Health Behavior Factors Research Articles

Exploring factors associated with self-rated health in individuals with diabetes and its impact on quality of life: Evidence from the Survey of Health, Ageing, and Retirement in Europe.

Self-rated health (SRH), a measure of self-reported general health, is a robust predictor of morbidity and mortality in various populations, including people with diabetes. Diabetes is negatively associated with SRH and quality of life (QoL). Little is known about how people with diabetes rate their health and which aspects influence the rating. Also, the predictive value of SRH on future QoL has not yet been evaluated. We analyzed data from 46 592 participants of the Survey of Health, Ageing and Retirement in Europe (SHARE). Using linear regression, we aimed to determine which sociodemographic, socioeconomic, medical, social, mental, and health behavior factors determine SRH in people with diabetes. In addition, we analyzed the predictive value of SRH on future QoL using the generalized estimating equations procedure. We determined that country, current job situation, hospitalization, pain, polypharmacy, memory, eyesight, activities of daily living, number of chronic diseases, and depression are all linked to SRH. Together these variables explained 38% of the SRH's variance, whereas depression, pain, and memory had the greatest influence on SRH of people with diabetes. We also found that SRH independently predicted future QoL, supported by a regression coefficient of β = -1.261 (Wald chi-square test, χ2 = 22.097, df = 1, p < .05). As SRH is linked to future QoL, we conclude that incorporating SRH assessment into medical evaluations can help health care professionals gaining a more comprehensive understanding of an individual's health trajectory and supporting patients to enhance their QoL.

The association between SII and aging: evidence from NHANES 1999-2018.

The study aimed to examine the association between the systemic immune-inflammation index (SII), a contemporary metric of systemic inflammatory response, and biological aging, which are closely interconnected processes. This cross-sectional study utilized 10 cycles of data from the NHANES database spanning from 1990 to 2018. The study examined the relationship between the SII index, calculated as P * N/L, where P represents preoperative peripheral platelet count, N represents neutrophil count, and L represents lymphocyte count, and biological aging. Biological aging was assessed through various methods, such as phenotypic age, phenotypic age acceleration (PhenoAgeAccel), biological age, and biological age acceleration (BioAgeAccel). Correlations were analyzed using weighted linear regression and subgroup analysis. Among the 7,491 participants analyzed, the average age was 45.26 ± 0.34 years, with 52.16% being female. The average phenotypic and biological ages were 40.06 ± 0.36 and 45.89 ± 0.32 years, respectively. Following adjustment for potential confounders, elevated SII scores were linked to increased phenotypic age, biological age, Phenotypic age acceleration, and Biological age acceleration. Positive correlations were observed between health behavior and health factor scores and biological aging, with stronger associations seen for health factors. In health factor-specific analyses, the β coefficient was notably higher for high BMI. The robust positive associations between SII scores and both phenotypic age and biological age in the stratified analyses were consistently observed across all strata. The evidence from the NHANES data indicate that SII may serve as a valuable marker for assessing different facets of aging and health outcomes, such as mortality and the aging process. Additional research is warranted to comprehensively elucidate the implications of SII in the aging process and its utility as a clinical instrument for evaluating and addressing age-related ailments.

Child mental health predictors among camp Tamil refugees: Utilizing linear and XGBOOST models.

While the association between migration and deteriorated refugee mental health is well-documented, existing research overwhelmingly centers on adult populations, leaving a discernible gap in our understanding of the factors influencing mental health for forcibly displaced children. This focus is particularly noteworthy considering the estimated 43.3 million children who are forcibly displaced globally. Little is known regarding the association between family processes, parental and child wellbeing for this population. This study addresses these gaps by examining the relationship between parental mental health and child mental health among refugees experiencing transmigration. We conducted in-person structured survey interviews with 120 parent-adolescent dyads living in the Trichy refugee camp in Tamil Nadu, India. Descriptive, multivariate analysis (hierarchical regression), and Machine Learning Algorithm (XGBOOST) were conducted to determine the best predictors and their importance for child depressive symptoms. The results confirm parental mental health and child behavioral and emotional factors are significant predictors of child depressive symptoms. While our linear model did not reveal a statistically significant association between child mental health and family functioning, results from XGBOOST highlight the substantial importance of family functioning in contributing to child depressive symptoms. The study's findings amplify the critical need for mental health resources for both parents and children, as well as parenting interventions inside refugee camps.

