Poor Health Behaviors Research Articles

In Our Sacred Voice – An Exploration of Tribal and Community Leader Perceptions as Health Communicators of Disease Prevention among American Indians in the Plains

ABSTRACT American Indians (AI) are disproportionately and significantly impacted by disease morbidity, mortalityand poor behavioral health outcomes. Health promotion and health communication programs exist to address these health disparities and health conditions; however, few programs fully integrate holistic approaches when targeting AI populations. The objective of this study was to explore how tribal and community leaders throughout the Central Plains (Kansas, Iowa, Missouri, and South Dakota) viewed themselves as health communicators and health promoters within their communities. Members of the Center for American Indian Community Health (CAICH) conducted 39 in-depth interviews with members of federally recognized tribes living in reservation communities as well as urban tribal communities across the region. Results from the sample show that these individuals do not necessarily see themselves as the “authority” health communicator or health promoter within their tribe or community. They did perceive themselves and others as gatekeepers of pertinent health information. Social and cultural authority within culturally centered messaging and collective delivery of this type of health information from trusted sources within tribes and communities is perceived to bolster health communication programs and positively impact health outcomes among AI populations.

Associations between COVID-19 mobility restrictions and economic, mental health, and suicide-related concerns in the US using cellular phone GPS and Google search volume data.

During the COVID-19 pandemic, US populations have experienced elevated rates of financial and psychological distress that could lead to increases in suicide rates. Rapid ongoing mental health monitoring is critical for early intervention, especially in regions most affected by the pandemic, yet traditional surveillance data are available only after long lags. Novel information on real-time population isolation and concerns stemming from the pandemic’s social and economic impacts, via cellular mobility tracking and online search data, are potentially important interim surveillance resources. Using these measures, we employed transfer function model time-series analyses to estimate associations between daily mobility indicators (proportion of cellular devices completely at home and time spent at home) and Google Health Trends search volumes for terms pertaining to economic stress, mental health, and suicide during 2020 and 2021 both nationally and in New York City. During the first pandemic wave in early-spring 2020, over 50% of devices remained completely at home and searches for economic stressors exceeded 60,000 per 10 million. We found large concurrent associations across analyses between declining mobility and increasing searches for economic stressor terms (national proportion of devices at home: cross-correlation coefficient (CC) = 0.6 (p-value <0.001)). Nationally, we also found strong associations between declining mobility and increasing mental health and suicide-related searches (time at home: mood/anxiety CC = 0.53 (<0.001), social stressor CC = 0.51 (<0.001), suicide seeking CC = 0.37 (0.006)). Our findings suggest that pandemic-related isolation coincided with acute economic distress and may be a risk factor for poor mental health and suicidal behavior. These emergent relationships warrant ongoing attention and causal assessment given the potential for long-term psychological impact and suicide death. As US populations continue to face stress, Google search data can be used to identify possible warning signs from real-time changes in distributions of population thought patterns.

A Scoping Review of the Examination of Sandwiched Caregivers’ Psychological Well-being and Physical Health

Caregivers of patients with dementia experience high levels of emotional distress. mHealth interventions have the potential to feasibly address some needs of caregivers and reduce stress. This qualitative research study of (n = 15) caregivers of patients with dementia explored caregivers’ experience using a mindfulness meditation mobile application. The qualitative interviews were guided and structured to allow participants to share their perceived benefits, drawbacks, likes, and dislikes of using mHealth strategies to manage stress and anxiety. We asked about the caregivers' experience with mindfulness before the study, use of the app, their positive/helpful and negative/unhelpful app experiences, the perceived value of the app, and potential enhancements of the app. Caregivers reported that the app was easy to use, engaging and that there were many perceived benefits. They also noted multiple barriers to using the app including time constraints and implementation of mindfulness techniques outside of direct app use. Most of the caregivers recommended using the app to increase knowledge of mindfulness and to reduce stress. Our findings support the growing body of literature on the practical use of mHealth strategies for caregivers. Future work should address the perceived barriers caregivers encounter when using mHealth strategies.

