Objective Health Measures Research Articles

Gratitude, fragility and strength: Perspectives of adults born preterm about prematurity.

The aim of the study was to explore how young adults thought that being born preterm had affected their lives. Adult participants of a research cohort were questioned about their perspectives. Answers were analysed using mixed methods. Forty-five participants evaluated their health at median score of 8/10. When asked about the meaning of being born preterm, 65% had positive self-centred answers, invoking two main themes: being stronger/'a fighter'/more resilient and being a survivor/chosen; 42% also reported negative themes, such as having health problems and a difficult start. All heard about their prematurity from their parents, 55% with positive child-centred or healthcare system-centred themes, 19% with neutral themes; 35% also heard negative parent-centred themes (tragic experience, guilt, mother's health). When asked which words were associated with prematurity, participants mainly chose positive words for themselves and their family, but more negative words for how the media and society depicted prematurity. Answers were not correlated with adverse objective health measures. Participants evaluated their health in a balanced fashion. Preterm-born adults often feel that they have experienced positive transformations as a result of their traumatic start. They often have feelings of gratitude and strength, independent of health problems.

Subjective social status and allostatic load among older people in England: A longitudinal analysis

BackgroundSubjective social status has a known association with health, whereby better health outcomes are observed for those with higher perceived status. In this research, we offer new evidence on the status–health relationship using a rigorous methodological approach that considers both observed and unobserved confounders. MethodsWe use 5 waves of data spanning 15 years from the English Longitudinal Study of Ageing and derive a measure of allostatic load with biomarkers as an objective measure of health. We apply ‘within–between’ panel regression models. ResultsModels reveal the expected association between subjective status and health when comparing participants (the ‘between’ estimate), but no association when examining temporal variation within participants (the ‘within’ estimate). When controlling for personality traits including optimism, and parental education, the ‘between’ association between subjective status and allostatic load is reduced but does not disappear. ConclusionsPerson-level confounders play some role in explaining the observed link between subjective status and health. The exact nature of the link, including the role of psychological pathways and early-life confounders, remains a question for future research.

Health asymmetry as a predictor of depressive symptomatology over time among older European adults: A growth curve analysis

ObjectiveSubjective (SH) and objective health (OH) measures are associated with depressive symptomatology in older adults. We explored whether the discrepancy between SH and OH (operationalised as ‘health asymmetry’ with four categories: ‘health optimistic’, ‘health pessimistic’ and ‘good health realistic’ and ‘poor health realistic’) may also relate to depressive symptomatology 1) cross-sectionally, and 2) longitudinally, among older European adults. MethodsAdults (n = 26,520), aged 50+, from 11 European countries, were assessed over six waves of data collection (2006–2020) in the SHARE study. A hierarchical multi-level growth curve model explored whether health asymmetry was associated with depressive symptomology at baseline, and with depressive symptom trajectories across time, accounting for country of origin. ResultsAt baseline, 11.8% of older adults were classified as health pessimistic, with 15.5% being health optimistic, 42.9% being poor health realistic and 29.8% being good health realistic. A positive linear trend in depressive symptomatology was noted across 14 years of SHARE data (β = 0.11, p < .001). Health pessimists displayed higher levels of depressive symptoms than both health realistic groups and health optimists. However, health pessimists experienced a less steep increase in depressive symptoms across time (β = −0.10, p < .001), relative to good health realists. ConclusionHealth pessimists experience elevated levels of depressive symptoms, but show less growth in depressive symptomatology than expected. Further research is required to understand the underlying causes of the varying depressive symptom trajectories among these groups.

Abstract P033: Characterizing the relationship between arsenic exposure and breast cancer risk in Canada