Changes in Health Behaviour Factors in Response to COVID-19

The coronavirus pandemic caused profound changes in many aspects of people's lives, especially in the area of health behaviour. The restrictions caused by the pandemic have had negative effects on both the physical and mental health of society, while also transforming the way individuals exercise. The aim of our research was to analyse the changes in health behaviour of Hungarian adults, including their sporting habits as well as their mental health, caused by the COVID-19 pandemic. We also focused on comparing the experiences of a population that regularly participates in sport and a population that rarely or never participates in sport. Results of the survey showed that individuals who regularly participate in sport activities rated their general physical health significantly better than those living a more sedentary life. More than half of the sample stated that they did not experience any particular change in their physical health, but the second highest percentage of respondents reported that their health had been affected negatively by the pandemic period. Results also showed that almost half of respondents said that their sporting habits had not changed as a result of the pandemic, while many reported that their sporting frequency had decreased. Finally, we also analysed the changes in sporting habits with regard to the place of residence, finding that those individuals living in an apartment complex building were most likely to choose a different type of exercise from the one they had previously practised, while a higher proportion of individuals living in a suburban area, or with access to garden reported that they had started to doing sports.Our research provided partial confirmation that the pandemic had a negative effect on people's health behaviour, but given the high levels of exercise in the target group,it is not surprising that many did not experience any change in sporting habits or physical health. JEL Code: I12

Strategies for integrating the Making Every Contact programme for the prevention and management of chronic disease across Irish Health Service

Introduction: The Irish Health Service Executive (HSE) Making Every Contact Count (MECC) Programme1 aims to integrate lifestyle behaviour interventions by health professionals to patients targeting health behavioural risk factors (e.g. physical activity, diet, smoking and drug and alcohol use. The MECC programme (implemented since 2019) is a key element of the Integrated care programme for the prevention and management of Chronic disease in Ireland (ICP CD)2 . I will present recent research which has identified key strategies for upscaling implementation and integrating brief interventions in the Irish Health Service.&#x0D; Aim, Objectives, Theory or Methods: The research team worked collaboratively to develop an evidence-based implementation strategy to optimise and scale up MECC. The implementation strategy was informed by three studies:&#x0D; 1.Study 1: Survey study of 357 healthcare professionals who had completed MECC e-Learning training to determine barriers and enablers to MECC intervention delivery.&#x0D; 2.Study 2: Qualitative interview study with 36 healthcare professionals and those involved in MECC implementation to understand the individual and organisational level enablers and barriers to the implementation of MECC.&#x0D; 3.Study 3: Consensus study to achieve stakeholder consensus on strategies to address identified barriers and enablers .&#x0D; &#x0D; Highlights or Results or Key Findings: Using the Theoretical Domains Framework3 barriers and enablers to Implementation were identified under the following domains: environmental context, goals and intentions, knowledge, professional role, beliefs about consequences, beliefs about capabilities and skills practice. &#x0D; A consensus process identified and refined the following nine implementation strategies.&#x0D; 1.Provide dedicated time to practitioners to attend training and use MECC&#x0D; 2.Empower and engage management/senior staff to take responsibility for MECC&#x0D; 3.Implement a user-friendly and integrated system of recording MECC&#x0D; 4.Develop service directories for healthcare professionals to refer patients&#x0D; 5.Have local MECC champions to model best practice and share experiences&#x0D; 6.Create a dedicated resource centre on the MECC website with information regarding MECC training courses and contacts&#x0D; 7.Have a HSE national communications campaign to promote MECC&#x0D; 8.Generate and highlight evidence for the impact of MECC on patients&#x0D; 9.Enhance integration of MECC with undergraduate healthcare professional education&#x0D; Conclusion: In this programme of research we have worked with key stakeholders to understand barriers and enablers to MECC implementation and develop recommendations to enhance the implementation and scaling-up of the MECC programme.&#x0D; Implementation of the MECC programme remains a key priority for the Irish Health Service. &#x0D; Implications for applicability/transferability, sustainability, and limitations: The outputs from this research provide strong evidence based strategies to support the ongoing implementation of the MECC programme. The dissemination of the findings to key policy and strategic stakeholders and the development of an implementation plan will further embed Making Every Contact Count in services.&#x0D; &#x0D;

Association of Life's Essential 8 with osteoarthritis in United States adults: mediating effects of dietary intake of live microbes.

