Sun protective behaviors among adolescents and young adults in the United States

PurposeWe described sun protective behaviors in adolescents and young adults (AYA) compared to older adults.MethodsWe used data from the 2013–2018 National Health and Nutrition Examination Survey, a nationally representative samples of the civilian, noninstitutionalized US population (10,710 respondents aged between 20 and 59 and without a history of skin cancer diagnoses). The primary exposure for the study was age group: aged 20–39 defined as AYA and aged 40–59 as adults. The outcome variable was sun protective behaviors: stay in the shade, wear a long-sleeved shirt, use sunscreen, at least one of the three; and all three measures. Multivariable logistic regression models were used to assess association between age group and sun protective behaviors adjusting for sociodemographic factors.ResultsOverall, 51.3% of respondents were AYA, 76.1% reported staying in the shade, 50.9% using sunscreen, 33.3% wearing long-sleeved clothes, 88.1% engaging in one of the three behaviors, and 17.1% engaging in all three behaviors. In the adjusted models, the odds of engaging in all three behaviors among AYAs was 28% (aOR: 0.72, 95% CI: 0.62–0.83) lower than adult respondents. Compared to adults, AYAs were 22% less likely to wear long sleeved clothes (aOR: 0.78, 95% CI: 0.70–0.87). There were no significant differences in the odds of engaging in at least one sun protective behavior, using sunscreen, and staying in the shade between AYAs and adults.ConclusionsMore targeted interventions need to be implemented to decrease the risk of skin cancer in the AYA population.     

Generalized anxiety disorder and peptic ulcer disease among adults in the United States

OBJECTIVE: Previous research has suggested a link between chronic anxiety and peptic ulcer disease, though recent evidence documenting an infectious cause (Helicobacter pylori) for ulcer has led to doubt about this association. The goal of the current study was to determine the relationship between generalized anxiety disorder (GAD) and self-reported peptic ulcer disease (PUD) among adults in the community. METHODS: Data were drawn from the National Comorbidity Survey, a representative household survey of the adult population of the United States (N = 8098). Multivariate logistic regression analyses were used to determine the relationship between GAD and self-reported ulcer, controlling for differences in sociodemographic characteristics and psychiatric and medical comorbidity. RESULTS: GAD was associated with a significantly increased risk of self-reported PUD (odds ratio = 2.8, 95% confidence interval = 1.4-5.7; p = .0002) after adjusting for differences in sociodemographic characteristics, comorbid mental disorders, and physical morbidity. Further analyses revealed a dose-response relationship between number of GAD symptoms (odds ratio = 1.2, 95% confidence interval = 1.1-1.4; p = .001) and increased risk of self-reported PUD. CONCLUSIONS: These findings are consistent with and extend previous clinical and epidemiologic data, providing evidence of a dose-response relationship between GAD and self-reported PUD among adults in the general population. The mechanism of this association remains unknown. Future work investigating the relationship between onset of GAD and development of PUD in prospective, longitudinal, epidemiologic data with objective measures of physical health status and mental health may be useful in improving our understanding of this link.     

Association between physical activity and brain health in older adults

In the present cross-sectional study, we examined physical activity (PA) and its possible association with cognitive skills and brain structure in 331 cognitively healthy elderly. Based on the number of self-reported light and hard activities for at least 30 minutes per week, participants were assigned to 4 groups representing different levels of PA. The cognitive skills were assessed by the Mini Mental State Examination score, a verbal fluency task, and the Trail-making test as a measure of visuospatial orientation ability. Participants also underwent a magnetic resonance imaging of the brain. Multiple regression analysis revealed that greater PA was associated with a shorter time to complete the Trail-making test, and higher levels of verbal fluency. Further, the level of self-reported PA was positively correlated with brain volume, white matter, as well as a parietal lobe gray matter volume, situated bilaterally at the precuneus. These present cross-sectional results indicate that PA is a lifestyle factor that is linked to brain structure and function in late life.     

Varicella susceptibility and vaccine use among young adults enlisting in the United States Navy

Primary varicella infection, or chicken pox, is a threat to all young adults who join the United States (U.S.) military if they fail to develop immunity prior to enlistment. Historically, outbreaks of chicken pox have caused marked morbidity and impaired military readiness. In December 1996, the U.S. Navy began performing serologic testing for varicella among all new recruits, and vaccinating those found to be sero-negative. We evaluated results of the screening program in its first 4 years, and used multivariable logistic regression modeling to describe factors associated with varicella susceptibility. Cases of chicken pox were tracked among all military services before and after program implementation. More than 190,000 young adults enlisted in the U.S. Navy between 1997 and 2000. Recruits originated from all 50 states and several foreign countries; 84% were male, and their average age was 19 years. Seven percent were found to be susceptible (sero-negative) to varicella. In multivariable modeling, race/ethnicity was associated with susceptibility, but age, gender, and home state were not. The overall incidence of chicken pox in the Navy was reduced by more than 80% after initiation of the screening-vaccination program. A successful varicella screening-vaccination program has been implemented in the U.S. Navy. Results of serologic screening undertaken on this large number of young adults may be useful in tracking the changing epidemiology of varicella in the general population in the post-vaccine era.     