Abstract Background: Although an established carcinogen for cancers of the skin, bladder and lungs, the relationship between arsenic exposure and breast cancer risk is not known. Studies to date have been conducted in populations with endemically high levels of arsenic, have been limited by small sample sizes and methodological concerns. The impact of chronic exposure to low levels of arsenic remains unclear. This project aims to: 1) describe arsenic exposure in Canada and 2) to evaluate the association between urinary arsenic levels and breast cancer risk among Canadian women. Methods: The Canadian Health Measures Survey (CHMS) is a nationally representative cross-sectional survey that collects self-reported and objective health measures, including biomonitoring data, from participants in biennial cycles. To date, CHMS has collected data from approximately 25,000 participants between the ages of 3 – 80 years. This analysis utilized demographic, lifestyle and reproductive data collected from Cycles 1-5 (2007-2017). Urinary arsenic levels (µg/L) were quantified using high-performance liquid chromatography (HPLC) with inductively coupled plasma mass spectrometry (ICP-MS). Incident breast cancers were ascertained through linkage to the Canadian Cancer Registry and the Discharge Abstract Database. Participants were eligible for inclusion if they were female, older than 18 at the time of urine sample collection, had no personal history of any cancer, and had quantified urinary arsenic and creatinine levels. Arsenic exposure was described using weighted percentiles and then categorized by tertiles. Cox proportional hazards regression was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) of arsenic exposure and breast cancer risk. Multivariate models adjusted for relevant confounders. Quantile g-computation will be used to estimate the joint association between multiple metals and breast cancer risk. Results: This analysis included 5,100 women with a mean age of 44.6 years and an average follow-up of 6.6 years. The median total urinary arsenic level was 7.8 µg/g of creatinine (2.70 µg/g – 84.83 µg/g). Approximately 5% of women had elevated urinary arsenic levels above the clinically relevant threshold of 50 ug/L. Women in the highest tertile of urinary arsenic levels (&amp;gt; 13.0 µg/L) had a significant two-fold increased risk of developing breast cancer compared to women in the referent group in age-adjusted models (HR = 2.10; 95%CI 1.06-3.96, P-trend = 0.03). Similar trends were observed in the fully adjusted models (HR= 2.05; 95%CI 1.05-3.94, P-trend = 0.035). Metal mixture analyses are ongoing, and results will be presented. Significance: To our knowledge, this represents the first analysis of arsenic levels and breast cancer risk in a nationally representative, Canadian cohort. Our findings suggest that exposure to arsenic, even at low levels, is associated with an increased risk of breast cancer and are important for informing population-level interventions to reduce the burden of breast cancer in Canada and around the globe. Citation Format: Katherine Pullella, Vicky Chang, Anthony Hanley, Shelley Harris, Jan Lubiński, Steven Narod, Joanne Kotsopoulos. Characterizing the relationship between arsenic exposure and breast cancer risk in Canada. [abstract]. In: Proceedings of the AACR Special Conference: Precision Prevention, Early Detection, and Interception of Cancer; 2022 Nov 17-19; Austin, TX. Philadelphia (PA): AACR; Can Prev Res 2023;16(1 Suppl): Abstract nr P033.

Dairy production sustainability through a one-health lens

Dairy production provides high-quality, healthful nutrients to people on a planet soon to be inhabited by over 9 billion people. In doing so, it is ever more important to continuously improve the care of dairy animals, safeguard the environment we all share, and reliably produce nutritious food while maintaining the economic viability of the people working in dairy agriculture. In this paper, we review some associations between dairy consumption and human health along with the many interconnections between people, dairy animals, plants, and our shared environment. Understanding these relationships is an example of one health at work. In the US, total dairy consumption is at its highest point in the last 50 years, while many objective measures of cow health (eg, subclinical mastitis) have never been better since they have been recorded. Further, indications of food safety such as violative antibiotic residues in milk have never been lower. Dairy foods provide essential nutrients such as protein, vitamin B12, and calcium, while there is also evidence that they are protective against chronic conditions such as cardiovascular disease. Finally, the environmental footprint of dairy production in the US, as measured by metrics such as carbon dioxide–equivalent emissions intensity per unit of dairy nutrient, is the lowest it has ever been. The companion Currents in One Health by Nguyen et al, AJVR, January 2023, discusses some additional animal welfare and environmental impact implications of modern dairy production management in detail.

Dairy production sustainability through a one-health lens.

Dairy production provides high-quality, healthful nutrients to people on a planet soon to be inhabited by over 9 billion people. In doing so, it is ever more important to continuously improve the care of dairy animals, safeguard the environment we all share, and reliably produce nutritious food while maintaining the economic viability of the people working in dairy agriculture. In this paper, we review some associations between dairy consumption and human health along with the many interconnections between people, dairy animals, plants, and our shared environment. Understanding these relationships is an example of one health at work. In the US, total dairy consumption is at its highest point in the last 50 years, while many objective measures of cow health (eg, subclinical mastitis) have never been better since they have been recorded. Further, indications of food safety such as violative antibiotic residues in milk have never been lower. Dairy foods provide essential nutrients such as protein, vitamin B12, and calcium, while there is also evidence that they are protective against chronic conditions such as cardiovascular disease. Finally, the environmental footprint of dairy production in the US, as measured by metrics such as carbon dioxide-equivalent emissions intensity per unit of dairy nutrient, is the lowest it has ever been. The companion Currents in One Health by Nguyen et al, AJVR, January 2023, discusses some additional animal welfare and environmental impact implications of modern dairy production management in detail.

