Lower Annual Income Research Articles

Exposures to ambient particulate matter are associated with reduced adult earnings potential

The societal costs of air pollution have historically been measured in terms of premature deaths (including the corresponding values of statistical lives lost), disability-adjusted life years, and medical costs. Emerging research, however, demonstrated potential impacts of air pollution on human capital formation. Extended contact with pollutants such as airborne particulate matter among young persons whose biological systems are still developing can result in pulmonary, neurobehavioral, and birth complications, hindering academic performance as well as skills and knowledge acquisition. Using a dataset that tracks 2014–2015 incomes for 96.2% of Americans born between 1979 and 1983, we assessed the association between childhood exposure to fine particulate matter (PM2.5) and adult earnings outcomes across U.S. Census tracts. After accounting for pertinent economic covariates and regional random effects, our regression models indicate that early-life exposure to PM2.5 is associated with lower predicted income percentiles by mid-adulthood; all else equal, children raised in high pollution tracts (at the 75th percentile of PM2.5) are estimated to have approximately a 0.51 decrease in income percentile relative to children raised in low pollution tracts (at the 25th percentile of PM2.5). For a person earning the median income, this difference corresponds to a $436 lower annual income (in 2015 USD). We estimate that 2014–2015 earnings for the 1978–1983 birth cohort would have been ∼$7.18 billion higher had their childhood exposure met U.S. air quality standards for PM2.5. Stratified models show that the relationship between PM2.5 and diminished earnings is more pronounced for low-income children and for children living in rural environments. These findings raise concerns about long-term environmental and economic justice for children living in areas with poor air quality where air pollution could act as a barrier to intergenerational class equity.

Effect of a Peer Health Coaching Intervention on Clinical Outcomes Among US Veterans With Cardiovascular Risks

Although cardiovascular disease (CVD) is the leading cause of death in the US, CVD risk factors remain suboptimally controlled. To test the effectiveness of a home-visit, peer health coaching intervention to improve health outcomes for veterans with multiple CVD risks. This 2-group, unblinded randomized clinical trial, called Vet-COACH (Veteran Peer Coaches Optimizing and Advancing Cardiac Health), used a novel geographic-based method to recruit a racially diverse population of veterans with low income. These veterans were enrolled at the Seattle or American Lake Veterans Health Affairs primary care clinics in Washington state. Veterans with a diagnosis of hypertension with at least 1 blood pressure reading of 150/90 mm Hg or higher in the past year, and 1 other CVD risk factor (current smoker, overweight or obesity, and/or hyperlipidemia), who resided in Census tracts with the highest prevalence of hypertension were eligible to participate. Participants were randomized to the intervention group (n = 134) or control group (n = 130). An intention-to-treat analysis was performed from May 2017 to October 2021. Participants in the intervention group received peer health coaching for 12 months with mandatory and optional educational materials, an automatic blood pressure monitor, a scale, a pill organizer, and healthy nutrition tools. Participants in the control group received usual care plus educational materials. The primary outcome was a change in systolic blood pressure (SBP) from baseline to 12-month follow-up. Secondary outcomes included change in health-related quality of life (HRQOL; measured using the 12-item Short Form survey's Mental Component Summary and Physical Component Summary scores), Framingham Risk Score, and overall CVD risk and health care use (hospitalizations, emergency department visits, and outpatient visits). The 264 participants who were randomized (mean [SD] age of 60.6 [9.7] years) were predominantly male (229 [87%]) and 73 (28%) were Black individuals and 103 (44%) reported low annual income (<$40 000 per year). Seven peer health coaches were recruited. No difference was found in change in SBP between the intervention and control groups (-3.32 [95% CI, -6.88 to 0.23] mm Hg vs -0.40 [95% CI, -4.20 to 3.39] mm Hg; adjusted difference in differences, -2.05 [95% CI, -7.00 to 2.55] mm Hg; P = .40). Participants in the intervention vs control group reported greater improvements in mental HRQOL scores (2.19 [95% CI, 0.26-4.12] points vs -1.01 [95% CI, -2.91 to 0.88] points; adjusted difference in differences, 3.64 [95% CI, 0.66-6.63] points; P = .02). No difference was found in physical HRQOL scores, Framingham Risk Scores, and overall CVD risk or health care use. This trial found that, although the peer health coaching program did not significantly decrease SBP, participants who received the intervention reported better mental HRQOL compared with the control group. The results suggest that a peer-support model that is integrated into primary care can create opportunities for well-being improvements beyond blood pressure control. ClinicalTrials.gov Identifier: NCT02697422.

