Rates Of Poor Health Research Articles

How do multimorbidity and lifestyle factors impact the perceived health of adults with intellectual disabilities?

Adults with intellectual disability (ID) have poorer physical and perceived health than the general population. Knowledge of perceived health predictors is both limited and important for guiding the development of preventive actions. The aims of this study were to investigate (1) the associations between perceived health and demographics, degree of ID, physical health conditions, and weight and physical activity level and (2) lifestyle factors and multimorbidity as predictors for perceived health adjusted for age, gender, and level of ID. The North Health in Intellectual Disability study is a community based cross-sectional survey. The POMONA-15 health indicators were used. Univariate and multivariate logistic regression analyses with poor versus good health as the dependent variable were applied. The sample included 214 adults with a mean age 36.1 (SD 13.8) years; 56% were men, and 27% reported perceiving their health as poor. In univariate analyses, there were significant associations between poor health ratings and female gender, lower motor function, number of physical health conditions and several indicators of levels of physical activity. In the final adjusted model, female gender [odds ratio (OR) 2.4, P<0.05], level of ID (OR 0.65, P<0.05), numbers of physical health conditions (OR 1.6, P<0.001) and lower motor function (OR 1.5 P<0.05) were significant explanatory variables for poor perceived health, with a tendency to independently impact failure to achieve 30min of physical activity daily (OR 2.0, P=0.07). Adults with ID with female gender, reduced motor function and more physical health conditions are at increased risk of lower perceived health and should be given attention in health promoting interventions. A lack of physical activity tends to negatively influence perceived health.

Complementary feeding practices of tribal mothers to their Infants and Young Children in Kerala

ProblemAs WHO recommends, timely and optimal introduction of complementary feeding (CF) at 6th month as it complements additional energy and growth needs of young children. We know relatively little about CF practices of tribal mothers in the context of high rate of poor health and under nutrition in tribal children of Kerala. This study therefore examined the factors influencing CF practices to tribal infants and young children. MethodsWe conducted a community based cross-sectional survey of 1150 tribal mother-infant pairs from five districts. We used pre-tested interview schedule for data collection. Alongside descriptive statistics, we used multiple linear regression for data analyses. ResultsAround 76.2% continued BF at 6th month, 62.7% introduced CF at 6th month, 22.7% children received low or potentially harmful CF, 48.4% children received harmful CF and merely 8.6% received optimal CF. The maternal education, marital status, age at first pregnancy optimized CF and occupational status, hours of work per day, work status before pregnancy and age at marriage were inversely associated with 40% of variance (R2 = 0.40). Tribal mothers' breastfeeding duration and frequency of child bathing significantly increased optimal CF and children’ age at CF initiation. The poor breastfeeding at public place inversely associated with 44.7% variance (R2 = 0.447). Tribal mothers’ perceived difficulty for breastfeeding at public space increased CF scores and mothers who early initiated CF were more likely to feed children less-optimal (R2 = 0.365). ConclusionTribal mothers practice predominantly poor and potentially harmful CF to young children aged 6–24 months.

Giving women WOICE postpartum: prevalence of maternal morbidity in high-risk pregnancies using the WHO-WOICE instrument

BackgroundThere are no accurate estimates of the prevalence of non-severe maternal morbidities. Given the lack of instruments to fully assess these morbidities, the World Health Organization (WHO) developed an instrument called WOICE. We aimed to evaluate the prevalence of non-severe maternal morbidities in puerperal women and factors associated to impaired clinical, social and mental health conditions.MethodA cross-sectional study with postpartum women at a high-risk outpatient clinic in southeast Brazil, from November 2017 to December 2018. The WOICE questionnaire included three sections: the first with maternal and obstetric history, sociodemographic data, risk and environment factors, violence and sexual health; the second considers functionality and disability, general symptoms and mental health; and the third includes data on physical and laboratory tests. Data collection was supported by Tablets with REDCAP software. Initially, a descriptive analysis was performed, with general prevalence of all variables contained in the WOICE, including scales on anxiety and depression (GAD-7 and PHQ-9- impaired if ≥10), functionality (WHODAS- high disability scores when ≥37.4) and data on violence and substance use. Subsequently, an evaluation of cases with positive findings was performed, with a Poisson regression to investigate factors associated to impaired non-clinical and clinical conditions.ResultsFive hundred seventeen women were included, majority (54.3%) multiparous, between 20 and 34 years (65.4%) and with a partner (75,6%). Over a quarter had (26.2%) preterm birth. Around a third (30.2%) reported health problems informed by the physician, although more than 80% considered having good or very good health. About 10% reported any substance use and 5.9% reported exposure to violence. Anxiety was identified in 19.8% of cases, depression in 36.9% and impaired functioning in 4.4% of women. Poisson regression identified that poor overall health rating was associated to increased anxiety/depression and impaired functioning. Having a partner reduced perception of women on the presence of clinical morbidities.ConclusionDuring postpartum care of a high-risk population, over one third of the considered women presented anxiety and depression; 10% reported substance use and around 6% exposure to violence. These aspects of women’s health need further evaluation and specific interventions to improve quality of care.

