Odds Of Poor Self-rated Health Research Articles

Necessary, burdensome, or threatening? Awareness of Black-White disparities in health care access and self-rated health for Black and White Americans.

Awareness of racial health care inequities is one prerequisite to eliminating them. Although extant research has described awareness of racial health care inequities in the United States, the health impacts of such awareness on communities that are most impacted by these inequities remains unknown. Therefore, we examined associations between awareness of Black-White racial health care inequities and self-rated health for Black and White adults in the United States. We used survey data from non-Hispanic Black and White participants (N = 6,449) who responded to the national American Health Values Survey (2015-2016) to test associations between awareness of Black-White inequities in health care and self-rated health. Accurate awareness of health care inequities was associated with 47% higher odds of poorer self-rated health for Black individuals. Inaccurate awareness was associated with 36% higher odds of poorer self-rated health for White individuals. Accurate awareness may be adaptive, yet place an additional burden on Black individuals. Inaccurate awareness may harm White individuals' health. Health care system changes and alleviation of racism-related stress may be preventive supports for the health of Black individuals. Accurate awareness should be a goal for White individuals, not only to prevent health risks, but to also facilitate structural change for racial equity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Multimorbidity in patients with low back pain in Danish chiropractic practice: a cohort study

BackgroundPeople with multimorbidity, defined as the co-existence of two or more chronic conditions in an individual, often suffer from pain and functional limitations caused by musculoskeletal disorders and the chronic conditions. In chiropractic practice, two thirds of patients are treated for low back pain (LBP). It is unknown to what extent LBP is accompanied with chronic conditions in chiropractic practice. The objective was to determine the prevalence of multimorbidity among patients with LBP in chiropractric practice and to investigate if multimorbidity affects pain intensity, self-rated health, physical and mental health. Finally, to explore if individuals with multimorbidity have a different recovery for the LBP.MethodsPatients presenting with a new episode of LBP were recruited from 10 chiropractic clinics in 2016–2018. Patient-reported data concerning socio-demographics, self-rated health, pain intensity, history of LBP, mental health and chronic conditions were collected at baseline. The prevalence of multimorbidity was determined. To evaluate differences in recovery from the LBP, we estimated changes in the Roland Morris Disability Questionnaire (RMDQ) score and use of pain medication at baseline, 2 weeks, 3 months and 12 months. The analyses were adjusted using regression models.Results2083 patients were included at baseline and 71%, 68% and 64% responded to follow-up questionnaires at 2 weeks, 3 and 12 months. 1024 (49%) participants reported to have at least one chronic condition and 421 (20%) had multimorbidity (≥ 2 chronic conditions). The presence of multimorbidity was associated with increased odds of poor self-rated health (OR 2.13), physical fitness (OR 1.79), poor muscular strength (OR 1.52), poor endurance (OR 1.51), and poor balance (OR 1.33). Patients with high LBP intensity combined with multimorbidity showed a poorer recovery than patients without chronic diseases (mean difference in RMDQ score 3.53 at 12 months follow-up). More patients with multimorbidity used pain medication for LBP at 12 months follow-up compared to those without chronic disease (OR 2.36).ConclusionsChiropractors should be aware that patients with LBP may suffer from multimorbidity with poor general health. Patients with multimorbidity also have poorer recovery from LBP than people without chronic disease and clinical follow-up may be indicated.

Self-rated health and the risk of incident chronic kidney disease: a community-based Korean study.

