Poor Health Behaviors Research Articles

Illicit drug use and its association with key sexual risk behaviours and outcomes: Findings from Britain's third National Survey of Sexual Attitudes and Lifestyles (Natsal-3).

ObjectivesWe explore the hypothesis that using illicit drugs other than, or in addition to, cannabis is associated with sexual risk behaviour and sexual health outcomes in the British population.MethodsWe analysed data, separately by gender, reported by sexually-active participants (those reporting > = 1 partners/past year) aged 16–44 years (3,395 men, 4,980 women) in Britain’s third National Survey of Sexual Attitudes and Lifestyles (Natsal-3), a probability survey undertaken 2010–12 involving computer-assisted personal-interview and computer-assisted self-interview. Analyses accounted for the stratification, clustering and weighting of the data. Multivariable logistic regression was used to calculate adjusted odds ratios.ResultsUse of illicit drugs other than, or in addition to, cannabis in the past year was reported by 11.5% (95%CI:10.4%-12.8%) of men and 5.5% (4.8%-6.3%) of women. Use of these types of drugs was more common among those <35 years, those who reported poor general and/or sexual health behaviours, e.g. binge drinking > = weekly (age-adjusted ORs, aAORs, 10.91 (6.27–18.97) men; 9.95 (6.11–16.19) women); having > = 2 condomless partners in the past year (aAOR:5.50 (3.61–8.39) men; 5.24 (3.07–8.94) women). Participants reporting illicit drug use were more likely (than those who did not) to report sexual health clinic attendance (ORs after adjusting for age, sexual identity and partner numbers: 1.79 (1.28–2.51) men; 1.99 (1.34–2.95) women), chlamydia testing (1.42 (1.06–1.92) men; 1.94 (1.40–2.70) women), unplanned pregnancy (2.93 (1.39–6.17) women), and among men only, sexually transmitted infection diagnoses (3.10 (1.63–5.89)).ConclusionsIn Britain, those reporting recent illicit drug use were more likely to report other markers of poor general and sexual health. They were also more likely to attend sexual health clinics so these should be considered appropriate settings to implement holistic interventions to maximise health gain.

Gambling with life: Masculinity, risk, and danger in the lives of unauthorized migrant roofers.

This paper examines the occupational experiences of unauthorized immigrants employed in one of the most dangerous occupations in the United States: roofing. We draw on 40 in-depth interviews with return migrants in Guanajuato, Mexico, to examine how the adoption of masculinity, dangerous working conditions, the labor market structure, and absence of legal status exacerbates injuries for unauthorized roofers. Undocumented men return to Mexico injured with chronic pain, health complications, and trauma. We find that men "do gender" that is adopt masculine beliefs, when they skirt safety practices, police each other's behaviors, withhold their emotions, experience heightened stress, and engage in poor health behaviors. It is a combination of dangerous working conditions, economic insecurity, and men seeking to fulfill their masculine roles that all combine to create unsafe working conditions and lead to injuries.

The association of medications with sedative properties with oral health behaviour in community-dwelling older people.

The objective of this study was to determine whether drugs with sedative properties are related to oral health behaviour-such as frequency of toothbrushing, using toothpaste and dental visits-and oral hygiene, measured by the number of teeth with dental plaque, among community-dwelling older people. The study population consisted of 159 community-dwelling, dentate, non-smoking, older people from the Oral Health GeMS study (Geriatric Multidisciplinary Strategy for the Good Care of Older People study). The data were collected by interviews and clinical examinations during 2004-2005. Sedative properties of drugs were assessed using the sedative load (SL) model. Logistic and Poisson regression models were used to estimate odds ratios/relative risks (OR/RR) and 95% confidence intervals (CI). After adjusting for confounding factors, SL associated with infrequent toothbrushing (OR 1.72, CI: 0.61-4.89), toothpaste use less than twice a day (OR 3.34, CI: 1.39-8.12), non-regular dental visits (OR 2.28 CI: 0.91-5.30) and the number of teeth with dental plaque (RR 1.20 CI: 1.04-1.39) compared to participants without a SL. The results of this study suggest that use of drugs with sedative properties indicates poor oral health behaviour among older people.

