Panel Survey Data Research Articles

Understanding the effect of abortion attitudes on elections after Dobbs: Evidence from cross‐sectional and panel surveys in Texas

AbstractObjectiveWe investigate the nature of abortion opinion after the Dobbs decision's reversal of Roe v. Wade with attention to the evaluation of incumbents and vote preference.MethodWe relied on pre‐ and post‐election cross‐sectional and panel survey data from Texas. Texas is an important case because (1) the ruling placed abortion policy squarely on the shoulders of the states and (2) each state has different laws regarding abortion (including so‐called “trigger” laws restricting abortion after Roe was overturned).ResultsThe data suggest that state abortion policy context affects voter attitudes and that incumbent evaluations and the vote in Texas were largely insulated from an anti‐Dobbs backlash in 2022.ConclusionIt is unrealistic to assume that a unidimensional response occurred to the Dobbs decision. The response to subnational policy changes has reflected a similar shift in the intensity of policy views that was found nationally after the Roe decision. We develop a broader thematic approach to understand the nature of abortion opinion and its impact on the evaluation of incumbents and on vote preference in 2022.

Family formation and health-related behavior: The case of meal skipping

Using four rounds of nationally representative U.S. panel survey data (NLSY97) and fixed-effects models, this study examines whether and how transitions to marriage/cohabitation/parenthood are associated with gender-specific changes in meal-skipping patterns. Two theoretical perspectives, social control and time scarcity, provide different explanations of how family formation relates to meal skipping. However, empirical research examining the association using a nationally representative sample is scarce. Results indicate that the transitions to romantic relationships (either marriage or cohabitation) are associated with less frequent meal skipping, consistent with social control theory, but in ways that differ by gender. The transition to marriage is associated with reduced meal skipping only for men, whereas the transition to cohabitation is associated with reduced meal skipping to some extent for women. The transition to parenthood has distinctive consequences for women’s meal patterns. Specifically, having two or more children at home is associated with increased meal skipping only for women, which can be explained by the time scarcity perspective. This study reveals that the consequences of family formation on health-related behaviors are gender specific and not universally positive, highlighting women’s persistent role as the primary caregiver for the family.

Move out of the land: certification and migration in China

Abstract Motivated by the emphasis on securing property rights as an important tool for the efficient allocation of resources, including land and labour, we use three rounds of China Rural Household Panel Survey data to assess the impact of a land certification programme (LCP) on the labour and land allocation in rural China. We find that the LCP results in increased rural–urban migration, more active land rental markets, as well as higher household income and consumption in rural China. These effects vary with age and are larger for younger individuals and households with heads aged 50 years or younger. Improving property rights could be a central task for the Chinese government to tackle issues related to labour and land misallocation.

The Validity of Impressions as a Media Dose Metric in a Tobacco Public Education Campaign Evaluation: Observational Study.

