Health Study Research Articles

Associations of seasonally available global positioning systems-derived walkability and objectively measured sleep in the Nurses' Health Study 3 Mobile Health Substudy.

Sleep is influenced by the environments that we experience while awake and while asleep. Neighborhood walkability has been linked with chronic disease and lifestyle factors, such as physical activity; however, evidence for the association between walkability and sleep is mixed. Extant studies assign walkability based on residential addresses, which does not account for mobility. We examined the association between walkability and sleep in the Nurses' Health Study 3 (NHS3) Mobile Health Substudy (MHS). From 2018 to 2020, individuals in the United States-based NHS3 prospective cohort participated in the MHS, in which minute-level global positioning systems (GPS) data and objective sleep duration and efficiency measures were collected via a custom smartphone application and Fitbit, respectively, for four 7-day periods across a year to capture seasonal variability. Census tract walkability was calculated by summing z-scores of population density (2015-2019 American Community Survey), business density (2018 Infogroup), and intersection density (2018 TIGER/Line road shapefiles). We ran generalized additive mixed models with penalized splines to estimate the association between walkability and sleep, adjusting for individual-level covariates as well as GPS-based exposure to environmental and contextual factors. The average main sleep period duration was 7.9 hours and the mean sleep efficiency was 93%. For both sleep duration and sleep efficiency, we did not observe an association with daily average walkability exposure. In this study of women across the United States, we found that daily GPS-based neighborhood walkability exposure during wake time was not associated with objective wearable-derived sleep duration or sleep efficiency.

The association between continuing work after retirement and the incidence of frailty: evidence from the China health and retirement longitudinal study

ObjectivesRetirement represents a significant life transition, with post-retirement status serving as a pivotal aspect of aging research. Despite its potential significance, little research has delved into the relationship between continuing work after retirement and the frailty. This study aims to investigate the association between continuing work after retirement and the incidence of frailty among older individuals. DesignA nationally representative cohort study. Setting and participantsWe utilized data from 4 waves (2011, 2013, 2015 and 2018) of the China Health and Retirement Longitudinal Study and a total of 5,960 participants were included in the study after applying specific inclusion and exclusion criteria. MethodsFrailty was assessed using a Frailty Index. To balance baseline covariates between workers (n = 3,170) and non-workers (n = 2,790), we employed inverse propensity of treatment weighting. The relationship between work status and the incidence of frailty was examined using Cox proportional hazards analysis, with results reported as hazard ratios and 95% confidence intervals. ResultsA total of 5,960 participants (mean age 64 years; 42.1% male) were included in the analysis. Over a mean follow-up of 6.9 years, 2,105 cases of frailty were identified. In the cohort analysis, following adjustment using the inverse propensity of treatment weighting (IPTW), continuing work after retirement showed a negative association with frailty incidence, with an HR of 0.72 (95% CI, 0.65−0.79). Subgroup analysis revealed a more significant protective effect of continuing work beyond retirement age among individuals aged 65 or older, males, smokers, and those with limited social activities. ConclusionsIn summary, this study identified a significant association between continuing work after retirement and a decreased risk of frailty. The findings underscore the potential benefits of policies promoting social engagement and extending working life in enhancing the quality of life for the aging population.

Clinical biomarker-based biological age predicts deaths in Brazilian adults: the ELSA-Brasil study.

Biological age is a construct that seeks to evaluate the biological wear and tear process of the organism that cannot be observed by chronological age. We estimate individuals' biological age based on biomarkers from multiple systems and validate it through its association with mortality from natural causes. Biological age was estimated in 12,109 participants (6621 women and 5488 men) from the first visit of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) who had valid data for the biomarkers used in the analyses. Biological age was estimated using the Klemera and Doubal method. The difference between chronological age and biological age (Δage) was computed. Cox proportional hazard models stratified by sex were used to assess whether Δage was associated with mortality risk after a median follow-up of 9.1years. The accuracy of the models was estimated by the area under the curve (AUC). Δage had equal mean for men and women, with greater variability for men. Cox models showed that every 1-year increase in Δage was associated with increased mortality in men (HR (95% CI) 1.21; 1.17-1.25) and women (HR (95% CI) 1.24; 1.15-1.34), independently of chronological age. Results of the AUC demonstrated that the predictive power of models that only included chronological age (AUC chronological age = 0.7396) or Δage (AUC Δage = 0.6842) was lower than those that included both, chronological age and Δage (AUC chronological age + Δage = 0.802), in men. This difference was not observed in women. We demonstrate that biological age is strongly related to mortality in both genders and is a valid predictor of death in Brazilian adults, especially among men.