The Long Arm of childhood hypothesis and systematic low-grade inflammation: Evidence from parental education of older European adults

Childhood SES has been extensively studied as a predictor for health outcomes in adulthood, though the direct mechanisms remain unclear. The Long Arm of Childhood Model hypothesizes that this process is a chain of events, moderated by numerous factors such as family economic status and environment, health behaviors, as well as biological processes. We expand on this model with objective measures of health in older age, namely C-reactive protein (CRP), as chronic low grade inflammation, which has been found to be connected to both childhood SES as well as a number of cardiovascular diseases in adulthood. Using life history data from SHARE, as well as a novel dried blood spot dataset, we explore the protective role of parent education on the blood level of C-reactive protein in adulthood. Estimating a stepwise linear regression model, we find evidence that years of parental education are negatively associated with CRP in adulthood, with a one-year increase in mother's (father's) years of education decreasing adult CRP by 1.8% (1.1%). Using a modified Sobel test, we measure both the direct and indirect effects, estimating the extent in which later-life mediators significantly alter the relationship between parental education and CRP. While father's education is completely mediated by individual factors such as respondent's education, employment, and health behavior – we observe a lasting association from mother's education, suggesting a direct link between mother's education and CRP in adulthood.

Is inconsistent reporting of self-assessed health persistent and systematic? Evidence from the UKHLS

In this paper, we investigate whether individuals provide consistent responses to self-assessed health (SAH) questions in the UK Household Longitudinal Study (UKHLS), and the potential implications for empirical research in case of inconsistent reporting behaviour. We capitalise on an opportunity in the UKHLS, asking respondents the same SAH question twice: with a self-completion and an open interview mode, within the same household interview over four waves. We estimate multivariate models to explore which individual characteristics are systematically relevant for the likelihood and frequency of inconsistent reporting. About 11–24% of those reported a particular SAH category in the self-completion reported inconsistently in the open interview. The probability of inconsistency is systematically associated with individual’s demographics, education, income, employment status, cognitive and non-cognitive skills. The same characteristics also predict the frequency of inconsistent reporting across four UKHLS waves. Analysis of the implications of reporting inconsistencies shows no impact of SAH measurement on the association between income and health. A set of dimensions of people’s physiological and biological health, captured using biomarkers, is associated equally with both SAH measures, suggesting that the interview mode does not play a role in the relationship between SAH and more objective health measures.

NEIGHBORHOOD QUALITY AS IT RELATES TO HEALTH AND WELL-BEING IN OLDER AFRICAN AMERICANS

Abstract With the burgeoning older adult population, there will be an increased demand for neighborhood environments that are conducive to successful aging. For example, the need for affordable and usable housing developments for older adults that provide greater opportunities for social engagement, social services, and convenience to neighborhood resources (e.g., grocery stores, healthcare) will continue to rise. Several initiatives have sought to develop age-friendly neighborhoods, which focused on improving accessibility and affordability of community resources. However, limited effort has focused on the health and cognitive effects of neighborhood-level socioeconomic disadvantage, with respect to neighborhood income, education, employment, and housing quality. This symposium will include presentations from two studies that explored how neighborhood disadvantage (measured by the Area Deprivation Index) relates to health and cognition. The objectives of the proposed symposium are the following: (1) discuss how neighborhood disadvantage relates to subjective and objective measures of physical health; and (2) discuss how neighborhood disadvantage relates to cognitive functioning. Allan and colleagues explored the association between neighborhood disadvantage as it relates to changes in self-reported health and objective measures (i.e., blood pressure) of health among older Black adults. Wright and colleagues explored the association between neighborhood disadvantage and measures of subclinical cardiovascular disease in older Black and White adults. Aiken-Morgan and colleagues examined associations between neighborhood disadvantage and cognitive functioning among Black older adults. Lastly, McCain and colleagues explored associations between neighborhood disadvantage and mobility among Black older adults.