Evaluation research increasingly needs alternatives to target or gross rating points to comprehensively measure total exposure to modern multichannel public education campaigns that use multiple channels, including TV, radio, digital video, and paid social media, among others. Ratings data typically only capture delivery of broadcast media (TV and radio) and excludes other channels. Studies are needed to validate objective cross-channel metrics such as impressions against self-reported exposure to campaign messages. This study aimed to examine whether higher a volume of total media campaign impressions is predictive of individual-level self-reported campaign exposure in California. We analyzed over 3 years of advertisement impressions from the California Tobacco Prevention Program's statewide tobacco education campaigns from August 2019 through December 2022. Impressions data varied across designated market areas (DMAs) and across time. These data were merged to individual respondents from 45 waves of panel survey data of Californians aged 18-55 years (N=151,649). Impressions were merged to respondents based on respondents' DMAs and time of survey completion. We used logistic regression to estimate the odds of respondents' campaign recall as a function of cumulative and past 3-month impressions delivered to each respondent's DMA. Cumulative impressions were positively and significantly associated with recall of each of the Flavors Hook Kids (odds ratio [OR] 1.15, P<.001), Dark Balloons and Apartment (OR 1.20, P<.001), We Are Not Profit (OR 1.36, P<.001), Tell Your Story (E-cigarette, or Vaping, product use Associated Lung Injury; OR 1.06, P<.05), and Thrown Away and Little Big Lies (OR 1.05, P<.01) campaigns. Impressions delivered in the past 3 months were associated with recall of the Flavors Hook Kids (OR 1.13, P<.001), Dark Balloons and Apartment (OR 1.08, P<.001), We Are Not Profit (OR 1.14, P<.001), and Thrown Away and Little Big Lies (OR 1.04, P<.001) campaigns. Past 3-month impressions were not significantly associated with Tell Your Story campaign recall. Overall, magnitudes of these associations were greater for cumulative impressions. We visualize recall based on postestimation predicted values from our multivariate logistic regression models. Variation in cumulative impressions for California Tobacco Prevention Program's long-term multichannel tobacco education campaign is predictive of increased self-reported campaign recall, suggesting that impressions may be a valid proxy for potential campaign exposure. The use of impressions for purposes of evaluating public education campaigns may help address current methodological limitations arising from the fragmented nature of modern multichannel media campaigns.

Use and Cost Patterns of Antihypertensive Medications in the United States From 1996 to 2021.

Antihypertensive medication use patterns have likely been influenced by changing costs and accessibility over the past 3 decades. This study examines the relationships between patent exclusivity loss, medication costs, and national health policies on antihypertensive medication use. Using 1996 to 2021 Medical Expenditure Panel Survey data of US adults with hypertension taking at least 1 antihypertensive medication, we conducted a cross-sectional analysis. We explored the associations between patent exclusivity loss, per-pill costs, and Medicare Part D enactment on medication use over time, focusing on the most commonly used medications (lisinopril, amlodipine, losartan, hydrochlorothiazide, and metoprolol). The unweighted sample comprised 50 095 US adults (mean age, 62 years; 53% female). The survey-weighted number of adults taking antihypertensive medications increased from 22 million (95% CIs, 20-23 million) to 55 million (95% CI, 51-60 million) between 1996 and 2021. Loss of patent exclusivity led to increased medication fills, notably for lisinopril, amlodipine, and losartan, which all exhibited within-class dominance. However, per-pill cost decreases coinciding with Medicare Part D did not increase the number of individuals treated or the use of specific antihypertensive medications or classes. The increase in antihypertensive medication use over the past decades highlights the significant impact of loss of patent exclusivity on the uptake in the use of specific medications. These findings underscore the complexity of factors influencing medication use, beyond cost reductions alone, and suggest that policies need to consider multiple facets to effectively improve antihypertensive medication accessibility and utilization.

The Effect of Mandatory Medicaid HMOs on Health Access, Utilization, and Health Outcomes for Children

ObjectiveMandatory enrollment into Medicaid-contracted Health Maintenance Organizations (HMOs) is the most common form of Medicaid managed care (MMC), but the effects of this enrollment on children are unclear. We leveraged variation in MMC implementation within and across states over time to examine the effect of mandatory Medicaid HMO enrollment on children’s access, utilization, and health outcomes. MethodsUsing Medical Expenditure Panel Survey data from 2000 to 2018 and multivariable regression models, we estimated the effects of living in a county with mandatory Medicaid HMO enrollment only, compared to other MMC types and FFS combined in one comparison group, on outcomes for children under 18 years. We also evaluated potential effect heterogeneity across age, race/ ethnicity, and for children with special healthcare needs (CSHCNs). ResultsThere were small and non-significant associations between mandatory HMO enrollment and most outcome measures. However, mandatory HMO enrollment was associated with a 1.8 percentage-point decline in the likelihood of having a usual source of care,95% CI[-0.035,-0.001], a 4.2 percentage-point increase in the likelihood of delayed access to care,95% CI[0.012,0.072], and a 2.2 percentage-point reduction in the likelihood of having any outpatient physician visits, 95% CI[-0.043,-0.0004], compared to other MMC and FFS combined in one group. Mandatory HMO enrollment was associated with more difficulty seeing a specialist for CSHCNs. ConclusionsOverall, there is little evidence that mandatory Medicaid HMO enrollment has discernable and consistent effects across a broad range of outcomes. Evaluating how mandatory Medicaid HMOs affect more nuanced healthcare measures especially for children with greater healthcare needs remains an important future research question.