Critical Care Nurses' Physical and Mental Health, Worksite Wellness Support, and Medical Errors.

Critical care nurses experience higher rates of mental distress and poor health than other nurses, adversely affecting health care quality and safety. It is not known, however, how critical care nurses' overall health affects the occurrence of medical errors. To examine the associations among critical care nurses' physical and mental health, perception of workplace wellness support, and self-reported medical errors. This survey-based study used a cross-sectional, descriptive correlational design. A random sample of 2500 members of the American Association of Critical-Care Nurses was recruited to participate in the study. The outcomes of interest were level of overall health, symptoms of depression and anxiety, stress, burnout, perceived worksite wellness support, and medical errors. A total of 771 critical care nurses participated in the study. Nurses in poor physical and mental health reported significantly more medical errors than nurses in better health (odds ratio [95% CI]: 1.31 [0.96-1.78] for physical health, 1.62 [1.17-2.29] for depressive symptoms). Nurses who perceived that their worksite was very supportive of their well-being were twice as likely to have better physical health (odds ratio [95% CI], 2.16 [1.33-3.52]; 55.8%). Hospital leaders and health care systems need to prioritize the health of their nurses by resolving system issues, building wellness cultures, and providing evidence-based wellness support and programming, which will ultimately increase the quality of patient care and reduce the incidence of preventable medical errors.

Violence predicts physical health consequences of human trafficking: Findings from a longitudinal study of labor trafficking in Ghana

Research consistently finds high rates of both poor physical health and violent victimization among survivors of human trafficking. While this literature documents the immediate effects of human trafficking on health, no published literature has compared short- and longer-term physical health consequences of trafficking or examined the role of violence in shaping physical health outcomes across the period of reintegration. Here, we utilize longitudinal data to document the prevalence of various forms of violence experienced by women and girls trafficked for labor in Ghana, as well as examine the effects of violence on self-reported physical health conditions at two time points following exit from trafficking. Consistent with the stress process model, we find a higher prevalence of physical health complaints during the second wave of data collection, suggesting a delayed somatization effect. We also find that while psychological violence has a strong effect on the number of physical health complaints in the period immediately after exit from trafficking, sexual violence experienced while being trafficked is most predictive of physical health complaints later in the reintegration period. These findings have implications for understanding the role of violence, more generally, in shaping physical health. Our research also suggests the importance of monitoring the physical health of trafficking survivors beyond the immediate post-trafficking period and of providing on-going access to healthcare.

Parent Feeding Practices in the Context of Food Insecurity.

The process of feeding is complex and highly dependent on parent, child, social, and environmental factors. Given the rising rates of food insecurity and concomitant poor nutrition and health, the purpose of this article was to outline the important and complex ways in which the context of food insecurity can impact parent feeding practices. Key factors discussed here include the impact of food insecurity on: expectations for motherhood, structural constraints, stress and depression, parents’ perceptions of health and child weight, and intergenerational transmission of parent feeding practices. Future research needs are also identified and discussed.