Sociodemographic Disparities in Mercury Exposure from United States Coal-Fired Power Plants.

Hazardous air pollutants emitted by United States (U.S) coal-fired power plants have been controlled by the Mercury and Air Toxics Standards (MATS) since 2012. Sociodemographic disparities in traditional air pollutant exposures from U.S. power plants are known to occur but have not been evaluated for mercury (Hg), a neurotoxicant that bioaccumulates in food webs. Atmospheric Hg deposition from domestic power plants decreased by 91% across the contiguous U.S. from 6.4 Mg in 2010 to 0.55 Mg in 2020. Prior to MATS, populations living within 5 km of power plants (n = 507) included greater proportions of frequent fish consumers, individuals with low annual income and less than a high school education, and limited English-proficiency households compared to the US general population. These results reinforce a lack of distributional justice in plant siting found in prior work. Significantly greater proportions of low-income individuals lived within 5 km of active facilities in 2020 (n = 277) compared to plants that retired after 2010, suggesting that socioeconomic status may have played a role in retirement. Despite large deposition declines, an end-member scenario for remaining exposures from the largest active power plants for individuals consuming self-caught fish suggests they could still exceed the U.S. Environmental Protection Agency reference dose for methylmercury.

Community attachment in the context of urban settlement regeneration: Mediating role of resident interaction

Large-scale urban settlement regeneration has created a dissonance between community environment improvement and resident interaction maintenance, posing challenges to community attachment. Relying on the three-pole triangular model, influential factors were identified in terms of resident interaction, community environment, and individual characteristics. Path analysis model was established to examine feasible pathways and effects of influential factors on community attachment, using survey data from Harbin, China. The results demonstrate that resident interaction is a mediation between community environment and community attachment, as well as between individual characteristics and community attachment. Resident interaction could be regarded to consist of three sub-dimensions: interaction depth, interaction breadth, and interaction frequency. Among them, interaction depth plays a crucial mediating role. Increased interaction depth could enhance community attachment, but extensive or frequent interactions do the opposite. Increasing greening directly benefits community attachment. Constructing public space and improving pedestrian walkways could directly and positively affect community attachment and enhance it by affecting resident interaction. Furthermore, residents with higher education attainment, lower annual income or longer residence time were more likely to be attached. Some policy implications and suggestions for local government and developers were proposed, which can encourage residents' identity in the regenerated community and enhance community attachment.

Measuring resilience and stress during pregnancy and its relation to vulnerability and pregnancy outcomes in a nulliparous cohort study

BackgroundResilience reflects coping with pregnancy-specific stress, including physiological adaptations of the maternal organism or factors arising from the socioeconomic context, such as low income, domestic violence, drug and alcohol use, lack of a support network and other vulnerability characteristics. Resilience is a dynamic characteristic that should be comparatively evaluated within a specific context; its association with perceived stress and social vulnerability during pregnancy is still not fully understood. This study aimed at exploring maternal resilience, perceived stress and social vulnerability during pregnancy and its associated factors and outcomes.MethodsProspective multicenter cohort study of nulliparous women in Brazil determining resilience (Resilience Scale; RS) and stress (Perceived Stress Scale; PSS) at 28 weeks of gestation (± 1 week). Resilience and stress scores were compared according to sociodemographic characteristics related to maternal/perinatal outcomes and social vulnerability, defined as having low level of education, being adolescent, without a partner or ethnicity other than white.ResultsWe included 383 women who completed the RS and PSS instruments. Most women showed low resilience scores (median: 124.0; IQR 98–143). Women with a low resilience score (RS < 125) were more likely from the Northeast region, adolescents, other than whites, did not study or work, had a low level of education, low family income and received public antenatal care. Higher scores of perceived stress were shown in the Northeast, other than whites, at low levels of education, low annual family income and public antenatal care. Pregnant women with low resilience scores (n = 198) had higher perceived stress scores (median = 28) and at least one vulnerability criterion (n = 181; 91.4%).ConclusionOur results reinforce the role of resilience in protecting women from vulnerability and perceived stress. It may prevent complications and build a positive experience during pregnancy.