독거노인가구의 주거빈곤이 주관적 건강에 미치는 영향: 자아존중감과 우울의 이중매개효과

The purpose of this study is to empirically identify the magnitude and characteristics of residential poverty among the elderly living alone and to determine the mediating effects of self-esteem and depression on the effects of residential poverty on the subjective health of the elderly living alone. The analysis data used was secondary data from the 15th Korea Welfare Panel (KOWEPS) (2020). Among the panel survey data, 1,502 cases of seniors aged 65 or older living alone were finally analyzed as of 2020, the time of the survey. SPSS 23.0 and PROCESS Macro 3.5 were used for analysis, and the main research results are as follows. First, the level of residential poverty among elderly households living alone was approximately 1 out of 3 households. Second, health status was confirmed in terms of self-esteem, depression, and subjective health. As a result of the analysis, the average subjective health score was 2.7057 points on a 5-point scale, depression was 11.8635 points, and self-esteem was 2.8427 points on a 4-point scale. Third, as a result of controlling and analyzing demographic characteristics to determine how residential poverty affects the health of single-person elderly households, the effect of residential poverty on subjective health of single-person elderly households was statistically significant (β=-. 2295, p&lt;.001), when self-esteem and depression were included, residential poverty no longer appeared to affect their subjective health (β=-.0418, p&gt;.05), showing that residential poverty and subjective health It was found that depression and self-esteem each fully mediated the relationship. Fourth, as a result of verifying the size of the double mediating effect, it was found that the housing poverty (X) → self-esteem (M1) → depression (M2) → health (Y) path was significant as -.0479 (-.0674~-.0307). Based on these results, implications and development tasks for the residential welfare policy and service direction of elderly households living alone were presented.

Transportation Network Density, Domestic Market Integration and Excess Sensitivity of Household Consumption

Abstract From the perspective of domestic market integration, this paper systematically examines the impact of transportation infrastructure conditions on excess sensitivity of household consumption based on the China Family Panel Survey (CFPS) and multi-level matching panel data of transportation network density. The results show that the fast-growing development of the transportation infrastructure network has a significant alleviating effect on excess sensitivity of household consumption along the route, and the conclusion is still robust after the use of the multi-dimensional instrumental variable method and a series of robustness tests. According to the heterogeneity tests, in terms of the alleviating effect of transportation infrastructure, railroads rank the first, highways the second, substandard roads the third, waterways the fourth, and roads of other grades at the bottom. The mechanism test reveals that the improvement of domestic market integration is an important channel for transportation infrastructure to alleviate excess sensitivity of household consumption. This paper confirms that improving the transportation infrustructure system is conducive to the construction of a unified national market, alleviating excess sensitivity of consumption and stimulating consumption.This paper provides suggestions for implementing the strategy of boosting domestic demand, and helps the government understand households’ consumption decision-making from a broader perspective. This study also provides a theoretical basis for the economic spillover effect of transportation infrastructure.

The Burden of Food Insecurity on Quality of Life in Adults with Diabetes.