Osteoarthritis (OA) is associated with cardiovascular disease and represents a persistent economic and physical burden on patients in the United States. This study evaluated the mediating effect of dietary live microbe intake on the association between cardiovascular health [based on Life's Essential 8 (LE8) scores] and osteoarthritis (OA) in adults. This cross-sectional study included data from the National Health and Nutrition Examination Survey, 1999-2019 (from patients aged ≥20 years). LE8 scores (0-100) were measured according to the American Heart Association definition and categorized as low (0-49), moderate (50-79), or high (80-100). OA disease status was assessed using self-reported data from patients. The relationships were evaluated using multivariate logistic and restricted cubic spline models. Mediation analysis was used to evaluate the mediating effect of dietary live microbe intake on the association between LE8 and OA risk. The study included 23,213 participants aged ≥20 years. After adjusting for latent confounders, higher LE8 scores were found to be associated with a lower incidence of OA. The odds ratios (with 95% confidence intervals) for low, moderate, and high OA risk were 0.81 (0.69, 0.96) and 0.55 (0.44, 0.69), respectively; a non-linear dose-response relationship was observed (P-nonlinear = 0.012). Health behavior and health factor scores showed a similar pattern of correlation with OA risk. Low live microbe intake mediated the association between LE8, health behavior, and health factor scores with OA risk and did not appear to reduce OA risk. Our findings suggest that although higher LE8 scores reduce the risk of developing OA, low live microbe intake may reduce the protective effect of higher scores. It is, therefore, essential to emphasize adherence to a lifestyle that confers high LE8 scores. Individuals should also be advised to reduce the intake of foods with low live microbe content.

BEHAVIORAL HEALTH PREDICTORS OF PREMATURE MORTALITY IN A BLACK AMERICAN LONGITUDINAL COHORT

Abstract Life expectancy among Americans is now the lowest it has been in 15 years. While startling, more alarming are the persistent racial disparities in mortality. Black Americans continue to die at significantly younger ages with Black men living, on average, 7.0 fewer years and Black women living 4.4 fewer years than their White counterparts. To inform intervention strategies and resource allocation, we need a complete understanding of the role that malleable factors, such as substance use and depression early in the life course, play in premature mortality for aging Black Americans. This study illuminates behavioral health factors that can be targeted to eliminate mortality disparities among a longitudinal cohort followed from childhood into their 60s. Utilizing data from the Woodlawn Study, a well-defined neighborhood cohort study of 1,242 Black Americans that began in 1966 (age 6), we examined the predictive value of family history of substance use, adolescent substance use and depression, and young adult substance use and depression. Through 2021 (modal age 61), based on National Death Index reports, 21.6% of the original cohort (n=268) has passed away. The poster will present cause and timing of death by gender and adjusted logistic regression findings showing that depression symptoms as early as adolescence (age 16) predict midlife mortality occurring between ages 32 and 60 (p=.003) and that those diagnosed with depression or a substance use disorder in young adulthood are 61% (p=.025) and 85% (p=.001) more likely to die by age 60. Policy and prevention implications will be presented.

Associations Between Life's Essential 8 and Chronic Kidney Disease.