Bullying and Being Bullied in Childhood Are Associated With Different Psychosocial Risk Factors for Poor Physical Health in Men

Bullying and being bullied in childhood are both linked with later adjustment problems. The impact of childhood bullying on risk for poor physical health in adulthood is understudied. Black and White men (n = 305; mean age = 32.3 years) enrolled in the Pittsburgh Youth Study since the first grade underwent a comprehensive assessment of psychosocial, behavioral, and biological risk factors for poor health. Indices of bullying and being bullied were created by averaging annual ratings collected from participants and their caregivers when the participants were 10 to 12 years old. Results showed that being a bully in childhood was associated with greater stress and aggression and poorer health behaviors in adulthood, whereas being a victim of bullies in childhood was associated with lower socioeconomic resources, less optimism, and greater unfair treatment in adulthood. Unexpectedly, neither bullying nor being bullied in childhood was related to inflammation or metabolic syndrome. Bullying and being bullied in childhood were associated with distinct domains of psychosocial risk in adulthood that may later lead to poor physical health.

Interrelationships Between Health Behaviors and Coping Strategies Among Informal Caregivers of Cancer Survivors.

Recent research among cancer survivors suggests that health behaviors and coping are intertwined, with important implications for positive behavior change and health. Informal caregivers may have poor health behaviors, and caregivers' health behaviors have been linked to those of survivors. This hypothesis generating study assessed the correlations among health behaviors and coping strategies in a population of lung and colorectal cancer caregivers. This cross-sectional study used data from the Cancer Care Outcomes Research & Surveillance Consortium. Caregivers ( n = 1,482) reported their health behaviors, coping, and sociodemographic and caregiving characteristics. Descriptive statistics assessed the distribution of caregivers' health and coping behaviors, and multivariable linear regressions assessed the associations between health behaviors and coping styles. Many informal caregivers reported regular exercise (47%) and adequate sleep (37%); few reported smoking (19%) or binge drinking (7%). Problem-focused coping was associated with greater physical activity and less adequate sleep (effect sizes [ESs] up to 0.21, p < .05). Those with some physical activity scored higher on emotion-focused coping, while binge drinkers scored lower (ES = 0.16 and 0.27, p < .05). Caregivers who reported moderate daily activity, current smoking, binge drinking, and feeling less well rested scored higher on dysfunctional coping (ES up to 0.49, p < .05). Health behaviors and coping strategies were interrelated among informal cancer caregivers. The relationships suggest avenues for future research, including whether targeting both factors concurrently may be particularly efficacious at improving informal caregiver self-care. Understanding the link between health behaviors and coping strategies may inform health behavior research and practice.

The role of parental rearing practices and family demographics on oral health-related quality of life in children.

To evaluate the direct and indirect (via oral health-related behaviour) effects of parental rearing practices on children's Oral Health-Related Quality of Life (OHRQoL) within a family-focused, comprehensive predictive model. Participants were 11- to 14-year-old children and their parents living in Telangana State, India (N = 1130). Children were clinically assessed for dental caries, gingivitis, oral hygiene status, fluorosis, and malocclusion, and completed a self-administered questionnaire on oral health-related behaviour and OHRQoL. Parents answered questions related to their socioeconomic status (SES), family circumstances, parent's perceptions of child's OHRQoL, and child rearing practices. Structural equation modelling was used to evaluate the pathways through which parenting practices were associated with children's OHRQoL. Parents with higher positive (β = -0.106) and lower power assertion rearing practices (β = 0.103) had children with better OHRQoL. Parental rearing practices did not have any effect on children's oral hygiene behaviour. Children who had malocclusion (β = 0.076) and fluorosis (β = 0.38) had lower OHRQoL. Family SES had a significant effect on children's oral hygiene behaviour and oral hygiene status with children of higher SES demonstrating better oral hygiene behaviour and status. Children living in single-parent families reported poorer oral hygiene behaviour (β = -0.048) than those living in other types of families. Parental rearing practices had direct effects on OHRQoL. However, the hypothesised indirect effects of these practices on OHRQoL via poor oral health behaviour were not supported.

