on vision preservation.     

Multimorbidity and Disability Among Venezuelan Migrants: A Population-Based Survey in Peru

The political and economic crisis in Venezuela has originated an unprecedented migration. As of November 2020, 1.04 million Venezuelans have moved to Peru. Understanding their health profile is needed to identify their needs, provide care and secure resources without affecting the healthcare of nationals. We quantified the burden of multimorbidity and disability in the Venezuelan population in Peru. We analyzed the 2018 Survey of Venezuelan Population Living in Peru; population-based with random sampling survey in six cities in Peru. Participants were asked about the presence of 12 chronic conditions (self-reported); this information was grouped into 0, 1 and?≥?2 conditions (i.e., multimorbidity). Disability was also ascertained with a self-reported questionnaire adapted from the short version of the Washington Group on Disability Statistics. Socioeconomic variables were analyzed as potential determinants. Variables were described with frequencies and 95% confidence interval (95% CI), compared with Chi2 test, and association estimates were derived with a Poisson regression reporting prevalence ratio and 95% CI. Results accounted for the complex survey design. The analysis included 7554 migrants, mean age 31.8 (SD: 10.2), 46.6% were women, 31.7% migrated alone and 5.6% had refugee status. The prevalence of multimorbidity was 0.6% (95% CI 0.4–0.9%), and was often present in women (p?<?0.001), people?≥?50 years (p?<?0.001) and those without recent job (p?<?0.001). The prevalence of disability was 2.0% (95% CI 1.5–2.7%), and was common among people?≥?50 years (p?<?0.001) and those without recent job (p?<?0.001). Migration alone and refugee status were not associated with multimorbidity or disability. The self-reported prevalence of multimorbidity and disability in Venezuelan migrants in Peru was low, and were not strongly influenced by migration status. While these results could suggest a healthy migrant effect, the healthcare system should be prepared to deliver acute and preventive care for these migrants, while also securing primary prevention to delay the onset of chronic conditions in this population.

     

Factors Associated with Hepatitis B Knowledge Among Vietnamese Americans: A Population-Based Survey

Vietnamese Americans have high rates of hepatitis B virus (HBV) infection but low rates of knowledge and screening. A population-based survey conducted in 2011 of Vietnamese Americans in two geographic areas (n?=?1666) was analyzed. The outcome variables were having heard of HBV and a score summarizing knowledge of HBV transmission. Most respondents (86.0%) had heard of HBV. Correct knowledge of transmission ranged from 59.5% for sex, 68.1% for sharing toothbrushes, 78.6% for during birth, and 85.0% for sharing needles. In multivariable analyses, factors associated with having heard of HBV and higher knowledge included Northern California residence, longer U.S. residence, higher education, family history of HBV, and discussing HBV with family/friends. Higher income was associated with having heard of HBV. English fluency and being U.S.-born were associated with higher knowledge. Interventions to increase knowledge of HBV transmission are needed to decrease this health disparity among Vietnamese Americans.     

Snus Use and Smoking Behaviors: Preliminary Findings From a Prospective Cohort Study Among US Midwest Young Adults

The effect of snus use on smoking behaviors among US young adults is largely unknown. Data from the Minnesota Adolescent Community Cohort Study collected in 2010 to 2011 and 2011 to 2012 (participants aged 20–28 years) showed that young adult nonsmokers who had tried snus were subsequently more likely than those who had not tried snus to become current smokers (n = 1696; adjusted odds ratio = 1.79; 95% confidence interval = 1.01, 3.14). Snus use was not associated with subsequent smoking cessation or reduction among young adult current smokers (n = 488; P > .46).Tobacco use is the leading preventable cause of death in the United States.1 Snus, made of finely cut smokeless tobacco leaves packaged in small bags, was recently introduced in the United States and sales reached more than 1 million pounds in 2011.2 Swedish studies found that snus use was not associated with smoking initiation but was positively associated with smoking cessation.3,4 However, a US study showed that the effect of snus use in Sweden is unlikely to be replicated in the United States, at least on smoking cessation.5To date, no longitudinal studies have examined whether snus use promotes smoking among nonsmokers, or cessation among smokers, in young adults in the United States, who are still developing their tobacco use behaviors and have the highest prevalence of smoking in all ages.6,7 We used data collected from the Minnesota Adolescent Community Cohort Study to examine if snus use was associated with progression of smoking among young adult nonsmokers and smoking cessation and reduction among young adult current smokers.     