Trends in the prevalence and incidence of chronic obstructive pulmonary disease among adults aged ≥50 years in the United States, 2000-2020.

Understanding the trends of the prevalence and incidence rate of chronic obstructive pulmonary disease (COPD) is vital for improving the control and prevention of COPD. We aimed to examine the trends in the prevalence and incidence rate of COPD among adults aged 50 years or older in the United States during 2000-2020. Utilizing data from the Health and Retirement Study, we analyzed COPD prevalence across survey waves and calculated COPD incidence rates between consecutive interview waves, stratified by gender and race. We employed joinpoint regression models to investigate trends in COPD prevalence and incidence. The individuals reporting COPD are more likely to be women and Caucasians. The age-adjusted prevalence of COPD among adults aged 50 years and over showed an increasing trend throughout the study period, spanning from 9.02% in 2000 to 9.88% in 2020 (average biennial percent change [ABPC] = 0.41, 95% confidence interval [CI]: 0.10, 0.71; p = 0.01). The age-adjusted incidence rate of COPD among adults aged 50 and over showed a decreasing trend throughout the study period 1031.1 per 100,000 person-years in 2000 to 700.5 per 100,000 person-years in 2020 (ABPC = -1.63, 95% CI: -2.88, -0.36; p = 0.02). Our findings indicate a rising prevalence of COPD among older adults in the United States since 2000, while the incidence rate of COPD has shown a declining trend.

Later-life social network profiles of male war survivors in Vietnam: Implications for health behaviors.

Emerging research emphasizes early-life war exposure as a key determinant of later-life health in older adults from low- and middle-income countries (LMICs). Yet, the linkages between war exposure, social networks, and later-life health behaviors have received little attention. Using data from the 2018 Vietnam Health and Aging Study, we investigate how early-life war experiences relate to the social networks and health behaviors of 1195 Vietnamese men aged 60+ who survived the Vietnam War (1965-1975). We utilize latent class analysis to identify men's network types and examine the associations between military service, war trauma, PTSD, and later-life network profiles. Furthermore, we assess the linkages between war experiences and risky health behaviors (physical inactivity, frequent alcohol and tobacco consumption) and the moderating effect of social networks on these behaviors. Our findings reveal that exposure to wartime malevolent living conditions, as opposed to direct war violence, and recent PTSD symptoms are linked to lower support levels in respondents' network profiles. Moreover, although diverse and supportive networks correspond to a reduced risk of physical inactivity, they are associated with higher risks of frequent alcohol consumption and are marginally associated with tobacco use. Importantly, social network profiles moderate the relationship between PTSD symptoms and the risk of frequent alcohol consumption. This evidence underscores the need for policymakers to consider the historical and social contexts of LMICs when deploying social support as a health intervention.

Assessment of Health Disparities and Sexual Orientation Response Choices Used in Two US National Population-Based Health Surveys, 2020‒2021.

Objectives. To (1) compare responses to 2 survey questions designed to measure sexual orientation and (2) understand how variation in responses is associated with mental health. Methods. Data were from the National Longitudinal Study of Adolescent to Adult Health (Add Health) Sexual Orientation/Gender Identity, Socioeconomic Status, and Health Across the Life Course (SOGI-SES) study (2020-2021) in the United States. We used the adjusted Wald test to compare proportions of respondents who were (1) categorized as heterosexual or straight and sexual minorities using the sexual orientation questions designed for the Add Health study and the National Health Interview Survey (NHIS) and (2) diagnosed with depression or anxiety or panic disorder. Results. The Add Health question detected more than twice as many sexual minority respondents as the NHIS question. Those who responded as sexual minorities to the Add Health question but as heterosexual or straight to the NHIS question, primarily "mostly heterosexuals," had mental health outcomes that were more like those who were consistently classified as sexual minorities versus those consistently classified as heterosexual or straight. Conclusions. Current measures of sexual orientation in national-level surveys may underestimate the sexual minority population and sexual orientation‒related health disparities. Public Health Implications. Results illustrate the need for further research to expand measurement of sexual orientation on population-based health surveys. (Am J Public Health. 2024;114(12):1375-1383. https://doi.org/10.2105/AJPH.2024.307839).