Integrating Psychological Services Into Community-Based Clinics

In Alabama, where mental health stigma is a critical barrier to care, integrated behavioral health services are vital to address the mental health needs that underlie substance use disorder (SUD) and opioid use disorder (OUD). Since October 2019, our team has developed partnerships with one rural and two peri-urban primary care clinics to offer behavioral health services with an emphasis on SUD/OUD prevention, screening, and treatment. The patient populations receiving services at these three facilities are under-resourced with multiple disadvantages placing them at risk for morbidity, mortality, SUD/OUD, and poor behavioral and mental health outcomes. Behavioral health services have been delivered primarily via telehealth due to the COVID-19 pandemic. This presentation will describe the process, current status, and future goals for implementing integrated behavioral health care, with a focus on identifying the barriers and facilitators during the COVID-19 pandemic era.

The Costs of Concern: Health Implications of Worries about Aging Parents and Adult Children

As their parents age and their children enter adulthood, midlife adults need to manage their worries and concerns about both generations. In midlife, worries about aging parents’ health and emerging needs for support co-occur alongside worries about adult children’s relationships and prolonged need for support. Research reveals links between midlife adults’ worry and sleep quality, underscoring how worries compromise health and well-being. In addition to compromising sleep, worries may also contribute to poor health behaviors, such as emotional eating. Emotional eating, where individuals eat in response to stressors and negative emotions, is a significant risk factor for overeating and obesity. Less is known; however, about how midlife adults’ worries contribute to poor health behaviors. To address this gap, the current study considers how midlife adults’ concurrent and previous day’s daily worries about aging parents and adult children are associated with daily well-being and health behaviors. Respondents are midlife adults (40-60 years) from Wave II of the Family Exchanges Study (Fingerman et al., 2009). During 7 days of daily telephone interviews, respondents indicated if they worried about their adult children and their aging parent(s), if they ate food for comfort, and their daily negative mood. Controlling for demographics, on days when midlife adults worried about their adult child(ren), they reported more negative emotions than on days without these worries (p <.05). Respondents engaged in more eating for comfort the day after they reported worrying about their mother (p < .05). Implications for aging families will be discussed.

Psychological stress perceived with respect to general health among urban Indian women

ABSTRACT Women face many sexist constraints globally, increasing the likelihood of psychological stress and related disorders. The present study explores general health constraints among urban Indian women with respect to stress. A cross-sectional study adhering to “strengthening the reporting of observational studies in epidemiology” (STROBE) guidelines was conducted in urban colonies in Delhi. A wide array of women above 18 years of age was recruited, which included students, working professional as well as housewives. General health issues and health behaviors among women were assessed through a questionnaire and stress was evaluated through Cohen’s perceived stress scale (PSS)-10. Overall 532 women were contacted, among which 306 women (mean age = 28.8 ± 7.52) years participated. There was significant difference in mean PSS-10 scores, mean±standard error = −3.3 ± 0.6 and −3.1 ± 0.6; p < .0001 for irregular periods and dysmenorrhea, respectively. Likewise, there was significant difference (Mean± SE = −8.9 ± 0.7; p < .0001) in stress scores among women with chronic respiratory, gastrointestinal, and musculoskeletal pain symptoms. Changes in eating behavior during stress; prolong sitting/standing; and lack of exercise were categorized as ‘negative health behaviors.’ One-way ANOVA showed significant differences in PSS-10 scores (Mean ±SE = −11.3 ± 0.7; p < .0001) among participants exhibiting all “negative health behaviors.” General health issues, not necessarily diagnosed medical condition can be psychological stressors among urban Indian women. Poor health behaviors adapted by urban Indian women like prolong sitting/standing, changes in eating habits during stress, and lack of exercise are associated with increased perception of stress.

Related Factors for Impaired Fasting Glucose in Korean Adults: A Population Based Study

BackgroundIndividuals with impaired fasting glucose (IFG) who have poor health behaviors are at a greater risk for various health outcomes. This study compared the health behaviors and health literacy between individuals with non-IFG and IFG; factors that were associated with IFG were identified by sex.MethodsThis study was an observational study with a cross-sectional design based on data from the Korea National Health and Nutrition Examination Survey (KNHANES) that used a stratified, multi-stage, cluster-sampling design to obtain a nationally representative sample. This study analyzed the KNHANES Health Examination Survey and Health Behavior Survey from 2016 to 2018 (N=9919). Multiple logistic regression analysis was employed to compute the odds ratios of health behaviors and health literacy to identify the risk factors for IFG.ResultsThe prevalence of IFG among the total was 29.0% (weighted n=2826, 95% CI 27.8–30.2). In the IFG group, 63.6% were male and 36.4% were female (X2=320.57, p<.001). In multiple logistic regression by sex, the factors associated with IFG in male were as follows: age (50s; OR=2.36, 95% CI 1.79–3.13), high BMI (OR=2.27, 95% CI 1.78–2.90), frequent drinking (OR=1.83, 95% CI 1.23–2.72), and using nutrition fact labels (OR=1.35, 95% CI 1.05–1.75). Low economic status (OR=4.18, 95% CI 1.57–11.15) and high BMI (OR=2.35, 95% CI 1.29–4.28) were the affecting factors in female. On the other hand, employment status, perceived stress, and job type were not related to IFG in both male and female.ConclusionsStrategies should be targeted to improve health behaviors and health literacy for those in their 40s and 60s, male in shift work, those who frequently dine out, overweight male, female with low economic statuses, and frequent drinkers. Moreover, healthcare providers should understand the barriers to health behaviors and literacy to effectively deliver healthcare service.

