Behavioral Risk Factor Research Articles

Adverse childhood experiences and myocardial infarction: Analysis of United States Behavioral Risk Factor Surveillance System (BRFSS) data

Adverse childhood experiences (ACEs) have been linked to an increased risk of disease in adulthood and a range of other negative health outcomes, including cardiovascular disease (CVD). This study aims to build on previous research on ACEs and CVD by investigating the association between ACEs and heart attack or myocardial infarction diagnosis. Our analysis used cross-sectional data from the 2021 Behavioral Risk Factor Surveillance System (BRFSS) annual survey and ACE Module questionnaires. Responses included data from a national sample of 52,492 adults aged 18 years or older in the United States. ACEs value is a composite score of physical, emotional and sexual abuse, household dysfunction, neglect, and other childhood traumas. The study population had a mean number of 1.75 ACEs (SD 2.25), with 61% experiencing at least one ACE and 17% experiencing four or more ACEs. Almost 6% of adults in the sample reported a previous myocardial infarction (5.7%). Multiple logistic regression analysis demonstrated that, after adjusting for a variety of sociodemographic and health covariates, every one-event increase in the number of ACEs was significantly associated with 6% increased odds of myocardial infarction in adulthood (adjusted odds ratio [aOR] = 1.06, 95% confidence interval [CI] = 1.04 – 1.09, p <0.001). Efforts to decrease the incidence of myocardial infarction and reduce cardiac-related mortality in the U.S. should include policies that reduce the occurrence of ACEs and provide resources for adults to address their childhood traumas.

Examining Self-Reported Physical Activity Levels Among Kidney Disease Patients in the United States Using the Behavioral Risk Factor Surveillance System (BRFSS) Database: A Retrospective Study.

Kidney diseases have a gradual and subtle onset, which usually results in end-stage renal disease with patients requiring renal replacement therapy. Though pharmacotherapy plays a crucial role, integrating lifestyle modifications like increased physical exercise has been associated with significant improvement in health for kidney disease patients. This study aims to retrospectively analyze the prevalence of self-reported physical activity among patients of kidney disease in the United States, based on demographic, socioeconomic, and healthcare access variables for the year 2021. Data was extracted from the Behavioral Risk Factor Surveillance System Web Enabled Analysis Tool (BRFSS WEAT) for the year 2021. Descriptive data, including numbers and percentages, was generated for each variable using cross-tabulations in the BRFSS WEAT. The data was stored in Microsoft Excel (Microsoft Corporation, Redmond, WA, USA), and statistical analysis was conducted using R version 4.3.1 (R Foundation for Statistical Computing, Vienna, Austria, https://www.R-project.org/). Statistical tests employed included the Chi-square test and Fisher's exact test to ensure robust and reliable results. A total of 436,057 people participated in the BRFSS study. Out of this, 17,054 (39%) self-identified to the question "ever told you had kidney disease." In the past month, 10,004 (58.7%) participants having kidney disease were involved in physical activity, whereas 7,050 (41.3%) were not. Also, the level of physical activity among kidney disease participants was highest in ages 18-25 (75.5%), male gender (63.6%), White non-Hispanic race (59.4%), patients having advanced education (64.2%), employed (72.6%), high income (82.1%), and having routine checkup within the past one year (8,957, 58.3%). Kidney disease patients in the United States who self-reported physical activity were found to have statistical significance between various demographic, socioeconomic, and last routine checkup variables. Prospectively, interventions must be designed to increase physical activity among kidney disease patients with a focus on high-risk demographic groups like older adults, people with lower socioeconomic status, and people who don't get regular checkups.

