College Access and Adult Health

We investigate the relationship between college openings, college attainment, and health behaviors and outcomes later in life. Though a large prior literature attempts to isolate the causal effect of education on health via instrumental variables (IV), most studies use instruments that affect schooling behavior in childhood or adolescence, i.e. before the college enrollment decision. Our paper examines whether an increase in 2- and 4-year institutions per capita (“college accessibility”) in a state contributes to higher college attainment and better health later in life. Using 1980-2015 Census and American Community Survey data, we find consistent evidence that accessibility of public 2-year institutions positively affects schooling attainment and subsequent employment and earnings levels, particularly among whites and Hispanics. With restricted-use 1984-2000 National Health Interview Survey data, we again find that public 2-year accessibility increases schooling and benefits a host of health behaviors and outcomes in adulthood: it deters smoking, raises exercise levels, and improves self-reported health. However, most long-term health conditions are unaffected, which may be partially due to the age of our sample.

College Access and Adult Health

Change in Health Status and Access to Care in Young Adults With Special Health Care Needs: Results From the 2007 National Survey of Adult Transition and Health

Objectives Service accessibility plays a pivotal role in older adults’ mental health. However, accessibility measures used in previous studies are either objective or perceived. This study aimed to integrate both objective and perceived measures of service accessibility to explore the relationship between environmental cognition on service accessibility and mental health in older adults and the pathways. Methods We used both questionnaire data collected from 2,317 older adults in Hong Kong and geographical data to explore the direct and indirect effect of environmental cognition (i.e. positive, negative, and matching evaluation) relating to service accessibility on mental health and two pathways (i.e. physical activity and sense of belonging) based on a structural equation model. Results Physical activity mediated the positive relationship between non-negative perceptions toward access to convenience stores, leisure facilities, clinics, community centers, places of worship and mental health. Sense of community can significantly mediate the positive relationships between non-negative perceptions toward all 10 types of services and mental health. Conclusion This study provides an empirical contribution to environmental cognition theory and person-environment fit theory; its findings have implications for urban planning policy.

Global impacts of video gaming behavior on young adults’ mental health during the COVID-19 pandemic: A systematic literature review

National data on the health of children and adolescents exposed to commercial sexual exploitation (CSE) are lacking, during both adolescence and adulthood. Using nationally representative data, we examined the health of male and female adolescents in grades 7-12 who experienced CSE exposure and subsequent adult health outcomes and access to health care. Our retrospective cohort study used data from Waves I-IV of the National Longitudinal Study of Adolescent to Adult Health (1994-2008) to characterize relationships between CSE exposure before or during adolescence and health during adolescence and adulthood. The analytic sample included 10 918 adult participants aged 24-34 in Wave IV. We performed bivariate analyses, stratified by sex, to quantify the relationship between CSE exposure before or during adolescence and adolescent and adult health outcomes. Four percent of participants reported having a CSE exposure before or during adolescence (5% of males, 3% of females). Factors associated with CSE exposure among adolescents included race/ethnicity, parental education level, previous abuse, same-sex romantic attractions, history of ever having run away from home, and substance use. During adolescence, exposure to CSE was associated with worse overall health, depressive symptoms, and suicidal thoughts for both males and females. In adulthood, adolescent CSE exposure was associated with depression among males and functional limitations among females. A higher percentage of males with CSE exposure before or during adolescence, compared with their non-CSE-exposed peers, used the emergency department as their usual source of care during adulthood. CSE exposure before or during adolescence was associated with poor adolescent and adult health outcomes and health care access. Observed differences between males and females warrant further exploration.

Background Societies and health systems are increasingly digitally transformed. Digital communication is considered a means to reach persons in vulnerable contexts, such as migrant families. We performed a scoping literature review to evaluate the assumption in the context of maternal and child health (MCH) and validate results qualitatively. Methods Jan. 2020 a literature search was conducted (Web of Science, MEDLINE, CINAHL) using synonyms for migrants, health, digital media and information seeking, limited to publications in English. Two researchers independently rated titles and then abstracts for suitability, obtaining consensus at each step. Primary target group, health topic and related life phase, country of data origin, and primary study question were extracted from remaining manuscripts. Data on digital health information seeking (impact, reasons, barriers, context) will be extracted from full texts and discussed. A focus group with mothers with migrant background in Switzerland will be held in Sept. to validate findings. Results After title and abstract screening 41 from 315 articles remained. 25 articles focused primarily on migrant populations and information seeking behavior. Dominant populations were Latinos, Hispanics and Asians. Studies were performed in North America (n = 32), Europe, Asia and Australia (each n = 3); seven were on MCH, four on child and adolescent and 30 on adult health (mainly general health and health access). Further results extracted from manuscripts and focus group validation results will be presented at the conference. Conclusions Few studies on health information seeking behavior of migrants and MCH exist. Evidence on digital information seeking overall is scarce. The many North American studies indicate an advanced digital transformation of health promotion and care. The discussion will focus on the generalizability of literature findings and potential of digital health promotion via MCH in vulnerable populations.