Factors Affecting Mechanization Index and Farm Power Availability in Guntur District of Andhra Pradesh

Background: Agriculture is the most vital sector of the Indian economy. In 2020, India’s population was 1.38 billion, with a projected growth of 1.80 billion by 2050. As a result, more food must be produced to meet the demands. Mechanization is recognized as an important input for increasing agricultural production. It assures timely field operations, improves product quality and quantity, improves input-use efficiency and reducing labour costs and drudgery. Methods: Randomly, 5 Mandals are selected; within each Mandal, 5 villages are chosen randomly; and from each village, 20 farmers are chosen at random. For the survey, a sample of 500 farmers from 25 villages was selected to examine the mechanization index and farm power availability by considering factors such as social status, landholding and economic status of farmers. Result: According to the study’s findings, that the average mechanization index and average farm power availability were 68% and 1.64-kW ha-1, respectively. The influencing factors that observed from the study was lack of knowledge about how to use farm machines and implements, lower annual income of farmers and marginal farmers who cannot afford to buy expensive machinery and implements. The mechanization index and farm power availability increase linearly with the farmer’s economic status.

Knowledge and Attitudes towards Human Papillomavirus Vaccination (HPV) among Healthcare Providers Involved in the Governmental Free HPV Vaccination Program in Shenzhen, Southern China.

No research has been conducted to explore the variables associated with healthcare providers' (HCPs) knowledge and attitudes toward the human papillomavirus vaccine (HPV) since the vaccine was approved for free use in some Chinese cities. In Shenzhen, southern China, a convenience sample strategy was used to distribute questionnaires to HCPs involved in the government's HPV vaccination program from Shenzhen. There were 828 questionnaires collected in total, with 770 used in the analysis. The mean HPV and HPV vaccine knowledge score was 12.0 among HCPs involved in the government HPV vaccination program (with a total score of 15). the average scores for HPV and HPV vaccine knowledge varied among different types of medical institutions. District hospitals had the highest mean score of 12.4, while private hospitals ranked fourth with a mean score of 10.9. Multivariate logistic regression results revealed significant disparities in the type of license and after-tax annual income across HCPs (p < 0.05). The future education and training for HCPs should focus on private community health centers (CHCs), HCPs whose license type is other than a doctor, and HCPs with low after-tax annual income.

Impact of COVID-19 on health disparities between migrant and non-migrant households: the case of Dearborn, Michigan

ABSTRACT Objectives: Studies on immigration have shown that cultural changes can positively or negatively affect psychological, behavioral, and physical outcomes when different cultures settle into a new host community or country. The majority of research done in the United States and North America has focused on these changes for larger immigrant and minority groups such as Hispanics/Latinos and Asians. However, in the United States, there is a sub-group of immigrants that is largely understudied, resulting in misunderstood data on mental and physical health: Arab Americans. This study assesses mental health disparities between immigrant and non-immigrant populations, before and after COVID-19 restrictions, in Dearborn, MI, a city that has one of the largest concentrations of Arab immigrants in the nation. Design: Using an online survey instrument, this study assessed mental health disparities before and since COVID-19 restrictions, and stressors induced since the pandemic for immigrants and non-immigrants in Dearborn, MI. Results: Through inferential statistics and logistic regressions, results indicate that immigrants are less likely to have healthcare coverage, have lower annual incomes, lower educational attainment, and experience continuously higher mental health issues before the pandemic than non-immigrants faced during the pandemic. Conclusion: This study reinforces that the Arab-American immigrant population is a disadvantaged sub-group and faces considerable stress and mental health concerns as an acculturating population. This stress gets exacerbated when a worldwide event such as the COVID-19 pandemic strikes. Oversight of this population’s health issues results in the inability to receive appropriate social services and healthcare that is vital to address this community’s concerns.

Deterioration in youth employment, social contexts, and marriage decline in Japan and South Korea

ABSTRACT Japan and South Korea are experiencing drastic declines in marriage rates. One of the main factors explaining these declines is deteriorating youth employment. This study examined the effects of youth employment on marriage timing and the moderating effects of social contexts in both countries using longitudinal data and discrete-time logit analysis. The results indicated that unmarried people, particularly men, who were not regular employees with low annual income delayed marriage; this association was moderated by educational background and family structure (parents living together, primogeniture). Comparing the two countries, Japan experiences a stronger influence on marriage from the traditional family system, and South Korea has a stronger influence from economic disadvantages. This reflects differences in the strength of the traditional family system and the degree of deterioration of youth employment in the two countries.