Rapid Detection of Microplastics/Nanoplastics Directly Exposed to Blood During Intravenous Injections via Mie Scattering Spectra

Microplastics/nanoplastics (M/NPs) are pervasive in the environment, leading to inevitable human exposure through various pathways and raising significant public and scientific concern. Understanding the sources and levels of M/NPs in human blood is crucial for environmental health studies. This work examined the content, type, shape, and size of M/NPs released directly into the bloodstream from medical devices via saline solution during intravenous (IV) injection. The results of the Mie scattering spectra method show that the M/NPs content from infusion bags was 1.0 ± 0.7μg/L, mainly fibers, polyethylene, and polypropylene, with fragments being predominant. During a IV process, the initial 12mL of saline from infusion tubes contained 8.4 ± 3.6μg/L of M/NPs, primarily polyvinyl chloride and fibers. These results suggest that M/NPs exposure during IV therapy mainly originates from infusion tubing, necessitating high concern for exposure risks. Recommendations include: 1) reducing non-essential IV treatments, 2) discarding the initial 12mL of saline solution flowing through the tubing during essential IV therapy, and 3) expediting the development of legal requirements and detection standards by national authorities and the healthcare industry to mitigate the risk of M/NPs exposure in the bloodstream.

Internal factors influencing students' decisions in choosing a public health study program, faculty of public health, Halu Oleo University, Kendari, Southeast Sulawesi, Indonesia, 2024

Background: The existence of public health colleges is very important to train professionals to handle various public health challenges. Data shows that Indonesia has 3,107 universities, of which 95.97% are private universities. In the field of public health, the Faculty of Public Health of Halu Oleo University (UHO), which was established in 2011, shows significant development with two study programs and six specializations relevant to the needs of the community. The increasing interest in the UHO Public Health Study Program, which is accredited B, reflects the high public interest in this field. Public health graduates have broad employment opportunities, thanks to the interdisciplinary skills they acquire. This study aims to analyze the factors that affect students' decisions in choosing a specialization in the UHO Public Health Study Program, which is expected to provide insights for curriculum development and strategies to increase learning interest in the field of public health. Methods: The research method uses a quantitative approach with an exploratory research type. The sample in this study is active students of each batch in the public health study program, Faculty of Public Health, Halu Oleo University. The number of samples was 392 respondents. The sampling technique uses Proportionated Stratified Random Sampling. Data analysis using SMARTPLS 4. Results: The results showed that there was no influence of image with a path coefficient output value of 0.040 and a construct value below 1.96 of 0.089 and a p value of 0.373 >0.05; there was an influence of interest with a path coeficient output value of 0.327 and a construct value above 1.96 of 6.854 and a p value of 0.000 <0.05; there was a psychological influence with a path coeficient output value of 0.327 and a construct value above 1.96 0.265 and the construction value above 1.96 is 5.270 and the p value is 0.000 <0.05; There is an influence of lecturers with a path efficiency output value of 0.308 and a construct value above 1.96 which is 6.854 and a p value of 0.000 <0.05 with a student decision in choosing the Public Health study program, Faculty of Public Health, Halu Oleo university. Conclusion: There is an influence of interest, psychology, and lecturers on students' decisions in choosing the Public Health study program and there is no influence on the student's decision in choosing the Public Health study program, Faculty of Public Health, Halu Oleo University. Therefore, the management of the study program needs to improve the quality of academic services and organizational development within the scope of FKM UHO by implementing various organizational development strategies through expanding academic access, providing infrastructure and facilities, and improving human resources. And the faculty needs to develop cross-sector cooperation to improve student competence so that the graduates produced are competent and ready to work

Abstract C011: The impact of reproductive factors on breast tumor and normal-adjacent tissue immune profile from menarche to menopause