Chronic kidney disease (CKD) is closely associated with cardiovascular disease. We aimed to examine the association of Life's Essential 8 (LE8), the recently updated measurement of cardiovascular health, with the prevalence of CKD among US adults. This population-based cross-sectional study used data from the National Health and Nutrition Examination Survey from 2007 to 2018 and included adults aged ≥20 years. Multivariable logistic and restricted cubic spline models were used to assess the associations between LE8 and CKD. Among 24 960 participants, 4437 were determined to have CKD (weighted percentage, 14.11%). After the adjustment of potential confounders, higher LE8 scores were associated with reduced odds of CKD (odds ratio for each 10-point increase, 0.79 [95% CI, 0.76-0.83]), and a nonlinear dose-response relationship was observed. Similar patterns were also identified in the associations of health behavior and health factor scores with CKD. Meanwhile, higher scores for blood glucose (odds ratio, for each 10-point increase, 0.88 [95% CI, 0.87-0.90]) and blood pressure (odds ratio, for each 10-point increase, 0.92 [95% CI, 0.91-0.94]) in the LE8 component are significantly associated with a lower prevalence of CKD. The inversed association of LE8 score and CKD was significantly stronger among middle-aged, male, and coupled participants. LE8 was negatively associated with the prevalence of CKD in a nonlinear fashion. Promoting adherence to optimal cardiovascular health levels may be beneficial to reduce the burden of CKD.

Finnish Retirement and Aging Study: a prospective cohort study

PurposeThe Finnish Retirement and Aging (FIREA) Study was set up to study changes in health behavioural and cardiometabolic risk factors across retirement transition, and to examine the long-term consequences of...

Abstract B130: Social determinants associated with HPV disparities among people with HIV infection in Puerto Rico

Abstract Background: People with HIV (PWH) have a higher risk of acquiring oral HPV infection when compared to people without HIV, which can lead to the high prevalence of oropharyngeal cancers in PWH. Puerto Rico (PR), a US jurisdiction, is on the top 10 in terms of HIV prevalence and cumulative AIDS cases among the US and have a significant burden and disparity of HPV-related malignancies. Additionally, PR has socio-economic disadvantages, which is a social determinant of oral health disparities, and can potentially affect oral HPV. The relationship of these social determinants with HPV have not been investigated in PWH in PR. Hence, in this study, we evaluated the relationship between socio-economic, behavioral, and oral health factors with oral HPV among PWH. Methods: We evaluated 117 sexually active PWH (102 males and 15 females) from a community clinic in San Juan, PR. Oral rinse samples were collected and analyzed for HPV infection and genotype using the DNA ELISA kit HPV SPF10 and RHA kit HPV SPF10-LiPA25. We collected sociodemographic characteristics (age, marital status, employment, income) as well as lifestyle variables (smoking habits, alcohol consumption, sexual practices) through an administered questionnaire. Participants also underwent a clinical full-mouth periodontal assessment following the CDC/AAP guidelines. Statistical analyses in relation to HPV were performed in R statistical software. Findings: There was a prevalence of oral HPV infection of 29.9% in PWH in PR, which 70% were high-risk genotypes, with HPV-18 being the most abundant genotype (27.5%). There were 33.3% of males who had oral HPV while only 20% of females had oral HPV. Also, oral HPV infection was significantly associated with periodontitis (p&amp;lt;0.05). In men, oral HPV positivity trended to be frequent with no HPV vaccination (p=0.08). No HPV vaccination was associated with lower income (p&amp;lt;0.05). There was no association between HPV status and sociodemographic and lifestyle variables. Interpretation: The prevalence in high-risk HPV genotypes among PWH was higher than what has previously been observed in PR. We also found a higher prevalence of HPV-18, which may explain clinical disparities concerning oropharyngeal cancer in PR’s population. Additionally, our findings highlight the importance of access to medical care in low-resource settings. Low income can be a surrogate of lack of access of care, which can impact early diagnosis, risk, and prevention of oral HPV. Therefore, targeting social determinants, may help lower the risk of infection and oral cancer in underserved populations. While our findings contribute to understanding the impact of social determinants in oral cancer, more studies are still needed that investigate the relationship between other sociodemographic factors that affect oral health in PWH. Citation Format: Carlos A. Solá-Morlá, Yabdiel Ramos-Valerio, Coral Martes-Villalobos, María M. Sánchez-Vázquez, Ramón F. Gonzalez-García, Ana P. Ortiz, Magaly Martinez-Ferrer, Josué Pérez-Santiago. Social determinants associated with HPV disparities among people with HIV infection in Puerto Rico [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B130.