Assessing farmers’ perception based composite drought vulnerability in Godavari Middle Sub-basin, India

Climate change has increased the frequency and intensity of drought in various parts of the world. Godavari Middle Sub-basin of India has been experiencing significant change in rainfall, maximum and minimum temperature. Farmers of Sub-basin depend on mercy of rainfall for their cultivation. Occurrence of drought lead to farmers suicide due to crop failure and losses of agricultural production. Therefore, composite drought vulnerability assessment is essential in the Sub-basin. This paper makes an initial attempt to quantify composite vulnerability to drought using socio-economic and environmental indicators at household level. Stratified random sampling was utilized to collect primary data. A total number of 450 households were surveyed. The composite vulnerability index calculation was based on 5 domains namely economic, social, environmental, ecological, adaption and mitigation strategies. Results revealed that highest drought vulnerability was found in marginal farmers among all the types of farmers due to high climate change vulnerability and low adaptation strategies. Low level of education, low annual income and high dependency on local money lenders were the main causes of high drought vulnerability for marginal farmers. High adaptation strategies helped large farmer to mitigate the impact of drought. The adaptations and mitigation strategies encompassed change in crops, diversification of crops, keeping land unsown after the possibility of drought, change in traditional irrigation practices to sprinkler and drip irrigation, change in crop calendar and sowing of drought-tolerant crops. Community-based preparedness planning could be effective to mitigate the impact of climate change induced drought vulnerability in Godavari Middle Sub-basin.

Social Determinants of Health and Uncontrolled Blood Pressure in a National Cohort of Black and White US Adults: the REGARDS Study.

Determining the contribution of social determinants of health (SDOH) to the higher proportion of Black adults with uncontrolled blood pressure (BP) could inform interventions to improve BP control and reduce cardiovascular disease. We analyzed data from 7306 White and 7497 Black US adults taking antihypertensive medication from the REGARDS (Reasons for Geographic and Racial Differences in Stroke) study (2003-2007). SDOH were defined using the Healthy People 2030 domains of education, economic stability, social context, neighborhood environment, and health care access. Uncontrolled BP was defined as systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg. Among participants taking antihypertensive medication, 25.4% of White and 33.7% of Black participants had uncontrolled BP. The SDOH included in the current analysis mediated the Black-White difference in uncontrolled BP by 33.0% (95% CI, 22.1%-46.8%). SDOH that contributed to excess uncontrolled BP among Black compared with White adults included low annual household income (percent-mediated 15.8% [95% CI, 10.8%-22.8%]), low education (10.5% [5.6%-15.4%]), living in a health professional shortage area (10.4% [6.5%-14.7%]), disadvantaged neighborhood (11.0% [4.4%-18.0%]), and high-poverty zip code (9.7% [3.8%-15.5%]). Together, the neighborhood-domain accounted for 14.1% (95% CI, 5.9%-22.9%), the health care domain accounted for 12.7% (95% CI, 8.4%-17.3%), and the social-context-domain accounted for 3.8% (95% CI, 1.2%-6.6%) of the excess likelihood of uncontrolled BP among Black compared with White adults, respectively. SDOH including low education, low income, living in a health professional shortage area, disadvantaged neighborhood, and high-poverty zip code contributed to the excess likelihood of uncontrolled BP among Black compared with White adults.

Evaluation of the sexual sphere in patients with psoriatic arthritis

IntroductionPsoriatic arthritis (PsA) is a chronic inflammatory disorder that primarily affects the joints and entheses. In addition, it is associated with depressive syndrome (DS), cardiovascular disease, hypertension (HT), diabetes mellitus (DM), obesity and psoriasis (Pso). There are few studies aimed to analyze the association of the involvement of the musculoskeletal system with sexual function (SF). MethodsA cross-sectional observational study was proposed in patients diagnosed with PsA, to whom self-administered validated questionnaires were applied to determine alterations in SF: MGH-SFQ and CSFQ-14, which assess the 4 domains of sexual function; Qualisex and DLQI designed for joint and dermatological pathology respectively, which explore sexual aspects. The objective was to describe the existence of altered sexual function in patients with PsA; analyze the association between sociodemographic characteristics, comorbidities (Pso, DS, cardiovascular risk factors) and the treatments of patients on SF; and describe differences of SF according to gender. Results72 patients were evaluated. It was observed that the variables of patients with PsA that were associated with lower scores in SF were gender and age in the CSFQ-14 and MGH-SFQ; annual incomes, treatment with NSAIDs, DL and depression were associated with worse results in some domains of the sexual sphere. ConclusionsPatients with PsA had impaired SF, especially women, elder patiens, those with low annual incomes, DL and emotional disorders. Anti-inflammatory treatments were associated with better SF. Globally, the chronic disease and the psychological burden behaved as factors associated with sexual dysfunction.