Background: This study aimed to investigate the relationship between food insecurity and physical- and mental-health-related quality of life in adults with diabetes. Methods: Using two years of national Medical Expenditure Panel Survey data (2016-2017), we investigated the relationship between food insecurity and physical-health-related (PCS) and mental-health-related (MCS) quality of life in adults with diabetes. PCS and MCS were measured with the Short-Form 12 health survey and food insecurity was measured with the USDA 10-item adult scale. Analyses were weighted to represent the US adult population. Adjusted linear regression models, including covariates of age, gender, education, race/ethnicity, marital status, region, poverty level, employment status, health insurance, and comorbidities were used. Results: After adjustment, food-insecure adults with diabetes maintained significantly lower quality of life compared to food-secure adults with diabetes (PCS: -3.44, 95%CI -4.63, -2.25; MCS: -5.37, 95%CI -6.68, -4.06). This drop in PCS was larger than the drop for chronic conditions, including arthritis (-3.77, 95%CI -5.02, -2.52), emphysema (-2.82, 95%CI -5.12, -0.53), stroke (-2.63, 95%CI -4.11, -1.15), cancer (-2.59, 95%CI -4.00, -1.17), and heart attack (2.58, 95%CI 4.68, 0.48). Similarly, the drop for MCS was larger than for chronic pain (-2.37, 95%CI -3.24, -1.50) and arthritis (-1.31, 95%CI -2.28, -0.33). Conclusions: Food insecurity was associated with a significant reduction in both physical- and mental-health-related quality of life in adults with diabetes, with a magnitude of effect greater than adjusted estimates for the drop in quality of life for key chronic conditions. Addressing food insecurity through integration of social and medical care may lead to improvements in quality of life for adults with diabetes.

When Disagreement Becomes Uncivil on Social Media: The Role of Passive Receiving and Active Expression of Incivility in Influencing Political Polarization

Exposure to cross-cutting viewpoints may not always play the deliberative role it is supposed to. This study uses both panel survey and social media data to examine how disagreement can trigger incivility, including exposure to and expression of incivility, and further elicit emotions and influence polarization. Results from the two-wave panel survey indicate that cross-cutting exposure has a polarizing effect first through promoting exposure to uncivil messages and expression of uncivil opinions, then through negative emotions. Notably, cross-cutting exposure can indirectly reduce polarization by first encouraging expression of uncivil opinions and then eliciting positive emotions, highlighting the importance of active expression. Analysis of data from the Hong Kong-based discussion forum HKDisc demonstrates that cross-cutting exposure is positively related to exposure to uncivil messages, and exposure to and expression of incivility predict polarization regardless of whether positive or negative emotions are detected in the uncivil content. This study provides empirical evidence of the effects of cross-cutting exposure and incivility on polarization at the individual and collective levels.

The Impact of Closing Medicare Part D Coverage Gap on Mental Health of Adults Over Age 65.

Using Medical Expenditure Panel Survey data from 2006 to 2019, this study assessed the effect of closing Medicare Part D coverage gap on mental health of older adults. We employed difference-in-differences and compared mental health outcomes of older adults on Medicare with those on private insurance before and after the 2011 policy change. Findings showed a 0.447-point reduction in the Kessler Index 6 (K-6) score after closure. These findings were mainly attributable to women, Hispanics, individuals with multiple chronic conditions, and those in Traditional Medicare. A reduction in out-of-pocket (OOP) expenditures appeared to be the primary mechanism for this finding. Our analysis was robust to several specifications, including using different measures of mental health and alternate constructions of treatment and control groups. The closure of the Medicare Part D coverage gap improved mental health among beneficiaries, potentially by reducing financial strain associated with high OOP expenditures.

Learning from YouTube? The role of exposure to partisan YouTube channels and news literacy in political learning during the South Korean general election campaign

ABSTRACT This study examined whether exposure to partisan YouTube channels, a soft-format journalistic content for partisans, can promote learning effects and how news literacy moderates these effects. Using online panel survey data (N = 808), findings revealed that spending more time viewing partisan YouTube channels led to lower knowledge of hard news (i.e. factual information about the electoral system and campaign slogans) but higher knowledge of soft news (i.e. human-interest-based information). However, individuals with higher news literacy showed an increase in hard news knowledge but a decrease in soft news knowledge as their time spent viewing partisan YouTube channels increased.

National Trends in Aspirin Use and Expenditures in the United States: Analysis of The Medical Expenditure Panel Survey 2000-2021.