The relationship between self-rated health (SRH) and the development of incident chronic kidney disease (CKD) has not been explored in the general population. We reviewed the data of 7027 participants in the Ansung-Ansan cohort study. SRH was categorized as poor, fair, or good, and the outcome was the development of CKD, defined as the first event of an estimated glomerular filtration rate < 60mL/min/1.73m2, at least twice during the follow-up period. Hazard ratios (HRs) and confidence intervals (CIs) were calculated using Cox proportional hazards regression analysis. Over a mean follow-up duration of 11.9years, 951 participants (13.5%) developed CKD. Compared with poor self-rated health, the HR (95% CI) of fair self-rated health for incident CKD development was 0.771 (0.657-0.905; P = 0.001), whereas that of good self-rated health was 0.795 (0.676-0.935; P = 0.006). However, the renal hazard of good self-rated health did not differ from that of fair self-rated health. In the fully adjusted model, the HR (95% CI) of poor self-rated health compared to non-poor self-rated health for incident CKD was 1.278 (1.114-1.465, P < 0.001). Old age, smoking, cardiovascular disease, diabetes, hypertension, impaired sleep, and high levels of C-reactive protein and white blood cell counts were associated with increased odds of poor self-rated health, whereas male sex, college graduate level of education, and alcohol consumption were associated with decreased odds of poor self-rated health. Poor self-rated healthis independently associated with CKD development. Therefore, the early detection of potential CKD patients through a brief questionnaire assessment may help control the incidence of CKD.

Independent and joint effect of chronotype and sleep duration on self-rated health in medical students

Objective: To investigate the independent and joint effects of chronotype and sleep duration on self-rated health in medical students. Methods: A cross-sectional study was conducted in 1 526 medical students selected through proportional stratified cluster random sampling from a medical university in Zhejiang province. A questionnaire survey was conducted to collect the information about their basic demographic characteristics, chronotype, sleep duration, and other lifestyle factors such as midnight snack, sedentary behavior, physical activity, meal time, and self-rated health. The independent and joint effects of chronotype and sleep duration on self-rated health were assessed by logistic regression model after controlling for confounding variables. Results: The numbers of the students with evening chronotype, neutral chronotype, and morning chronotype were 664 (43.5%), 442 (29.0%), and 420 (27.5%), respectively. Among the medical students, 42.8% (653) had poor self-rated health. Compared with those with the morning chronotype, the adjusted ORs for those with neutral chronotype and evening chronotype were 1.69 (95%CI: 1.23-2.31) and 2.43 (95%CI: 1.81-3.26), respectively, trend test P<0.001. Compared with those with sleep duration of 8 h or above per night, the adjusted ORs for those with sleep duration of 7 and ≤6 h per night were 1.40 (95%CI: 1.07-1.84) and 2.38 (95%CI: 1.69-3.37), respectively, trend test P<0.001. In the joint effect, compared with those with the morning chronotype and sleep duration of 8 h or above per night, the adjusted OR for those with evening chronotype and sleep duration of ≤6 h per night was 6.53 (95%CI: 3.53-12.09). Conclusions: Both evening chronotype and insufficient sleep were associated with increased odds of poor self-rated health in medical students, and they had joint effects. Therefore, it is necessary to promote early to bed, early to rise and adequate sleep in medical student to maintain their health.

Air pollution in association with mental and self-rated health and the mediating effect of physical activity

BackgroundRecent studies showed that air pollution might play a role in the etiology of mental disorders. In this study we evaluated the association between air pollution and mental and self-rated health and the possible mediating effect of physical activity in this association.MethodsIn 2008, 2013 and 2018 the Belgian Health Interview Survey (BHIS) enrolled 16,455 participants who completed following mental health dimensions: psychological distress, suboptimal vitality, suicidal ideation, and depressive and generalized anxiety disorder and self-rated health. Annual exposure to nitrogen dioxide (NO2), particulate matter ≤ 2.5 µm (PM2.5) and black carbon (BC) were estimated at the participants’ residence by a high resolution spatiotemporal model. Multivariate logistic regressions were carried out taking into account a priori selected covariates.ResultsLong-term exposure to PM2.5, BC and NO2 averaged 14.5, 1.4, and 21.8 µg/m3, respectively. An interquartile range (IQR) increment in PM2.5 exposure was associated with higher odds of suboptimal vitality (OR = 1.27; 95% CI: 1.13, 1.42), poor self-rated health (OR = 1.20; 95% CI: 1.09, 1.32) and depressive disorder (OR = 1.19; 95% CI: 1.00, 1.41). Secondly, an association was found between BC exposure and higher odds of poor self-rated health and depressive and generalized anxiety disorder and between NO2 exposure and higher odds of psychological distress, suboptimal vitality and poor self-rated health. No association was found between long-term ambient air pollution and suicidal ideation or severe psychological distress. The mediation analysis suggested that between 15.2% (PM2.5-generalized anxiety disorder) and 40.1% (NO2-poor self-rated health) of the association may be mediated by a difference in physical activity.ConclusionsLong-term exposure to PM2.5, BC or NO2 was adversely associated with multiple mental health dimensions and self-rated health and part of the association was mediated by physical activity. Our results suggest that policies aiming to reduce air pollution levels could also reduce the burden of mental health disorders in Belgium.