Associations between Experiences of Police Contact and Discrimination by the Police and Courts and Health Outcomes in a Representative Sample of Adults in New York City

Communities marginalized because of racism, heterosexism, and other systems of oppression have a history of being aggressively policed, and in those contexts, researchers have observed associations between a range of negative experiences with police and poor physical, mental, and behavioral health outcomes. However, past studies have been limited in that experiences of police contacts were aggregated at the neighborhood level and, if police contacts were self-reported, the sample was not representative. To address these limitations, we employed NYC Department of Health and Mental Hygiene 2017 Social Determinants of Health Survey (n = 2335) data to examine the associations of self-reported police contacts and discrimination by police and the courts with measures of physical (poor physical health), mental (poor mental health, serious psychological distress), and behavioral health (binge drinking). Residents marginalized because of racial, ethnic, and sexual minority status were more likely to be stopped, searched, or questioned by the police; threatened or abused by the police; and discriminated against by the police or in the courts; those experiences were associated with poor physical, mental, and behavioral health outcomes. The associations between experiences with police and poor health outcomes were strongest among Black residents and residents aged 25–44. Our findings suggest that the health of NYC residents who have had exposure to police and experienced discrimination by the police and courts is poorer than those who have not, and build on a growing body of evidence that aggressive policing practices have implications for public health.

Intuitive eating buffers the link between internalized weight stigma and body mass index in stressed adults

Internalized weight stigma (IWS) is independently associated with less intuitive eating (i.e., eating based on endogenous hunger/satiety cues) and higher Body Mass Index (BMI), and intuitive eating training is commonly conceptualized as protective against the effects of IWS on poor behavioral health. The 3-way relationship between IWS, intuitive eating, and BMI has yet to be examined, and it is unclear whether the link between IWS and BMI is buffered by high intuitive eating. This secondary preliminary analysis examined baseline data of stressed adults with poor diet (N = 75, 70% female, 64.1% White, 42.7% with overweight/obesity) in a parent clinical trial that tested the effects of yoga on diet and stress. Validated self-report surveys of IWS and intuitive eating were analyzed with objectively-assessed BMI. Moderated regression analyses using the SPSS PROCESS macro tested whether intuitive eating moderated the IWS-BMI link. The analysis revealed IWS was positively associated with BMI except among people with high intuitive eating. Results extend observational findings linking intuitive eating to lower BMI, and offer preliminary support for the hypothesis that this link may hold even among those with greater IWS. It's possible that individuals with lower BMI and greater IWS may gravitate more towards intuitive eating than those with greater BMI, and/or intuitive eating may be an important target for ameliorating the adverse association of IWS with behavioral and physical health indicators linked to BMI. Continued work is warranted in larger, more generalizable samples using causal and prospective designs.

Loneliness: An Immunometabolic Syndrome.

Loneliness has been defined as an agonizing encounter, experienced when the need for human intimacy is not met adequately, or when a person’s social network does not match their preference, either in number or attributes. This definition helps us realize that the cause of loneliness is not merely being alone, but rather not being in the company we desire. With loneliness being introduced as a measurable, distinct psychological experience, it has been found to be associated with poor health behaviors, heightened stress response, and inadequate physiological repairing activity. With these three major pathways of pathogenesis, loneliness can do much harm; as it impacts both immune and metabolic regulation, altering the levels of inflammatory cytokines, growth factors, acute-phase reactants, chemokines, immunoglobulins, antibody response against viruses and vaccines, and immune cell activity; and affecting stress circuitry, glycemic control, lipid metabolism, body composition, metabolic syndrome, cardiovascular function, cognitive function and mental health, respectively. Taken together, there are too many immunologic and metabolic manifestations associated with the construct of loneliness, and with previous literature showcasing loneliness as a distinct psychological experience and a health determinant, we propose that loneliness, in and of itself, is not just a psychosocial phenomenon. It is also an all-encompassing complex of systemic alterations that occur with it, expanding it into a syndrome of events, linked through a shared network of immunometabolic pathology. This review aims to portray a detailed picture of loneliness as an “immunometabolic syndrome”, with its multifaceted pathology.