Prevention Lab: a predictive model for estimating the impact of prevention interventions in a simulated Italian cohort

BackgroundA large fraction of the disease burden in the Italian population is due to behavioral risk factors. The objective of this work is to provide a tool to estimate the impact of preventive interventions that reduce the exposure to smoking and sedentary lifestyle of the Italian population, with the goal of selecting optimal interventions.MethodsWe construct a Markovian model that simulates the state of each subject of the Italian population. The model predicts the distribution of subjects in each health status and risk factor status for every year of the simulation. Based on this distribution, the model provides a rich output summary, such as the number of incident and prevalent cases for each tracing disease and the Disability Adjusted Life Years (DALY), used to assess the impact of preventive interventions, and how this impact is shaped in time.ResultsThis paper focuses on the methodological aspects of the model. The proposed model is flexible and can be applied to estimate the impact of complex interventions on the two risk factors and adapted to consider different cohorts. We validate the model by simulating the evolution of the Italian population from 2009 to 2017 and comparing the output with historical data. Furthermore, as a case-study, we simulate a counterfactual scenario where both tobacco and sedentary lifestyle are eradicated from the Italian population in 2019 and estimate the impact of such intervention over the following 20 years.ConclusionsWe propose a Markovian model to estimate how interventions on smoking and sedentary lifestyle can affect the reduction of the disease burden, and validate the model on historical data. The model is flexible and allows to extend the analysis to consider more risk factors in future research. However, we are aware that, given the ever-increasing availability of data, it is necessary in the future to increase the complexity of the model, to be closer to reality and to provide decision-making support to the policy-makers.

Modifying Non-communicable Disease Behaviours through Effective Health Communication and Behaviour Change: A Systematic Review

Abstract Non-communicable diseases (NCD) account for 74% of global mortality. Approximately 86% of all premature deaths occur in low- and middle-income countries majorly attributed to lifestyle changes or behavioural risk factors. The theory-based behaviour change interventions (BCIs) appear promising, but their applicability is not explored within the national programmes. The current paper aims to review the effectiveness of theory-based BCI in modifying the NCD risk factors and provide insights into the national NCD programmes. Interventions conducted to evaluate theory-based BCIs between 2002 and 2022 in modifying behavioural risk factors for NCDs were identified from multiple databases (PubMed, Scopus, Google Scholar and Cochrane Library) for systematic review. The final analysis included 35 studies that used theories and models that broadly come under one of the four approaches, i.e. intrapersonal (targets inherent individual factors for behaviour change), interpersonal (targets the family or groups), community (target socio-cultural ecosystems) and integrated (combination of other three approaches). Twenty-seven studies showed significant results. The highest number of studies were of interpersonal approach using socio-cognitive theory and integrated (11 each), and strength of evidence was moderate for both. Twenty-six studies focused on physical inactivity and unhealthy diet. The review supports the effectiveness of behaviour change interventions for mitigating NCD risk factors. Further efforts, including implementation research study methods, should be directed to evaluate effects of these interventions on population health outcomes within specific cultural and social contexts.

Prevalence of COVID-19 and Long COVID by industry and occupation: Behavioral Risk Factor Surveillance System 2022.

Workers in healthcare and other essential occupations had elevated risks for COVID-19 infection early in the pandemic. No survey of U.S. workers to date has comprehensively assessed the prevalence of both COVID-19 and Long COVID across industries and occupations (I&O) at a detailed level. Behavioral Risk Factor Surveillance System data for 2022 from 39 states, Guam, and the U.S. Virgin Islands were used to estimate prevalence of self-reported history of COVID-19 and Long COVID, as well as the prevalence of Long COVID among those reporting prior COVID-19, by broad and detailed I&O. Adjusted prevalence ratios were used to compare outcome prevalence in each I&O to prevalence among all other workers combined. By broad I&O, workers in healthcare, protective services, and education had elevated prevalences of COVID-19. The prevalence of Long COVID was elevated in healthcare and protective service but not education workers. Detailed I&O with significantly elevated prevalences of COVID-19 but not Long COVID included Dairy Product Manufacturing industry workers and subsets of mining workers. Both COVID-19 and Long COVID were elevated among bartenders/drinking places and personal care and appearance workers. The prevalence of Long COVID was elevated among farmworkers who reported having had COVID-19. Industries and occupations with elevated levels of COVID-19 or Long COVID in this study may warrant increased measures to prevent transmission of airborne respiratory viruses. Accommodations are a key component for supporting workers in all workplaces. This new information about the distribution of Long COVID by I&O suggests where employer understanding and implementation of tailored workplace supports and accommodations are most needed to support continued employment of affected workers.