Drivers of Financial Inclusion among Cocoa Producers in the Southwest Region of Cameroon

Purpose: Financial inclusion can considerably promote cocoa production and provide a buffer for the escape from poverty traps for cocoa-growing economies like Cameroon. However, the Southwest region of Cameroon still experiences a low level of cocoa production and poverty primarily due to financial exclusion. This article explores the drivers of financial inclusion in the region. Method: A stratified multistage sampling technique was used to survey 380 cocoa producers in the main cocoa-producing areas in the region through semi-structured questionnaires. Descriptive statistics were used to analyze the socio-economic variables and the probit model to analyze the drivers of financial inclusion, subject to the three major dimensions of financial inclusion; access to, use, and quality of financial services. Results: On average, the long distance of financial institutions (9.3 km), intermediate farm sizes (2.6 ha), and low annual income (1,125,863 FCFA) negatively influenced financial inclusion resulting in just 16.6% of farmers being financially included. The findings also revealed that financial inclusion is significantly enhanced by an increase in income, farm training, the closeness of formal financial institutions (FFIs), larger household size, and small-scale production at a 1% significance level, and more years of farming experience at 5%. Moreover, 51.3% of the major constraints to financial inclusion were accounted for by lack of collateral security, distant FFIs, and low income. Implications: Reducing the distance of FFIs by establishing more institutions with considerations on collateral, increasing income through extension services like farm training, and sound agronomic practices will enhance financial inclusion. Originality: The uniqueness of this study lies in the context of the socio-political crisis during which cocoa producers were interviewed and exploring how the crisis influenced financial inclusion through a host of factors. Moreover, besides just access to credit as considered by most studies in Cameroon, the current study considers the use and quality of formal financial services as well.

Dissemination of Remote Patient Monitoring: An Academic-Community Primary Care Partnership in South Carolina.

Remote patient monitoring (RPM) for diabetes and hypertension may reduce barriers to patient care, leading to improved disease control and decreased morbidity and mortality. We describe the implementation of a community-academic partnership to improve diabetes and hypertension control for underserved populations using RPM. In 2014, our academic medical center (AMC) began working with community health centers (CHCs) to implement a centrally monitored RPM program for patients with diabetes. AMC nurses recruited, trained, and supported community partners through regular communication. Community sites were responsible for enrollment, follow-up visits, and all treatment adjustments. More than 1350 patients have been enrolled across 19 counties and 16 predominantly rural CHCs. The majority of patients reported low annual household income and African American or Hispanic background. It took about 6 to 9 months of planning at each CHC prior to first enrolled patient. More than 30% of patients utilizing the newer device continued to transmit glucose readings regularly at week 52 of enrollment. Hemoglobin A 1c data reporting was completed for more than 90% of patients at 6 and 12 months postenrollment. Partnering of our AMC with CHCs enabled dissemination of an effective, inexpensive tool that engaged underserved populations in rural South Carolina and improved chronic disease management. We supported implementation of clinically effective diabetes RPM programs at several CHCs, reaching a large number of historically underserved and underresourced rural CHC patients with diabetes. We summarize key steps to achieving a successful, collaborative RPM program through AMC-CHC partnerships.

Severity and worsening of fatigue among individuals with multiple sclerosis.

Fatigue is associated with reduced quality of life and social participation, and poor employment outcomes. However, most studies examining fatigue are limited by small sample sizes or short follow-up periods. To characterize the natural history of fatigue. The North American Research Committee on Multiple Sclerosis Registry participants with ≥7 years of longitudinal data between 2004 and 2019 and a relapsing disease course were included. A subset of participants enrolled within 5 years of diagnosis was identified. The Fatigue Performance Scale assessed fatigue and ≥1-point increase in Fatigue Performance Scale sustained at the next survey defined fatigue worsening. Of 3057 participants with longitudinal data, 944 were within 5 years of multiple sclerosis diagnosis. Most participants (52%) reported fatigue worsening during follow-up. Median time to fatigue worsening ranged from 3.5 to 5 years at lower levels of index fatigue. Fatigue worsening was associated with lower annual income, increasing disability, lower initial fatigue level, taking injectable disease-modifying therapies and increasing depression levels in the relapsing multiple sclerosis participants. Most multiple sclerosis participants early in their disease suffer from fatigue and at least half reported fatigue worsening over time. Understanding factors associated with fatigue may help to identify populations most at risk of fatigue worsening will be informative for the overall management of patients with multiple sclerosis.