Spiritual care may impact mental health and medication adherence in HIV+ populations.

ObjectiveTo explore a potential role for spirituality in medication-related needs assessment for integrated care in chronically ill populations.MethodA systematic literature review was conducted to explore the impact of faith beliefs on health and/or medication adherence in individuals with depression and/or HIV+/AIDS. Retrospective electronic medical record review of adult HIV+ patients of an urban primary care clinic with integrated mental health services was conducted, with Substance Abuse and Mental Illness Symptoms Screener (SAMISS), major depressive disorder (MDD) incidence over the preceding year, and history of contact with a spiritual advisor. A convenience sample was interviewed to qualitatively assess potential medication therapy management needs and medication-related problems. Another sample was examined utilizing the Daily Spiritual Experience Scale.ResultsThe literature reports positive influence on health behaviors, coping and outcomes; and poor medication adherence and treatment decisions due to patient passivity or resistance. Spiritual advisor contact (not limited to a specific religion) was significantly associated with MDD absence (1.7% vs. 15.3%, P<0.005) and inversely related to SAMISS, depression, and poor health behaviors. Patient interviews reflected significance of faith in terms of insight and acceptance of illness, the role or need for medications, coping, and medication adherence. An illustrative model was designed based on the literature and data collection.ConclusionSpiritual assessment may help identify positive or negative influence on health. Spiritual interventions could be beneficial in promoting adherence and positive health outcomes. Further research is recommended.

Common Crime and Domestic Violence Victimization of Older Chinese in Urban China: The Prevalence and Its Impact on Mental Health and Constrained Behavior

This article examines the prevalence of victimization among older Chinese living in urban China and its psychological and behavioral impacts. A representative sample of 453 older adults aged 60 or above was recruited from Kunming, the People's Republic of China, using multistage sampling method. Participants were individually interviewed on their demographic characteristics, experience of common crime and domestic violence victimization, fear of common crime and domestic violence, mental health, and constrained behavior. Results showed that 254 participants (56.1%) reported one or more types of common crime and 21 (4.6%) reported experiencing domestic violence in the past. Seventeen participants (3.8%) reportedly experienced both common crime and domestic violence victimization. There was no gender difference in the overall incidence of victimization but in some subtypes. Regression analyses indicated that past experience of common crime victimization was significantly associated with greater fear of common crime (β = .136, p = .004), poorer mental health (β = .136, p = .003), and more constrained behavior (β = .108, p = .025). Fear of common crime predicted increased constrained behavior (β = .240, p < .001) independent of gender, age, education, household finances, living arrangement, and physical health. Domestic violence victimization was not significant in predicting poor mental health and constrained behavior but was significant in predicting fear of domestic violence (β = .266, p < .001), which was related to poorer mental health (β = .102, p = .039). The study suggests the importance of taking older people's risk and experience of victimization into consideration in gerontological research, practice, and policymaking.

Implementing health promotion programs in the Australian construction industry

PurposeThe purpose of this paper is to identify possible agents and levers to trigger the development and implementation of work place health promotion programs (WHPPs) in the Australian construction industry. Unlike most large workplaces and most high-risk workplaces, these programs are rarely found in the construction sector.Design/methodology/approachQualitative interviews with 80 trades workers and site-based and off-site construction managers are used to reveal perceptions of the impact of WHPPs and ill-health and poor health behaviors on site activities with a view to identifying leverage points to introduce WHPPs in construction.FindingsUnhealthy lifestyle behaviors are seen as impacting on sites in three main ways: productivity (broadly defined), safety and interpersonal relations. Results also reveal specific roles and levers for different actors in the supply chain and a clear desire for a collective, industry-based response to identified health problems.Practical implicationsHigh levels of chronic diseases in the construction industry means firms within the sector must make a concerted attempt to change patterns of behavior or face significant long-term health implications for their workforce. Reducing levels of health and longevity of the workforce, mean work performance, productivity and participation is likely to decline.Originality/valueAlthough construction workers are recognized as one of the workforces at most risk for life limiting diseases such as Type 2 diabetes and cardiovascular disease, relatively little work has investigated health and well-being considerations for construction workers. This study contributes by investigating possible levers and agents to create healthier workplaces in construction.

