Examine Health Outcomes Research Articles

1.L. Scientific session: Public Health data in support of healthy ageing policies

Abstract As Europe grapples with an ageing population, the imperative of health policies that promote healthy ageing is increasingly critical. This workshop aims to explore the significant role of public health data in shaping and supporting such policies. By integrating insights from administrative records to sophisticated research infrastructures, we will highlight the multifaceted uses of data in public health, particularly in the realms of non-communicable diseases and health-related behaviours in older populations. The session will open by examining how administrative records have been utilised within Lombardy’s regional health system to understand the epidemiology and access to care for people living with dementia. The discussion will then cover the advantages and challenges associated with integrating health data from diverse sources, emphasising the importance of quality, privacy, and the potential for real-time surveillance and response systems in healthcare. Following this, the focus will shift to the determinants of good health among older adults, presenting findings from a comprehensive cross-sectional study that identifies key factors contributing to what can be termed as “superhero” health status: seniors who maintain excellent physical and mental health. This analysis will delve into socioeconomic, behavioural, and environmental factors that influence health outcomes in the elderly, providing evidence-based recommendations for public health interventions and highlighting the potentialities of ad hoc surveys in examining health outcomes during emergencies. Thirdly, the workshop will also address the impact of significant life transitions on health behaviours, specifically the transition to retirement and its effects on alcohol consumption. Leveraging longitudinal data from a pan-European multidisciplinary research infrastructure, it will be demonstrated how retirement affects daily habits and lifestyles, including changes in alcohol consumption patterns. This segment will explore the implications of these findings for public health planning and policy formulation. In conclusion, there will be a discussion about healthcare system policies that support healthy ageing and the global impact of ageing on economics and health economics. These discussions will draw from the presented data sources and studies to suggest ways in which public health policies can be designed to reduce disparities and improve overall health outcomes among the elderly. This workshop is designed to provide a comprehensive overview of how data-driven insights can inform effective public health strategies and interventions to support an ageing society. By exploring various aspects of health data application, from individual behaviour to systemic policy adjustments, the session aims to highlight the critical role of data in promoting sustainable health and well-being in older adults, especially in the context of increasing life expectancy and prolonged retirement periods. Key messages • Harnessing data from diverse sources is crucial for understanding and enhancing healthy ageing processes. • Utilising longitudinal studies and robust data to design informed public health policies is essential for effective ageing interventions.

Away from home, into the fields: Assessing the health of undocumented and indigenous farmworkers

A large and growing literature argues that the agricultural labor market is stratified by ethnicity and legal status. However, other markers of distinction, such as indigeneity, may overlap with legal status to reveal additional health inequalities. Our study contributes to this scholarly dialogue by assessing the relation between indigeneity, legality, and health among immigrant-origin farmworkers from Latin America. To this end, we use data from the National Agricultural Worker Survey (N = 21,092) to examine health outcomes among indigenous and non-indigenous immigrants. Results indicate that indigenous farmworkers experience higher rates of pain—but not chronic conditions—than their non-indigenous counterparts. While undocumented farmworkers who are not indigenous exhibit especially favorable health, indigenous workers who are documented are significantly more likely to suffer from pain. Finally, there is limited evidence that differences in insurance coverage can fully explain the patterning between legal status, indigeneity, and health. This project sheds light on the well-being of indigenous migrant laborers in the U.S. food system, a population that experiences pervasive barriers to socioeconomic advancement at home and abroad.

Dog and owner demographics impact dietary choices in Dog Aging Project cohort.

To describe the demographic factors of owners and their dogs associated with owner feeding choices and the regularity with which those diets were fed to a US-based population of dogs. This cross-sectional analysis examined 40,367 initial survey responses from US dog owners participating in the Dog Aging Project. The surveys were collected from January 2, 2020, to December 31, 2022, and included primary and secondary diet component types and dog and owner demographic variables. Each demographic variable was compared across diet type choices with a χ2 test of independence. Most owners (82%) fed a commercially prepared extruded dry diet (kibble) as the primary diet component. Most owners (89%) reported that they fed their dogs a consistent diet over time. Owner demographic factors (income, education level) were less correlated with difference in diet choices than dog demographic factors (size, neuter status, purebred status, activity level), but owner age did correlate with choice: younger owners tended to feed kibble more compared to older owners. Home-cooked diets were most often consumed by small (< 30-lb) dogs, purebred dogs in poorer health status, and dogs with owners aged 45 years or older. Raw diets were more commonly fed to purebred, intact, and highly active dogs. Ten percent of service dogs were reportedly fed a raw diet of some sort. Demographic variables are associated with statistically significant differences in diet types selected. Nutrition studies examining health outcomes associated with the feeding of different diet types should account for these factors during design or analysis in order to avoid bias. An epidemiological tool, the directed acyclic graph, is presented. This information will help clinicians in their discussions with clients about pet nutrition.