Aircraft Noise Levels, Annoyance and General Health of Residents of Communities contiguous to a Major Airport in Lagos State

The purpose of this study was to investigate the relationship between the aircraft noise exposure, annoyance reactions and health status of the residents living within the vicinity of the Murtala Muhammed International Airport (MMA) in Lagos state, Nigeria. Aircraft noise monitoring was conducted in five locations within the vicinity (0-5Km) of MMA, and a sixth distant location (14km away). Levels of aircraft noise for all five locations within the vicinity of the airport exceeded the EPA Victoria threshold of 75 dB LAmax for the residential area (outdoor). A survey on annoyance induced by aircraft noise exposure and general health status was conducted on 450 local residents in the study locations using the International Commission on Biological Effect of Noise question and a single question that has been applied in Dutch national health care surveys since 1983 on self-reported general health status respectively. Percentage of residents within the vicinity of MMA that were highly annoyed (%HA) exceeded 15% guideline limit stipulated by Federal Interagency Committee on Urban Noise while 14.5% reported poor health status. There was a significant association between the annoyance reactions and aircraft noise levels in the study locations while the association between self-reported health status and aircraft noise levels was not significant. Taken together, the residents within the vicinity of the airport are exposed to aircraft noise levels above permissible limit which may be associated with high annoyance reaction but may not be associated with poor health rating. Evidence-based aircraft noise related policies by government are advocated.

Self-Related Views of Aging After Age 50: The Long-Term Effects of Poor Health in Childhood

Age stereotypes and expectations about one’s own aging commence in childhood but most research focuses on predictive associations with midlife health behaviors, later-life chronic conditions, and longevity. Surprisingly little is known about the role of poor childhood health in these associations. This study aims to fill this gap. Using data from the Health and Retirement Study (HRS: N = 5807; aged 50-98), we investigated whether diagnosed chronic illness before age 16 and self-rated childhood health predict late-life self-perceptions of aging (SPA) and subjective age discrepancy (AD). We conducted multivariate multiple regressions to determine the joint and unique effects of childhood health. Models included controls for current health (functional limitations), memory status, and demographic covariates (age, gender, race/ethnicity, marital status, and education). Multivariate tests (Pillai’s trace) revealed that both childhood health indicators were significant predictors. Over and above all covariates and the covariation of the two views of one’s own aging, univariate models showed that the number of childhood diagnoses was significant predictor of AD (p < .007) but not for SPA. In contrast, self-rated childhood health was a significant predictor of SPA (p < .001) but not for AD. This study provides new insight into precursors of self-evaluations of aging. Whereas childhood diagnoses of chronic illness attenuated the extent that individuals felt younger than their actual age, ratings of poor childhood health enhanced negative SPA. The non-normative experience of poor health in early life is a lifelong foundation for both late life beliefs and health.

Early adversity and children's emotion regulation: Differential roles of parent emotion regulation and adversity exposure.

Exposure to early life adversity (ELA) is associated with increased rates of psychopathology and poor physical health. The present study builds on foundational work by Megan Gunnar identifying how ELA results in poor long-term outcomes through alterations in the stress response system, leading to major disruptions in emotional and behavioral regulation. Specifically, the present study tested the direct effects of ELA against the role of parent socialization to shed light on the mechanisms by which ELA leads to emotion regulation deficits. Children ages 4-7 years (N = 64) completed interviews about their experiences of deprivation and threat, a fear conditioning and extinction paradigm, and an IQ test. Parents of the children completed questionnaires regarding their own emotion regulation difficulties and psychopathology, their children's emotion regulation, and child exposure to adversity. At the bivariate level, greater exposure to threat and parental difficulties with emotion regulation were associated with poorer emotion regulation in children, assessed both via parental report and physiologically. In models where parental difficulties with emotion regulation, threat, and deprivation were introduced simultaneously, regression results indicated that parental difficulties with emotion regulation, but not deprivation or threat, continued to predict children's emotion regulation abilities. These results suggest that parental socialization of emotion is a robust predictor of emotion regulation tendencies in children exposed to early adversity.

Working-age adults using food banks in England have significantly poorer health and higher rates of mental health conditions than adults in the general population: A cross-sectional quantitative study.

Food bank use has risen rapidly in the UK since 2010. The negative health impacts of food insecurity are well-documented, but there is a lack of quantitative research exploring the health of people using food banks, who are most often severely food insecure. To address this gap, this study compares health outcomes between working-age adults using food banks and those in the general population in England, investigating whether adults using food banks are disproportionately affected by poor health, even after accounting for socioeconomic differences. Data from a survey of 598 adults using Trussell Trust food banks in 2016-2017 were merged with data from the Health Survey for England (HSE) from 2016. Outcome variables of interest were: self-rated health, life-limiting health conditions (disability) and self-reported metabolic, cardiovascular, musculoskeletal and mental health conditions. Logistic regression models were used to examine the odds of adults using food banks having health conditions, disability and poor self-rated health compared to the general population. The prevalence rates of poor self-rated health, disability, mental health disorders and musculoskeletal conditions were significantly higher among adults using food banks than the general population (p<.05 for all outcomes). These associations remained after accounting for gender, age, marital status, employment and education. This comparative study highlights the many health disadvantages among adults using food bank compared to the general population. The higher risk of poor self-rated health, disability and mental health conditions was not fully explained by measures of low socioeconomic status. Possible explanations for these findings include: first, that poor health may increase vulnerability to food insecurity, and, in turn, use of food banks; second, that experiences of food insecurity and food bank use may cause declines in health; and third, that food bank use and poor health may be joint outcomes arising from the last decade of austerity in the UK.