The Impact of Low Back Pain and Physical Activity on Mental and Physical Health Outcomes in Older Adults With Arthritis

Abstract Nearly 50% of Americans aged 65 and above have been diagnosed with arthritis at any point in time, and an estimated 80% of adults experience low back pain (LBP) at some point in their lives. However, little is known about the experience of LBP in older adults with arthritis and whether or not it is related to adverse mental and physical health outcomes over and above those linked to arthritis. This study examined the relationship between LBP and four associated physical and mental health conditions (depression, insomnia, mobility limitations, and self-rated health) in older adults with arthritis. We also examined whether physical activity mediated the relationships between LBP and these four conditions. A cross-sectional analysis was conducted using data from the National Health and Aging Trends Study. Descriptive analyses and chi-square tests assessed whether there were demographic differences between persons with and without LBP. Binary logistic regressions found that participants with LBP were 30% more likely to endorse insomnia (95% confidence interval (CI) =1.1 to 1.5, p&amp;lt;.001), had 40% higher odds of depression (95% CI=1.1 to 1.6, p&amp;lt;.001), and 70% higher odds of poor self-rated health (95% CI=1.5 to 1.9, p&amp;lt;.001) than those without LBP. Activity mediated the relationship between LBP and the four health outcomes in unadjusted models. Findings indicate that LBP may be associated with adverse mental and physical health in older adults with arthritis, and treatment for older adults with arthritis and comorbid LBP should include interventions targeting LBP and routine assessment of mental and physical health.

Delaying Health Care Due to the COVID-19 Pandemic: Associations With Physical and Mental Health and Preventive Care

Health care is important for maintaining optimal physical and mental health. However, due to the COVID-19 pandemic, many older adults have delayed or postponed care. Data from the special midterm release of the 2020 Health and Retirement Study (HRS) were used to examine the relationship between chronic conditions and delayed care, as well as between delayed care and mental health outcomes and preventative care among Americans aged 50+ (N=3,266). Approximately 30% of respondents said yes when asked “Since March 2020, was there any time when you needed medical or dental care, but delayed getting or did not get it at all?” Of those, 55% said their provider cancelled, closed or suggested rescheduling, 28.5% decided it could wait, and 20.8% were afraid to go. Results from OLS and logistic regression, controlling for sociodemographic characteristics, indicate that those with lung disease and those with a heart condition had significantly higher odds of delaying care. Delaying care was associated with significantly higher odds of poor self-rated health and feeling depressed, as well as significantly higher average hopelessness, loneliness and negative affect and significantly lower average positive affect. Surprisingly, delaying care was not associated with receiving a flu shot, cholesterol test, colonoscopy, mammogram or prostate exam in the previous two years. It is likely that the full effects of delaying health care during the pandemic have yet to be felt and there is a need to study the implications of such delays.

The Relationship Among Pain Location, Complications, and Quality of Life in Individuals With Fibromuscular Dysplasia