Family Economic Security Policies and Child and Family Health.

In this review, we examine the effects of family economic security policies (i.e., minimum wage, earned income tax credit, unemployment insurance, Temporary Assistance to Needy Families) on child and family health outcomes, summarize policy generosity across states in the USA, and discuss directions and possibilities for future research. This manuscript is an update to a review article that was published in 2014. Millions of Americans are affected by family economic security policies each year, many of whom are the most vulnerable in society. There is increasing evidence that these policies impact health outcomes and behaviors of adults and children. Further, research indicates that, overall, policies which are more restrictive are associated with poorer health behaviors and outcomes; however, the strength of the evidence differs across each of the four policies. There is significant diversity in state-level policies, and it is plausible that these policy variations are contributing to health disparities across and within states. Despite increasing evidence of the relationship between economic policies and health, there continues to be limited attention to this issue. State policy variations offer a valuable opportunity for scientists to conduct natural experiments and contribute to evidence linking social policy effects to family and child well-being. The mounting evidence will help to guide future research and policy making for evolving toward a more nurturing society for family and child health and well-being.

Gender and Health Behavior Clustering among U.S. Young Adults

ABSTRACTU.S. trends in population health suggest alarming disparities among young adults, who are less healthy across most measureable domains than their counterparts in other high-income countries; these international comparisons are particularly troubling for women. To deepen our understanding of gender disparities in health and underlying behavioral contributions, we document gender-specific clusters of health behavior among U.S. young adults using nationally representative data from the National Longitudinal Study of Adolescent to Adult Health. We find high levels of poor health behavior, but especially among men; 40 percent of men clustered into a group characterized by unhealthy behavior (e.g., poor diet, no exercise, substance use), compared to only 22 percent of women. Additionally, women tend to age out of unhealthy behaviors in young adulthood more than men. Further, we uncover gender differences in the extent to which sociodemographic position and adolescent contexts inform health behavior clustering. For example, college education was more protective for men, whereas marital status was equally protective across gender. Parental drinking mattered for health behavior clustering among men, whereas peer drinking mattered for clustering among women. We discuss these results in the context of declining female advantage in U.S. health and changing young adult social and health contexts.

Consequences of bullying victimization in childhood and adolescence: A systematic review and meta-analysis.

AIMTo identify health and psychosocial problems associated with bullying victimization and conduct a meta-analysis summarizing the causal evidence.METHODSA systematic review was conducted using PubMed, EMBASE, ERIC and PsycINFO electronic databases up to 28 February 2015. The study included published longitudinal and cross-sectional articles that examined health and psychosocial consequences of bullying victimization. All meta-analyses were based on quality-effects models. Evidence for causality was assessed using Bradford Hill criteria and the grading system developed by the World Cancer Research Fund.RESULTSOut of 317 articles assessed for eligibility, 165 satisfied the predetermined inclusion criteria for meta-analysis. Statistically significant associations were observed between bullying victimization and a wide range of adverse health and psychosocial problems. The evidence was strongest for causal associations between bullying victimization and mental health problems such as depression, anxiety, poor general health and suicidal ideation and behaviours. Probable causal associations existed between bullying victimization and tobacco and illicit drug use.CONCLUSIONStrong evidence exists for a causal relationship between bullying victimization, mental health problems and substance use. Evidence also exists for associations between bullying victimization and other adverse health and psychosocial problems, however, there is insufficient evidence to conclude causality. The strong evidence that bullying victimization is causative of mental illness highlights the need for schools to implement effective interventions to address bullying behaviours.