The severity of facial burns, dental caries, periodontal disease, and oral hygiene impact oral health-related quality of life of burns victims in Pakistan: a cross-sectional study

BackgroundA burn to the face and neck area leaves a visible scar that impacts the victims physically and psychologically. This report was aimed to examine the factors associated with oral health-related quality of life (OHRQoL) in patients with a facial burn injury.MethodsPatients with facial burn who attended the Burn Care Centre in Islamabad, Pakistan were systematically and randomly invited to participate in this cross-sectional study. They underwent extra- and intra-oral examinations and, completed self-administered instruments in the Urdu language. The severity of disfigurement, dental caries experience (DMFT), periodontal disease (CPI) and oral hygiene (OHI-S) statuses were assessed. The validated instruments collected information relating to sociodemographic background, oral health behaviours, OHRQoL and satisfaction with appearance (SWAP). Information relating to the time of the incident, cause and severity (type, TBSA) of the burn were obtained from medical records. The OHRQoL prevalence of impact and severity measures were derived and analysed using simple and multiple, logistic and linear regression.ResultsA total of 271 patients had participated in the study. The OHIP-14 prevalence of impact was 94% with mean severity score = 37 unit (sd = 8.5). The most impacted domains were physical pain (87%), psychological disability (87%), social disability (85%) and physical discomfort (83%). The main determinants of oral health-related quality of life were poor clinical oral conditions - particularly caries, and severity deformity. Other risk factors included poor oral health behaviours, psychological distress and longer time elapsed since the incident, and sex (p < 0.05).ConclusionDental caries, the severity of the facial deformity, oral health behaviour and time are associated with oral health-related quality of life of patients with facial burns. Oral health behaviour improvement can lower the risk of developing dental problems and oral health-related quality of life impact.

Regularity and Timing of Sleep Patterns and Behavioral Health Among Adolescents.

Sleep is vital to supporting adolescent behavioral health and functioning; however, sleep disturbances remain under-recognized and undertreated in many health care settings. One barrier is the complexity of sleep, which makes it difficult for providers to determine which aspects-beyond sleep duration-may be most important to assess and treat to support adolescent health. This study examined associations between 2 sleep indices (regularity and timing) and adolescent behavioral health and functioning over and above the impact of shortened/fragmented sleep. Eighty-nine adolescents recruited from the community (mean age = 14.04, 45% female participants) completed 7 days/nights of actigraphy and, along with a parent/guardian, reported on behavioral health (internalizing and externalizing symptoms) and psychosocial functioning. Stepwise linear regressions examined associations between sleep timing and regularity and behavioral/functional outcomes after accounting for shortened/fragmented sleep. Delayed sleep timing was associated with greater self-reported internalizing (F[6,82] = 11.57, p = 0.001) and externalizing (F[6,82] = 11.12, p = 0.001) symptoms after accounting for shortened/fragmented sleep. Irregular sleep was associated with greater self-reported and parent-reported externalizing symptoms (self: F[7,81] = 6.55, p = 0.01; parent: F[7,80] = 6.20, p = 0.01) and lower psychosocial functioning (self: F[7,81] = 6.03, p = 0.02; parent: F[7,78] = 3.99, p < 0.05) after accounting for both shortened/fragmented sleep and delayed sleep timing. Sleep regularity and timing may be critical for understanding the risk of poor behavioral health and functional deficits among adolescents and as prevention and intervention targets. Future work should focus on developing and evaluating convenient, low-cost, and effective methods for addressing delayed and/or irregular adolescent sleep patterns in real-world health care settings.