BackgroundFibromuscular dysplasia (FMD), a nonatherosclerotic arterial disease, can cause pain and vascular complications. The aim of this study was to examine the impact of FMD symptoms and complications on quality of life, depression, anxiety, and self-rated health. DesignThis was a cross-sectional, correlational study. MethodsParticipants were adults with a diagnosis of FMD. Quality of life (36-Item Short Form Health Survey), anxiety and depression (Patient-Reported Outcomes Measurement Information System [PROMIS®]), self-rated health question, and symptom/complication questionnaires were mailed to patients with FMD. Scores were compared with symptoms and complications. Multivariable linear models were fit for symptoms and survey scores. Ordinal regression was used for self-rated health. Backwards selection was run for each model. Alpha of 0.05 and 95% confidence intervals were used. ResultsOf the 162 (275 total; 47.8%) patients who returned surveys (156 female), 130 had carotid or vertebral artery involvement (80.2%). Migraine (p < .001), neck pain (p = .036), and flank pain (p = .025) were associated with decrease in Mental Component scores. Migraine (p = .002) and neck pain (p = .023) were associated with lower Physical Component scores. Patients reporting abdominal pain compared with those without had 4.88 points higher depression. Abdominal pain (p = .031) and pulsatile tinnitus (p = .011) were associated with greater anxiety. Migraine was associated with (p = .002) lower self-rated health. Participants with history of stroke/transient ischemic attack had 2.42 (1.08, 5.46; p = .033) times the odds of poor self-rated health compared with those without stroke/transient ischemic attack. ConclusionsAmong patients with FMD, presence of pain and history of vascular complications were related to lower quality of life and self-rated health.

Unequal Returns of Employment on Self-Rated Health: Asian-White Differences.

Previous research has shown that employment status is one of the most powerful socioeconomic resources utilized to promote health and well-being. However, racial and ethnic minorities often experience diminished returns of socioeconomic resources compared to non-Hispanic Whites. This analysis explores the association between employment status and self-rated health among Asians and non-Hispanic Whites, and whether race or ethnicity moderates this association. We used data from the 2016 National Asian American Survey, a nationally representative survey of Asians from ten ethnic backgrounds. We measured the association between employment status and self-rated health, using race and ethnicity as the primary moderators. Age, gender, income, education, nativity status, and English proficiency were used as controls. Pooled (by race) and stratified (by ethnicity) logistic regressions were estimated. The pooled logistic regressions showed that employment was associated with lowerodds of poorerself-rated health among Asians and Whites. Race, however, moderated this relationship, indicating a stronger protective effect of employment for Whites. In the stratified logistic regressions, employment was not associated with lower odds of poorerself-rated health across all of the assessed Asian ethnic subgroups. Ethnicity moderated the association between employment and self-rated health, suggesting a stronger protective effect of employment for Whites than for Chinese, Hmong, Koreans, Japanese, and Filipinos. The protectivehealth benefits of employment do not operate the same for Whites and Asians. Discrimination and unequal labor market and working conditions may weaken the positive health returns of employment for Asians compared to their White counterparts.

Associations between everyday and major discrimination and health status among a diverse national sample of ten Asian ethnic subgroups

PurposeWe examined the associations between major and everyday discrimination and self-rated health among a national sample of ten Asian ethnic subgroups, including Vietnamese, Chinese, Hmong, Cambodians, Pakistanis, Indians, Bangladeshis, Japanese, Filipinos, and Koreans. MethodsWe used data from the 2016 National Asian American Survey (n = 4427). Logistic regression analyses were conducted to explore the associations between major and everyday discrimination and self-rated health among ten Asian ethnic subgroups, controlling for relevant sociodemographic factors. ResultsFindings showed that major discrimination was associated with higher odds of poorer self-rated health among Asians as a group. Subgroup analyses revealed that encounters with major discrimination were associated with poorer self-rated health among Vietnamese, Filipinos, Cambodians, and Hmong. Everyday discrimination was associated with poorer self-rated health only among Hmong. ConclusionOverall, the negative health consequences of everyday and major discrimination vary by Asian ethnic subgroup. Targeting certain forms of discrimination facing specific Asian ethnic groups is needed to reduce their risk of adverse health outcomes.

The effect of stress and acculturation on the self-rated health of Arab Americans.