Abstract Background: Reproductive factors and sex hormones are tightly linked to systemic immunity. However, no studies have examined whether reproductive factors and exogenous hormone use modulate the immune microenvironment of breast tissue. Methods: We prospectively evaluated the associations of reproductive factors (age at menarche, parity, age at first birth, age at menopause, and menopausal status) and exogenous hormone use (oral contraceptives, and menopausal hormone therapy (MHT)) with breast tumor and normal-adjacent tissue immune cell markers among 935 breast cancer cases in the Nurses’ Health Studies. We deconvoluted immune cell abundance using CIBERSORTx and derived gene expression signatures of markers for immune checkpoint (PD1, PDL1, and CTLA4), co-regulatory signal and antigen presentation (MHC class I/ II and T cell receptor) and mammary cytokine signaling (IFN gamma, IL2, IL4, IL12, IL13, TGF beta). Linear regression was used with adjustment for potential confounders. Results: Majority of participants had estrogen receptor (ER)-positive breast cancer (81%) and were post-menopausal at diagnosis (72%). Compared to tumors from pre-menopausal women, tumors from post-menopausal women had higher signature scores for tumor pro-inflammatory cytokine signaling (IFN gamma, IL2, IL4, IL12, IL13, TGF beta) and antigen presentation (FDR≤0.05). Several of the inflammatory cytokine signatures showed modest inverse relations with signatures of immune checkpoint markers (ρ=-0.3 to -0.4). Women who reported current use of estrogen only MHT had higher expression of CTLA4 in ER-positive breast tumors. For normal-adjacent tissues of ER-positive tumors, parity was associated with higher CD8+ T cell abundance, higher PDL1 expression and lower cytokine signaling in normal-adjacent tissues at p≤0.05; while breastfeeding was associated with lower abundance of CD8+ T cell and higher expression of cytokine signaling in normal-adjacent tissues of ER-negative tumors (p≤0.05). None of the associations in normal-adjacent tissues met FDR significance. The associations between other reproductive factors and immune cell profiles were in general weak. Conclusions: Our study suggests pre-diagnostic reproductive factors may influence breast tumor immune profiles. Future studies are needed to validate these results. Citation Format: Cheng Peng, Yuxi Liu, Yujing Heng, Clara Bodelon, Daniel Stover, Wendy Y. Chen, Michelle D. Holmes, A. Heather Eliassen, Peter Kraft, Rulla M. Tamimi. The impact of reproductive factors on breast tumor and normal-adjacent tissue immune profile from menarche to menopause [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Tumor-body Interactions: The Roles of Micro- and Macroenvironment in Cancer; 2024 Nov 17-20; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2024;84(22_Suppl):Abstract nr C011.

Higher socioeconomic deprivation in areas predicts cognitive decline in New Zealanders without cognitive impairment.

Previous studies identified individual-level socioeconomic factors as key determinants of cognitive health. This study investigated the effect of area-based socioeconomic deprivation on cognitive outcomes in midlife to early late-life New Zealanders without cognitive impairment at baseline. Data stemmed from a subsample of the New Zealand Health, Work and Retirement Study, a cohort study on ageing, who completed face-to-face interviews and were reassessed two years later. Cognitive functioning was measured using Addenbrooke's Cognitive Examination-Revised, adapted for culturally acceptable use in Aotearoa New Zealand. Area-based socioeconomic deprivation was assessed using the New Zealand Deprivation Index (NZDep2006). Linear mixed-effects models analysed the association between area-based socioeconomic deprivation and cognitive outcomes. The analysis included 783 participants without cognitive impairment at baseline (54.7% female, mean age 62.7 years, 25.0% Māori, the Indigenous people of Aotearoa New Zealand). There was an association between higher area-based socioeconomic deprivation and lower cognitive functioning (B = -0.08, 95%CI: -0.15;-0.01; p = .050) and cognitive decline (B = -0.12, 95%CI: -0.20;-0.04, p = .013) over two years, while controlling for covariates. The findings emphasise the importance of considering neighbourhood characteristics and broader socioeconomic factors in strategies aimed at mitigating cognitive health disparities and reducing the impact of dementia in disadvantaged communities.

Characteristics of longitudinal maternal health studies in sub-Saharan Africa: A systematic mapping of literature between 2012 and 2022.