Lung cancer incidence rates in young women and men by state in the United States.

Previous studies reported higher lung cancer incidence in women than men among persons aged 35-54 years in the United States, a reversal of historically higher rates in men. We examined whether this pattern varies by state. Based on lung cancer incidence (2015-2019) data among adults aged 35-54 years from Cancer in North America database and historical cigarette smoking prevalence data (2004-2005) among adults 20-39 years from the Behavioral Risk Factor Surveillance System, incidence rates in women were equal to or higher than rates in their male counterparts in 40 of 51 states, with statistically significant differences in 20 states (two-sided, p < .05). In contrast, current and ever smoking prevalence in women compared to men was statistically significantly lower (33 and 34 states, respectively) or similar. Furthermore, there was no association between differences in historical smoking prevalence and lung cancer incidence by sex. Lung cancer incidence rate is higher in young women than young men in most states and is unexplained by differences in smoking prevalence.

A Comparison of Nationwide Dental Utilization and Medicaid Dental Coverage

Background: In 2020, Medicaid provided health and long-term care coverage to 72,995,197 adults aged 18-64 in the United States. While Medicaid broadly covered medical services, dental benefits were limited in many states. This study aims to examine the relationship between state-level differences in adult Medicaid dental coverage and access to oral health care, using oral health metrics from the Centers for Disease Control and Prevention (CDC). Methods: We conducted a retrospective analysis of data from the official Medicaid website, which outlined dental procedures covered in each state. Dental attendance for individuals aged 18 and older, based on income, was obtained from the Behavioural Risk Factor Surveillance System (BRFSS) for the period of January to December 2019. Authors analysed dental visits across three income groups: Group A (&lt;$15,000), Group B ($15,000-$24,000), and Group C (&gt;$50,000). Each dental procedure covered by Medicaid was assigned a value of '1,' resulting in a 'Total Score' for each state (ranging from 0-13). States were then grouped into categories based on their Total Scores: 1-4, 5-8, and 9-12. Scores of '0' and '13' were analysed separately. Authors found that Groups A and B visited the dentist less frequently than Group C, suggesting a correlation between income, dental coverage, and access to care. Result: This study examined the relationship between state-level Medicaid benefits and access to Oral Health care, demonstrating a direct relationship between Medicaid coverage in each state and overall access to dental services in the same state. Conclusion: Expanding Medicaid dental coverage for various procedures will enhance accessibility to dental care and ultimately protect oral health.

Latent classes of sleep problems and subjective cognitive decline among middle-aged and older adults in the United States

ObjectivePrevious studies have linked sleep problems to subjective cognitive decline (SCD) using a variable-centered approach (e.g., adding sleep symptoms to form a score); however, sleep problems may cluster differently between individuals. Thus, employing a person-centered approach, we aimed to: 1) identify profiles of self-reported sleep problems among U.S. middle-aged and older adults; 2) examine the cross-sectional association between these classes and SCD. MethodsWe studied 33,922 adults aged 45+ years from the 2017 U.S. Behavioral Risk Factor Surveillance System (BRFSS) with data on sleep problems, including short or long sleep duration, trouble falling or staying asleep, unintentionally falling asleep, snoring loudly, and observed apneas. Latent class analysis classified participants based on their responses to sleep items. We then used a subsample from Oregon, the only state that administered both sleep and SCD modules (n = 2,747), to examine the association between class membership and SCD using logistic regression, adjusting for sociodemographic and health-related characteristics. ResultsWe identified and labeled four classes: “Healthy Sleep” (48.0 %); “Primarily Apnea” (25.8 %); “Primarily Insomnia” (17.6 %); and “Comorbid Insomnia and Sleep Apnea (COMISA)” (8.6 %). In adjusted models, individuals in the “COMISA” class had almost twice the odds of SCD, compared to those in the “Healthy Sleep” class (OR=1.91, 95 % CI =1.15–3.15). ConclusionsCompared to U.S. middle-aged and older adults with healthy sleep, those with COMISA were significantly more likely to report SCD, which is a risk factor for dementia. Studies are needed investigating whether sleep interventions delay cognitive decline in these individuals.