The impact of familism on physical and mental health among Hispanics in the United States

The rapidly expanding number of Hispanics living in USA has increased the need for their inclusion in research on physical and mental health. Current studies that have explored health outcomes among Hispanics have often noted an ‘epidemiological paradox’, in which there is a discrepancy between their minority status and positive health outcomes when compared with other racial/ethnic groups. Certain socio-cultural variables, in particular the value placed on family, have been largely implicated in these findings. This review will provide a summary of the literature exploring familism within the structure of the Hispanic family and its potential impact on health. We will focus on research exploring the plausible impact that family and familism values may have on the physical health (particularly within the HIV, diabetes, and breast cancer literature) and also on health behaviours of Hispanics, as well as its effect on mental health (particularly related to acculturative stress and caregiver stress). Throughout the review, we highlight some of the potential mechanisms by which familism may impact on the health status of Hispanics. We conclude the review by noting some of the clinical and ethical implications of this research, and by offering suggestions for future work in this area.     

Affective disorders in five United States communities

Results on the age/sex specific prevalence of DSM-III affective disorders from the NIMH Epidemiologic Catchment Area Study (ECA), a probability sample of over 18,000 adults from five United States communities, are presented. The cross-site means for bipolar disorder ranged from 0.7/100 (2 weeks) to 1.2/100 (lifetime), with a mean age of onset of 21 years and no sex difference in rates. The cross-site means for major depression ranged from 1.5/100 (2 weeks) to 4.4/100 (lifetime), with a mean age onset of 27 years and higher rates in women. The cross-site means for dysthymia, a chronic condition, was 3.1/100 with a higher rate in women. There was reasonable consistency in prevalence rates among sites. The implications of these findings for understanding psychopathology are discussed.     

Prevalence of mental disorders,psychological distress,and mental health services use among lesbian,gay, and bisexual adults in the United States

Recent estimates of mental health morbidity among adults reporting same-gender sexual partners suggest that lesbians, gay men, and bisexual individuals may experience excess risk for some mental disorders as compared with heterosexual individuals. However, sexual orientation has not been measured directly. Using data from a nationally representative survey of 2,917 midlife adults, the authors examined possible sexual orientation-related differences in morbidity, distress, and mental health services use. Results indicate that gay-bisexual men evidenced higher prevalence of depression, panic attacks, and psychological distress than heterosexual men. Lesbian-bisexual women showed greater prevalence of generalized anxiety disorder than heterosexual women. Services use was more frequent among those of minority sexual orientation. Findings support the existence of sexual orientation differences in patterns of morbidity and treatment use.     

Assessing the attitudes, knowledge, and awareness of HIV vaccine research among adults in the United States

OBJECTIVES: To assess HIV vaccine research attitudes, awareness, and knowledge among adults in the general US population, African Americans, Hispanics, and men who have sex with men (MSM). METHODS: Applying results of focus groups and a media content analysis, a survey was designed and conducted to validate key HIV vaccine research themes and messages identified by focus groups and a media content analysis. Between December 2002 and February 2003, 3509 telephone interviews were conducted, including 2008 randomly selected from the general population, and 501 population-specific samples of African Americans and Hispanics, and 500 from MSM. RESULTS: Although the majority of each population believes that an HIV preventive vaccine is the best way to control and end the global AIDS epidemic, only 34.9% of African Americans and 28.8% of the general population are supportive of someone they know volunteering for an HIV vaccine trial. The study also found that 47.1% of African Americans, 26.5% of Hispanics, and 13.4% of MSM believed an HIV vaccine already exists and is being kept secret, and 78.0% of African Americans, 57.5% of Hispanics, and 68.0% of MSM did not know or incorrectly believed that the vaccines being tested could cause HIV infection. A subanalysis of the general population also found that women generally had less knowledge of or a decreased awareness about HIV vaccine research. CONCLUSIONS: Awareness, knowledge, and attitudes toward HIV vaccine research vary by population and these issues must be addressed to ensure an adequate number of volunteers for future domestic HIV preventive vaccine clinical trials. In some populations, barriers such as misinformation and distrust must be targeted to increase support for HIV vaccine research.     

Literacy skills,language use,and online health information seeking among Hispanic adults in the United States

ObjectiveOnline health information is underutilized among Hispanics with low English proficiency in the U.S. This study examines the association between a unique measure of general English literacy, language use, and online health information seeking among Hispanic adults.MethodsData for Hispanics ages 25–65 (N = 700) come from the 2012/2014 Program for International Assessment of Adult Competencies (PIAAC). Binary logistic regression models were used to predict online health information seeking as a function of literacy skill scores (0–500 points) and primary language use (Spanish vs. other).ResultsLiteracy (Odds-Ratio = 1.012, p < 0.001) was a positive predictor, while speaking Spanish at home (Odds-Ratio = 0.352, p < 0.01) was a negative predictor of online health information seeking.ConclusionLiteracy skills and language use appear to be separate contributors of online health information seeking among Hispanic adults.Practice implicationsOnline health information providers should be aware of literacy skills and Spanish language use as barriers to online health information seeking among Hispanics, particularly those who have both limited literacy skills and predominantly Spanish language use.     