High maternal mortality rates in sub-Saharan Africa necessitate the need for aligned research focusing on prevalent causes and neglected conditions in the region. This mapping review aimed to describe the characteristics of longitudinal maternal health studies between 2012 and 2022 in sub-Saharan Africa and identify gaps in priority conditions or geographical locations. We identified references through a Medline (PubMed) search covering September 2012 to June 2022. We included prospective cohort or clinical trials that enrolled at least 1000 pregnant women, with a study site in sub-Saharan Africa, and published in English or French. Screening and data extraction were done in duplicate using EPPI-reviewer software. Descriptive analysis was used to summarize the results, identifying patterns in studies across time, country, study design, topics, and funders. We identified 213 eligible studies, which were covered in 534 publications. We identified studies in 33 of the 48 sub-Saharan African countries, with the majority in east and southern Africa. The predominant study topics were HIV (36.4%), nutrition (20%), and malaria (16.3%), with very few publications on hypertensive disorders of pregnancy (6.4%), ante/postpartum hemorrhage (3.7%), and sexually transmitted infections (3.2%). More studies were cohorts (115/213; 54%) than clinical trials. The National Institutes of Health (31.5%), Bill and Melinda Gates Foundation (22.1%), and USAID (10.8%) were the largest research funders. Identifying research trends and mismatches between research topics and disease burden provides useful information for guiding future research prioritization. In particular, gaps exist for studies on hypertensive disorders of pregnancy and ante/postpartum hemorrhage, among the top causes of maternal mortality in sub-Saharan Africa.

Exposure to air pollution and non-neoplastic digestive system diseases: findings from the China health and retirement longitudinal study

ObjectivesIncreasing concern about air pollution’s impact on public health underscores the need to understand its effects on non-neoplastic digestive system diseases (NNDSD). This study explores the link between air pollution and NNDSD in China.MethodsWe conducted a national cross-sectional study using 2015 data from the China Health and Retirement Longitudinal Study (CHARLS), involving 13,046 Chinese adults aged 45 and above from 28 provinces. Satellite-based spatiotemporal models estimated participants’ exposure to ambient particulate matter (3-year average). An analysis of logistic regression models was conducted to estimate the association between air pollutants [particulate matter with a diameter ≤ 2.5 μm (PM2.5) or ≤10 μm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), and carbon monoxide (CO)] and NNDSD. Interaction analyses were conducted to examine potential modifiers of these associations.ResultsThe prevalence of NNDSD among participants was 26.29%. After adjusted for multivariate factors, we observed a 6% [odd ratio (OR) = 1.06, 95% confidence interval (CI): 0.94, 1.19], 23% (OR = 1.23, 95% CI: 1.09, 1.38), 26% (OR = 1.26, 95% CI: 1.12, 1.41), 30% (OR = 1.30, 95% CI: 1.16, 1.46), 13% (OR = 1.13, 95% CI: 1.01, 1.27) and 27% (OR = 1.27, 95% CI: 1.13, 1.43) increase in NNDSD risk with an interquartile range increase in PM2.5 (23.36 μg/m3), PM10 (50.33 μg/m3), SO2 (17.27 μg/m3), NO2 (14.75 μg/m3), O3 (10.80 μg/m3), and CO (0.42 mg/m3), respectively. Interaction analyses showed that PM2.5, SO2, and O3 had stronger effects on NNDSD risk among older adults, highly educated individuals, smokers, and married people, respectively.ConclusionThis study demonstrates that long-term exposure to PM2.5, PM10, SO2, NO2, O3, and CO is positively associated with NNDSD risk in Chinese adults aged 45 and above. Implementing intervention strategies to enhance air quality is essential for reducing the burden of NNDSD.

Digital Exclusion and Cognitive Function in Elderly Populations in Developing Countries: Insights Derived From 2 Longitudinal Cohort Studies.