Relationship between income and concerns about physical changes and help-seeking by older adult cancer survivors: a secondary analysis

ObjectiveGlobally, the number of older adults surviving cancer is anticipated to grow rapidly over the next decades. Cancer and its treatment can leave survivors with a myriad of challenges including physical changes which impact independence and quality of life. This project explored the relationship of income level with concerns and help-seeking for physical changes following treatment in older Canadian survivors of cancer.MethodsA Canada-wide survey of community-dwelling survivors of cancer explored their experiences with survivorship care one to three years following completion of treatment. A secondary trend analysis examined the relationship of income with older adults’ level of concern and help-seeking experiences regarding physical consequences they attributed to their cancer treatment.ResultsIn total, 7,975 people aged 65 years and older who survived cancer responded to the survey, of whom 5,891 (73.9%) indicated annual household income. Prostate (31.3%), colorectal (22.7%) and breast (21.8%) cancer accounted for the majority of respondents. Of those who reported household income data, over 90% wrote about the impact of physical changes following treatment, their concerns about the changes, and whether they sought help for their concerns. The most frequently identified physical challenge was fatigue (63.7%). Older survivors with low annual household incomes of less than $CA25,000 reported the highest levels of concern about multiple physical symptoms. 25% or more of the survey respondents across all income levels reported difficulty finding assistance for their concerns about the physical challenges, especially in their local communities.ConclusionOlder survivors of cancer can experience a range of physical changes, amenable to intervention by physical therapy, yet experience challenges obtaining relevant help. Those with low income are more severely affected, even within a universal healthcare system. Financial assessment and tailored follow-up are recommended.

Association between physical exercise and non-alcoholic fatty liver disease in people infected with hepatitis B virus

Objective: To investigate the association between physical exercise and non-alcoholic fatty liver disease (NAFLD) in people infected with HBV. Methods: The information about the 3 813 participants infected with HBV, including the prevalence of NAFLD, prevalence of physical exercise and other covariates, were collected from the National Science and Technology Major Project of China during 2016-2020. The logistic regression model was used to evaluate the association between physical exercise and NAFLD in HBV infected patients, and subgroup analysis was performed to identify the effect modifiers. Results: A total of 2 259 HBV infected participants were included in the final analysis and 454 (20.10%) had NAFLD. After adjusting for covariates, we found that moderate physical exercise was a protective factor for NAFLD (OR=0.66, 95%CI: 0.46-0.94). Subgroup analysis suggested that the protective effect of moderate physical exercise on NAFLD might be stronger in women (OR=0.61, 95%CI: 0.36-1.01), those <45 years old (OR=0.24, 95%CI: 0.06-0.80), those who had low education level (OR=0.16, 95%CI: 0.04-0.49), those who had low annual income (OR=0.39, 95%CI: 0.16-0.89 for <30 000 yuan RMB; OR=0.64, 95%CI: 0.40-1.00 for 30 000-80 000 yuan RMB), those who had hypertension (OR=0.45, 95%CI: 0.21-0.88), those with BMI ≥24.0 kg/m2 (OR=0.66, 95%CI: 0.43-1.01), those who had more daily fruit or vegetable intake (OR=0.61, 95%CI: 0.38-0.97), those who had more daily meat intake (OR=0.49, 95%CI: 0.23-0.97), and those who had no smoking history (OR=0.66, 95%CI: 0.45-0.95) or passive smoking exposure (OR=0.61, 95%CI: 0.37-0.97). Conclusions: Among HBV infected patients, moderate physical exercise was negatively associated with the prevalence of NAFLD. Women, young people, those who had low education level, those who had low annual income, those with hypertension, those with high BMI, those who had more daily fruit or vegetable and meat intakes, and those who had no smoking history or passive smoking exposure might be more sensitive to the protective effect.

A study on the influence of community spiritual comfort service on the mental health of older people.