WEALTH INEQUALITIES IN PHYSICAL AND COGNITIVE IMPAIRMENTS AMONG OLDER ADULTS ACROSS EUROPE AND JAPAN

Abstract Although prior research has provided insights on the association between country-level factors and health inequalities, key research gaps remain. First, most previous studies examine subjective rather than objective health measures. Second, the wealth dimension in health inequalities is understudied. Third, a handful of studies explicitly focus on older adults. To bridge these research gaps, this study aims to: i) measure wealth-related health inequalities in physical and cognitive impairments; and ii) examines the extent to which welfare states moderate wealth inequalities in physical and cognitive impairments among older people across Japan and Europe. We utilized harmonized data of non-institutionalized individuals aged 50-75 for physical and cognitive impairments from the Japanese Study of Aging and Retirement (JSTAR) and the Survey of Health, Ageing and Retirement in Europe (SHARE), for (n= 31,969 and 31,348, respectively). We applied a concentration index to quantify the degree of wealth inequalities in impairments. Our multilevel linear regression analyses examined whether national public health spending and healthcare access resources explained cross-country differences in wealth inequalities in physical and cognitive impairments. Findings indicated that inequalities in both impairment outcomes favored wealthier individuals in all countries, but the magnitude of inequality varied across countries under examination. Furthermore, a higher share of public health spending, lower out-of-pocket expenditures, and higher investment in healthcare resources were associated with lower wealth inequalities especially for physical impairments. Our findings suggests that different health interventions and policies may be needed to mitigate specific impairment inequalities.

GENETIC ARCHITECTURE OF SUBJECTIVE HEALTH: RELATIONSHIP WITH PHYSICAL HEALTH, COGNITION, AND DEPRESSION

Abstract The fact that self-rated health (SH) predicts mortality and a variety of other health outcomes independent of objective health measures generates questions about mechanisms and etiologies. SH can be considered an indicator of physical health, per se, resulting from active cognitive processing of explicit information about one’s own health and intuitive knowledge of symptoms and physical sensations. The extent to which SH taps shared cultural ideas about health should be reflected in estimates of the shared environmental component of variance (C). SH has also been associated with emotional health measures, such as neuroticism and depression. Previous analyses have been limited by sex (only women), sample size, age (range = 63-76), and failure to include cognitive function. The current analysis used data from 8291 adults ranging in age from 22 to 102 from the international Interplay of Genes and Environment Across Multiple Studies (IGEMS) consortium to investigate the genetic architecture of SH. Genetic influences on self-rated health (SRH) were investigated in the context of CIRS (Cumulative Illness Rating Scale), MMSE (Mini-Mental Status Exam), and depression (CES-D or CAMDEX). Independent pathways modeling indicated that all genetic variance for SRH was shared with CIRS, MMSE, and depression. Comparison of groups older and younger than 74 indicated age differences in genetic architecture of SRH. Evidence suggests that the discordance between objective and subjective health increases in late adulthood, possibly as a result of greater emphasis on psychological rather than physical components of subjective health assessments by older adults.

Abstract 13203: Cardiovascular Health in Cardiac Rehabilitation: Applying the American Heart Association Life's Simple 7 in a Center-Based Cohort

Introduction: Cardiac rehabilitation (CR) is a comprehensive secondary cardiovascular disease (CVD) program which integrates structured lifestyle interventions to reduce morbidity and mortality. The Life’s Simple 7 (LS7) is an objective measure of cardiovascular health (CVH) which incorporates health-promoting behaviors and clinical factors however, it has not been rigorously evaluated in the CR setting. Methods: Retrospective cohort study of 937 patients who attended center-based CR at Mayo Clinic from Jan 2018 -Sept 2020. Patient characteristics and LS7 component metrics at baseline (pre-CR) and completion (post-CR) were collected: 3 clinical factors (blood pressure [BP], cholesterol, and hemoglobin A1c [HbA1c]), and 4 health behaviors (smoking, body mass index [BMI], physical activity [PA] and diet). LS7 score was computed as a composite of each LS7 component by assigning 2-points for ideal, 1-point for intermediate, or 0-points for poor CVH ranging from 0-14 points. LS7 score was further categorized as poor 0-6, intermediate 7-8 and ideal 9 -14. Results: Patients were 64±13 years old, 34% were female, and attended a mean of 11±12 CR sessions, Table 1. At baseline, the LS7 components with the highest proportion within the poor category were HbA1c (201/495, 41%) and BMI (465/936, 50%), Table 2. From pre to post-CR, there was a reduction in proportion of patients classified within the poor category for each LS7 component except HbA1c ( Figure 1 ), and the proportion of patients with LS7 scores in the ideal range increased from 6.4% to 19% (P&lt;0.001). There was a statistically significant improvement in LS7 score from 5.5±1.8 to 6.7± 2.4 (+Δ1.6±2.4, P&lt;.0001), Table 2 . Conclusions: Patients attending CR demonstrated an improvement in LS7 score and almost all LS7 components suggesting an overall positive impact of CR on CVH. Further research is needed to better understand the impact of the individual LS7 components on CV outcomes in diverse populations participating in CR.