Cognition disorders not only lead to adverse health consequences but also contribute to a range of socioeconomic challenges and diminished capacity for performing routine daily activities. In the digital era, understanding the impact of digital exclusion on cognitive function is crucial, especially in developing countries. This study aimed to evaluate the association between digital exclusion and cognitive function among elderly populations in developing countries. Using data from CHARLS (China Health and Retirement Longitudinal Study) from 2011 to 2020 and MHAS (Mexican Health & Aging Study) from 2012 to 2021, we defined digital exclusion as self-reported absence from the internet. Cognitive function was assessed through 5 tests: orientation, immediate verbal recall, delayed verbal recall, serial 7s, and figure recall. Cognitive function was assessed in 2 categories: worse cognition (a categorical variable that classifies cognition as either better or worse compared to the entire cohort population) and cognitive scores (a continuous variable representing raw cognitive scores across multiple follow-up waves). Logistic regression analyses and generalized estimating equation (GEE) analyses were used to examine the relationship between cognitive function and digital exclusion, adjusting for potential confounders, including demographics, lifestyle factors, history of chronic diseases, basic activities of daily living (BADL) disability, instrumental activities of daily living (IADL) disability, and basic cognitive abilities. After excluding participants with probable cognitive impairment at baseline and those who did not have a complete cognitive assessment in any given year (ie, all tests in the cognitive assessment must be completed in any follow-up wave), a total of 24,065 participants in CHARLS (n=11,505, 47.81%) and MHAS (n=12,560, 52.19%) were included. Of these, 96.78% (n=11,135) participants in CHARLS and 70.02% (n=8795) in MHAS experienced digital exclusion. Adjusted logistic regression analyses revealed that individuals with digital exclusion were more likely to exhibit worse cognitive performance in both CHARLS (odds ratio [OR] 2.04, 95% CI 1.42-2.99; P<.001) and MHAS (OR 1.40, 95% CI 1.26-1.55; P<.001). Gender and age did not significantly modify the relationship between digital exclusion and worse cognition (intervention P>.05). The fully adjusted mean differences in global cognitive scores between the 2 groups were 0.98 (95% CI 0.70-1.28; P<.001) in CHARLS and 0.50 (95% CI 0.40-0.59; P<.001) in MHAS. A substantial proportion of older adults, particularly in China, remain excluded from internet access. Our study examined longitudinal changes in cognitive scores and performed cross-sectional comparisons using Z-score standardization. The findings suggest that digital exclusion is linked to an increased risk of cognitive decline among older adults in developing countries. Promoting internet access may help mitigate this risk and support better cognitive health in these populations.

Study of the Mental Health of the Elderly and Related Factors

Background: Aging and increase in the elderly population are the most important issues in recent years in developed countries and some developing countries. Mental health is one of the crucial aspects of elderly well-being and must be addressed to improve community health. This study is conducted to examine the mental health of the elderly and the related factors in Gorgan city, 2022. Methods: The present study is descriptive-analytical and was conducted using a two-stage cluster random sampling method. First, four comprehensive health service centers were selected as a cluster from among the centers of Gorgan city, and then 263 people were randomly selected from the chosen centers, proportionate to the number of registered elderly individuals in the electronic service system. The standard depression questionnaire for the elderly was utilized for assessment. Data were then entered into SPSS software version 18 and with descriptive and analytical statistical tests, including the Mann-Whitney test, Chi-square test, and logistic regression (The significance level was less than 0.05(. Results: A total of 263 elderly people were evaluated with a mean age of 68.64 ± 7.2 . 143 (54.4%) were male and 120 (45.6%) were female. The prevalence of depression was reported to be 27.8. The occurrence of depression was significantly associated with age, marital status, and the presence of underlying disease conditions (p &lt; 0.05). However, gender, place of residence, and BMI did not show a statistically significant relationship with the occurrence of depression. Aging, underlying diseases, and not being married increase the chance of depression in the elderly. Conclusion: Although the prevalence of depression in the elderly is lower than the average of the whole country in this study, they are in a better condition. However, due to the fact that they are a special target group, as well as the various risk factors of the disease, including age, lack of marriage, and the presence of an underlying disease in this group, it is suggested that more appropriate planning be done to improve their mental health status.

Association between blood lead and periodontitis among American adults: a cross-sectional study of the national health and nutrition examination survey