BACKGROUND:The self-rated health of Arab Americans has been found to be worse than non-Hispanic whites. Psychosocial factors such as stress and acculturation may explain this disparity. As a result, we designed this survey to better understand the effects of stress and acculturation on the self-rated health of the Arab-American community.MATERIALS AND METHODS:Using a convenience sample, we surveyed 142 self-identified Arab Americans regarding demographics, stress, acculturation, and self-rated health. Stress was measured using instruments assessing perceived stress, everyday discrimination, and acculturative stress. Acculturation was measured using a modified Vancouver Index of Acculturation. To measure self-rated health, participants were asked to rate their current health on a scale of 1 (very poor) to 5 (very good).RESULTS:A logistic regression model adjusted for age, sex, body mass index, and education did not find that stress significantly affected the odds of having poor self-rated health in Arab Americans. Heritage identity was associated with lower odds of having poor self-rated health (odds ratio = 0.37, 95% confidence interval [CI] 0.15, 0.94, P < 0.05). No association was found between acculturation and poor self-rated health.CONCLUSION:Greater levels of stress were not significantly associated with greater odds of poor self-rated health in Arab Americans. We also found that greater heritage identity significantly decreased the odds of poor self-rated health in Arab Americans. The effects of everyday discrimination, perceived stress, and acculturation on self-rated health in Arab Americans remain unclear and need to be examined further.

Estimation of the Impact of Migraine on Self-rated Health: A Cross-sectional Study in Slovenia.

AimWith the aim of providing a foundation for evidence-based public health actions, as well as the more individualised clinical treatment of migraine in Slovenia, the objective of our study was to assess the association between poor self-rated health (PSRH) and migraine, adjusted for selected comorbidity and socioeconomic factors.MethodsThe survey, conducted between August and December 2014, involved included 6,262 adults aged 15 years and over. Binary logistic regression was used in univariate as well as multivariate analysis. Three multivariate models were defined: MODEL 1 (migraine and comorbidities related to the physical dimension of health); MODEL 2 (comorbidities related to the mental dimension of health); MODEL 3 (demographic and socioeconomic factors).ResultsIn univariate as well as all three multivariate models, the odds of PSRH were statistically significantly higher in migraine sufferers in comparison to non-sufferers (univariate model: ORmigraine=yes vs. migraine=no=2.22 (p<0.001); MODEL 1: ORmigraine=yes vs. migraine=no=2.27 (p<0.001); MODEL 2: ORmigraine=yes vs. migraine=no=1.51 (p=0.002); MODEL 3: ORmigraine=yes vs. migraine=no=1.56 (p=0.001)).ConclusionMigraine is an important PSRH-related factor. Comorbidities related to the physical dimension of health do not reduce the power of association between migraine and PRSH, while comorbidities related to the mental dimension reduce the power of association of migraine and other health conditions. The power of the association between migraine and PRSH is also independent of demographic/socioeconomic factors. We can also conclude that migraine seems to be a phenomenon that is in a bi-directional relationship with mental states (thus having an impact on PSRH) and is itself a stressor.

The role of individual, household, and area of residence factors on self-rated health in Colombian adults: A multilevel study.

Introduction: Self-rated health is strongly associated with morbidity and mortality. It is largely influenced by individual factors but also by individuals’ social surroundings and environment.Objective: To investigate individual, household, and locality factors associated with self- rated health in Colombian adults.Materials and methods: We conducted a cross-sectional multilevel study using data from national databases on 19 urban localities and 37,352 individuals nested within 15,788 households using a population-based survey. Given the natural hierarchical structure of the data, the estimates of self-rated health related to individual, household, and locality characteristics were obtained by fitting a three-level logistic regression.Results: The adjusted multilevel logistic models showed that at individual level, higher odds of poor self-rated health were found among older adults, persons from low socio-economic status, those living without a partner, with no regular physical activity, and reporting morbidities. At the household level, poor self-rated health was associated with households of low socioeconomic status located near noise sources and factories and in polluted and insecure areas. At the locality level, only poverty was associated with poor self-rated health after adjusting for individual and household variables.Conclusions: These results highlight the need for a more integrated framework when designing and implementing strategies and programs that aim to improve health conditions in urban populations in Latin America.

Self-Rated Health in Migrant and Non-Migrant Women before, during and after Pregnancy: A Population-Based Study of 0.5 Million Pregnancies from the Swedish Pregnancy Register.