Relationships between fear of cancer recurrence, anxiety and worry, and health behaviors and health service use: a systematic review

Abstract Background: This systematic review was conducted to improve our understanding of the relationship between fear of cancer recurrence (FCR), anxiety and worry, and engagement in health behaviors and/or health service use. Methods: A systematic review following PRISMA methodology was performed to identify any publications that examined FCR, anxiety and worry, and health behaviors and/or health service use in the following databases: PubMed, CINAHL, and PsychINFO from January 1990 to April 2021. Quality was assessed using QualSyst, a standard quality assessment for evaluating primary research articles. Results: Seventy articles met the inclusion criteria, but the outcomes were too heterogeneous to combine in statistical meta-analysis. The measurement of FCR also varied widely and was inconsistent across studies. Among FCR specific measures, 36% used some version of the Fear of Cancer Recurrence Inventory. Prevention and detection of new and recurrent cancers accounted for 60% of all included studies, with the most frequently examined health behaviors being smoking status (17%) and physical activity (16%). Most associations indicated a significant relationship between FCR and current smoking, with those who are currently smoking experiencing higher levels of FCR. Relatively few studies explored the relationship between FCR and surveillance. Associations categorized under Interventions for Late Effects included a range of health services use with largely mixed results. Overall, studies had moderate to high quality. Conclusions: Given the measurement heterogeneity of FCR, future research would benefit from consistent operationalization and measurement. Some evidence suggests that FCR is associated with poor health behaviors. More studies are needed examining the relationship between FCR and surveillance. Research and clinical interventions may choose to focus on early post-treatment survivorship, given greater opportunities for support and intervention around FCR and other psychosocial concerns.

Examining Health Behaviors of Chronic Disease Caregivers in the U.S.

Many informal caregivers experience a significant caregiving burden, which may interfere with their health behaviors. Caregiver health behaviors may vary by disease context, but this has rarely been studied. This study compares the health behaviors of prevalent groups of chronic illness caregivers (i.e., dementia, cancer, chronic obstructive pulmonary disease/emphysema, diabetes) with those of noncaregivers and examines whether caregiving intensity is associated with these behaviors. In 2021, using pooled cross-sectional 2015-2019 Behavioral Risk Factor Surveillance System data, health behaviors (i.e., physical activity, diet, alcohol use, smoking, sleep, and influenza immunization) of caregivers of patients with dementia (n=5,525), cancer (n=4,246), chronic obstructive pulmonary disease/emphysema (n=1,959), and diabetes (n=2,853) and noncaregivers (n=203,848) were compared. Relationships between caregiving intensity (e.g., hours, type of tasks) and caregiver health behaviors were examined. Regression analyses were used to compare groups. Compared with noncaregivers, caregiver groups were more likely to report engaging in both risky (i.e., smoking, shorter sleep duration) and health-promoting (i.e., physical activity, vegetable consumption, abstaining from heavy drinking) behaviors, whereas nonsignificant differences were observed for influenza immunization. Longer caregiving hours and providing help with personal care were associated with poorer health behaviors (e.g., shorter sleep duration). Few differences in health behaviors were observed between caregivers of patients with dementia and other caregiver groups. Results suggest that caregivers are more likely to engage in both risky and health-promoting behaviors than noncaregivers. Furthermore, findings suggest that greater caregiving responsibilities are associated with certain risky health behaviors. Findings support the development and implementation of strategies to improve caregivers' health behaviors across disease contexts.

Increased Smoking Cessation Among Veterans With Large Decreases in Posttraumatic Stress Disorder Severity.

Improvement in posttraumatic stress disorder (PTSD) is associated with better health behavior such as better medication adherence and greater use of nutrition and weight loss programs. However, it is not known if reducing PTSD severity is associated with smoking cessation, a poor health behavior common in patients with PTSD. Veterans Health Affairs (VHA) medical record data (2008-2015) were used to identify patients with PTSD diagnosed in specialty care. Clinically meaningful PTSD improvement was defined as ≥20 point PTSD Checklist (PCL) decrease from the first PCL ≥50 and the last available PCL within 12 months and at least 8 weeks later. The association between clinically meaningful PTSD improvement and smoking cessation within 2 years after baseline among 449 smokers was estimated in Cox proportional hazard models. Entropy balancing controlled for confounding. On average, patients were 39.4 (SD = 12.9) years of age, 86.6% were male and 71.5% were white. We observed clinically meaningful PTSD improvement in 19.8% of participants. Overall, 19.4% quit smoking in year 1 and 16.6% in year 2. More patients with versus without clinically meaningful PTSD improvement stopped smoking (n = 36, cumulative incidence = 40.5% vs. 111, cumulative incidence = 30.8%, respectively). After controlling for confounding, patients with versus without clinically meaningful PTSD improvement were more likely to stop smoking within 2 years (hazard ratio = 1.57; 95% confidence interval: 1.04-2.36). Patients with clinically meaningful PTSD improvement were significantly more likely to stop smoking. Further research should determine if targeted interventions are needed or whether improvement in PTSD symptoms is sufficient to enable smoking cessation. Patients with PTSD are more likely to develop chronic health conditions such as heart disease and diabetes. Poor health behaviors, including smoking, partly explain the risk for chronic disease in this patient population. Our results demonstrate that clinically meaningful PTSD improvement is followed by greater likelihood of smoking cessation. Thus, PTSD treatment may enable healthier behaviors and reduce risk for smoking-related disease.