Health improvements of older adults based on benefit duration: Lessons from Korean social pension policies

The social pension, introduced in 2008 in Korea, has now become the most prominent old age income for most older adults. As of May 2022, it paid a monthly benefit of around USD 275 for 6.0 million older persons aged 65 and over who belong to the bottom 70% of the income and asset distribution. Although social pension's objectives focus on alleviating old age poverty and increasing income levels, it also encompasses a clear implication on health: social pension benefit can be spent on items or activities that improve the beneficiary's health.Using the Korean Longitudinal Study on Ageing data, between 2006 and 2018, and the Propensity Score Matching combined with Generalized Difference-In-Differences based on event study design, this study investigates the effects of receiving the social pension on objective measures of health that are representative of health and well-being in old age, by benefit duration. Study results showed that continually receiving social pension significantly improved beneficiaries’ grip strength and cognitive ability. Grip strength was improved by 2.3-kg in the fifth year of receiving social pension. Additionally, the cognitive ability (K-MMSE score) was improved by 1.309 points in the first year. Results of descriptive analysis suggested that the social pension may have benefitted the health of the beneficiaries by improving their nutrition, health care utilization, and physical activities, and reducing financial strain and associated stress level.To the best of our knowledge, this is the first study to investigate the cumulative effects of nation-wide social pension programs on older adults’ objective health measures by benefit duration up to five years, in a high-income country setting where old age income security systems are under-developed.

Physical Activity as a Means to Improve Subjective Vitality of University Students

ABSTRACTPurpose: This study compared physical self-concept and subjective vitality of police, physical education, and psychology students. Moreover, the study investigated whether students who reported a higher level of physical activity differently rated physical self-concept and subjective vitality and whether physical activity was associated with subjective vitality. Methods: The study sample included 422 university students (249 females) from three state academic institutions: University of Criminal Investigation and Police Studies (n = 165), Faculty of Sport and Physical Education (n = 156) and Faculty of Psychology (n = 101). The mean age was 20.85 ± 3.59 years. They completed a physical self-description questionnaire, the subjective vitality scale, and a physical activity questionnaire using the Survey Monkey platform. Multivariate analysis of variance investigated the differences in physical activity, physical self and vitality, while regression analysis investigated the association of physical self and physical activity with subjective vitality. Results: Police students and physical education students reported higher levels of physical activity and perceived higher their own physical self and subjective vitality than psychology students. From the whole sample, students who were sufficiently physically active also scored higher on physical self-concept and subjective vitality. There was a significant association of physical activity level with subjective vitality. Conclusion: Physical activity was directly associated with students’ subjective evaluation of their own health. It can be concluded that students should aim to attain a minimum of 150 min per week of physical activity. Students and faculties should be involved in the attainment of minimal levels of physical activity. This could improve students’ subjective perception of self, along with objective measures of health and wellbeing.

Does cycling to work benefit mental health? A natural experiment using linked administrative data.