KAJIAN FAKTOR PERILAKU KESEHATAN IBU NIFAS YANG MEMPENGARUHI KUNJUNGAN MASA NIFAS DI INDONESIA

The phenomenon that occurs in Indonesian society is that there is a gap between the coverage of postpartum visits and the visit standards set by the Indonesian Ministry of Health, namely a minimum of four postpartum visits. The standard of four visits is to maximize the recovery period for the reproductive organs of the postpartum woman. This indicator is the government's effort to provide postpartum maternal health services in accordance with quality standards as an effort to reduce the Maternal Mortality Rate (MMR). The method used in this study was a systematic literature review using the PICOS approach (to determine inclusion and exclusion criteria) and the PRISMA approach (to screen articles). The database used to search for articles is Google Scholar with the help of the Publish or Perish software. The results obtained from the ten research articles, namely, 80% of the articles provide an overview of postpartum visits that still apply three visits, and 60% of the articles provide an overview of the frequency of complete visits which is higher than incomplete visits. The majority of health behavior factors are influenced by predisposing factors, namely attitudes and knowledge. Through this research it is hoped that it can encourage health workers to provide solutions to existing problems related to the lack of coverage of postpartum visits, so that postpartum visits become more optimal in all regions in Indonesia.

Survey of Vaccine Hesitancy in Patients Visiting Three Tertiary-care Emergency Departments in Southeast Louisiana.

Vaccine hesitancy has been a barrier to achieving herd immunity during the coronavirus 2019 (COVID-19) pandemic. Having low socioeconomic status and education levels, and being a person of color, are associated with higher COVID-19 infection risk and worse outcomes. These same groups are associated with higher vaccine hesitancy. The state of Louisiana has one of the lowest vaccination rates in the country. In this study we aimed to identify demographic, perspective, and health behavior factors associated with vaccine hesitancy in emergency departments (ED) in Southeast Louisiana. A cross-sectional survey was distributed at three tertiary-care hospital EDs. Patients >18years old and not in acute distress were recruited between April-July 2021. The 37-item questionnaire addressed socioeconomic demographics, social determinants of health, COVID-19 safety practices, thoughts and perceptions on COVID-19 and vaccines, sources of COVID-19 and vaccine information, and trust in the healthcare system. Overall, 247 patients completed our survey. Of those, 29.6% reported they were vaccine hesitant. These respondents were significantly more likely, when compared to vaccine-acceptant respondents, to never have married, to have some college education, make less than <$25,000 in household earnings yearly, be unsure whether vaccines prevent disease, not have discussed the COVID-19 vaccine with their primary care doctor, and to prefer to do their own research for COVID-19 vaccine information. We observed no statistically significant differences based on gender, race/ethnicity, parental status, area of living, or their perceived risk of needing hospitalization for treatment or dying from the virus. Vaccine hesitancy was associated with multiple socioeconomic factors, perspectives, and beliefs. Vaccine-hesitant individuals were more uncertain about the safety of the COVID-19 vaccine, the feasibility of obtaining the vaccine, and its efficacy. Public health interventions aimed at these findings and improving public trust in healthcare systems are needed to increase vaccine acceptance.

Abstract 079: Preliminary Outcomes of a Survivor‐Centric Digital Platform in Stroke Recovery