China is experiencing rapid population aging, with the proportion of older adult people aged 60 and above reaching 19. 8% of the total population in 2022. With the growth of age, the physical function of older adults declines and their mental health is getting worse, with the increasing trend of empty nesting and childlessness, older adults lack information and social interaction with others and fall into social isolation, loneliness and some mental health problems, the proportion of older adults with mental health problems gradually rises and the mortality rate increases incrementally, requiring effective ways to intervene in the mental health of older adults and promote healthy aging. The present study investigated the influence of spiritual comfort older adult services on the mental health of 12,624 older adults aged 60 years or older in 23 provinces in China from 2017 to 2018, with the aim of providing a case for the development of more targeted mental health strategies for older people. Using the data from the 2018 CLHLS Survey, the influencing factors of the mental health of older people were analyzed using chi-square test and the logit regression model. The mechanism of the health care facilities and the spiritual comfort services on mental health was analyzed using the chain mediation effect. The spiritual comfort services decreased the risk of negative emotion and mental health of older adults, with female (OR = 1.168), rural residents (OR = 1.385), no drinking (OR = 1.255), not exercising (OR = 1.543), not having pension insurance (OR = 1.233), and low annual household income (OR = 1.416) being the characteristics as risk factors. The mediating effect results showed that the health care facilities had a partial mediating effect between the spiritual comfort services and the mental health status of older people, and the mediating effect accounted for 40.16% of the total effect. The use of spiritual comfort services can effectively reduce and alleviate the adverse mental health symptoms of older people, promote guidance and health education for healthy older people and chronically ill patients, and improve the good health perception of older people in order to improve their quality of life and mental health status.

Changes in Food Security, Healthfulness, and Access During the Coronavirus Disease 2019 Pandemic: Results From a National United States Survey

BackgroundCoronavirus disease 2019 (COVID-19) disrupted access to food and adequate nutrition and the types of foods consumed. However, little empiric data exists on the changes in American’s food and nutrition habits 2 y into the pandemic. ObjectivesTo assess current and altered food choices ∼2 y into the COVID-19 pandemic in the months after historic public pandemic relief. MethodsA national sample of 1878 United States adults balanced by age, sex, race/ethnicity, and income completed a one-time, online, semi-quantitative, 44-item questionnaire in Fall 2021 asking about the demographics, COVID-19 food choice changes (including free-text), and consumer priorities. This analysis investigates COVID-19 impacts on food security, healthfulness, and access. ResultsMore than 35% of respondents reported improved food security and >45% reported improved food healthfulness compared with prepandemic status. Improvement was reported in more than 30% of Black/African-American and Hispanic/Latinx adults, adults with lower annual income, and female sex, despite over 75% reporting reduced choice of where to eat or buy food. The pandemic offered occasion for many to improve diet, but a similar number expressed that the pandemic destabilized healthy habits. ConclusionsOur novel findings suggest that by late 2021, most Americans had improved food security and food choice healthfulness, despite reduced access to food service and retail, although with worsening among a meaningful proportion of Americans as well as heterogeneity in these changes. Vigorous federal, state, city, and community responses to the pandemic may have played a role in improving the food security and food choice healthfulness during the COVID-19 pandemic. Health crises differently impact health behaviors, but when accompanied by vigorous civic and community response, food security, and food healthfulness can be fortified.

Mental Health and the COVID-19 Pandemic: Observational Evidence from Malaysia.

The interplay of physical, social, and economic factors during the pandemic adversely affected the mental health of healthy people and exacerbated pre-existing mental disorders. This study aimed to determine the impact of the COVID-19 pandemic on the mental health of the general population in Malaysia. A cross-sectional study involving 1246 participants was conducted. A validated questionnaire consisting of the level of knowledge and practice of precautionary behaviors, the Depression, Anxiety, and Stress Scales (DASS), and the World Health Organization Quality of Life-Brief Version (WHOQOL-BREF) was used as an instrument to assess the impacts of the COVID-19 pandemic. Results revealed that most participants possessed a high level of knowledge about COVID-19 and practiced wearing face masks daily as a precautionary measure. The average DASS scores were beyond the mild to moderate cut-off point for all three domains. The present study found that prolonged lockdowns had significantly impacted (p < 0.05), the mental health of the general population in Malaysia, reducing quality of life during the pandemic. Employment status, financial instability, and low annual incomes appeared to be risk factors (p < 0.05) contributing to mental distress, while older age played a protective role (p < 0.05). This is the first large-scale study in Malaysia to assess the impacts of the COVID-19 pandemic on the general population.