Oral Health Knowledge and Attitude as Determinants of Oral Health Behavior in a Sample of Old People in Port Harcourt, Rivers State, Nigeria

Adequate oral health knowledge, attitude and behavior are very important for the improvement of patient’s oral health. The objective of the study was to assess the oral health knowledge, attitude and behavior of elderly people in Port Harcourt and determine the relationship between these variables. The research was descriptive survey and correlational in design. A total of 543 old people were selected by systematic random sampling. Data was collected with a self-developed Oral Health Assessment Questionnaire (OHAQ) designed in four sections (A-D) and analysed using SPSS version 20 (IBM SPSS Armonk, New York). Relationship between variables was established by simple regression and significance determined at 0.05 alpha level. Majority (63%) and (66%) of the pensioners in Port Harcourt Rivers State had poor knowledge of oral health and negative attitude toward oral health respectively. About 60% of the participants had poor oral health behavior. Oral health knowledge and attitude accounted for 43.56% (R2 = 0.4356) and 22.09% ((R2 = 0.2209) respectively of the variance in the behavior of the pensioners. There was a significant moderate and positive relationship between oral health knowledge and behavior (R = 0.66) and between oral health attitude and behavior (R = 0.47). The present study showed that oral health knowledge and attitude of the respondents significantly and moderately predicted their oral health behavior. There is therefore the need to educate this group on appropriate oral self-care and regular dental visits as a cornerstone to the promotion of oral health and prevention of oral diseases.

Child Health, Human Capital and Adult Financial Behavior

In this work, utilizing yearly variation between biological siblings, we test for a correlation between poor child health and adult household financial behavior, i.e. risky asset market participation. Our results indicate a negative correlation of roughly -11.0 percentage points conditional on demographics and family background. Moreover, our results suggest that disruption in pre-labor market skill formation is one of the main mediators of this relationship. This work highlights the importance of good child health for adult financial behavior.

Adverse Childhood Experiences (ACE) among American Indians in South Dakota and Associations with Mental Health Conditions, Alcohol Use, and Smoking.

To assess the prevalence of Adverse Childhood Experiences (ACEs) and their association with behavioral health in American Indian (AI) and non-AI populations in South Dakota. We included the validated ACE questionnaire in a statewide health survey of 16,001 households. We examined the prevalence of ACEs and behavioral health conditions in AI and non-AI populations and associations between ACEs and behavioral health. Compared with non-AIs, AIs displayed higher prevalence of ACEs including abuse, neglect, and household dysfunction and had a higher total number of ACEs. For AIs and non-AIs, having six or more ACEs significantly increased the odds for depression, anxiety, PTSD, severe alcohol misuse, and smoking compared with individuals with no ACEs. American Indians in South Dakota experience more ACEs, which may contribute to poor behavioral health. Preventing and mitigating the effects of ACEs may have a significant impact on health disparities in AI populations.

Psychosocial Risk Is Associated with High Readmission Rates and Increased Length of Stay for Patients Following Hematopoietic Stem Cell Transplantation