Since its invention in 1897, aspirin (ASA) has been the most widely used and cost-effective antiplatelet agent to prevent and treat atherosclerotic cardiovascular disease (ASCVD). We aimed to study the trends and expenditures associated with ASA use in the USA. We conducted a serial cross-sectional analysis using the Medical Expenditure Panel Survey data from January 2000 to December 2021, focusing on adults aged ≥ 40years. Total and out-of-pocket expenditures associated with ASA were estimated to 2021 US dollars (USD). Trends, demographics, and predictors of ASA use among patients with and without ASCVD were also evaluated. A total of 53million adults were identified during the study period. The number of ASA users increased from 2.9million to 6.6million with increased female (36.7%-49.7%; ptrend = 0.02) and African American (13%-18.9%; ptrend = 0.03) representation amongst all ASA users during the survey period. The use of low-dose ASA increased, while high-dose ASA declined significantly. Only 50% of all ASA users had known ASCVD. The most prevalent ASA users among patients with ASCVD were those aged ≥ 70years, while patients without ASCVD, it was the 50-69 age group. The total annual expenditure on ASA averaged approximately 60million USD, with 27.3million USD out-of-pocket. Total and low-dose (81mg) ASA use has increased, while high-dose (325mg) ASA has declined. ASA use for primary prevention has risen among adults aged 50-69years, and patients ≥ 70years continue to use ASA without known ASCVD. Further studies are needed to understand the implications of increased ASA use, especially among those without ASCVD.

Factors associated with physical and psychological wellness of American adults with asthma

Objective: The study objective was to investigate the factors associated with the physical and psychological wellness of United States (US) adults with asthma.Methods: This cross-sectional analysis used a sample of 2329 US adults with asthma in the 2021 Medical Expenditure Panel Survey data. A logistic regression model investigated the association of the following factors and the dependent variables (physical wellness and psychological wellness): age, sex, race, ethnicity, education, employment, healthcare provision, marriage, income, regular physical activity, current smoker, pain, and limitations. Nationally representative estimates were produced through a weighted analysis. The data structure was maintained using cluster and strata variables. The alpha limit was 0.05.Results: Factors associated with higher odds of reporting good physical wellness included: private (versus no) healthcare provision (odds ratio [OR] = 2.63, 95% confidence interval [CI] = 1.10–6.26), good (versus poor) psychological wellness (OR = 6.83, 95% CI = 4.35–10.72), regular (versus no regular) physical activity (OR = 2.18, 95% CI = 1.42–3.34), little/moderate (versus quite a bit/extreme) pain (OR = 3.51, 95% CI = 2.38–5.15) and no (versus any) limitation (OR = 3.73, 95% CI = 2.30–6.06). In the psychological wellness model, those aged ≥70 (OR = 6.18, 95% CI = 2.72–14.07), 60–69 (OR = 4.64, 95% CI = 2.13–10.10), and 50–59 (OR = 4.96, 95% CI = 2.24–11.02) versus those aged 18–29, and good (versus poor) physical wellness (OR = 6.89, 95% CI = 4.34–10.94) were associated with higher odds of reporting good versus poor psychological wellness.Conclusion: These results may be helpful at targeting resources to optimize the wellness of US adults with asthma. Additional studies are needed to determine any temporal associations between these findings.

Exploring organizational aspects that promote health-related preventive behavior: using the example of work-related SARS-CoV-2 infection control measures in Germany, August 2020 to November 2021.