The mediating role of behavioral risk factors in the pathway between childhood disadvantage and adult psychological distress in a Finnish employee cohort.

Childhood disadvantage is associated with increased adult psychological distress, but the role of behavioral risk factors in the pathway remains unclear. We examined whether behavioral risk factors mediate the effects of childhood disadvantage on adult psychological distress. We used the Helsinki Health Study data of employees of the City of Helsinki, Finland, aged 19-39 (mean age 32.0) years at baseline (2017). We included women (n = 2397) and men (n = 586) who responded to both baseline and follow-up (2022) surveys. At baseline, eight types of childhood disadvantage were asked retrospectively, and six adult behavioral risk factors were included. Psychological distress was measured by the DASS-21 at follow-up. We conducted mediation analyses using generalized structural equation modeling. Among women, we found indirect path effects of childhood disadvantage on adult psychological distress through behavioral risk factors (symptoms of depression: β = 0.68, 95% CI 0.20-1.17; anxiety: β = 0.54, 95% CI 0.13-0.95; and stress: β = 0.69, 95% CI 0.20-1.09). Among men, childhood disadvantage contributed only directly to adult depressive (β = 0.71, 95% CI 0.16-1.26) and stress (β = 0.61, 95% CI 0.10-1.13) symptoms. Our findings suggest that behavioral risk factors can mediate some of the adverse effects of childhood disadvantage on adult psychological distress among women.

Differences in Exposures to Adverse Childhood Experiences by Primary Source of Health Care, Behavioral Risk Factor Surveillance System 2019-2020.

To estimate the prevalence of adverse childhood experiences (ACEs) among a population-based sample of adults in the United States by their primary source of health care. Debate continues around the effectiveness and implementation of health care-based screening of ACEs. However, it is unclear how the burden of ACEs would be distributed across different sources of health care (ie, what a health system might expect should it implement ACEs screening). Data are from 8 U.S. states that include optional modules for ACEs and health care utilization in their 2019 or 2020 Behavioral Risk Factor Surveillance System survey. The analytic sample includes respondents with completed interviews (n = 45,820). ACEs were categorized into ordinal categories of 0, 1, 2, 3, or ≥4, and the prevalence of ACEs was summarized across 5 sources of health care: (1) employer-based or purchased plan, (2) Medicare, Medicaid, or other state programs, (3) TRICARE, Veterans Affairs, or military (ie, military-related health care), (4) Indian Health Service, or (5) some other source. All estimates were weighted to account for the complex sampling design. Across all health insurance types, at least 60% of individuals reported at least one ACE. The greatest prevalence of patients reporting ≥4 ACEs occurred for military-related health care (21.6%, 95% CI = 18.2-25.5) and Indian Health Service (45.4%, 95% CI = 22.6-70.3). ACEs are extremely common across sources of health care, but some health systems have greater proportions of patients with high ACE exposures. The unique strengths and challenges of specific health care systems need to be integrated into the debate about clinical ACEs screening.

The Health of Those Who Feed Us: An Assessment of Health Inequities Along the United States Food Chain.