IntroductionAs society ages and the digital economy continues to develop, accessibility to information and communication technology (ICT) has emerged as a critical factor influencing the mental health of older adults. Particularly, in the aftermath of the COVID-19 pandemic, the need for non-face-to-face communication has significantly increased older adults’ reliance on ICT for accessibility. This transition from a self-motivated engagement to a more socially passive mode of interaction highlights the importance of creating a digitally inclusive aging society.MethodsThis empirical study used pooled cross-sectional data from the Digital Gap Survey conducted in South Korea in 2018 and 2020. It aimed to analyze the association between ICT accessibility and the mental health of older adults during the COVID-19 pandemic.ResultsA significant positive relationship was found between ICT and mental health among older adults in South Korea. However, this positive association weakened during the COVID-19 period. Furthermore, the analysis revealed heterogeneity among older adults by age, sex, and place of residence, with older females in their 70s living in rural areas experiencing the greatest weakening.DiscussionThese results highlight the need for tailored interventions and support mechanisms for specific demographic groups of older adults. We recommend that the South Korean government implement various policies to facilitate the post-COVID-19 digital landscape. These include initiatives such as ICT-related education programs, development of user-friendly e-government systems, and creation of social media platforms designed to accommodate the needs and preferences of older adults.

Editorial on the Research Topic Mental health in older adults with cognitive impairments and dementia: a multidisciplinary perspective Population aging has become an irreversible global trend. The number of people over 60 years old worldwide has surpassed 1.1 billion, with rising prevalence of cognitive impairment and dementia. Extensive literature has evidenced the high incidence rates and detrimental impacts of mental illnesses among older adults (1, 2). Older patients with cognitive decline or dementia coupled with psychiatric conditions are generally more susceptible to medical risks owing to the chronic and costly nature of such disorders. Moreover, public health emergencies, racism, climate change and other social or policy changes can also potentially affect overall treatment regimens, exacerbating existing mental health problems among older people with cognitive decline or dementia. Reports indicate that multidisciplinary approaches have become mainstream in this field, with interdisciplinary scholars examining geriatric mental health through an expanded lens. They account for not only the illnesses themselves, but also social impacts, neural mechanisms, genetic influences, and policy guidance to enhance standards of care holistically. Therefore, this Research Topic applies a multidisciplinary perspective from medical and social domains (e.g., epidemiology, geriatrics, genomics, psychiatry, sociology, management) utilizing diverse methodologies and theories. It provides critical insight into mental health mechanisms, accessibility, utilization, strategies, social indicators, and outcomes for those with cognitive impairments and dementia. The aim for this Research Topic is to facilitate communication and disseminate the latest advancements across countries, cultures, and disciplines.

Health care access, psychosocial outcomes and mental health in adults living with epilepsy during the COVID-19 pandemic

Dental health in adults and subadults from the 16th-century plague cemetery of Alghero (Sardinia, Italy)

Objective: In this paper, we explore how the relevance of college-level personal health courses could be enhanced and how these courses could be leveraged for improving student health and providing access to information useful in reducing health disparities and improving overall health in adulthood. Methods: We examine and interpret literature on college student health and the content and delivery of personal health courses. Results: College-level personal health courses occur in many different academic units and through numerous delivery modes. College students’ ability to access and use health information may be a social determinant of health later in life. Whereas specific course content varies, it underperforms in relevance to students’ lives. Specific areas needing improvement are mental health, interpersonal relationships, food selection and preparation on a budget, harm reduction with respect to alcohol use, and other areas that currently receive insufficient attention. Conclusion: Personal health courses may have the potential to reduce health disparities if access to college and relevant health-related information can be operationalized better. Motivated by the impact on collegiate life by the COVID-19 pandemic, we recommend research that leads to reform of college-level personal health courses responsive to student interests and delivery mechanisms that enhance motivation to learn, and result in reduced susceptibility to chronic diseases and improved adult health and quality of life.