BackgroundLead is persistent in the environment as a toxic substance and accumulates in the human body. Lead exposure has far-reaching harmful effects on all human systems and is widely recognized as a health and public health concern. Lead exposure poses a significant risk to oral health, as it destroys salivary glands and alveolar bone. It also induces oxidative stress which results in an immune response. Lead exposure appears to adversely affect periodontal tissues. Currently, the available evidence on the relationship between blood lead and periodontitis is insufficient and further research is necessary.ObjectiveIn this study, the objectives were to clarify the association between blood lead and periodontitis, as well as to explore potential dose-response relationships between blood lead exposure and periodontitis, as well as to determine appropriate thresholds for the effects of blood lead on periodontitis.MethodsWe conducted a cross-sectional study involving 8,550 participants with American adults aged 30 or older. blood Lead, periodontitis, age, sex, race, heart rate, education level, poverty index, marital status, body mass index, smoking status, alcohol drinking status, hypertension, diabetes and stroke. were collected from participants. Logistic regression, smooth curve fittingwere utilized to substantiate the research objectives.ResultsThere were a total of 8,550 participants of which 52.2% (4,467/8,550) had moderate/severe periodontitis. Compared with Q1 (0.15–0.93 ug/L), where blood lead levels were lower, the OR values for adjusted blood lead and periodontitis in Q2 (0.93–1.60 ug/L) and Q3 (1.60–61.29 ug/L) were 1.18 (95% CI: 1.12–1.25, P &amp;lt; 0.001) and 1.43 (95% CI: 1.34–1.52, P &amp;lt; 0.001). The association between blood lead levels and periodontitis exhibited a curve (non-linear, P &amp;lt; 0.001), with an inflection point of roughly 2.700 ug/L. The OR values for moderate/severe periodontitis in participants with blood lead levels &amp;lt;2.700ug/L was 1.318 (95% CI: 1.193–1.457, P &amp;lt; 0.001).ConclusionBlood lead levels are positively associated with periodontitis. Blood lead levels increased by five units and were associated with an increase in moderate and severe periodontitis risk by 36%. There is a curvilinear relationship between blood lead and periodontitis with a threshold effect and an inflection point of approximately 2.7 ug/L.

The crowding-out effect of physical fitness activities on medical expenditure in the aged group

IntroductionChina is facing the challenge of “deep aging”, and promoting healthy aging has become a key research topic. Both medical care and physical exercise are important for health, but while medical services focus on treating illness, physical fitness activities focus on prevention, making them a more effective approach for promoting healthy aging.MethodsThis study uses data from the China Health and Retirement Longitudinal Study (CHARLS), focusing on individuals aged 60 to 80, to investigate the relationship between physical fitness activities and medical expenditures. A Tobit model was employed to analyze the data.Results(1) Active participation in physical fitness activities significantly improves the health of older adults, making physical activity an essential pathway to achieve healthy aging. (2) Participation in sports and fitness activities leads to a crowding-out effect on medical expenditures, significantly reducing healthcare costs for participants. (3) High-intensity physical activities are most suitable for individuals aged 60-65, moderate-intensity activities for those aged 66-70, and low-intensity activities for those aged 71–80.Discussion(1) Policies should focus on raising awareness of physical fitness benefits among older adults, encouraging regular physical activity to improve health and reduce medical costs. (2) A shift from treatment to prevention in health management is needed, promoting exercise as a cost-effective way to reduce healthcare spending. (3) Age-specific fitness guidelines should be developed to provide tailored exercise recommendations for different older aldult age groups.

Engaging Low-Wage Workers in Health and Well-Being Survey Research: Strategies From 5 Occupational Studies.

Without perspectives of low-wage workers in studies of worker health and well-being, researchers cannot comprehensively assess occupational health and health equity impacts of workplace exposures and interventions. Researchers and practitioners have noted particular challenges in engaging low-wage workers in worksite-based health survey research, yet little scholarship has described strategies for improving their engagement and response rates. To fill this gap, we present case examples from 5 occupational studies conducted between 2020 and 2024 in industries including health care, food service, and fulfillment centers. For each case, we describe how we identified barriers to worker engagement in surveys, explain specific strategies we used to address those barriers, and assess the effectiveness of these actions. Then, summarizing across case examples, we offer practical recommendations to researchers surveying low-wage populations, highlighting that high-touch recruitment, building trust with workers and managers, and obtaining manager support to take surveys during work time (for worksite-based studies) are critical for obtaining reliable, representative data. Our work contributes to broader discussions on improving survey response rates in vulnerable worker populations and aims to support future researchers undertaking similar efforts. (Am J Public Health. Published online ahead of print November 14, 2024:e1-e8. https://doi.org/10.2105/AJPH.2024.307875).

Disparities in the Life Course Origins of Dual Functionality.