Background: Patients undergoing hematopoietic stem cell transplantation (HSCT) are routinely screened for psychological and social risk factors prior to transplantation to determine eligibility and optimize support. Although patients with psychosocial risk factors have been shown to have a higher rate of depression and anxiety, the relationship between psychosocial risk and clinical outcomes in HSCT is not well established. We hypothesized that psychosocially vulnerable patients would be at a higher risk for adverse clinical outcomes including hospital readmission and increased length of stay (LOS) following HSCT.Methods: We performed a retrospective observational study at a single center of 395 consecutive HSCT patients who underwent pre-transplant psychosocial screening using the Transplant Evaluation Rating Scale (TERS). The TERS is a validated screening tool utilized to identify patients who are psychosocially vulnerable (κ=0.89-0.98, α=0.76, p=<0.001). TERS scoring is based on an aggregate of 10 different factors (Axis I diagnosis, Axis II diagnosis, substance abuse, compliance, health behaviors, family/social support, coping history, disease coping, affect quality, and mental status). The primary endpoint was time to readmission or death (TTRD) and was calculated as time from transplant discharge to readmission or death, censoring patients without an event at last follow-up or 90 days post-transplant. Estimates for TTRD were obtained using the Kaplan-Meier method and compared by the log-rank test. Multivariable regression analyses were performed to determine hazard ratios (HR) of TERS adjusting for other important covariates.Results: Patients underwent autologous (n=218, 55%) and allogeneic (n=177, 45%) HSCT for acute leukemia (n=140, 35%), multiple myeloma (n=134, 34%), lymphoma (n=93, 24%) and other indications (n=28, 7%). Patients were classified according to psychosocial risk as no-risk (TERS=26.5, 52%) vs. at-risk (TERS>26.5, 48%), with at-risk patients subdivided into mild risk (TERS=27-35.5, 39%) and moderate risk (TERS>35.5, 9%). Psychiatric conditions (24%), poor health behaviors (16%), and poor coping history (13%) were the most common identified risk factors while substance abuse (7%) and non-compliance (2%) were less frequent. Characteristics were similar among TERS groups with respect to race, disease, remission status, type of HSCT, and graft source. Patients with higher TERS scores tended to be younger (no-risk [median age = 58 years] vs. moderate risk [median age = 50.5 years], p=0.04). In multivariable analysis controlling for comorbidity index and disease type, at-risk patients were significantly more likely to be readmitted within 90 days (mild risk HR=1.53 (95% CI [1.04-2.26], p=0.03), moderate risk HR=1.88 (95% CI [1.08-3.29], p=0.03)). This association held across diseases and HSCT type when examined separately. Additionally, in the multiple myeloma cohort, mild risk patients tended to have longer LOS (mean LOS = 19.06 days) than no-risk patients (mean LOS = 16.78 days, p=0.005). Overall survival did not differ significantly among groups.Conclusion: All patients who are identified pre-transplant to have any degree of psychosocial vulnerability are at higher risk for hospital readmission following HSCT and certain groups are at risk for longer length of stay. Hospital readmission in HSCT patients is associated with poor overall survival, increased cost, and worse quality of life. As many psychosocial risk factors are potentially modifiable, at-risk patients undergoing HSCT would be an ideal population for a prospective study with targeted interventions such as early utilization of cancer psychologists, counselors, or healthcare navigators. Further research needs to be pursued to delineate which, if any, particular psychosocial risk factors are driving this association. [Display omitted] DisclosuresAndritsos:Hairy Cell Leukemia Foundation: Research Funding. Hofmeister:Arno Therapeutics, Inc.: Research Funding; Signal Genetics, Inc.: Membership on an entity’s Board of Directors or advisory committees; Janssen: Pharmaceutical Companies of Johnson & Johnson: Research Funding; Incyte, Corp: Membership on an entity’s Board of Directors or advisory committees; Celgene: Research Funding; Karyopharm Therapeutics: Research Funding; Takeda Pharmaceutical Company: Research Funding; Teva: Membership on an entity’s Board of Directors or advisory committees.

Prevalence and correlates of perceived teeth health status and oral health behavior among school-going adolescents in Cambodia.

ABSTRACTThe purpose of the study was to investigate perceived teeth health status and oral health behavior, as well as their correlates, among adolescents in Cambodia. The analysis included 3806 Cambodian school children (mean age 15.7 years, SD=1.8 years) who took part in the “Global School-based Student Health Survey” (GSHS) in 2013. Overall, 7.8% of the students reported poor perceived teeth status, 18.0% had missed school in the past year because of a toothache, 26.7% engaged in combined oral health behavior (brushing teeth twice daily or more often = 79.8%, using fluoride toothpaste = 59.9%, and drinking soft drinks less than once a day = 53.6%), and 59.9% had never visited a dentist for a routine examination or other dental work. In the multivariate logistic regression analysis, older age, being female, missing school because of a toothache, having a toothache in the past 12 months, poor oral health behavior and sedentary leisure time were associated with poor perceived teeth status. Older age, good perceived teeth status, having had a dental check-up, washing hands before eating and after toilet use, and not eating fast food were associated with a positive oral health behavior (brushing teeth twice daily or more often, using fluoride toothpaste, and drinking soft drinks less than once a day). Significant proportions of poor perceived teeth status and poor oral health behavior were found among school children in Cambodia. Various risk factors (sociodemographic, dental variables, general health risk behaviors) for perceived poor teeth status, oral health behavior and never having had a dental check-up were identified, which can be utilized for intervention programs.