While the health of all depends on the food chain, few studies have focused systematically on the health of food chain workers themselves (production, manufacturing, wholesale, retail, and commercial and institutional services). In this study we used 2018 and 2019 data from the Behavioral Risk Factor Surveillance System (BRFSS) to examine health-related metrics of food chain workers, combined and by industry sector, compared to non-food chain workers, among 32 U.S. states. Logistic regression indicated U.S. food chain workers had higher prevalences of barriers to health care access, smoking, no physical exercise, and poor self-reported health than all other workers. Patterns were similar among food chain workers in all industry sectors except wholesale. Additionally, commercial food services workers had higher prevalence of poor mental health, while institutional food services workers had higher prevalences of obesity, diabetes, and hypertension than all other workers. We discuss implications of these results for interventions, with specific attention to improving employment conditions. Food chain worker health is critical for food system sustainability and population health equity.

Association between adverse childhood experiences and current use of e-cigarettes or electronic vaping products across sex race ethnicity and age based on 2020–2022 BRFSS data

IntroductionThe use of e-cigarettes or other electronic vaping products (EOEVP) has been on the rise since their introduction. Concurrently, Adverse Childhood Experiences (ACEs) have been linked to various negative behavioral health outcomes. We explore the association between ACEs and current EOEVP use, with a focus on variations across sex, race/ethnicity, and age.MethodsUtilizing data from the Behavioral Risk Factor Surveillance System (BRFSS) for 2020–2022, we analyzed responses from 202,126 adults in the United States in a cross-sectional study. Multivariable logistic regression models were used to evaluate the adjusted odds ratios (aORs) of current EOEVP use for different levels of ACEs. Stratified and interaction analyses were used to examine potential effect modification.ResultsAmong adults 54 years of age and younger, even a lower number of ACEs [1 (aOR 1.52), 2 (aOR 2.01), and 3 (aOR 1.51)] was associated with higher odds of current EOEVP use. Stratified analyses revealed significant differences in the odds of current EOEVP use among Non-Hispanic White adults between 1 ACE (95% CI 1.75–2.28) and 4 ACEs (2.34–3.17). Hispanic adults with ≥ 1 ACEs (p-value 0.001) and 8 ACEs (p-value 0.005) showed strong associations compared to Non-Hispanic White adults. The influence of ACEs on current EOEVP use was observed to decrease with age, particularly in older adults with fewer ACEs. The aORs did not very by sex.ConclusionThe findings emphasize the importance of considering any number of ACEs in public health strategies targeting current EOEVP use, especially among younger adults and specific minority groups. These insights are crucial for tailoring interventions and policies to address the nuanced impacts of early life adversities on health risk behaviors.

Exploring Veteran Mental Health Disparities: A Comparative Analysis of Rural and Urban Communities in the Midwest of the United States.

Veterans face unique mental health challenges influenced by their service experiences and post-military transitions into civilian life. Geographic location also plays an integral role in impacting veterans' outcomes and access to proper care. The purpose of this case study is to examine disparities between rural and urban veterans in the Midwest using data collected from the 2022 Behavioral Risk Factor Surveillance System (BRFSS). Self-reported bad mental health days among veterans in rural and urban regions across twelve Midwestern states were analyzed through direct rate estimation and small area estimation techniques utilizing RStudio software. Higher rates of poor mental health days were ultimately observed among urban veterans in most states through both analyses. The results of the direct rate analysis revealed 13.5% of veterans reporting 14 + poor mental health days per month versus 9.5% in rural areas. Likewise, the results of the small area analysis demonstrated 12.2% of veterans reporting 14 + days of poor mental health days per month in urban areas versus 9.8% in rural areas. This highlights the significance of environmental stressors and social determinants of health in differentially impacting mental health outcomes. Thus, tailored interventions utilizing interdisciplinary teams are needed to meet the unique barriers for veterans in different geographic contexts. Despite the cross-sectional nature of the study and reliance on self-reported data, this case study provides valuable insights for mental health disparities among Midwest veterans. Creating a more equitable and accessible mental health landscape for veterans will require targeted and collaborative approaches.