Examining the "White Health Advantage" Effect among Latinos in the United States.

There is consensus regarding the socio-political roots of the concept of race (and ethnicity) in the United States (US). However arbitrary, the US societal constructions of race have meant racial/ethnic minorities experience disproportionate health burdens. The present study examined the so-called "white health advantage" effect in a large sample of US respondents, comparing Latinos (non-White and White) with non-Latino Whites. This cross-sectional study used deidentified data from the Dynata Global COVID Symptoms map project, collected between July 7-14, 2020 (n = 135,075). A dichotomous health status variable was created with respondents answering yes/no to any COVID-19 symptoms (difficulty breathing, coughing, fatigue, fever, and loss of taste or smell). We included relevant predisposing (age, gender, number of children, race, ethnicity, marital status, and education) and enabling factors (housing conditions, income, employment status, business ownership, and number of cars owned - a proxy measure for wealth). Multivariate logistic regression models showed significant differences in health status (as measured by COVID-19 symptoms) when comparing Latinos (non-White, White) and non-Latino Whites. For instance, higher socioeconomic status had a protective effect only among non-Latino Whites. In turn, being married/living with a partner was only associated with COVID-19 symptoms among White Latinos, indicating that the apparent benefits of this "improving" socio-political location are somewhat limited. Our study found significant differences in COVID-19 symptoms when comparing Latinos (non-White, White) and non-Latino Whites. Our findings underscore the importance of further examining health outcomes by racial identities of US Latinos, which can help inform future health equity efforts.

Perinatal Health Outcomes Among Women on Community Supervision: A Scoping Review.

The purpose of this scoping review is to review the extant literature regarding perinatal health outcomes for women on community supervision in the United States. PubMed, CINAHL, Scopus, PsycINFO, and Public Health were searched for peer-reviewed articles published in the United States from January 1, 1970, to March 7, 2023. After removal of duplicates and review of 1,412 article titles and abstracts, 19 articles were retrieved for full-text review; this yielded 4 studies for inclusion. Studies range in size from 10 to 292 participants (N = 405) and only two reported geographic locations. Three studies comprised probation or parole and two studies included court-mandated treatment for substance use. All studies examined outcomes during the postpartum period, such as mood disorder or substance use severity. No studies evaluated the health of women during pregnancy and/or childbirth. To enhance health equity and reduce maternal morbidity and mortality among women on community supervision, more inclusive research that examines health outcomes during the perinatal period is needed. Furthermore, there must be interventions that address the social determinants of health, racial and systemic discrimination, socioeconomic barriers, and violence that are often experienced among women with criminal justice system involvement.

Multiple environmental and nutritional effects of changing food consumption in urban and rural China

Driven by urbanization and increasing income, dietary changes are dramatic in China. Food consumption directly links environmental and human health, and an in-depth understanding on environment–health nexus is necessary to achieve their co-benefits. Previous studies mostly examine health outcomes through disease risks and premature deaths, overlooking the hidden hunger resulting from inadequate nutrients intakes. Here, we evaluated multiple dietary environmental and nutritional impacts as well as their linkages in urban and rural China for the period 1990–2020. The results showed that daily per capita water, land and carbon footprints are 1.25–1.61 m3, 1.67–2.23 g2, and 1.47–1.84 kg CO2eq. Fat, fiber and Ca were key nutrients influencing dietary nutritional quality. Dietary changes in China increased environmental effects, and increased intakes of both beneficial and restricted-intake nutrients. More importantly, adoption of Chinese Dietary Guidelines, Mediterranean diet, EAT–Lancet, WHO recommendations, and DASH dietary scenarios would increase environmental footprints by 33% and 48% on average compared with current urban and rural diets. It would improve nutritional quality, but increase intakes of restricted-intake nutrients. The complex trade-offs between dietary environmental and nutritional effects emphasize the need for formulating comprehensive dietary guidelines, and food waste reduction is a possible strategy for addressing the environment–health dilemma effectively.