Introduction This study evaluates the feasibility of a survivor‐centric, navigator‐driven, and technology‐enabled platform supporting survivors and care partners in post‐stroke recovery. We hypothesize that post‐stroke navigation can favorably impact stroke recovery through monitoring medical and behavioral health factors, social needs assessment and support, curated educational content, evidence‐based interventions, and clinical guidance. Methods An app‐based, virtual care model was used to increase survivor quality of life and improve outcomes for stroke survivors. This mixed methods study utilizes both focus group feedback, survey, and patient‐reported outcomes data along with digital engagement. Participants (n=40) were facilitated by a clinical navigator (occupational therapist or licensed clinical social worker) through understanding lived experiences and health‐related motivators. Stroke survivors and their care partners, if they have one, were referred from one of four partner hospitals by the primary stroke team during the pilot program (starting July 2022) prior to their discharge. The Navigators worked through phone, messaging, and video calls with the stroke survivor and their care partner who had shared access within the app but had separate profiles. The duration of participation was a median of 12 weeks but could be as short as 2 weeks based on individual needs including post‐stroke impairments, social determinants of health, resource needs, education and health literacy, risk factors and lifestyle management, as well as mental health support. The average participant had 9 Navigator touchpoints totaling 6‐8 hours over the 12 weeks. Results In this feasibility study, clinician‐assessed mRS scores were captured at 90 days following hospital discharge for 95% of participants. This is similar to the results recently reported for another clinician‐supported, app‐based post‐acute platform in Spain. Significant functional improvement was seen over time, with 84% achieving mRS scores of 0‐2 at 90 days, compared to 60% of participants at the time of enrollment. 88% of enrollees completed the validated Take Charge Intervention. The 30‐ and 90‐day all‐cause readmission rates for survivors were 6% and 12%, respectively. This is superior to recent publications reporting 30‐day unplanned readmission rates after stroke ranging from 8.7%‐12.5%, and 90‐day readmissions ranging from 18.9% to 20.7%. Nearly all (96%) of the stroke survivors that participated in the program reported adherence to their medications, compared to a national average of 64%. At 90 days, 90% of enrollees had completed a neurology follow‐up visit. Among the 15% of participants who did not have a primary care physician (PCP) prior to their stroke, the Navigators were able to assist in establishing care with a PCP for all of them. The demographics reflect typical stroke populations: Ten percent of the enrollees were on Medicaid or uninsured at the time of their stroke, more than half were non‐white, and 20% had five or more needs related to social determinants of health. Conclusion This feasibility study demonstrates that a tech‐enabled healthcare services program can engage and impact the outcomes of individuals and care partners during stroke recovery.

Findings from the Indonesian family life survey on patterns and factors associated with multimorbidity

The prevalence of multimorbidity tends to increase with age, but it is now also reported in the middle-aged population, which has a negative impact on healthcare systems and health outcomes. This study aims to analyze the patterns and factors associated with multimorbidity in Indonesia. This national cross-sectional population-based survey used publicly available data from the Indonesian Family Life Survey (IFLS-5) for 2014 among middle-aged (40–59 years old) and elderly (≥ 60 years old) respondents. Information on all chronic diseases was assessed using a self-reported questionnaire. Sociodemographic and health-related behavioral factors were obtained from self-reported data. Binary logistic regression analysis was used to identify the factors associated with multimorbidity. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported. The study recruited 11,867 respondents. The prevalence of multimorbidity was 18.6% (95% CI 17.9–19.3) with which 15.6% among middle age (95% CI 14.95–16.25) and 24.9% among the elderly (95% CI 24.12–25.68). Hypertension was the most commonly reported disease (23.2%) in all combinations of multimorbidity and among all age groups. Socio-demographic factors: elderly (AOR: 1.66; 95% CI 1.46–1.89), female (AOR: 1.42; 95% CI 1.20–1.69), living in the urban area (AOR: 1.22; 95% CI 1.09–1.38), higher educational level (AOR: 2.49; 95% CI 1.91–3.26), unemployed (AOR: 1.63; 95% CI 1.44–1.84), and higher economic level (AOR: 1.41; 95% CI 1.18–1.68) were associated with multimorbidity. Poor health behavior factors: being former smokers (AOR: 2.03; 95% CI 1.65–2.51) and obesity (AOR: 1.53; 95% CI 1.35–1.75) were also associated with multimorbidity. The prevalence of multimorbidity in the middle-aged and elderly population in Indonesia is relatively high, particularly in populations with poor health behaviors. Therefore, healthcare professionals should integrate more patient-specific factors when designing and implementing tailored interventions to manage multimorbidity in Indonesia.