Do cancer survivors develop healthier lifestyle behaviors than the cancer-free population in the PLCO study?

Current studies report mixed results in health status and health behaviors after a diagnosis of cancer. The aim of our study is to investigate potential differences in lifestyle factors among cancer survivors and cancer-free individuals in a prospective cohort study conducted in the United States. Using data from the Prostate, Lung, Colorectal and Ovarian (PLCO) Trial, 10,133 cancer survivors were identified and compared to 81,992 participants without cancer to evaluate differences in body mass index (BMI), smoking, NSAID use, and physical activity. Cancer survivors, compared to the cancer-free, were significantly less likely to engage in physical activity (odds ratio (OR)=0.82, 95% CI=0.77-0.88). Compared to those who were obese at baseline, cancer survivors were more likely to be at normal BMI at follow-up compared to the cancer-free (OR=1.90, 95% CI=1.42-2.54). Cancer survivors were less likely to report regular aspirin use as compared to the cancer-free population (OR=0.86, 95% CI=0.82-0.92). Of the current smokers, cancer survivors were more likely to be former smokers at follow-up compared to the cancer-free (OR=1.50, 95% CI=1.30-1.74). Upon stratification by baseline health markers, cancer survivors practice healthier lifestyle habits such as smoking cessation and maintenance of a healthy weight. However, cancer survivors are less likely to be physically active as compared to cancer-free individuals, regardless of baseline practices. For cancer survivors who reported poor health status and behaviors at baseline, a cancer diagnosis may encourage the practice of healthier lifestyle behaviors.

Associations Between Geriatric Syndromes and Mortality in Community-Dwelling Elderly: Results of a National Longitudinal Study in Taiwan

ObjectiveAlthough geriatric syndromes have been studied extensively, their interactions with one another and their accumulated effects on life expectancy are less frequently discussed. This study examined whether geriatric syndromes and their cumulative effects are associated with risks of mortality in community-dwelling older adults. MethodsData were collected from the Taiwan Longitudinal Study in Aging in 2003, and the participant survival status was followed until December 31, 2007. A total of 2744 participants aged ≥65 years were included in this retrospective cohort study; 634 died during follow-up. Demographic factors, comorbidities, health behaviors, and geriatric syndromes, including underweight, falls, functional impairment, depressive condition, and cognitive impairment, were assessed. Cox proportional hazard regression analysis was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the probability of survival according to the cumulative number of geriatric syndromes. ResultsThe prevalence of geriatric syndromes increased with age. Mortality was significantly associated with age ≥75 years; male sex; ≤6 years of education; history of stroke, malignancy; smoking; not drinking alcohol; and not exercising regularly. Geriatric syndromes, such as underweight, functional disability, and depressive condition, contributed to the risk of mortality. The accumulative model of geriatric syndromes also predicted higher risks of mortality (N = 1, HR 1.50, 95% CI 1.19–1.89; N = 2, HR 1.69, 95% CI 1.25–2.29; N ≥ 3, HR 2.43, 95% CI 1.62–3.66). ConclusionsCommunity-dwelling older adults who were male, illiterate, receiving institutional care, underweight, experiencing a depressive condition, functionally impaired, and engaging in poor health behavior were more likely to have a higher risk of mortality. The identification of geriatric syndromes might help to improve comprehensive care for community-dwelling older adults.

Impact of the 2008 global financial crisis on the health of Canadians: repeated cross-sectional analysis of the Canadian Community Health Survey, 2007–2013

BackgroundDespite a clear impact on the Canadian economy, little is known about the subsequent health impacts of the 2008 global financial crisis (GFC) in this country. This study fills this...