Beyond reducing direct medical cost: examining health outcomes in tuberculosis through a difference-in-differences analysis of South Korea’s out-of-pocket payment exception policy

BackgroundUniversal health coverage and social protection are major global goals for tuberculosis. This study aimed to investigate the effects of an expanded policy to guarantee out-of-pocket costs on the treatment outcomes of patients with tuberculosis.MethodsBy linking the national tuberculosis report and health insurance data and performing covariate-adjusted propensity-score matching, we constructed data on health insurance beneficiaries (treatment group) who benefited from the out-of-pocket payment exemption policy and medical aid beneficiaries as the control group. Using difference-in-differences analysis, we analyzed tuberculosis treatment completion rates and mortality in the treatment and control groups.ResultsA total of 41,219 persons (10,305 and 30,914 medical aid and health insurance beneficiaries, respectively) were included in the final analysis (men 59.6%, women 40.4%). Following the implementation of out-of-pocket payment exemption policy, treatment completion rates increased in both the treatment and control groups; however, there was no significant difference between the groups (coefficient, −0.01; standard error, 0.01). After the policy change, the difference in mortality between the groups increased, with mortality decreasing by approximately 3% more in the treatment group compared with in the control group (coefficient: −0.03, standard error, 0.01).ConclusionThere are limitations to improving treatment outcomes for tuberculosis with an out-of-pocket payment exemption policy alone. To improve treatment outcomes for tuberculosis and protect patients from financial distress due to the loss of income during treatment, it is essential to proactively implement complementary social protection policies.

Expanding comprehensive pregnancy care for Emergency Medicaid recipients: a cost-effectiveness analysis

BackgroundEmergency Medicaid is a restricted benefits program for individuals who are low-income and immigrants ObjectiveWe compared the cost-effectiveness of two strategies of pregnancy coverage for Emergency Medicaid recipients: the federal minimum of covering the delivery only vs extended coverage to 60 days postpartum. Study DesignsWe built a decision-analytic Markov model to evaluate the outcomes and costs of these policies, and applied results to a theoretical cohort of 100,000 postpartum Emergency Medicaid recipients. We adopted the payor perspective. We examined health outcomes and cost-effectiveness over a one- and three-year time horizon. All probabilities, utilities and costs were obtained from the literature. Our primary outcome was the incremental cost effectiveness ratio of the competing strategies. ResultsExtending Emergency Medicaid to 60 days postpartum is a cost-effective strategy. Providing postpartum and contraceptive care resulted in 33,900 additional people receiving effective contraception in the first year and prevented 7,290 additional unintended pregnancies. Over 1 year; it resulted in a gain of 1,566 quality adjusted life year at a cost of $10,903 per quality adjusted life year. By 3 years of policy change, greater improvements were observed in all outcomes and expansion of Emergency Medicaid became cost-saving and the dominant strategy. ConclusionInclusion of postpartum care and contraception for immigrant women who are low-income results in lower costs and improved health outcomes.

Randomized Trial of Assisted Hybrid Closed-Loop Therapy Versus Sensor-Augmented Pump Therapy in Pregnancy.

Objective: Examine gestational safety, glycemic and health outcomes, of a hybrid closed-loop (HCL) system without pregnancy-specific glucose targets. Research Design: This was a pilot feasibility investigator-initiated, two-site, single-blind, randomized controlled trial of sensor-augmented pump therapy (SAPT) versus HCL therapy in type 1 diabetes pregnancies. Participants were enrolled in the first trimester and randomized at 14-18 weeks of gestation and used SAPT or HCL until 4-6 weeks postpartum. We compared continuous glucose monitoring (CGM) metrics, severe hypoglycemia (SH), diabetic ketoacidosis (DKA), adverse skin reactions, and pregnancy outcomes between groups. Results: Baseline characteristics were similar between groups (n = 11 HCL and n = 12 SAPT). There was no SH or DKA episode after randomization. Time spent <54 mg/dL did not differ between groups. Time spent <63 mg/dL decreased in both groups, significantly in the HCL group (3.5% [1.3% standard error] second trimester and 2.8% [1.3%] third trimester vs. 7.9% [1.3%] run-in phase, P < 0.05 for both). Mean sensor glucose was lower with SAPT compared to HCL therapy in the third trimester (119 [4] mg/dL SAPT vs. 132 [4] mg/dL HCL, P < 0.05). Third trimester time-in-range (TIR; 63-140 mg/dL) increased with SAPT (68.2% [3.1%] vs. 64.3% [3.1%] run-in phase, P < 0.05). Gestational health outcomes did not differ between groups. The HCL group used assistive techniques, such as fake carbohydrate boluses and exiting HCL overnight. Conclusions: CGM within group differences were seen for time <63 mg/dL favoring HCL therapy and TIR favoring SAPT (third trimester vs. baseline). Safety and adverse pregnancy outcomes were similar between groups.