Options and realities for trans and gender diverse young people receiving care in Australia's mental health system: findings from Trans Pathways.

Trans and gender diverse young people experience mental health difficulties self-harm and suicidality at markedly higher rates than the general population, yet they often feel isolated from mental health services. There is little qualitative research on the experiences of trans and gender diverse young people accessing mental health support in Australia. The objective of this study was to comprehensively explore the experiences of trans and gender diverse young people in Australia who have sought mental health support from therapists, counsellors, psychiatrists and/or inpatient care providers. We report on findings from the Trans Pathways study, which was a mixed-methods study to evaluate the experiences of trans and gender diverse young people accessing mental health services: specifically, therapy and counselling services, psychiatric services and mental health inpatient services. A total of 859 trans and gender diverse young people aged 14-25 years across Australia completed an anonymous online questionnaire. Therapy and/or counselling services (64.4%) were most frequently sought by trans and gender diverse young people in this study, followed by psychiatric services (43.0%) and mental health inpatient services (12.3%). The findings demonstrated that many mental health professionals lacked expertise in gender diversity, and that trans and gender diverse young people found it difficult to locate mental health professionals who were able to meet their needs in a timely manner. These findings indicate that training is necessary for all mental health professionals to improve their knowledge of gender diversity, enhance the support provided to trans and gender diverse young people and help to address the high rates of poor mental health. The findings outlined here provide insight into the areas in which clinicians could optimise their care of trans and gender diverse young people.

The impact of adverse childhood experiences on the health and health behaviors of young Australian women

BackgroundAdverse childhood experiences have been linked to poor health and adverse health behavior in adulthood. ObjectiveThis study aimed to estimate the prevalence of adverse childhood experiences among young Australian women (aged 20–25) and examine associations between adverse childhood experiences and adult health behaviors and physical and mental health. Participants and SettingsData were from the 1989−95 cohort of the Australian Longitudinal Study on Women’s Health, who completed the Adverse Childhood Experiences Scale at Survey 3 in 2015 (N = 8609). MethodsOutcomes included: self-rated health, sexual health, psychological distress, depression, anxiety, suicide ideation, self-harm, substance abuse (drinking, smoking, illicit drugs), severe obesity, and exercise. Prevalence of childhood adversities were presented, with the association between childhood adversity and outcomes evaluated using log-binomial multivariable regressions (99% CI). ResultsWhile 59% of women reported experiencing at least one childhood adversity, 10% of participants reported adverse childhood experiences across four or more categories, indicating a significant burden of risk for young Australian women. Women reporting four or more categories had higher rates of poor physical health (adjPR = 1.79, 99% CI = 1.51–2.12), sexually transmitted infections (adjPR = 1.36, 99% CI = 1.11–1.67), and poor mental health (adjPR = 2.78, 99% CI = 2.34–3.32), and increased rates of severe obesity (adjPR = 2.14, 99% CI = 1.61–2.86) and smoking (adjPR = 2.23, 99% CI = 1.89–2.64). ConclusionUsing nationally representative data, this study shows adverse childhood experiences directly impact physical and mental health, and health behaviors in adulthood among young Australian women. The management of health and wellbeing in adulthood should look beyond the contemporaneous factors, incorporating a focus on how childhood adversity may negatively influence health behavior, health and wellbeing in later life.