Trends in Use of Antipsychotics and Mood Stabilizers Among Medicaid Beneficiaries With Bipolar Disorder, 2001-2004

Issue There are two main public mental health problems in Slovenia: suicide and harmful alcohol consumption. The average suicide rate (25 per 100.000 people) is above the European average. There are substantial differences in the accessibility of mental health services and socio-economic and demographic differences within individual geographical areas. To address those challenges the establishment of comprehensive and accessible mental health centres within local environments were planned. Description of the Problem First ten adult mental health centres (AMHC) were established last year, one covering population of approximately 80.000 people. The implementation process is well established, while the evaluation process has just begun and assessment of characteristics of the population covered by one of the first AMHC serves as the basis. Results There were 74 people in medical treatment in one of the rural AMHC in Slovenia in 2019, mostly women (68.9%) and older people (x ̅=61.9). The income of people included is very low (x ̅=523 EUR). The number of hospitalisations were higher before inclusion (x ̅=1.2 before; x ̅=0.2 after). Beside regular treatment patients receive non-pharmacological therapies such as health education (90.5%) and occupational therapy (47.3%). Within first patients’ assessment mostly the physical health needs, psychological distress, daytime activities and safety to self were not met, which changes after the second assessment (p < 0.05, t > 2.000). Lessons Multiple needs of the patients seem to be well addressed through comprehensive, multidisciplinary team work and intersectoral collaboration at local level (e.g. with social work centres, family physicians, non-governmental services). Key messages Patients’ needs are well addressed through patient-centred approach at local level. Comprehensive, multidisciplinary team work and intersectoral collaboration at local level can address multiple needs of the patients.

Approximately 15 percent of U.S. adults report some degree of hearing loss. Untreated hearing loss is a huge issue for health.1,2 It may lead to isolation, and has been associated with serious conditions such as depression,3 anxiety, low self-esteem, dementia,4 reduced mobility, and falls.5 Hearing aids and other assistive devices can significantly improve the quality of life of many people, but only about one in four adults who could benefit from hearing aids has ever used these devices, citing roadblocks such as cost, stigma, perception that they are not effective, and limited access to hearing health care.1 As the lead federal agency supporting research and initiatives to prevent, detect, and treat hearing loss, the National Institute on Deafness and Other Communication Disorders (NIDCD), part of the National Institutes of Health, has made research on improving access to and affordability of hearing health care a priority over the past decade. In 2009, the NIDCD started a coordinated effort to tackle accessible and affordable hearing health care by forming a working group.6 The working group created a blueprint for research priorities to enhance the affordability and accessibility of hearing health care for adults with mild-to-moderate hearing loss. This launched a focused effort by the institute that has, to date, inspired a dozen funding opportunities leading to NIDCD's support of 40 research projects on the topic. In 2016, the National Academies of Sciences, Engineering, and Medicine (NASEM) published a consensus report, “Hearing Health Care for Adults: Priorities for Improving Access and Affordability.”1 The NIDCD co-sponsored this effort with other federal agencies and the Hearing Loss Association of America. The independent expert panel that conducted the study made recommendations for hearing health care reform, prioritizing the needs of adults with hearing loss. The panelists encouraged agencies, organizations, and professionals to improve access and affordability of services, develop innovative technologies, and better inform consumers about their choices for managing hearing loss. One of the panel's recommendations was for the U.S. Food and Drug Administration (FDA) to create and regulate a new category of over-the-counter (OTC) hearing devices, which could improve access to affordable hearing loss interventions for adults with mild-to-moderate hearing loss. In 2017, the president signed a law that directed the FDA to establish guidelines and quality standards for this new category of OTC hearing aids. A draft of these regulations is underway and expected to be released by August 2020.7 NIDCD-funded research informed the expert panel's recommendations, as well as the policy changes around improving adult hearing health care. For example, preliminary research showed that people with hearing loss are able to independently adjust the settings on their hearing devices in response to changing acoustic environments,8 and when given the ability to control their own hearing aid settings, they are generally more satisfied with the sound of the devices than with the audiologist's fit.9 In 2016, the first randomized, double-blind, placebo-controlled clinical trial comparing an OTC delivery model of hearing aids with traditional fitting by an audiologist found that hearing aid users in both groups reported similar benefits, supporting the viability of a direct-to-consumer service delivery model.10,11 The NIDCD also supports research that improves hearing aid technology for consumers. A small business research grant funded by the NIDCD led to the first self-fitted hearing aid approved by the FDA.12,13 As hearing researchers and clinicians, we are excited to witness the transformation of hearing health care for adults in the United States with mild-to-moderate hearing loss. We applaud the scientists who provided critical evidence leading to positive changes in public policy and in the marketplace. The NIDCD remains committed to improving the landscape of adult hearing health care, and we encourage continued research in this area to fill remaining gaps.