Behavioral Risk Profiles of Stroke Survivors Among US Adults: Geographic Differences Between Stroke Belt and Non-Stroke Belt States.

Stroke, a leading cause of illness, death, and long-term disability in the US, presents with significant disparities across the country, most notably in southeastern states comprising the "Stroke Belt." This study intended to identify differences between Stroke Belt states (SBS) and non-Stroke Belt states (NSBS) in terms of prevalence of stroke, sociodemographic and behavioral risk factors, and health-related quality of life (HRQOL). We analyzed data from the 2019 Behavioral Risk Factor Surveillance System to compare demographic characteristics, risk factors, physical activity adherence, functional independence, and HRQOL among stroke survivors in SBS and NSBS. Of 18,745 stroke survivors, 4,272 were from SBS and 14,473 were from NSBS. Stroke was more prevalent in SBS (odds ratio [OR] = 1.39; 95% CI, 1.35-1.44; P < .001), with significant differences by age, sex, and race and ethnicity, except for Hispanic ethnicity. Selected stroke risk factors were more common in every category in SBS. Stroke survivors in SBS were less likely to meet physical activity guidelines for aerobic (OR = 0.77; 95% CI, 0.69-0.86; P < .001) and aerobic and strengthening combined (OR = 0.77; 95% CI, 0.70-0.86; P < .001) activities. Stroke survivors in SBS were more likely to not meet either physical activity guideline (OR = 1.31; 95% CI, 1.22-1.41; P < .001). Living in SBS significantly increased the odds of stroke occurrence. Stroke survivors from SBS reported lower HRQOL and insufficient physical activity as well as lower functional independence. Specific strategies are needed for residents of SBS, with a focus on policies and primary and secondary prevention practices across healthcare professions.

Analysis of Mpox by Occupation and Industry in Seven U.S. Jurisdictions, May 2022-March 2023.

During responses to outbreaks, the collection and analysis of data on employed case patients' industry and occupation are necessary to better understand the relationship between work and health outcomes. The occurrence of mpox by occupation and industry has not previously been assessed in the context of the 2022 outbreak. We analyzed employment data from 2548 mpox cases reported to the U.S. Centers for Disease Control and Prevention from surveillance systems in seven U.S. jurisdictions and population-based reference data on employment patterns from the U.S. Bureau of Labor Statistics to describe the differential proportionate distribution of cases across occupation and industry groups using the proportionate morbidity ratio. In gender-specific analyses, we found that men employed in certain occupations and industries had a higher relative risk of mpox than others. While occupational transmission cannot be ruled out, it is more likely that individuals with personal and behavioral risk factors for mpox were more likely to work in these occupations and industries. This analysis provides an example of collecting and analyzing occupation and industry data in case reports to understand possible differences in risk by occupation and industry in infectious disease outbreak investigation and help inform resource allocation, messaging, and response.

Epigenetic regulation of cardiovascular diseases induced by behavioral and environmental risk factors: Mechanistic, diagnostic, and therapeutic insights.

Behavioral and environmental risk factors are critical in the development and progression of cardiovascular disease (CVD). Understanding the molecular mechanisms underlying these risk factors will offer valuable insights for targeted preventive and therapeutic strategies. Epigenetic modifications, including DNA methylation, histone modifications, chromatin remodeling, noncoding RNA (ncRNA) expression, and epitranscriptomic modifications, have emerged as key mediators connecting behavioral and environmental risk factors to CVD risk and progression. These epigenetic alterations can profoundly impact on cardiovascular health and susceptibility to CVD by influencing cellular processes, development, and disease risk over an individual's lifetime and potentially across generations. This review examines how behavioral and environmental risk factors affect CVD risk and health outcomes through epigenetic regulation. We review the epigenetic effects of major behavioral risk factors (such as smoking, alcohol consumption, physical inactivity, unhealthy diet, and obesity) and environmental risk factors (including air and noise pollution) in the context of CVD pathogenesis. Additionally, we explore epigenetic biomarkers, considering their role as causal or surrogate indicators, and discuss epigenetic therapeutics targeting the mechanisms through which these risk factors contribute to CVD. We also address future research directions and challenges in leveraging epigenetic insights to reduce the burden of CVD related to behavioral and environmental factors and improve public health outcomes. This review aims to provide a comprehensive understanding of behavioral and environmental epigenetics in CVD and offer valuable strategies for therapeutic intervention.