Depression, posttraumatic stress disorder (PTSD) and their comorbidity: Implications of adversity amongst young women living in informal settlements in Durban, South Africa

• Informal settlements have exceedingly high rates of depression, PTSD and comorbid PTSD-depression. • Compared to women with ‘just’ depression, those with comorbid PTSD-depression reported more disability, childhood trauma and lifetime trauma experience. • Belonging to a social group was protective against depression and comorbid PTSD-depression. • Group-based interventions should be considered in treatment of depression and PTSD. Informal settlements have high rates of poor mental health, yet little research has looked at PTSD-depression co-occurrence in these settings. We investigated the prevalence of depression, PTSD, and comorbid PTSD-depression amongst a non-clinical sample of 18–30 year old women, in informal settlements in South Africa. Cross-sectional analysis of self-selecting young women, enrolled at baseline of an intervention trial. We assessed the occurrence of depression, PTSD and co-occurring PTSD and depression, and used multinomial and logistic regressions to assess risk factors for these. Depression, PTSD and comorbid PTSD-depression were reported by 45.2%, 21.0% and 18.6% of the women respectively. Depression was associated with social group membership (ß -0.74, p = 0.022), food insecurity (ß. 0.97, p = 0.001), stress related to lack of work (ß 0.61, p = 0.022), childhood traumas (ß 0.07, p = 0.004), IPV (ß 0.58, p = 0.007), other lifetime traumas (ß 0.51, p = 0.021) and alcohol misuse (ß 0.04, p = 0.002). Comorbid PTSD-depression was associated with social group membership (ß -0.73, p = 0.008), lack of work stress (ß 1.13, p = 0.009), disability (ß 0.99, p = 0.002), childhood traumas (ß 0.19, p <0.001), alcohol misuse (ß 0.05, p = 0.036) and other lifetime traumas (ß 1.32, p <0.001). Differentiating depression and comorbid PTSD-depression were disability (adj.OR 2.20, p = 0.013), childhood traumas (adj.OR 1.13, p <0.001) and other lifetime traumas (adj.OR 2.44, p = 0.012). This was a cross-sectional study, limiting delineation of the direction of associations. Findings cannot be generalised as the study was non-representative. Findings motivate for trauma informed mental health interventions. Potential for group-based interventions is indicated.

Go&Grow: An Evaluation of a Pervasive Social Exergame for Caregivers of Loved Ones with Dementia.

Caregivers of persons with dementia (PWD) experience higher rates of stress, social isolation, and poor mental and physical health compared to non-caregiving populations. There is a vital need for engaging, sustainable, and scalable resources to support social, physical, and emotional wellbeing amongst caregivers of PWD. To explore this open design space, we designed and conducted a 6-week mixed-method evaluation of Go&Grow, a pervasive social exergame in which flowers grow as users increase physical activity and interact with other caregivers of PWD. Our findings showed that using Go&Grow helped participants relieve stress, increase physical activity, and develop empathy for and patience towards the loved one with dementia that they cared for. At the same time, tension arose as some caregivers desired to learn about the life challenges that Go&Grow users faced, while others hesitated to share such content. We discuss our findings and recommendations for future technology that promotes caregivers' time for themselves, understanding of PWD, and connections with other caregivers.

Disparities Old and New in US Mental Health during the COVID-19 Pandemic.

The COVID‐19 pandemic has reduced well‐being and economic security on a number of dimensions, likely worsening mental health. In this paper, we assess how mental health in the US population has changed during the pandemic. We use three large, nationally representative survey sources to provide a picture of mental health prior to and during the pandemic. We find dramatic but broad‐based declines in the level of mental health from pre‐pandemic baseline measures across both people and places. Rates of poor mental health have jumped roughly 25 percentage points, from a base of roughly one‐third. We document substantial disparities in mental health but show that the pandemic has generally preserved, rather than widened, these. Significant worsening in relative mental health among Hispanics and respondents aged 30 and older are exceptions. Consistent with an important role for pandemic‐specific shocks, We find that income loss, food insecurity, COVID‐19 infection or death in one's close circle, and personal health symptoms are all associated with substantially worse mental health. If anything, the decline in mental health is worsening as the pandemic wears on and is becoming less related to local COVID‐19 case rates.

Pollution, Health, and the Moderating Role of Physical Activity Opportunities.

Air and water pollution have detrimental effects on health, while physical activity opportunities have a positive relationship. The purpose of this study was to explore whether physical activity opportunities moderate the relationships among air and water pollution, and measures of health. Aggregate data were collected at the county level in the United States (n = 3104). Variables included the mean daily density of fine particle matter (air pollution), reported cases of health-related drinking water violations (water pollution), subjective ratings of poor or fair health (overall health), the number of physically and mentally unhealthy (physical and mental health, respectively), and the percentage of people living in close proximity to a park or recreation facility (access to physical activity). Air and water pollution have a significant positive effect on all measures of residents’ poor health, while physical activity opportunities only have a negative effect on overall health and physical health. Access to physical activity only moderates the relationship between air pollution and all health outcomes. Since physical activity behavior can be more rapidly changed than some causes of pollution, providing the resident population with better access to physical activity can represent an effective tool in environmental health policy.