ObjectivesWe spend an increasing part of our daily lives commuting. Observational studies have shown commuting by bicycle improves subjective well-being. This study uses a quasi-experimental approach and an objective measure of mental health taken from linked administrative data to ask “does cycling to work benefit mental health?” ApproachPrevious studies have tended to use cross-sectional survey data which have small sample sizes and self-reported health measures that are subject to reporting bias. The potential for unmeasured confounding and reverse causation also weakens any conclusions. Our study links the Scottish population census with NHS Prescribing Information System records for data on commuting in Edinburgh and Glasgow and mental health prescriptions, respectively. Although there are complexities in determining causal effects from observational data, we employ an instrumental variable approach to address this using road distance from home to nearest cycle path as an instrument. ResultsApproximately 400,000 people aged 16-74 living and working in the City of Edinburgh and Glasgow City council areas as at the 2011 census were included in our study. Of those, 1.85% of commuters in Glasgow and 4.8% of commuters in Edinburgh cycled to work. Amongst cyclists 9% had a prescription for mental health compared to 14% amongst non-cyclists. More than 50% of commutes in both cities are less than 5km. Using the instrumental variable in a bivariate probit model we estimate an average treatment effect of -16.1% (95% confidence interval: -15.1% to -17.1%) in mental health prescriptions amongst those who cycle to work compared to those who use other forms of transport. ConclusionThis work confirms the benefit of cycling to work for mental health and provides further evidence in support of the promotion of active travel to encourage commuters travelling shorter distances to shift to cycling to work.

Communicatively Restricted Organizational Stress (CROS) on Campus: An Exploratory Investigation of Stress and Support among Predominantly White University Faculty.

Communicatively Restricted Organizational Stress (CROS) is a phenomenon characterized by real and/or perceived prohibitions against communicating with others about one’s organizational stressors. Given that CROS is marked by an inability to utilize social support, effects are often profoundly negative for the organizational members. However, the extent to which CROS functions similarly across similar types of organizations is unknown. In this exploratory project, the effects of CROS are investigated in a small sample (n = 41) of predominantly white university faculty. Conceptualizations of CROS argue that it is dependent both on the existence of stress and the presence of close and potentially supportive relationships. Provided that academia is a high-stress environment characterized by a strong likelihood of the formation of Personal Workplace Relationships (PWRs), CROS should be prevalent for this population and should lead to negative effects. Results indicated that CROS exists for university faculty and that its prevalence correlated negatively with measures of social support. Furthermore, CROS-associated distress is positively associated with perceived stress, burnout, and overcommitment and negatively associated with work well-being and job satisfaction. Although objective physiological measures of health were collected, the data were not able to be analyzed. The discussion focuses on implications and directions for future research.

Understanding shedders: Which socio-demographic, health and wellbeing characteristics best inform appropriate health promotion action in men's sheds and a 'Shed for Life'?

Men's sheds ('Sheds') have been identified as inherently health promoting and as potential settings to engage 'hard-to-reach' men in more structured health promotion initiatives. However, little is known about the socio-demographic or health and wellbeing characteristics of Shed members ('Shedders') on which such initiatives might be based. This study captures a baseline cross-sectional analysis of Shedders (n=384) who participated in 'Sheds for Life', a health promotion initiative tailored to Sheds. Objective health measures (body composition, blood pressure, blood lipids) captured via health screening as well as socio-demographic and health and wellbeing measures (physical activity, subjective wellbeing, mental health, social capital, cooking and diet) via questionnaires were assessed. Descriptive statistics were generated and differences between groups were determined via parametric and non-parametric testing. Bivariate analysis was used to determine associations and regression analysis then estimated various predictors on mental wellbeing, life satisfaction and loneliness. Participants were mostly over 65 years (77.3%), retired (88.6%) with limited educational attainment (77%). The majority were in the 'at-risk' categories for objective health measures, with most being referred to their GP following health screening (79.6%). Older Shedders were also more likely to meet physical activity guidelines. Mental wellbeing was positively correlated with life satisfaction and increased social capital and these were also positively correlated with physical activity (P< .05). Findings highlight the potential of Sheds in reaching a 'hard-to-reach' and 'at-risk' cohort of men. Despite a high prevalence of 'at-risk' objective health measures, participants report their health in positive terms. Future health promotion initiatives should capitalise on the inherent health-promoting properties of Sheds. SO WHAT?: Findings raise important implications for prioritising and designing health promotion initiatives in Shed settings.

Early-life exposure to economic stress and metabolic risks in young adulthood: the children of the reunification in East Germany

BackgroundResearch on the long-term health consequences of early-life exposure to economic crises is scarce. We examine for the first time the long-term effects of early-life exposure to an economic crisis...

Health Indicators as Measures of Individual Health Status and Their Public Perspectives: Cross-sectional Survey Study.