Self-rated health is a strong health marker. Migrants have been suggested to have poorer self-rated health than non-migrants (i.e., native-born). However, little is known about whether there are disparities in self-reported health in relation to pregnancy. Therefore, the aim of the current study was to examine the odds of poor self-rated health before, during and after pregnancy in migrant women as compared to women born in Sweden. We utilized population-based data from the Swedish Pregnancy Register containing 0.5 million women born in Sweden (i.e., non-migrant women) and migrant women between 2010 and 2018. Self-rated health was reported on a 5-point scale (from very poor to very good). Very poor and poor health were categorized as poor self-rated health. Logistic regression was utilized to calculate odds ratios (ORs) that were unadjusted and adjusted for covariates (age, parity, educational attainment and body mass index). The results demonstrate disparities in self-rated health across birth regions. In comparison to women born in Sweden, women born in Latin America and the Caribbean, South Asia as well as North Africa and the Middle East had consistently higher odds of poor self-rated health before, during and after pregnancy (ORs ranging from 1.14 to 1.96 in both unadjusted and adjusted models). Although women born in Sub-Saharan Africa did have comparable self-rated health as to women born in Sweden before pregnancy, after accounting for covariates, they had lower odds of poor self-rated health during and after pregnancy (ORs: 0.71 and 0.80 respectively). Therefore, additional measures and support may be needed to tackle disparities in health between migrant and non-migrant women before, during and after pregnancy.

Change in quality of life over eight years in a nationally representative sample of US adults with heart disease and type 2 diabetes:minority race and toxic stress as keysocial determinants

BackgroundToxic stress (TS), minority race and their interaction are evaluated as determinants of change in quality of life (QOL) over 8 years follow-up in a nationally representative sample of United States (US) adults (≥50 years old) with heart disease (HD) and/or type-2 diabetes (T2DM) diagnosed by 2006 as part of the Health and Retirement Study (HRS).MethodsRecent and life-course stress plus experiences of lifetime discrimination were measured every 2 years using the stressful life experiences questionnaire. QOL was assessed by participant self-rated health (SRH) and operationally defined as improved, unchanged or declined in current year versus two years prior. Repeated measures multinomial logistic regressionusing generalized estimating equations (GEEs) was implemented to estimate race-, TS and their interaction- related odds of worse SRH from2006–2014. Odds ratios (OR) and 95% confidence intervals (CIs) were calculated with adjustment for time, age, sex and socio-economic status.ResultsThree thousand nine hundred four adults with HD/T2DM, mean age 71.1 ± 9.3 years old, 80.9, 14.7 and 4.4% that respectively self-identified as Caucasian, African-American and Other race, were included. Over the eight-year follow-up, the odds of worse SRH for African-American and Other race were respectively 1.46 (95% CI: 1.25–1.70) and 1.43 (95% CI, 1.10–1.86) times higher relative to Caucasians. Relative to older Americans that reported ≥2 lifetime discrimination events, the odds of poor SRH was respectively 33% (OR = 0.67, 95%CI: 0.50–0.89) and 17% (OR = 0.83, 95%CI: 0.59–1.17) lower for those that reported none vs one lifetime discrimination experience. Furthermore, the relationship of life-course stress to SRH decline over 8 years varied by race (time*stress*race, p = 0.1173). Specifically, increasing life-course stress predicted worse QOL among Caucasians (p = 0.0063) and among African-American (p = 0.0820) but not among Other race (p = 0.9943).ConclusionToxic stress and minority race are social determinants of deterioration in QOL among older Americans with chronic diseases (HD/T2DM). The types and prevalence of toxic stressors varied by race/ethnicity. Policy interventions to address root causes of TS while targeted at proximate drivers of TS by race/ethnicity represent a viable strategy for mitigating racial disparities in overall wellbeing and improving QOL in all aging Americans regardless of race.

Ethnicity and health inequalities: an empirical study based on the 2010 China survey of social change (CSSC) in Western China