First implantable cardiac defibrillator insertions in New South Wales, 2005-2020: an analysis of linked administrative data.

To determine the annual numbers of first ICD insertions in New South Wales during 2005-2020; to examine health outcomes for people who first received ICDs during this period. Retrospective cohort study; analysis of linked administrative health data. All first insertions of ICDs in NSW, 2005-2020. Annual numbers of first ICD insertions, and of emergency department presentations and hospital re-admissions 30 days, 90 days, 365 days after first ICD insertions; all-cause and disease-specific mortality (to ten years after ICD insertion). During 2005-2020, ICDs were first inserted into 16 867 people (18.5 per 100 000 population); their mean age was 65.7 years (standard deviation, 13.5 years; 7376 aged 70 years or older, 43.7%), 13 214 were men (78.3%). The annual number of insertions increased from 791 in 2005 to 1256 in 2016; the first ICD insertion rate increased from 15.5 in 2005 to 18.9 per 100 000 population in 2010, after which the rate was stable until 2019 (19.8 per 100 000 population). Of the 16 778 people discharged alive from hospital after first ICD insertions, 54.4% presented to emergency departments within twelve months, including 1236 with cardiac arrhythmias (7.4%) and 434 with device-related problems (2.6%); 56% were re-admitted to hospital, including 1944 with cardiac arrhythmias (11.5%) and 2045 with device-related problems (12.1%). A total of 5624 people who received first ICDs during 2005-2020 (33.3%) died during follow-up (6.7 deaths per 100 person-years); the survival rate was 94.4% at one year, 76.5% at five years, and 54.2% at ten years. The annual number of new ICDs inserted in NSW has increased since 2005. A substantial proportion of recipients experience device-related problems that require re-admission to hospital. The potential harms of ICD insertion should be considered when assessing the likelihood of preventing fatal ventricular arrhythmia.

Measuring variation in infant mortality and deaths of despair by US congressional district in Pennsylvania: a methodological case study.

Many ecological studies examine health outcomes and disparities using administrative boundaries such as census tracts, counties, or states. These boundaries help us to understand the patterning of health by place, along with impacts of policies implemented at these levels. However, additional geopolitical units (units with both geographic and political meaning), such as congressional districts (CDs), present further opportunities to connect research with public policy. Here we provide a step-by-step guide on how to conduct disparities-focused analysis at the CD level. As an applied case study, we use geocoded vital statistics data from 2010-2015 to examine levels of and disparities in infant mortality and deaths of despair in the 19US CDs of Pennsylvania for the 111th-112th (2009-2012) Congresses and 18 CDs for the 113th-114th (2013-2016) Congresses. We also provide recommendations for extending CD-level analysis to other outcomes, states, and geopolitical boundaries, such as state legislative districts. Increased surveillance of health outcomes at the CD level can help prompt policy action and advocacy and, hopefully, reduce rates of and disparities in adverse health outcomes.

Racial/ethnic/gender-Based Differences in Health Trajectories Among American Older Adults: 10-Year Longitudinal Evidence from the Health and Retirement Study