Prevalence and Correlates of Behavioral Risk Factors of Non-Communicable Diseases Among Undergraduates in University of Nigeria: A Cross-Sectional Study

Background: There is an increasing prevalence of behavioral risk factors of non-communicable diseases (NCDs) among the youths in low- and middle-income countries. These may later in life lead to chronic diseases with high morbidity, mortality, and undesirable economic impact. Aim: To assess and compare the prevalence of major behavioral risk factors of NCDs between medical and non-medical university students in Enugu, Nigeria. Methods: A questionnaire-based comparative cross-sectional study was carried out among 620 undergraduates of the University of Nigeria using the modified WHO STEPS questionnaire for chronic disease surveillance and the International Physical Activity Questionnaire (IPAQ). Data were analyzed with descriptive and inferential statistics at the significance level of P &lt; 0.05. Logistic regression analysis was carried out to predict the behavioral risk factors of NCDs. Results: The mean age of all the students was 22.5 ± 2.9 years. A greater proportion were females (54.8%). Physical inactivity was the most common behavioral risk factor of NCDs and was more prevalent in the medical students (91.0%) compared to 87.4% in the non-medical students. Overall, 95.0% of all respondents had at least one behavioral risk factor. For the medical students, younger age (AOR = 1.80 CI = 1.00 – 3.22, P = 0.049) and parents’ lower educational level (AOR = 3.49, CI = 1.29 – 9.40, P = 0.014) predicted the presence of risk factors. For the non-medical students, single marital status (AOR = 3.66, CI = 1.20 –11.19, P = 0.022), lower level of study (AOR =2.92, CI = 1.13– 7.57, P = 0.027) and parents’ lower level of education (AOR =6.48, CI = 1.41 – 29.85, P = 0.017) predicted the risk factors of NCDs. Conclusion: Behavioral risk factors were highly prevalent in both groups. There is an urgent need to introduce evidence-based intervention to curb the situation.

Hypertension in India: a gender-based study of prevalence and associated risk factors