BackgroundDisease status (eg, cancer stage) has been used in routine clinical practice to determine more accurate treatment plans. Health-related indicators, such as mortality, morbidity, and population group life expectancy, have also been used. However, few studies have specifically focused on the comprehensive and objective measures of individual health status.ObjectiveThe aim of this study was to analyze the perspectives of the public toward 29 health indicators obtained from a literature review to provide evidence for further prioritization of the indicators. The difference between health status and disease status should be considered.MethodsThis study used a cross-sectional design. Online surveys were administered through Ohio University, ResearchMatch, and Clemson University, resulting in three samples. Participants aged 18 years or older rated the importance of the 29 health indicators. The rating results were aggregated and analyzed as follows (in each case, the dependent variables were the individual survey responses): (1) to determine the agreement among the three samples regarding the importance of each indicator, where the independent variables (IVs) were the three samples; (2) to examine the mean differences between the retained indicators with agreement across the three samples, where the IVs were the identified indicators; and (3) to rank the groups of indicators into various levels after grouping the indicators with no mean differences, where the IVs were the groups of indicators.ResultsIn total, 1153 valid responses were analyzed. Descriptive statistics revealed that the top five–rated indicators were drug or substance abuse, smoking or tobacco use, alcohol abuse, major depression, and diet and nutrition. Among the 29 health indicators, the three samples agreed upon the importance of 13 indicators. Inferential statistical analysis indicated that some of the 13 indicators held equal importance. Therefore, the 13 indicators were categorized by rank into seven levels: level 1 included blood sugar level and immunization and vaccination; level 2 included LDL cholesterol; level 3 included HDL cholesterol, blood triglycerides, cancer screening detection, and total cholesterol; level 4 included health literacy rate; level 5 included personal care needs and air quality index greater than 100; level 6 included self-rated health status and HIV testing; and level 7 included the supply of dentists. Levels 1 to 3 were rated significantly higher than levels 4 to 7.ConclusionsThis study provides a baseline for prioritizing 29 health indicators, which can be used by electronic health record or personal health record system designers or developers to determine what can be included in the systems to capture an individual’s health status. Currently, self-rated health status is the predominantly used health indicator. Additionally, this study provides a foundation for tracking and measuring preventive health care services more accurately and for developing an individual health status index.

Abstract 5895: Examining the association between arsenic exposure and cancer risk among Canadian adults

Abstract Background: Arsenic is a highly prevalent environmental toxin and an established carcinogen for cancers of the skin, bladder, and lung. Emerging evidence also suggests that arsenic exposure may be a risk factor for breast and other cancers. Previous studies have been conducted in populations with endemically high levels of arsenic; however, the impact of chronic exposure to low levels is not known. Thus, the purpose of this study was to describe the arsenic exposure in Canadian adults and to evaluate the association between arsenic status and cancer risk. Methods: The Canadian Health Measures Survey (CHMS) is an ongoing, nationally representative survey that collects self-reported and objective health measures, including biomonitoring data, from participants in biennial cycles. This analysis utilized total, inorganic and organic urinary arsenic biomarkers (µg/L) from Cycles 1-5 (2007-2017) of the CHMS. Incident cancers were ascertained through a linkage to the Canadian Cancer Registry. Arsenic exposure was described using weighted percentiles, and Cox proportional hazards regression models were used to estimate the association between arsenic exposure and cancer risk (overall and site-specific). Results: This analysis included 10,000 individuals, aged 18-80. The median total urinary arsenic level was 7.5 ug/g of creatinine. Preliminary models showed that levels of inorganic arsenic exposure above the geometric mean (&amp;gt; 4.5 µg/L) were associated with a 3-fold increased risk of developing any cancer (HR = 3.58; 95%CI 1.63-7.85), compared to those with lower levels. Site-specific risk modelling is ongoing and preliminary results will be presented. Significance: This study found inorganic arsenic exposure may be associated with an increased risk of developing cancer. To our knowledge, this study is the first to ascertain national estimates of arsenic exposure and provide insight on the relationship between arsenic exposure and cancer risk in Canadian adults. These findings are critical for developing population-level interventions to reduce the Canadian, and global, cancer burden. Citation Format: Katherine Pullella, Vicky C. Chang, Shelley A. Harris, Anthony J. Hanley, John R. McLaughlin, Jan Lubinski, Steven A. Narod, Joanne Kotsopoulos. Examining the association between arsenic exposure and cancer risk among Canadian adults [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5895.