Experiences of care coordination among older adults in the United States: Evidence from the Health and Retirement Study

IntroductionThe goal of this study was to examine variation in patient experiences and perceptions of care coordination across sociodemographic and health factors.MethodsData come from the 2016 Health and Retirement Study (N = 1, 216). Three domains of coordination were assessed: 1) Perceptions (e.g., patient impressions of provider-provider communication), 2) Tangible supports (e.g., meeting with a care coordinator, being accompanied to appointments), and 3) Technical supports (e.g., use of a “patient portal”). Logistic regression was used to quantify the frequency of each domain and examine variation by racial minority status, socioeconomic status, and health status.ResultsApproximately 42% of older adults perceived poor care coordination, including 14.8% who reported receiving seemingly conflicting advice from different providers. Only one-third had ever met with a formal care coordinator, and 40% were occasionally accompanied to appointments. Although racial minorities were less likely to have access to technical supports, they were more likely to use them. Better perceived coordination was associated with higher care satisfaction (Odds Ratio: 1.43, 95% CI: 1.27–1.61).ConclusionsImportant gaps in care coordination remain for older adults.Practice implicationsProviders should consider assessing patient perceptions of care coordination to address these gaps in an equitable manner.     

Suicidal ideation among college students in the United States

This study analyzed data from the 1995 National College Health Risk Behavior Survey (NCHRBS) to assess the prevalence of suicidal ideation among college students in the United States and to examine the association between suicidal ideation and substance use in this population. The NCHRBS used a mail questionnaire to assess health-risk behaviors in a nationally representative sample of undergraduate students. During the 12 months preceding the survey, 10% of the students had seriously considered attempting suicide. When controlling for demographic characteristics, the analysis showed that students who had considered suicide were at increased odds of using tobacco, alcohol, and illegal drugs. These results suggest that colleges and universities should establish suicide prevention programs that also address the related problem of substance use.     

Association between beta2-adrenoceptor polymorphisms and asthma diagnosis among Mexican adults

BACKGROUND: Recent studies demonstrate that genetic variations in the human beta(2)-adrenergic receptor (beta(2)AR) structure at codons 16 and 27 alter receptor function in vitro and are associated with asthma severity and airway hyperresponsiveness but have not been linked to asthma diagnosis. The nature of the relation in a more homogeneous population is uncertain. OBJECTIVE: We determined frequencies of these polymorphisms to explore the association between beta(2)AR haplotypes and asthma diagnosis and phenotype. METHODS: This is a population-based, case-control study that involves a total sample of 907 unrelated Mexican Mestizos. Genotyping at beta(2)AR was identified by polymerase chain reaction-restriction fragment length polymorphism analysis. Multivariate logistic regression analysis was used to estimate the odds ratio (OR) of the association between beta(2)AR haplotype status and asthma diagnosis. RESULTS: A significant inverse association was found between subjects with Glu27 allele (OR, 0.5; 95% CI, 0.4 to 0.7) and Gly16-Glu27 alleles (OR, 0.5; 95% CI, 0.3 to 0.8) and asthma. Sex differences in this association were explored, given the complex relation between sex and asthma. Among men, a positive association was present between the "Gly16 allele without Glu27" (OR, 2.9; 95% CI, 1.26 to 6.8) and asthma. In contrast, a lower risk of asthma was found among women Gly16-Glu27 alleles (OR, 0.3; 95% CI, 0.2 to 0.6). Nocturnal asthma was associated with the Gly16 allele (OR, 1.8; 95% CI, 1.3 to 2.6). CONCLUSIONS: Variation in the beta(2)AR gene is associated in the pathogenesis of asthma and acts as a disease modifier in nocturnal asthma.     

Perceived neighborhood disorder and psychological distress among Latino adults in the United States: Considering spousal/partner relationship

It has been well-established that neighborhood disorder and disadvantage are detrimental to mental health and psychological well-being. There has been growing research interest in minority stress issues, however, less is known about how perceived neighborhood disorder matters for psychological well-being among Latino adults in the United States. Analyzing data from National Latino Asian American Study, 2002–2003, the present study investigates the relationships among perceived neighborhood disorder, spousal/partner relationships (i.e., spousal/partner strain and support), and psychological distress. The findings indicated that perceived neighborhood disorder and spousal/partner strain were positively associated with increased psychological distress, whereas spousal/partner support had no protective effect against psychological distress. Moreover, mediation analysis showed that the association between perceived neighborhood disorder and psychological distress was partially mediated by spousal/partner strain (i.e., 15.13%), not spousal support. Finally, moderation analysis revealed that the presence of spousal/partner strain exacerbated the relationship between perceived neighborhood disorder and psychological distress. Conversely, the absence of spousal/partner strain appeared to buffer the adverse impact of neighborhood disorder on psychological distress. These findings highlighted the ill effect of problematic neighborhood environments on the quality of the spousal/partner relationship and subsequently Latino's psychological well-being.