ABSTRACT Health disparity by race/ethnicity or gender has been well-documented. However, few researchers have examined health outcomes based on the intersection of individuals’ race, ethnicity, and gender or investigated various health dimensions. Guided by an intersectionality framework, this study explores racial/ethnic/gender-based differences in trajectories of multiple health outcomes over a ten-year period among American older adults. Longitudinal data from the Health and Retirement Study (2004–2014) were used (N = 16,654). Older adults (65+) were stratified into six mutually-exclusive groups based on their race, ethnicity, and gender: Non-Hispanic (NH) White Men, NH White Women, NH Black Men, NH Black Women, Hispanic Men, and Hispanic Women. Growth curve models examined the trajectories of three health measures, including cognitive function, physical function limitations (i.e. activities of daily living and instrumental activities of daily living), and depressive symptoms. NH White men and women reported significantly better outcomes in cognition and physical function trajectories than racial/ethnic minority groups. Women in all racial/ethnic groups had more depressive symptoms but better cognition than men. Hispanic women reported the most depressive symptoms. Hispanic women and NH Black women had the worst physical function limitations. NH Black men/women were the most disadvantaged in cognition. Racial/ethnic/gender-based differences were stable over time in all health trajectories. Study findings highlight the utility of an intersectional framework in understanding how multiple social identities intersect to generate protective and/or risk effects on cognitive, mental, and physical health. Multilevel intervention strategies are warranted to reduce the persistent health inequity gap.

Food insecurity and its association with multiple health outcomes among Indigenous peoples in Canada: the buffering role of culture-based resources

ABSTRACT Objectives Despite growing interest in the health disparities associated with food insecurity, research focusing on Indigenous peoples has been limited, especially in studies using nationally representative samples. This study investigates the association between food insecurity and various health outcomes – self-rated general and mental health, chronic health conditions, suicidal ideation, and obesity – among Indigenous peoples in Canada. It also explores the potential moderating effects of culture-based resources, which include cultural identity affect, cultural group belonging, cultural engagement, and cultural exploration. Design The study utilized data from the 2017 Aboriginal Peoples Survey, a nationally representative sample of First Nations individuals living off-reserve, Métis, and Inuit across Canada (N = 15,533). Logistic regression models were used to analyze the data. Results Food insecurity was negatively associated with all examined health outcomes. Culture-based resources demonstrated a mixture of anticipated and unexpected effects on these relationships. Consistent with the stress process model, cultural group belonging mitigated the negative impact of food insecurity on all health outcomes. A similar pattern was observed for cultural engagement. However, contrary to expectations from the stress-buffering perspective, little evidence was found to support the moderating effects of cultural identity affect and cultural exploration. Conclusion The results underscore the detrimental effects of food insecurity on the health of Indigenous peoples in Canada and suggest that culture-based resources, particularly cultural group belonging, play a crucial role in mitigating health disparities.

Kumanu Tāngata: the aftermatch study – protocol to examine the health outcomes of high-level male rugby union players using linked administrative data

There is increasing interest in the potential long-term outcomes of participation in contact and collision sports, driven by evidence of higher rates of neurodegenerative diseases among former athletes. Recent research...

O.6.1-8 Exploration of health outcomes among adolescent peer leaders of a school based physical activity intervention: baseline data

Abstract Purpose Low physical activity (PA) levels among adolescents emphasises the need for PA interventions. School-based interventions that involve peer leaders (PL) such as the second-level Active School Flag (SLASF) program may be a useful way to encourage PA among adolescents. However, it is unclear what effect being a peer leader of a PA intervention has on PL physical, social and mental health outcomes. This study aims to explore PL health outcomes at the initial stages of peer leading a PA intervention. Methods Quasi-experimental research design was used to test if being PL provides physical, social and mental health benefits in comparison to non-PL (control). In Autumn 2022, senior students in Irish second level schools in the second year of the SLASF program were recruited. Students completed a self-report questionnaire, consisting of moderate-vigorous PA (MVPA) levels (PACE+), wellbeing (WHO5) and social connectedness. Social connectedness was assessed using three items and grouped into good social connectedness (yes to all three) or poor social connectedness. Data was analysed using IBM SPSS statistics. To compare PL of the SLASF program and non-PL students, a Chi-Square test of Association was used to explore social connectedness. Wellbeing and average number of days per week of MVPA was not normally distributed (p &amp;lt; 0.05), therefore a Mann-Whitney U Test compared groups. Results Seven schools, 277 adolescents (63.5% male) aged 15-16 years completed the online questionnaire, 49% were in the PL group and 51% in non-PL group. At baseline, no differences existed in median wellbeing scores (Mdn=21.0) (U = 7750.500, Z= -0.953, p = 0.341) and days of MVPA per a week (Mdn=4.5) (U = 7320.500, Z= -0.105, p = 0.916) between the PL and non-PL group. Although more students in the PL group (68%) had good social connectedness compared to non-PL group (58%) the differences were not statistically significant (X2(1) &amp;gt; = 1.724, p = 0.189). Conclusions At the initial stages of peers leading a PA intervention, no statistically significant differences in social and mental health outcomes were observed. Future research could examine health outcomes of PL over the course of the peer led physical activity intervention. Support/Funding Source Mayo Educaton Centre.