Factors associated with COVID-19 brought-in deaths: A data-linkage comparative cross-sectional study

BackgroundThe phenomenon of Coronavirus disease 2019 (COVID-19) brought-in-dead (BID), i.e., COVID-19 deaths occurring outside hospital settings, suggests missed opportunities for life-saving care. However, much is still unknown with regards to its potential determinants. The present study aimed to examine the factors associated with COVID-19 BID by integrating new variables from multiple databases. MethodsThis multi-database comparative cross-sectional study examined COVID-19 in-patient deaths (IPD) and COVID-19 BID (n = 244 in each group) in Selangor, Malaysia. BID cases, IPD cases, and their sociodemographic, clinical, and health behaviour factors were identified from the COVID-19 mortality investigation reports submitted to the Selangor State Health Department between 14 February 2022 and 31 March 2023. Data linkage was used to connect three open-source databases—GitHub-MOH, Socioeconomic Data and Applications Center, and OpenStreetMap—and identify health infrastructure and geospatial factors. The groups were compared using chi-square tests, independent t-tests, and logistic regression analyses to identify factors associated with COVID-19 BID. ResultsThe COVID-19 IPD and BID cases were comparable. After adjusting for confounders, non-Malaysian nationality (AOR: 3.765, 95% CI: 1.163, 12.190), obesity (AOR: 5.272, 95% CI: 1.131, 24.567), not seeking treatment while unwell (AOR: 5.385, 95% CI: 3.157, 9.186), and a higher percentage of COVID-19-dedicated beds occupied on the date of death (AOR: 1.165, 95% CI: 1.078, 1.259) were associated with increased odds of COVID-19 BID. On the other hand, being married (AOR: 0.396, 95% CI: 0.158, 0.997) and the interaction between the percentage of COVID-19-dedicated beds occupied and the percentage of ventilators in use (AOR: 0.996, 95% CI: 0.994, 0.999) emerged as protective factors. ConclusionThese findings indicated that certain groups have higher odds of COVID-19 BID and thus, require closer monitoring. Considering that COVID-19 BID is influenced by various elements beyond clinical factors, intensifying public health initiatives and multi-organisational collaboration is necessary to address this issue.

The Impact of Multimorbidity on All-Cause Mortality: A Longitudinal Study of 87,151 Thai Adults.

Objectives: To investigate associations between multimorbidity, socio-demographic and health behaviour factors, and their interactions (multimorbidity and these factors) with all-cause mortality among Thai adults. Methods: Associations between multimorbidity (coexistence of two + chronic diseases) and mortality between 2005 and 2019 were investigated among Thai Cohort Study (TCS) participants (n = 87,151). Kaplan-Meier survival curves estimated and compared survival times. Multivariate Cox proportional hazards models examined associations between risk factors, and interactions between multimorbidity, these factors, and survival. Results: 1,958 cohort members died between 2005 and 2019. The risk of death was 43% higher for multimorbid people. In multivariate Cox proportional hazard models, multimorbidity/number of chronic conditions, age, long sleep duration, smoking and drinking were all independent factors that increased mortality risk. Women, urbanizers, university education, over 20,000-baht personal monthly income and soybean products consumption lowered risk. The interactions between multimorbidity and these variables (except for female, urbanizers and soybeans intake) also had significant (p < 0.05) impact on all-cause mortality. Conclusion: The results emphasise the importance of healthy lifestyle and reduced intake of alcohol and tobacco, in reducing premature mortality, especially when suffering from multimorbidity.

Exposures to humidifier disinfectant and various health conditions in Korean based on personal exposure assessment data of claimants for compensation

BackgroundHumidifier disinfectants (HDs) were commonly used household chemicals to prevent microbial growth in a humidifier water tank in South Korea. A growing body of evidence has indicated that its airborne exposure can induce severe lung injury. However, there has been low awareness of other health outcomes in HD users. This study aimed to evaluate health conditions appealed by claimants for compensation in relation with an increased exposure to HD.MethodsFrom survey data of personal HD exposure assessment of claimants for compensation in Korea, we included a total of 4,179 subjects [cases in each dataset were defined by nine reported health conditions, i.e., pneumonia, asthma, cardiovascular disease, respiratory disease, otorhinolaryngologic disease, brain disease (including cerebrovascular disease), dermatological disease, lung cancer, and all cancers]. HD exposures was considered as the following exposure criteria: exposure duration, exposure proximity, exposure direction, chemical type, cumulative exposure time, indoor air concentration, and cumulative exposure level. Logistic regression models were used to evaluate the associations between HD exposure and health conditions.ResultsAfter adjusting for sociodemographic and health behavioral factors and other chemical exposures (households, environmental, and occupational exposures), an increase in cumulative HD exposure time was significantly associated with risks of all nine diseases (all p-trends < 0.05). An increase in HD exposure duration was associated with asthma, respiratory disease, otorhinolaryngologic disease, dermatological disease, all cancers, and lung cancer (p-trends < 0.05). Indoor HD concentration was associated with only pneumonia (p-trend = 0.015).ConclusionsOur findings suggest that cumulative exposures to airborne HD might potentially increase the risk of various reported health outcomes.