BackgroundIn China, ethnic minorities often live in frontier areas and have a relatively small population size, and tremendous social transitions have enlarged the gap between eastern and western China, with western China being home to 44 ethnic minority groups. These three disadvantages have health impacts. Examining ethnicity and health inequality in the context of western China is therefore essential.MethodsThis paper is based on data from the 2010 China Survey of Social Change (CSSC2010), which was conducted in 12 provinces, autonomous regions and province-level municipalities in western China and had a sample size of 10,819. We examined self-rated health and disparities in self-rated health between ethnic minorities and Han Chinese in the context of western China. Self-rated health was coded as poor or good, and ethnicity was coded as ethnic minority or Han Chinese. Ethnic differences in self-rated health was examined by using binary logistic regression. Associations among sociodemographic variables, SES variable, health behaviour variable, health problem variables and self-rated health were also explored.ResultsFourteen percent of respondents reported their health to be poor. A total of 15.75% of ethnic minorities and 13.43% of Han Chinese respondents reported their health to be poor, indicating a difference in self-rated health between ethnic minorities and Han Chinese. Age, gender, marital status, education, alcohol, and health problems were the main factors that affected differences in self-rated health.ConclusionIn western China, there were obvious ethnic disparities in self-rated health. Elderly ethnic minorities, non-partnered ethnic minorities, ethnic minorities with an educational level lower than middle school, and ethnic minorities with chronic disease had higher odds of poor self-rated health.

Abstract P283: Where You Shop and Neighborhood Access to Fruit and Vegetables are Associated With Self-rated and Cardiometabolic Health

Introduction: The food environment, including food retail venues, has been shown to be associated with diet, and many disadvantaged neighborhoods lack access to high quality and affordable healthy foods. Research has sought to understand whether and how the food retail environment influences diet, and it is possible that shopping at different types of stores (e.g. full-service vs discount grocery store) influences diet and self-reported health outcomes. There is limited understanding of whether factors of the food environment and primary shopping location impact cardiometabolic health (blood pressure, HbA1c, cholesterol) and self-rated health. Methods: We report on 459 individuals who participated in a blood draw in 2018 as part of the Pittsburgh Hill/Homewood Research on Eating, Shopping, and Health, a longitudinal natural-experiment study among African American adults from two socioeconomically similar neighborhoods. Participants reported their perceived access to fruit and vegetables within their neighborhood and where they did their primary food shopping. Outcomes include measured height, weight, blood pressure, cholesterol (HDL, Total), HbA1c, and participant’s self-rated health. We employed logistic regression to examine associations between 1) perceived fruit and vegetable availability, quality, and price and 2) primary food shopping store type and reason for shopping there, with cardiometabolic and self-rated health outcomes. Covariates were neighborhood, years lived in neighborhood, age, race, income, education, and marital status. Results: Participants were on average, 60.7 years old (SD=13.9); 81.7% (375 of 459) female; 80.4% (369 of 459) overweight/obese. After covariate adjustment, both more perceived accessibility of purchasing (OR: 0.47, 95% CI: 0.28, 0.79) and pricing of fruits and vegetables (OR: 0.59, 95% CI: 0.36, 0.96) within one’s neighborhood were associated with lower odds of high blood pressure. More accessible purchasing (OR: 0.59, 95% CI: 0.39, 0.90), pricing (OR: 0.62, 95% CI: 0.41, 0.94), and higher quality of fruits and vegetables (OR: 0.64, 95% CI: 0.42, 0.97) within one’s neighborhood were associated with lower odds of poor self-rated health. Doing one’s primary food shopping at a discount grocery store compared to a full-service grocery store was associated with lower odds of being overweight (OR: 0.51, 95% CI: 0.26, 0.99). Choosing a primary food store based on price rather than quality of food was associated with increased odds of high cholesterol (OR: 2.02, 95% CI: 1.19, 3.45). Conclusion: These results suggest that higher perceptions of access to fruits and vegetables in one’s neighborhood and choice of primary food shopping store are important correlates of cardiometabolic health. Further research should look towards understanding how direct food choices made at stores impact cardiometabolic outcomes within this population.

Self-Reported Health and Patterns of Romantic Love in Adolescents from Eight European Countries and Regions.