During the communicable coronavirus disease (COVID-19) pandemic, organizational infection control measures (oICMs) were introduced in the workplace. The employees' positive attitudes and active participation are relevant for full effectiveness regarding disease prevention. Therefore, we explore changes in employees' attitudes toward oICM at work from August-October 2020 (T0) over January 2021 (T1) to October-November 2021 (T2). We further investigate the role an organization can play in supporting health-related preventive behavior. We considered repeated cross-sectional and longitudinal panel survey data from 5,554 employees of a global supplier of technology and services in Germany. A total of 16 items constitute the attitude scores toward oICM (5-point Likert scale). Via mixed-effect model, aspects associated with employees' attitudes toward oICM were explored. Via 'extreme-group' approach, we compared the 20% of participants with the largest changes into less favorable to the 20% with the largest changes into more favorable attitudes toward oICM over time. The overall positive attitudes toward work-related oICM were more favorable at T1 (mean ± SD: 4.2 ± 0.6, median (IQR): 4.3 (0.8), n = 2,515) compared to T0 (4.1 ± 0.6, 4.1 (0.8), n = 2,417) but less favorable at T2 (3.9 ± 0.7, 4.0 (0.9), n = 2,062). Among others, feeling well-informed about possible work-related risks of infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), perceived psychosocial demands through work environment aspects, and perceived management's commitment to safety and health were associated with long-term positive attitudes toward oICM. Individuals developing more favorable attitudes toward oICM reported feeling well-informed about possible work-related SARS-CoV-2 infection risks and improved COVID-19-specific resilience over time. Individuals developing less favorable attitudes toward oICM reported decreased perceptions of COVID-19-associated risks. oICMs in the workplace were perceived appropriate even after COVID-19 vaccines were widely available although the perceived affective risks about SARS-CoV-2 decreased. Taken together, our findings highlight how organizations can support employees in adopting health-related preventive behavior. Among others, we found that feeling well-informed about possible work-related health risks was positively associated with long-term favorable attitudes toward work-related oICM. We expect that the results contribute to the development of interventions to prepare and adapt to future global public health concerns.

Predicting Health-Related Quality of Life Among Chinese Residents: Latent Class Analysis Based on Panel Survey Data.

This study aimed to identify distinct trends among Chinese residents based on their health-related quality of life (HR-QoL) outcomes and to analyze the demographic characteristics that contribute to these trends. The study conducted latent class analysis using baseline data obtained from a survey of health service utilization behaviors (from July to December 2016) among residents of Hubei Province, China (N = 1517). Latent classes were used to implement the HR-QoL grouping of different trends among the respondents. Multinomial logistic regression analysis was used to identify demographic characteristic factors affecting HR-QoL in the trend groups. A three-class model emerged as the most suitable grouping classification for HR-QoL among Chinese residents: the low HR-QoL class, exhibiting a downward trend (5.5%); the medium HR-QoL class, exhibiting an upward trend (12.1%); and the stable HR-QoL class, exhibiting high HR-QoL (82.4%). Participants in the medium class were more likely to be without chronic diseases, aged 45-64 years, and employed than those in the low class. Conversely, urban participants had a higher likelihood of belonging to the low class. Participants in the stable class were more likely to be without chronic diseases, aged 15-44 years or 45-64 years, and employed than those in the low class. Conversely, urban participants had a higher likelihood of belonging to the low class. Three latent trend classes of HR-QoL were observed, which exhibited distinct characteristics. Residents without chronic diseases, residents under 65 years of age, and employed residents had better HR-QoL than individuals in other classes, while urban residents had poorer HR-QoL than individuals in other classes.

How general practitioners in France are coping with increased healthcare demand and physician shortages. A panel data survey and hierarchical clustering

BackgroundGeneral practitioners (GPs) face quantitative and qualitative changes in patient demand and doctor shortages. ObjectivesTo investigate how GPs cope with doctor shortage issues. Materials and methodsTwo cross-sectional surveys of a representative panel of 1530 GPs in 2019 and 2022 about their perceptions of physician shortages, working hours worked (WHW), and adaptive behaviors. Hierarchical clustering enabled identification of profiles with different adaptation patterns. Multiple Poisson or logistic regression models studied associations between GPs’ profiles and professional characteristics. Results87.4 % of GPs applied at least one adaptation to control patients’ healthcare demand. 24 % adopted task-shifting while their average WHW decreased by 3.6 h between 2019 and 2022. Four GP profiles were identified. “Low adapters/low workload” and “Low adapters/high workload” (25 % of the sample each) reported 2.4 adaptive measures: 75.5 % refused to be new patients' preferred doctor in the former group (vs 5.1 %). “High adapters/unchanged consultations” (30.7 %) and “High adapters/shortened consultations” (18.9 %) reported 4.8 and 6.1 adaptations, respectively. They were more likely to practice in medically underserved areas. ConclusionThese results call into question GPs’ gatekeeper role in the French healthcare system. Moreover, the marked reduction in WHW in underserved areas is likely to exacerbate their uneven distribution nationwide. Encouraging vertical integration between HCPs while enhancing cooperation and task-shifting is probably a pathway toward improving the relative GP shortage.