Gardening Is Associated With Better Cardiovascular Health Status Among Older Adults in the United States: Analysis of the 2019 Behavioral Risk Factor Surveillance System Survey.

Gardening benefits health in older adults, but previous studies have limited generalizability or do not adequately adjust for sociodemographic factors or physical activity (PA). We examined health outcomes, fruits and vegetables (F&V) intake, and 10-year mortality risk among gardeners and exercisers compared with nonexercisers. Cross-sectional data of noninstitutionalized US adults in the 2019 Behavioral Risk Factor Surveillance System was collected via landline and cellular phone survey. Adults 65 years and older reporting any PA (n= 146,047) were grouped as gardeners, exercisers, or nonexercisers. Outcomes included cardiovascular disease (CVD) risk factors, mental and physical health, F&V intake, and 10-year mortality risk. Summary statistics were calculated and adjusted logistic regression models were conducted to calculate adjusted odds ratios (aORs) and 95% CIs, accounting for the complex survey design. The sample included gardeners (10.2%), exercisers (60.0%), and nonexercisers (30.8%). Gardeners, compared with nonexercisers, had significantly lower odds of reporting all studied health outcomes and higher odds of consuming 5 or more F&V per day (CVD: aOR 0.60, 95% CI 0.53 to 0.68; stroke: aOR 0.55, 95% CI 0.47 to 0.64; heart attack: aOR 0.63, 95% CI 0.55 to 0.73, high cholesterol: aOR 0.86, 95% CI 0.79 to 0.93; high blood pressure: aOR 0.74, 95% CI 0.68 to 0.81; diabetes: aOR 0.51, 95% CI 0.46 to 0.56; body mass index ≥25: aOR 0.74, 95% CI 0.68 to 0.80; poor mental health status: aOR 0.50, 95% CI 0.43 to 0.59; poor physical health status: aOR 0.35, 95% CI 0.31 to 0.39; 5 or more F&V per day: aOR 1.56, 95% CI 1.40 to 1.57; high 10-year mortality risk: aOR 0.39, 95% CI 0.36 to 0.42). Male and female gardeners had significantly lower odds of reporting diabetes even when compared with exercisers. Among adults 65 years and older, gardening is associated with better CVD health status, including lower odds of diabetes. Future longitudinal or interventional studies are warranted to determine whether promoting gardening activities can be a CVD risk reduction strategy.

Gender Minority Youth Experiencing Homelessness and Corresponding Health Disparities

PurposePediatricians and youth service providers frequently interface with vulnerable populations, including gender minority youth (e.g., transgender, nonbinary, gender questioning, and other gender diverse individuals) and youth experiencing homelessness. The purposes of this study are to estimate the prevalence of homelessness and types of homelessness experienced among gender minority youth and their corresponding health outcomes. MethodsData for this study came from gender minority (n = 3,194) and cisgender (n = 93,337) high school students who answered questions on transgender status and homelessness status in the 2017 and 2019 Youth Risk Behavior Survey (YRBS). We compared the prevalence of homelessness between gender minority and cisgender youth and assessed where youth experiencing homelessness had slept in the prior month: shelters, nonparental homes, streets, hotel, or other locations. Finally, logistic regression models and marginal effects (ME) were used to examine health outcomes at the intersection of gender minority status and homelessness. Results22% of gender minority youth reported homelessness during the prior month. Cisgender youth were significantly less likely to report being homeless (3%). Transgender youth experiencing homelessness were significantly more likely to live on the streets than cisgender youth experiencing homelessness (ME = 0.20; 95% CI = 0.10–0.30; p < .001). Gender minority youth experiencing homelessness reported elevated health-risk behaviors in excess of nonhomeless gender minority youth and cisgender youth experiencing homelessness. DiscussionPublic health campaigns, housing interventions, and youth service providers should consider and create tailored programs to secure housing and to promote the health of gender minority youth experiencing homelessness.