S1235 Prevalence of Behavioral Health Factors in Patients Undergoing Endoscopic Sleeve Gastroplasty and Impact on Weight Loss Outcomes

S1235 Prevalence of Behavioral Health Factors in Patients Undergoing Endoscopic Sleeve Gastroplasty and Impact on Weight Loss Outcomes

Characterization of quality of life among individuals with current treated, untreated, and past alcohol use disorder

ABSTRACTBackground: Understanding health-related quality of life (HRQOL) among those who seek treatment for their alcohol use disorder (AUD) and those not seeking AUD treatment is critical to decreasing morbidity and mortality, yet HRQOL in these groups has been little characterized.Objectives: Characterize HRQOL among those who meet diagnostic criteria for AUD, both receiving and not receiving treatment.Methods: This analysis used the NESARC-III database (n = 36,309; female = 56.3%), a nationally representative survey of US adults, to compare four groups: those treated for current AUD; those untreated for current AUD; those with past AUD only; and those who never met criteria for AUD. Multiple regression analysis was used to account for differences in sociodemographic and other behavioral factors across these groups. HRQOL was operationalized using annual quality-adjusted life years (QALYs).Results: Patients treated for past-year AUD had a deficit of 0.07 QALYs/year compared to those who never met criteria for AUD (P < .001). They retained a still clinically meaningful 0.03 QALYs/year deficit after controlling for concomitant psychiatric disorders and other behavioral health factors (P < .001). Those with past-year untreated AUD or past AUD had a near-zero difference in QALYs compared with those who never met criteria for AUD.Conclusion: These findings suggest that previously-reported differences in HRQOL associated with AUD may be due to the problems of the relatively small sub-group who seek treatment. Clinicians seeking to treat those with currently untreated AUD may do better to focus on the latent potential health effects of AUD instead of current HRQOL concerns.

Association between life’s essential 8 and biological ageing among US adults

BackgroundBiological ageing is tightly linked to cardiovascular disease (CVD). We aimed to investigate the relationship between Life’s Essential 8 (LE8), a currently updated measure of cardiovascular health (CVH), and biological ageing.MethodsThis cross-sectional study selected adults ≥ 20 years of age from the 2005–2010 National Health and Nutrition Examination Survey. LE8 scores (range 0–100) were obtained from measurements based on American Heart Association definitions, divided into health behavior and health factor scores. Biological ageing was assessed by different methods including phenotypic age, phenotypic age acceleration (PhenoAgeAccel), biological age and biological age acceleration (BioAgeAccel). Correlations were analyzed by weighted linear regression and restricted cubic spline models.ResultsOf the 11,729 participants included, the mean age was 47.41 ± 0.36 years and 5983 (51.01%) were female. The mean phenotypic and biological ages were 42.96 ± 0.41 and 46.75 ± 0.39 years, respectively, and the mean LE8 score was 67.71 ± 0.35. After adjusting for potential confounders, higher LE8 scores were associated with lower phenotypic age, biological age, PhenoAgeAccel, and BioAgeAccel, with nonlinear dose–response relationships. Negative associations were also found between health behavior and health factor scores and biological ageing, and were stronger for health factors. In health factor-specific analyses, the β negativity was greater for blood glucose and blood pressure. The inverse correlations of LE8 scores with phenotypic age and biological age in the stratified analyses remained solid across strata.ConclusionsLE8 and its subscale scores were strongly negatively related to biological ageing. Encouraging optimal CVH levels may be advantageous in preventing and slowing down ageing.