Living in a Diverse Community: Effects of Geographical Variations in Diversity on Partisan Communication

This study examines the effects of geographical variations in diversity on political communication within the context of partisan media and audiences. Partisan heterogeneity, as an indicator of political diversity, was conceptualized as a geographical context of the distribution of party preferences within a county. Using a set of nationwide panel survey data with county-level statistics, we conducted multilevel modeling to test its effects on partisan news use, political discussion, knowledge, and affective polarization. The results indicate that county-level partisan heterogeneity reduced the average levels of like-minded news consumption. Moreover, it attenuated the positive relationship between like-minded news use and political talk with strong ties. Additionally, we found that the context of partisan heterogeneity significantly moderated the mediation effects of partisan news use on political knowledge and affective polarization through political discussion. Implications of these results on partisan communication were discussed.

A Longitudinal Analysis of Long Working Hours and the Onset of Psychological Distress

Abstract OBJECTIVES There is a paucity of longitudinal studies examining the relationship between working hours and the development of Psychological Distress (PD) among U.S. workers. This study utilized a longitudinal approach to examine this relationship. METHODS The 2010-2019 Medical Expenditure Panel Survey (MEPS) data was utilized. PD was analyzed among full-time U.S. employees without PD at baseline using a fixed effect approach. RESULTS The sample comprised 27,548 full-time workers. Individuals working 61 hours or more weekly had the highest risk of PD onset, at 9.9% (95% Confidence Interval, CI = 1.9% - 17.8%, p &lt; 0.05), compared to those working 30-35 hours weekly. Interestingly, an increased risk of PD onset was found among individuals working 36-40 hours per week at 6.6% (CI = 1.5% - 11.6%%, p &lt; 0.05). CONCLUSION Long working hours were associated with the increased development of PD.

COVID-19 Health Impact: A Use Case for Syndromic Surveillance System Monitoring Based on Primary Care Patient Registries in the Netherlands.

The COVID-19 pandemic challenged societies worldwide. The implementation of mitigation measures to limit the number of SARS-CoV-2 infections resulted in unintended health effects. The objective of this study is to demonstrate the use of an existing syndromic surveillance system in primary care during a first series of quarterly cross-sectional monitoring cycles, targeting health problems presented in primary care among Dutch youth since August 2021. Aggregated data from the surveillance system of Nivel Primary Care Database were analyzed quarterly to monitor 20 health problems often reported in the aftermath of disasters and environmental incidents. Results were stratified by age (ie, 0-4, 5-14, and 15-24 years), sex, and region (province). Weekly prevalence rates were calculated as the number of persons consulting their general practitioner in a particular week, using the number of enlisted persons as the denominator. Findings were compared to quarterly survey panel data, collected in the context of the Integrated Health Monitor COVID-19, and the Dutch stringency index values, indicative of the intensity of COVID-19 mitigation measures. Over time, weekly rates pointed to an increased number of consultations for depressive feelings and suicide (attempts) among youth, during and after periods with intensified domestic restrictions. The results illustrate how, from a disaster health research perspective based on the COVID-19 pandemic, health consequences of pandemics could be successfully followed over time using an existing infrastructure for syndromic surveillance and monitoring. Particular areas of health concern can be defined beforehand, and may be modified or expanded during the monitoring activities to track relevant developments. Although an association between patterns and changes in the strictness of mitigation measures might seem probable, claims about causality should be made with caution.