Study on Health/Lifestyle, Oxidative Stress, and Antioxidant Capacity Among Female Care Workers and Female General Workers

Background: Care workers have been considered to have higher work-related stress than general workers, which can have a considerable effect on their lifestyle. Hence, psychological and physiological stress levels should be examined. While several studies have investigated psychological stress among care workers, none have examined physiological stress. In addition, very few studies have been investigated the relationship between lifestyle and physiological stress.Aims: This study aimed to examine the relationship between health/lifestyle and physiological stress among female care workers and general workers and identify differences therein.Methods: Subjects included 30 workers (average age: 49.8) and 33 general workers (average age: 51.9). No significant difference in their age was noted. The “Diagnostic Inventory of Health and Life Habit” developed by Tokunaga et al. was used to examine lifestyle habits. Physiological stress was examined by measuring diacron-reactive oxygen metabolites (d-ROMs) and biological antioxidant potential (BAP) using FRAS4 manufactured by WISMERLL Co., Ltd. during the subjects’ working hours.Results: Care workers were taller, heavier, woke up later, and slept longer than general workers. Both care workers and general workers had average health/lifestyle parameter scores that fell within the “moderate” category, with no differences between both groups. Both care workers and general workers had a poor health rating and were evaluated as “caution required,” which indicated undesirable lifestyle habits. No significant differences in d-ROMs and BAP were observed between both groups, many of whom fell under the “high oxidative stress” category for d-ROMs and “borderline” for BAP. Regarding the relationship between d-ROMs and BAP values and health/lifestyle parameters, our results found some relationship between exercise habits and d-ROMs only among care workers.Conclusion: General workers and care workers included herein had similarly poor health levels and undesirable lifestyle habits. Moreover, both groups were both had high d-ROM and normal BAP levels, with no significant differences in both indexes. Several care workers confirmed to have high d-ROMs tended to not participate in sport activities or exercise and did not to expect to benefit from them.

Gender inequalities in depression/anxiety and the consumption of psychotropic drugs: Are we medicalising women's mental health?

Aims: Clinical studies show that women are more likely to be diagnosed with depression and anxiety, and to consume prescribed psychotropic drugs. Applying an intersectional perspective that considers age, education and social class, the present study assesses gender inequalities in the diagnosis of depression/anxiety and in psychotropic consumption. Methods: We analysed data from the 2018 Basque Country Health Survey (Spain; n=8014). Prevalence rates of poor mental health, diagnosis of depression/anxiety and psychotropic consumption were calculated for each sex by age and socio-economic status. Poisson regression models were calculated to estimate PRs of these variables in women, adjusted for age, mental health status and health-care visits, and for diagnosis of depression/anxiety in the case of psychotropic drug consumption. Results: Women were 2.48 times more likely than men to be diagnosed with depression or anxiety, and this difference remained significant after adjustments (prevalence ratio (PR)=1.86; 95% confidence interval (CI) 1.40-2.47). Women also took significantly more prescribed psychotropic drugs, even controlling for their poorer mental health, their higher prevalence of diagnosis and their more frequent health-care visits (PR=1.52; 95% CI 1.28-1.82). No gender inequalities were observed in those younger than 45 or with the highest level of education. Conclusions: Gender inequalities in the diagnosis and prescription of psychotropic drugs exist, and these cannot be explained by differences in mental-health status or health-care visit frequency. It seems, then, that medicalisation of mental health is occurring among women. Further evidence about the mechanisms that underlie the results is crucial to design truly gender-sensitive health policies that reduce medicalisation of women's mental health.