Behavioral diversity as a potential positive indicator of animal welfare in bottlenose dolphins.

Accredited zoological facilities are committed to fully understanding the behavioral, mental, and physical needs of each species to continuously improve the welfare of the animals under their professional care and detect when welfare has diminished. In order to accomplish this goal, internally consistent and externally valid indicators of animal welfare are necessary to advance our understanding of the current welfare status of individual animals. Historically, efforts have focused on monitoring visible or observable signs of poor health or problem behavior, but lack of signs or problems does not necessarily demonstrate that an individual animal is thriving. The current study examined fecal hormone metabolite levels and behavior for two species of bottlenose dolphins (Tursiops truncatus and Tursiops aduncus) from 25 different accredited zoological facilities. At the time of the study, all facilities were accredited by the Alliance of Marine Mammal Parks and Aquariums and/or the Association of Zoos and Aquariums. This was part of the multi-institutional study ‘Towards understanding of the welfare of cetaceans in zoos and aquariums” commonly referred to as the Cetacean Welfare Study. Behavioral diversity was calculated using the Shannon Diversity Index on species-appropriate behavioral events. Behavioral diversity was compared to the fecal metabolites of cortisol, aldosterone, and the ratio of cortisol to dehydroepiandrosterone (DHEA) as well as the stereotypic behavior of route tracing. Similar to previous studies on other species, there was a significant inverse relationship between behavioral diversity and both fecal cortisol metabolites and route tracing. Additionally, a significant inverse relationship also exists between behavioral diversity and the ratio of fecal cortisol to DHEA metabolites. Behavioral diversity and fecal aldosterone metabolites were not associated. Additional research is still needed to validate behavioral diversity as an indicator of positive animal welfare for bottlenose dolphins and across species. However, based on current results, facilities could utilize behavioral diversity combined with other measures of welfare to more comprehensively evaluate the welfare of bottlenose dolphins.

Taxi drivers and modifiable health behaviors: Is stress associated?

Taxi drivers, an immigrant male population, may exhibit poor health behaviors and increased health risks. The current study examined stress and demographics as predictors of physical activity (PA), nutrition, sleep, and smoking, and the co-occurrence of these behaviors among taxi drivers. A cross-sectional needs assessment was conducted in New York City. The sample (n = 252) was comprised of male taxi drivers, 98%of whom were born outside of the U.S., with the majority from South Asian countries (62%), and 45 years old on average (SD = 11). We found low rates of fruit/vegetable consumption and PA. Rates of stress, PA, and smoking varied by demographic factors. Stress was positively associated with sleep disturbances and negatively associated with smoking. Aside from a relationship between sugar consumption and smoking, other health behaviors were not associated. While stress appears to impact some indicators of modifiable health behaviors, its lack of relationship with others points to more persistent health issues. Demographic differences found for PA and smoking also point to groups that may especially benefit from interventions. These findings suggest the need for targeted health interventions for taxi drivers in large metropolitan cities.