Incidence and Determinants of Cigarette Smoking Initiation in Young Adults

PurposeTo describe the incidence and identify predictors of smoking initiation in young adults.MethodsData were collected in self-report questionnaires in 22 cycles over 13 years in a prospective cohort investigation of 1,293 students recruited in 1999–2000 from all grade 7 classes in a convenience sample of 10 high schools in Montreal, Canada. Participants were 12.7 years of age on average at cohort inception and 24.0 years of age in cycle 22. Independent predictors of smoking initiation in young adulthood (post–high school) were identified in multivariable logistic regression analysis using generalized estimating equations.ResultsOf 1,293 participants, 75% initiated smoking by cycle 22. Of these, 44%, 43%, and 14% initiated before high school, during high school, and in the 6 years after high school, respectively. The incidence density rate of initiation was .33, .13, .14, .11, and .12 initiation events per person-year in grade 7, 8, 9, 10, and 11, respectively, and .05 post–high school. Independent predictors of smoking initiation in young adults included alcohol use, higher impulsivity, and poor academic performance.ConclusionsA total of 14% of smokers who initiated smoking before age 24 years did so after high school. The predictors of initiation in young adults may provide direction for relevant preventive interventions.     

Sexuality Among Adults with Congenital Deafblindness: A Cross-Sectional Survey Study Among Primary Carers

Research investigating the sexuality of individuals with physical or intellectual disabilities is increasing. However, little is known about the sexuality of people with congenital deafblindness (CDB). The aim of the current study was to create a profile of the sexuality of adults with CDB in Denmark. Data was collected from the primary carers of 95 adults with CDB by use of a survey with questions about sexual behavior, the object of sexual behavior, level of sexual frustration, and pedagogical support for sexual satisfaction. The data were analyzed with regard to gender, age, severity of deafblindness, communication, activities of daily living (ADL), cognitive abilities, and carer characteristics. The results revealed that approximately half the number of participants showed sexual behavior while the other half did not. In the majority of cases, sexual behavior was self-stimulation, while, for the rest, sexual behavior was directed toward other people and/or objects. Around one out of ten participants was provided with pedagogical support to help satisfy their sexual needs. Sexual behavior was significantly associated with high scores for communication skills, ADL, and cognitive abilities. Further, high ADL and cognitive abilities were associated with the provision of pedagogical support for sexual satisfaction. Around one out of ten participants, all of whom were men, experienced sexual frustrations. The findings of the current study—the first quantitative study on sexuality among individuals with CDB—are comparable to the findings of studies among individuals with developmental disorders and underline the need for sexuality-related support for individuals with disabilities including those with CDB.

     

Lifestyle-Related Determinants of Hookah and Cigarette Smoking in Iranian Adults

To identify lifestyle-related determinants of hookah and cigarette smoking in Iranian adults, a total of 12,514 men and women aged ≥19 years in three counties in central Iran (Isfahan, Najafabad, Arak) were selected in multistage random sampling. Data on socio-demographic characteristics and lifestyle were collected in interviewer-administered questionnaires, as part of the baseline survey of the Isfahan Healthy Heart Program. Unhealthy lifestyle-related factors independently associated with cigarette and hookah smoking, were identified in sex-specific multivariate logistic regression analyses. High stress levels (OR: 1.55; 95% CI: 1.35–1.78 for men; OR: 1.63; 95% CI: 1.17–2.27 for women), family member smoking (OR: 1.61; 95% CI: 1.27–4.92 for men; OR: 2.49; 95% CI: 2.20–2.95 for women), and short/long sleep duration (OR: 1.18; 95% CI: 1.01–1.39 for men; OR: 1.52; 95% CI: 1.10–2.35 for women) were associated with cigarette smoking in both men and women. Poor diet was also related to cigarette smoking in men (OR: 1.55; 95% CI: 1.62–1.89). Family member smoking was associated with hookah smoking in both men (OR: 1.16; 95% CI: 1.05–3.12) and women (OR: 1.56; 95% CI: 1.02–4.92), and in addition high stress levels (OR: 2.87; 95% CI: 1.14–5.83) and short/long sleep duration (OR: 1.07; 95% CI: 1.02–2.41) were associated with hookah smoking in women. Unhealthy lifestyle-related factors co-occur with cigarette and hookah smoking in Iranian adults, likely increasing the risk for chronic health problems. Sex differences in the determinants of hookah and cigarette smoking may need to be taken into account in planning tobacco control strategies.     

Menthol Brand Switching Among Adolescents and Young Adults in the National Youth Smoking Cessation Survey

This study examines patterns of menthol and nonmenthol cigarette use from 2003 to 2005 in a cohort of smokers, aged 16 to 24 years in the National Youth Smoking Cessation Survey. At follow-up, 15.0% of baseline menthol smokers had switched to nonmentholated cigarettes; by contrast, 6.9% of baseline nonmenthol smokers had switched to mentholated cigarettes. Differences in switching patterns were evident by gender, race/ethnicity, parental education, and smoking frequency. These data support previous evidence that young smokers start with mentholated cigarettes and progress to nonmentholated cigarettes.Following enactment of the Family Smoking Prevention and Tobacco Control Act in June 2009,1 fruit, candy, and clove characterizing flavorings in cigarettes were banned to reduce youth smoking initiation. Menthol is the only characterizing flavor that was not banned outright by the act. Nationally representative surveys have shown an age gradient in menthol use, with the youngest smokers (aged 12–17 years) most likely to smoke mentholated cigarettes.2^,3 Studies of adolescents report that middle school smokers and recent initiates are more likely to use mentholated cigarettes than high school smokers and those smoking longer than 1 year, respectively.4 With other studies,5–7 these results argue that menthol facilitates smoking initiation and that mentholated cigarettes serve as starter tobacco products for youths.4Although these nationally representative studies document an age gradient in menthol use, they do not address smoking patterns in the same individuals over time and whether there is a disproportionate shift from early use of mentholated cigarettes to nonmentholated cigarette use later on. The current study assesses patterns in menthol and nonmenthol cigarette use over time in young smokers, aged 16 to 24 years.     