Cancer history and risk factors in healthy older people enrolling in the ASPREE clinical trial

BackgroundCancer is a leading cause of death globally. Given the elevated risk of cancer with age and an ageing population, it is important to understand the changing burden of cancer in older populations. The ASPirin in Reducing Events in the Elderly (ASPREE) study randomised healthy older individuals to 100 mg aspirin or placebo, with clinical outcomes and disability-free survival endpoints. Detailed baseline data provides a rare opportunity to explore cancer burden in a uniquely healthy older population. MethodsAt study enrolment (2010–2014), self-reported personal cancer history, cancer type and cancer risk factor data were sought from 19,114 participants (Australia, n = 16,703; U.S., n = 2411). Eligible participants were healthy, free of major diseases and expected to survive 5 years. ResultsNearly 20% of enrolling ASPREE participants reported a prior cancer diagnosis; 18% of women and 22% of men, with women diagnosed younger (16% vs 6% of diagnoses <50 years). Cancer prevalence increased with age. Prevalence of prostate and breast cancer history were higher in U.S. participants; melanoma and colorectal cancer were higher in Australian participants. Cancer history prevalence was not associated with contemporary common risk factors nor previous aspirin use, but was associated with poor health ratings in men. Blood and breast cancer history were more common with past aspirin use. ConclusionsPersonal cancer history in healthy older ASPREE participants was as expected for the most common cancer types in the respective populations, but was not necessarily aligned with known risk factors. We attribute this to survivor bias, likely driven by entry criteria.Trial Registration: International Standard Randomised Controlled Trial Number Register (ISRCTN83772183) and clinicaltrials.gov (NCT01038583).

Sports activity patterns and cardio-metabolic health over time among adults in Germany: Results of a nationwide 12-year follow-up study

BackgroundPhysical activity is favorable for health, and vigorous sports activity is particularly beneficial. This study investigates the association between changes in sports participation patterns over time and cardio-metabolic and self-perceived health outcomes. MethodsData from 3752 adults (18–79 years of age) who participated in 2 national health interview and examination surveys in 1997–1999 and 2008–2011 were included, with a mean follow-up time of about 12 years. A change in self-reported sports activity was analyzed with respect to the incidence of type 2 diabetes, coronary heart disease (CHD), hypertension, obesity, dyslipidemia, metabolic syndrome, and poor self-perceived health. Participants with pre-existing disease or risk factor of interest at baseline were excluded from the analysis. Being sufficiently active in sports was specified as doing sports for at least 1–2 h per week, and 4 activity categories were defined: 1) inactive at both time points (inactive–inactive), 2) inactive at baseline and active at follow-up (inactive–active), 3) active at baseline and inactive at follow-up (active–inactive), and 4) active at both time points (active–active). Associations between sports activity engagement and health outcomes were estimated by logistic regression models with different stages of adjustments. ResultsNot engaging in any regular sports activity at both time points (inactive–inactive) was associated with higher rates of type 2 diabetes (odds ratio (OR) = 1.82, 95% confidence interval (95%CI): 1.08–3.08), CHD (OR = 1.82, 95%CI: 1.16–2.84), hypertension (OR = 1.36, 95%CI: 1.03–1.81), metabolic syndrome (OR = 1.58, 95%CI: 1.08–2.32), and poor self-perceived health (OR = 2.54, 95%CI: 1.83–3.53) compared to doing regular sports for a minimum of 1–2 h per week over time (active–active). In case of change from inactivity to any regular sports activity (inactive–active), the rate of risk factor occurrence was not statistically different from the active–active reference group except for poor self-perceived health, but it was higher for type 2 diabetes (OR = 2.15, 95%CI: 1.12–4.14) and CHD (OR = 1.77, 95%CI: 1.03–3.03). Being active at baseline but inactive at follow-up (active–inactive) was not associated with higher disease incidence of type 2 diabetes (OR = 0.70, 95%CI: 0.25–1.97) or CHD (OR = 1.20, 95%CI: 0.49–2.99), but was associated with higher rates of hypertension (OR = 1.61, 95%CI: 1.11–2.34), obesity (OR = 2.34, 95%CI: 1.53–3.57), metabolic syndrome (OR = 1.70, 95%CI: 1.11–2.63), and poor self-perceived health (OR = 2.16, 95%CI: 1.53–3.07) at follow-up. ConclusionEven a low weekly quantity (1–2 h) of regular sports activity is partly associated with health benefits. Being formerly but not currently active was not associated with an increased disease incidence, but was associated with a higher risk-factor development compared to the reference group (active–active). Becoming active was preventive for risk-factor development but was not preventive for disease incidence, which probably means that the health benefits from sports activity are not sustainable and disease incidence is only shifted to a later period in life. For this reason, the promotion of and commitment to regular sports activity should be addressed as early as possible over the lifespan to achieve the best health benefits.