Neighborhood deprivation and epigenetic aging

BACKGROUND AND AIM: Recent research suggests widening socioeconomic disparities in life expectancy in the United States. Both individual-level and small-area socioeconomic status factors, such as living in a socioeconomically disadvantaged neighborhood, are independently associated with early onset of age-related disease, reduced life expectancy and all-cause mortality. Neighborhood deprivation may increase the risk of early onset of age-related disease, reduced life expectancy, and all-cause mortality. Mechanisms linking neighborhood deprivation and age-related disease are multifactorial and complex. Residence in a deprived neighborhood can lead to poor health behaviors, increased toxicant exposures, lack of access to health services, and low social cohesion. Living in a deprived neighborhood can also lead to chronic stress and induce biological weathering on endocrine and inflammatory systems. METHODS: Emerging evidence suggests epigenetics may be implicated in biological mechanisms underpinning this relationship. DNA methylation is the most well-understood epigenetic factor and involves the addition of a methyl group to DNA, typically at the 5-carbon of cytosine at cytosine-guanine (CpG) dinucleotides. Recently developed ‘epigenetic clocks’ are a class of biological age predictors that use DNA methylation at predetermined CpG sites to measure biological variation among those with the same chronologic age. These clocks are better at predicting chronologic age than other markers including telomere length and may be a more sensitive measure of biologic aging. RESULTS:This presentation will focus on recent findings of the association between neighborhood deprivation and epigenetic measures of age acceleration from the Sister Study, a prospective breast cancer cohort study. CONCLUSIONS:Findings from this study suggest that residing in a neighborhood with higher deprivation is associated with methylation-based markers of aging. African American/Black women in the U.S. may be more likely to live in disadvantaged neighborhoods. Planned research focused on methylation patterns in African American/Black individuals will allow researchers to evaluate how neighborhood disadvantage and methylation changes contribute to health disparities. KEYWORDS: ‘Advancing racial health equity through studies of the environment and epigenetic aging’, neighborhood environment, epigenetics, aging

Nonmedical Determinants of Congenital Heart Diseases in Children from the Perspective of Mothers: A Qualitative Study in Iran.

Introduction Mortality due to noncommunicable diseases has increased in the world today with the advent of demographic shifts, growing age, and lifestyle patterns in the world, which have been affected by economic and social crises. Congenital heart defects are one of the forms of diseases that have raised infant mortality worldwide. The objective of present study was to identify nonmedical determinants related to this abnormality from the mother's perspectives. Methods This research was a qualitative study and the data collection method was a semistructured interview with mothers who had children with congenital heart diseases referring to the Shahid Rajaei Heart Hospital in Tehran, Iran. A thematic analysis approach was employed to analyze transcribed documents assisted by MAXQDA Plus version 12. Results Four general themes and ten subthemes including social contexts (social harms, social interactions, and social necessities), psychological contexts (mood disorders and mental well-being), cultural contexts (unhealthy lifestyle, family culture, and poor parental health behaviors), and environmental contexts (living area and polluted air) were extracted from interviews with mothers of children with congenital heart diseases. Conclusions Results suggest that factors such as childhood poverty, lack of parental awareness of congenital diseases, lack of proper nutrition and health facilities, education, and lack of medical supervision during pregnancy were most related with the birth of children with congenital heart disease from mothers' prospective. In this regard, targeted and intersectorial collaborations are proposed to address nonmedical determinants related to the incidence of congenital heart diseases.

Knowledge of Non-Communicable Diseases and Risk Factors among Final Year Students in a Tertiary Institution

Background and Objective: Chronic or non-communicable diseases (NCDs) are rapidly emerging as leading causes of morbidity and premature mortalities globally, with greater effect being felt in low and middle income nations. As poor health behaviours practised in youthful years have been implicated in developing NCDs in later years in life, It is important to understand the level of awareness of young people regarding NCDs in order to remedy any knowledge gaps and encourage healthy practices among them that will reduce the burden of these diseases in later life. This study seeks to describe the knowledge of two groups of final year students of a tertiary institution in Nigeria on the awareness and knowledge of non-communicable diseases and their risk factors.&#x0D; Methods: The study was designed as a cross-sectional survey at the University of Lagos, Nigeria during the 2017/2018 academic session. A sample size of 422 final year students were used with convenient stratification. Self administered questionnaires was distributed to the class of students who consented to participating in the study. The questionnaires were used to assess the level of awareness of the students of non communicable diseases and their risk factors. Data obtained from the questionnaires was analyzed using SPSS version 21.&#x0D; Results: A result of 94.7% was obtained. The results show 89.5% versus 65% of students in health related discipline (college of medicine campus) and those in Akoka campus respectively had good knowledge of NCDs and their risk factors while 10.5% versus 35% had poor knowledge.&#x0D; Conclusion: Students in the campus of college of medicine had more knowledge of NCDs and their risk factors. Campus location of students had statistically significant relationship with awareness and knowledge on NCDs. (p, &lt;0.05).