AGRICOH: a consortium of agricultural cohorts

AGRICOH is a recently formed consortium of agricultural cohort studies involving 22 cohorts from nine countries in five continents: South Africa (1), Canada (3), Costa Rica (2), USA (6), Republic of Korea (1), New Zealand (2), Denmark (1), France (3) and Norway (3). The aim of AGRICOH, initiated by the US National Cancer Institute (NCI) and coordinated by the International Agency for Research on Cancer (IARC), is to promote and sustain collaboration and pooling of data to investigate the association between a wide range of agricultural exposures and a wide range of health outcomes, with a particular focus on associations that cannot easily be addressed in individual studies because of rare exposures (e.g., use of infrequently applied chemicals) or relatively rare outcomes (e.g., certain types of cancer, neurologic and auto-immune diseases). To facilitate future projects the need for data harmonization of selected variables is required and is underway. Altogether, AGRICOH provides excellent opportunities for studying cancer, respiratory, neurologic, and auto-immune diseases as well as reproductive and allergic disorders, injuries and overall mortality in association with a wide array of exposures, prominent among these the application of pesticides.     

Social determinants of ethno-racial inequalities in substance use: a decomposition of national survey data

Background

Similar to the US, mortality due to suicide and the use of opioids, alcohol, and other substances (so-called “Deaths of Despair”), is rising in Canada and has been disproportionately observed among Whites compared to other racial and ethnic groups. This study aimed to assess the determinants of the ethno-racial differences in the use of substances that underlie these deaths.

Methods

Using nationally representative data from the Canadian Community Health Survey (2003, 2015–2016, 2018 cycles), a decomposition analysis was performed to estimate the contribution of psychosocial determinants, including age, sex, marital status, immigration, education, income, rurality, and affective health on inequalities between White and non-White populations in illicit substance, opioid, and problematic alcohol use and combined use (≥ 2) of substances.

Results

Overall, White respondents reported higher levels (by 5% to 10%) of substance use than non-White peers. Over 30% of the ethno-racial inequalities in illicit substance, problematic alcohol, and polysubstance use are explained by the protective role of immigration among those who are not White, whose low levels of substance use lower the prevalence in the non-White population overall. Among those born in Canada, no ethno-racial differences in substance use were observed.

Conclusion

Social determinants, particularly immigrant status, explain a substantial proportion of ethno-racial inequalities in substance use in Canada. The jump in substance use between racialized populations who immigrated to Canada and those Canadian-born highlights the importance of exploring within-group variability in deaths of despair risk and considering how intersecting forces including systemic racism shape substance use patterns across generations.

     

Extremes of weight gain and weight loss with detailed assessments of energy balance: Illustrative case studies and clinical recommendations

Extreme weight changes, or changes in weight greater than 10 kg within a 2-year period, can be caused by numerous factors that are much different than typical weight fluctuations. This paper uses two interesting cases of extreme weight change (a female who experienced extreme weight gain and a male who experienced extreme weight loss) from participants in the Energy Balance Study to illustrate the physiological and psychosocial variables associated with the weight change over a 15-month period, including rigorous assessments of energy intake, physical activity (PA) and energy expenditure, and body composition. In addition, we provide a brief review of the literature regarding the relationship between energy balance (EB) and weight change, as well as insight into proper weight management strategies. The case studies presented here are then placed in the context of the literature regarding EB and weight change. This report further supports previous research on the importance of regular doses of PA for weight maintenance, and that even higher volumes of PA are necessary for weight loss. Practitioners should emphasize the importance of PA to their patients and take steps to monitor their patients’ involvement in PA.