Although research has identified how stressors are related to either physical or cognitive function in later life, we bridge these literatures by examining dual functionality (neither physical nor cognitive impairment) among Black, White, and Hispanic adults. Using data from the Health and Retirement Study (2006-2016), we investigated whether stressors and resources during childhood and adulthood are related to functional loss at baseline and longitudinally. Analyses revealed that lifetime trauma was associated with dual functionality impairment at baseline, but childhood stressors and everyday discrimination were prospectively associated with loss of dual functionality. Black and foreign-born Hispanic adults experienced earlier loss of dual functionality than White adults, and the effect of childhood stressors on the transition to impairment occurred earlier for U.S.-born Hispanic adults. Findings reveal the influence of exposures in childhood and adulthood on functional health in later life-and how resources may be a counterbalance to functional loss.

The associations between adverse childhood experiences and body pain among middle-aged and older adults: findings from China.

Adverse Childhood Experiences (ACEs) have been implicated in the development of body pain, yet research on their impact on body pain and its progression remains scarce. This study aimed to examine the associations between ACEs and the presence and areas of body pain, as well as their developmental trajectories among middle-aged and older Chinese adults. We included participants aged 45 years and above from the China Health and Retirement Longitudinal Study (CHARLS) conducted between 2011 and 2018. Retrospective data on ACEs and pain sites were collected with questionnaires. The presence of pain at different body sites was categorized into three areas: head & neck, trunk, and limbs. ACEs consisted of ten types of adverse experiences and were cumulatively scored. For the cross-sectional analysis (2011), logistic regressions were performed to estimate the associations between ACEs and pain presence in specific areas. In the longitudinal analysis (2011-2018), we further applied group-based trajectory modelling (GBTM) to determine the developmental trajectories of body pain. Multinomial logistic regressions were then conducted to estimate the associations between ACEs and pain trajectories. In the cross-sectional analysis (n = 8157), ACEs were positively associated with the presence of pain in the head & neck (odds ratio [OR] = 3.55, 95% confidence intervals [CI] = 2.37-4.74), trunk (OR = 3.28, 95% CI = 2.47-4.34), and limbs areas (OR = 2.30, 95% CI = 1.77-3.00) compared to no ACEs. These associations varied by sex and residence. In the longitudinal analysis (n = 5188), GBTM identified three developmental trajectories of body pain (n = 9521): high-increasing (7.44%), low-moderate (33.67%) and maintained-low trajectories (58.89%) trajectories. Compared to participants without ACEs, individuals had three ACEs and 4 or more ACEs were consistently associated with low-moderate (three ACEs: OR = 2.26, 95% CI = 1.81-2.83, four or more ACEs: OR = 3.11, 95% CI = 2.51-3.87) and high-increasing (three ACEs: OR = 3.28, 95% CI = 2.03-5.30, four or more ACEs: OR = 6.78, 95% CI = 4.30-10.68) body pain trajectories across sexes and residence. This study highlighted the significant association between ACEs and body pain among middle-aged and older Chinese, emphasizing the importance of preventing or mitigating ACEs as a strategy for the prevention and management of body pain.

Forming of modern Russian youth’s social representations about maintaining health: condition and problems

The article deals with the study of health maintaining among Russian youth. Based on data from all-Russian surveys and presented in relevant studies, the contradictions between the value perception of health and destructive health practices among young people were found. In this regard, based on the understanding of health conservation as a purposeful activity, in the structure of which the cognitive component plays a significant role, the author underlines to study young people’s ideas about health and health caring in order to realise the reasons of differences between the state of health and the attitude of Russian youth. In this regard, the author conducted a study of the structure of social ideas of young Russians. The theoretical basis of the study was the key provisions of the concept of social representations by S. Moscovici. The empirical basis was the data of the author’s empirical study “Health Saving of Modern Russian Youth: Ideas and Practices”. Based on the results of the study, it was established that the core of modern youth’s social ideas about health conservation are traditional images and ideas that reflect the most characteristic of Russian society and its health conservation culture, but in a limited format. The peripheral zone includes components such as breaking bad habits, well-being, and maintaining emotional stability. The least characteristic of young Russians is the connection between ideas about health and health preservation with institutional practices of clinical examination and preventive examinations, which suggests a decrease in the role of the medical institute as an agent of social control in relation to health in the ideas of the younger generation. Thus, the social ideas of young Russians about health and the practices of its preservation, along with traditional ideas, are distinguished by features, the formation of which, according to the author, is due to the influence of new agents of healthy lifestyle socialization and the online-sources