Factors Associated with Use of Hormone Therapy Among Women with Mobility Impairments

ABSTRACT

The purpose of the study was to examine the factors associated with hormone therapy (HT) use among women with mobility impairments. A non-probability sample of 188 menopausal women (average age = 53 years) from 38 states was recruited in 2004 for the study. Twenty-two percent of participants were currently taking HT; 33% were past users. Using multinomial logistic regression, this study found that those most likely to be taking HT now or in the past were older women, knowledgeable about HT, had had a hysterectomy, had bone loss, and had their providern's encouragement. Implications for health care providers are discussed.     

Ages at Initiation of Cigarette Smoking and Quit Attempts Among Women: A Generation Effect

OBJECTIVES: This study sought to determine whether the age at initiation of regular cigarette smoking and the likelihood of quitting smoking through age 35 differ among women from younger versus older generations. METHODS: Annual population-based, random surveys (total of 3676 female residents of Geneva, Switzerland, aged 35-74 years) were conducted from 1992 to 1998. RESULTS: Women younger than 55 years were more likely to be past or current smokers, began smoking earlier (median age < 20 years), and smoked more cigarettes per day than older women, yet attempted to quit smoking more often before age 35 (log-rank P <.001). CONCLUSIONS: Young female smokers have a higher propensity to quit smoking compared with older women. Encouraging young smokers to quit-in addition to preventing nonsmokers from starting-may be an important facet of reducing cigarette smoking prevalence among adolescents.     

Disposable Income With Tobacco Smoking Among Young Adolescents: A Multilevel Analysis

PurposePrior studies examining the connection between disposable income and adolescent smoking often yielded mixed results, partly due to the lack of consideration for contextual variables. In the present study, we sought to broaden understanding of disposable income on adolescent smoking behaviors via both absolute and relative perspectives in the school context.MethodsWe obtained data from the 2010 Global Youth Tobacco Survey (GYTS) in Taiwan. Information concerning sociodemographics, disposable income, smoking history, and contextual smoking exposure (e.g., school) were assessed via self-report. Recent-onset smokers were defined as those who had their first cigarette within two years of the survey. Complex survey and multilevel analyses were carried out to estimate association.ResultsAdolescents with higher monthly disposable income were 2～5 times more likely to start smoking and become regular smokers. Having the least disposable income in a class appeared linked with increased risk of tobacco initiation by 40% (95% confidence interval [CI]: 2%–91%). Pupils’ odds to start smoking were lowered to .70 when the majority of schoolmates had low disposable income (95% CI: .51–.99).ConclusionsAdolescent risk of smoking initiation may be differentially affected by individual- and contextual-level absolute and relative disposable income. Future research is needed to delineate possible mechanisms underlying unfavorable health behaviors associated with disposable incomes in early adolescence.     

Association of Smoking Status With Quality of Life in a Cross-sectional Population-Based Sample of Iranian Adults: Isfahan Healthy Heart Program

This study aimed to examine the association between smoking status and quality of life (QOL) in a population-based sample of Iranian adults. The study used data from the Isfahan Healthy Heart Program (IHHP). A total of 5830 participants were included. They were categorized as current, former, or never smokers. QOL was evaluated using the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF), Persian version. Data entry was performed using SPSS (SPSS Inc, Chicago, IL) software version 13.0. QOL was associated with marital status (P = .014), education (P = .001), occupation (P = .007), and income (P < .000) among current smokers. After adjusting for sociodemographic characteristics, smoking decreased QOL among current (odds ratio [OR] = 0.98; 95% confidence interval [CI] = 0.97-0.99) and past (OR = 0.97; 95%CI = 0.95-0.98) smokers relative to never smokers. QOL is lower among Iranian current and past smokers, and the relation is independent of underlying sociodemographic factors.     

Predicting Cigarette Smoking Among Adolescents Using Cross-Sectional and Longitudinal Approaches

ABSTRACT: The ability to identify groups of children at risk of initiating a smoking habit may prove useful in developing effective smoking prevention programs. This report includes data collected over a three-year period, and attempts to predict adolescents' smoking behavior using both cross-sectional and longitudinal analyses. In addition, predictor variables reflecting both interpersonal and intrapersonal domains were included. Results indicated the highest rates of accurate classification into smoking categories were achieved with cross-sectional analyses. In addition, interpersonal variables emerged as most important in all analyses. Implications for smoking prevention programming are discussed.