BackgroundHypertension, a major non-communicable disease, is responsible for a significant number of global deaths, including approximately 17.9 million yearly. The Global Burden of Disease 2019 (GBD 2019) estimates that 19% of global deaths are attributed to elevated blood pressure. India, with a population of over 1.4 billion, is facing a serious challenge in combating this silent killer. This study aims to analyze the gender-based prevalence of hypertension in India and explore its associated risk factors using data from the fifth National Family Health Survey (NFHS-5).MethodsNFHS-5 collected data from 636,699 households across all states and union territories. The study includes standardized blood pressure measurements for 17,08,241 individuals aged 15 and above. The data were analyzed using Stata, employing descriptive statistics for the assessment of the prevalence and binary logistic regression to identify predictors of hypertension.ResultsThe study found the overall prevalence of hypertension in India to be 22.6%, with men (24.1%) having a higher prevalence than women (21.2%). Prevalence increased with age, reaching 48.4% in individuals aged 60 and above. Urban residents had a slightly higher prevalence (25%) than rural residents (21.4%), indicating the rapid spread of hypertension across all populations. Regional variations were observed, with the highest prevalence in Sikkim (37.9%) and the lowest in Rajasthan (16.5%). Increasing age, urban residence, belonging to certain religions (Muslim and other than Hindu or Muslim), and being classified as Scheduled Tribes (ST) were associated with a higher likelihood of hypertension. Conversely, belonging to Scheduled Castes (SC) or Other Backward Classes (OBC), being currently unmarried, and having higher education were associated with a lower likelihood of hypertension. Wealth index analysis revealed that those in the richest quintile were more likely to have hypertension. Behavioural risk factors, such as alcohol consumption, overweight, obesity, increased waist circumference, and high blood glucose levels, are positively associated with hypertension.ConclusionHypertension is a significant health burden in India, affecting both men and women. Age is the strongest non-modifiable predictor for both men and women. However, ageing women have higher odds of hypertension than ageing men, and this distinction becomes much more evident in their older ages. Obese women, based on BMI, have higher odds of hypertension than men. However, hypertension prevalence is slightly higher among men who are overweight or obese compared to women. BMI, waist circumference, random glucose level, alcohol use, and education level emerged as major predictors. Health education and awareness campaigns are critical to control the growing burden of hypertension in India. Policymakers must focus on preventive measures, targeting lifestyle changes and improved healthcare access for both men and women. By addressing these risk factors, India can make significant progress in controlling hypertension and reducing its impact on public health.

Assessment of knowledge and behavioral risk factors of reproductive tract infections among married women of 15–49 years in rural areas of Haldwani block, Uttarakhand

ABSTRACT Background: One of the most serious public health issues in India is reproductive tract infections (RTIs), which have a profound effect on the lives of men and women, as well as their families and communities. Objectives: To describe the sociodemographic traits, assess women’s RTI knowledge, and determine which behavioral risk factors are involved in female RTI. Methods: Using a 30-cluster sampling approach, a cross-sectional study design was employed to examine RTIs in 30 villages located in the Haldwani block of the district Nainital. Results: It was shown that just 7.6% of women knew enough about RTIs. Among the 450 women surveyed, the percentage of RTI cases was significantly lower for those who used the barrier method during menstruation (7.7%), had more than three children (25.7%), had a trained person deliver their baby in a hospital (24.1%), used condoms as a family planning method (5.6%), used sanitary pads during menstruation (25.6%), and maintained good personal hygiene (22.4%). Conclusion: The study revealed that the participants’ understanding of RTI was lacking.

Genetics of suicide ideation. A role for inflammation and neuroplasticity?

Suicide is a leading cause of death worldwide. Suicide ideation (SI) is a known risk factor for suicide behaviour (SB). The current psychobiology and genetic predisposition to SI and SB are poorly defined. Despite convincing relevance of a genetic background for SI, there is no current implementable knowledge about the genetic makeup that identifies subjects at risk for it. One of the possible reasons for the absence of a clear-cut evidence is the polygenetic nature of SI along with the very large sample sizes that are needed to observe significant genetic association result. The CATIE sample was instrumental to the analysis. SI was retrieved as measured by the Calgary test. Clinical possible covariates were identified by a nested regression model. A principal component analysis helped in defining the possible genetic stratification factors. A GWAS analysis, polygenic risk score associated with a random forest analysis and a molecular pathway analysis were undertaken to identify the genetic contribution to SI. As a result, 741 Schizophrenic individuals from the CATIE were available for the genetic analysis, including 166,325 SNPs after quality control and pruning. No GWAS significant result was found. The random forest analysis conducted by combining the polygenic risk score and several clinical variables resulted in a possibly overfitting model (OOB error rate < 1%). The molecular pathway analysis revealed several molecular pathways possibly involved in SI, of which those involved in microglia functioning were of particular interest. A medium-small sample of SKZ individuals was analyzed to shed a light on the genetic of SI. As an expected result from the underpowered sample, no GWAS positive result was retrieved, but the molecular pathway analysis indicated a possible role of microglia and neurodevelopment in SI.