Description of Audiologic, Developmental, Ophthalmologic, and Neurologic Diagnoses at a Primary Care Clinic for Children in Foster Care.

This study aimed to describe the prevalence of medically diagnosed audiologic, developmental, ophthalmologic, and neurologic conditions in a foster care primary care clinic and to identify any associations among these diagnoses and patient characteristics, placement type, and maltreatment type. This study used the electronic medical records for patients (n = 4977), aged 0 to 20 years, with at least 1 visit to an academic-affiliated medical center primary care clinic exclusively serving children in foster care between January 1, 2017, and December 31, 2020. This study was a retrospective chart review. Descriptive statistics were calculated. Bivariate logistic regression analysis was used to determine associations between the outcome variables and each independent variable. Multivariable logistic regression analysis was performed using only significant independent variables from the bivariate analysis. Overall, 3.5% of children had an audiologic diagnosis, 42% had a developmental diagnosis, 9.0% had an ophthalmologic diagnosis, and 4.5% had a neurologic diagnosis. There were increased odds of developmental delay with child neglect and medical complexity and decreased odds with Hispanic ethnicity, Black race, female sex, obesity, and shelter placement. These findings add to the limited data regarding medically diagnosed audiologic, developmental, ophthalmologic, and neurologic conditions for children in foster care in a primary care setting. A medical home may help children in foster care, who experience many barriers to comprehensive health care, to better identify and address these health conditions. Future studies are needed that examine health outcomes of children in foster care with these health conditions followed in a medical home.

Linking health and social care data to identify teenage pregnancy outcomes for Care Experienced Young People in Fife.

ObjectivesCare experienced young people (CEYP) are thought to be at increased risk of experiencing teenage pregnancy but little is known about teenage pregnancy rates among CEYP in Scotland. The aim of this study was to use data linkage techniques to compare teenage pregnancy outcomes for CEYP in Fife, Scotland with that of their non-care experienced but similarly deprived peers.&#x0D; ApproachThe study linked social care administrative data for 1119 females looked after by Fife Council between 1991-2015 with national health data. Probabilistic linkage was used to match CEYP demographic data (names, sex, date of birth and postcodes) to the Community Health Index (CHI) number, the unique patient identifier used in Scottish health records. The CHI number was then used to identify teenage pregnancy outcomes from national Scottish Morbidity Record datasets (SMR01 and SMR02). Outcomes for CEYP were compared with a group of non-care experienced peers from a similar socio-economic background, with three non-care experienced young people selected for every CEYP.&#x0D; ResultsAn acceptable match to a CHI number was achieved for 90.5% (1013/1119) of CEYP. Data analysis is ongoing and will be completed by April 2022. Outcomes being analysed include: the proportion of young people experiencing a termination of pregnancy before age 20; the proportion of young people experiencing a live birth before age 20; whether CEYP are more likely to progress a teenage pregnancy to delivery than their non-care experienced peers; antenatal behaviours such as smoking history; and postnatal outcomes such as preterm delivery.&#x0D; The presentation will discuss the results. It will also discuss the challenges of linking health and social care data to identify health outcomes for CEYP.&#x0D; ConclusionCross-sectoral data linkage offers considerable potential for examining health outcomes for CEYP and was successfully used in this study to identify teenage pregnancy outcomes for CEYP in Fife, Scotland. Understanding outcomes will help inform prevention initiatives and address health inequalities. However, securing the necessary permissions and undertaking the linkage was a time-consuming process.

Health Outcomes of Elder Orphans: An Umbrella and Scoping Review of the Literature.

As the population of elder orphans grows, little research has investigated the health outcomes of these socially and physically isolated older adults without caregiving support. Umbrella and scoping reviews were performed for studies examining health outcomes of older adults experiencing elements of elder orphanhood. Studies published 2010- June 2021 and indexed on PubMed, Web of Science, CINAHL, Medline, or SocINDEX were eligible. Results of included studies were examined both by individual category and overall to determine overlapping outcomes. Umbrella review returned 1,686 studies, with 14 meeting criteria for social isolation (n=10) and physical isolation (n=4). The scoping review of studies examining unmet caregiving need returned 3,741 results: five met inclusion criteria. Included studies reviewed differing health outcomes in older adults, with a focus on dementia, frailty, and healthcare utilization. Further studies are needed that appraise targeted policies and interventions to improve health outcomes of elder orphans.