Purpose: Sexual minority youth (SMY) are at increased risk of poor health, but it remains unclear whether this phenomenon is universal. In this study, nationally representative samples of 15-year olds from eight European countries and regions were investigated to test if adolescents who have been in love with same- or both-gender partners report poorer health than those exclusively in love with opposite-gender partners or who have never been in love.Methods: A subsample of 13,674 adolescents participating in the 2014 Health Behaviour in School-aged Children (HBSC) study was used. We conducted binary logistic regression, adjusted for gender, region, and relative family affluence, to analyze associations between self-reported romantic love, multiple psychosomatic symptoms, and poor self-rated health.Results: Adolescents reporting same-gender love (adjusted odds ratio [aOR] = 1.50, 95% confidence interval [CI]: 1.11–2.02) and both-gender love (aOR = 3.57, 95% CI: 2.65–4.83) had significantly higher odds for multiple psychosomatic symptoms than those who reported opposite-gender love. Similarly, both SMY groups had higher odds of poor self-rated health (aOR = 2.95, 95% CI: 1.64–5.31 and aOR = 3.08, 95% CI: 1.79–5.31, respectively). Those who reported that they have never been in love had significantly lower odds for multiple symptoms. Adjustment for sociodemographic variables and stratifying by gender did not substantially change the odds ratios.Conclusion: Adolescents in love with same- and both-gender partners reported poorer subjective health outcomes than those in love with opposite-gender partners or who reported never being in love, suggesting that SMY health inequalities are found across various European countries and regions.

Sex discrimination and mental health in women: A prospective analysis.

The purpose of this study was to examine cross-sectional and prospective associations between perceived sex discrimination and health and well-being in a sample from the United Kingdom. Data were from 2,956 women aged ≥16 years who participated in the U.K. Household Longitudinal Study. Perceived discrimination was reported in 2009-2010. Psychological distress, mental functioning, life satisfaction, and self-rated health were assessed in 2009-2010 and 2013-2014. Depression was assessed in 2009 and 2010. Linear and logistic regression analyses adjusted for age, income, education, and ethnicity. Prospective analyses adjusted for baseline well-being. Perceived sex discrimination was reported by 576 (19.5%) participants. Younger, wealthier, better educated, White women reported more discrimination (p < .001). Cross-sectionally, perceived discrimination was associated with increased depression (odds ratio [OR] = 3.16, 95% confidence interval [CI; 2.10, 4.79]) psychological distress (B = 1.26, 95% CI [0.95, 1.56]), poorer mental functioning (B = -5.39, 95% CI [-6.33, -4.46]), lower life satisfaction (B = -0.52, 95% CI [-0.69, -0.36]), and greater odds of poor self-rated health (OR = 1.89, 95% CI [1.47, 2.41]). Prospectively, perceived sex discrimination was associated with increased psychological distress (B = 0.66, 95% CI [0.07, 1.24]), poorer mental functioning (B = -1.37, 95% CI [-2.71, -0.03]), and lower life satisfaction (B = -0.32, 95% CI [-0.58, -0.05]) over 4-year follow-up. Women who perceive that they have been discriminated against based on their sex report poorer mental health and well-being than those who do not perceive discrimination. These results provide cross-sectional and prospective evidence of associations between perceived sex discrimination and mental well-being outcomes in U.K. women. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Associations Between Major and Everyday Discrimination and Self-Rated Health Among US Asians and Asian Americans.

Asians and Asian Americans in the USA have historically and continue to experience everyday and major forms of discrimination. However, much less is known, on a population-level, concerning the relationship between experiences with major discrimination and health outcomes among this racial/ethnic minority group, while also accounting for the daily influence of everyday discrimination. This analysis explores the concurrent association of both forms of discrimination among the Asian population in the USA. Using data from the 2016 National Asian American Survey, a nationally representative sample of Asians from 10 ethnic subgroups, I examined the association between various forms of self-reported encounters with major as well as everyday discrimination-several of which relate to the unique, racialized experiences of Asians-and self-rated health. I ran three weighted logistic regression models examining the individual and concurrent association between major and everyday discrimination and self-rated health, controlling for relevant demographic and acculturation factors. When assessed in isolation, unit increases in major and everyday discrimination were associated with poorer self-rated health. However, when examined concurrently, only higher levels of encounters with major forms of discrimination were associated with higher odds of poorer self-rated health. Although everyday discrimination contributes to poorer health outcomes among Asians, a finding consistent with past research, instances of lifetime major discrimination should be viewed as a more toxic form of discrimination that may more negatively impact their perceived health status. Reducing instances of structural-level discrimination is therefore key toward the prevention of poorer health outcomes among this rapidly growing racial/ethnic minority group.