Population Health Studies Research Articles

Geospatial data sources to produce new evidence for routine population health monitoring

Abstract Background Many public agencies collect geospatial data in relation to Environment and Territorial Planning. This data is harmonized, standardized, made available online, and it is often collected for a group of countries. These characteristics make this data particularly useful for population health studies, yet in public health there is a certain lack of knowledge with regard to this type of data. The large datasets, the data format and the ways to access this data all hamper their use. The aim of this work is to present an overview of geospatial databases that produce routinely available geospatial data able to support population health monitoring and interventions. The process of how to transform this data in evidence at the local scale will also be highlighted. Methods First, we conducted a survey via the websites of international public institutes with relevant geospatial data gathered for Europe. Second, we identified how we could transform the data into evidence relevant to both, population health studies and decision makers, namely at the local level. Results At the EU level, the European Territorial Observatory Network (ESPON), EUROSTAT, the Joint Research Centre and the Environment European Agency (EEA) are some examples of public agencies both producing and offering access to geospatial data. They are responsible for collecting data regarding, e.g., land use, road and rail networks, amenities and pollution. Although geospatial data has been compiled all over Europe, it can be used to produce evidence at the local level. For instance, it is possible to extract information on the greenspace area at a local administrative level from the Corine Land Cover project, managed by the EEA, and then, measure the share of area per inhabitant. Conclusions Geospatial data have much more to offer than the obvious location factor. It brings new evidence at the local level, supporting studies and empowering decision-makers at all levels.

Association between leisure-time physical activity and the risk of chronic diseases

Abstract Background According to the World Health Organization, non-communicable diseases or chronic diseases, account for 71 percent of all deaths globally, affecting individuals of all age groups and countries. Epidemiological studies have shown an association between a lack of physical activity (PA) and the risk of raised blood pressure, increased body mass index and obesity that can lead to chronic diseases. Methods The aim of the study was to assess the relationship between leisure-time PA and the risk of chronic diseases among adult population. We conducted a cross-sectional study of 470 men and 641 women who participated in “The Impact of Sustainable Mobility, Physical Activity and Environmental Factors on Urban Population Health Study (ISMA)” in Lithuania. Leisure-time PA was self-reported and divided into three levels: low, moderate and high. Logistic regression was used to estimate adjusted odds ratios (ORs) of chronic diseases according to leisure-time PA. Results More than half (55%) of the study population engaged in a moderate intensity PA and 12% of participants engaged in a high intensity leisure-time PA. Men 1.6 times more often than women reported engaging in a high intensity PA in leisure time (p = 0.004). Adults who engaged in low intensity leisure-time PA had almost 3 times (OR = 2.91; 95% confidence interval (CI) 1.62-5.24) higher risk of chronic diseases, whereas those adults who reported moderate intensity leisure-time PA had an OR of 1.63 (95% CI 0.92-2.87) compared to individuals who engaged in a high-level PA. Conclusions Our findings suggest that high levels of leisure-time PA could reduce the risk of chronic diseases and this effect was significantly stronger in men. Key messages Global decline in PA is related to inaction during leisure time and sedentary behaviour at work and at home that has a major health impact worldwide. High levels of leisure-time PA are important factor for chronic disease prevention.

P4154MicroRNA Signatures Predict Early Major Coronary Events in Middle Aged Men and Women

Abstract Background The role of microRNA as biomarkers able to predict major coronary events (MACE) has not been fully elucidated, reproducibility being a critical issue. Aim To identify circulating microRNA signatures able to predict MACE. Methods We employed a PCR-based method to screen 754 microRNAs in a cohort of 60-year-olds (60YOs) from Stockholm, using a nested case-control design (100 cases vs 100 matched controls). The association of microRNAs and their interaction with the risk of MACE (myocardial infarction (MI), angina and sudden cardiac death) was estimated with random-effect logistic regression and expressed as OR with 95% CI. A bioinformatics approach identified microRNA clusters based on predicted targets. Main findings were tested in 58 MI and 60 age and sex matched referents from the the Nord-Trøndelag Health (HUNT) Study, a longitudinal population health study conducted in Norway. Results Fifty-five microRNAs were found to be associated with risk of MACE in the 60YO. MicroRNA-145-3p was associated with the largest estimated risk increase of MACE after adjustment for the common CV risk factors (OR: 2.18; 95% CI: 1.27–3.75). Interaction analysis revealed that increasing plasma levels of microRNA-320b modulated the association of 16 microRNAs with risk of MACE. As an example the estimated MACE risk associated with microRNA-145-3p was 1.47 (0.87–2.47) in the presence of low (<25th percentile) and 4.00 (1.79- 8.93) in the presence of high (>75th percentile) miRNA 320b expression levels. Sixteen microRNA pairs could be classified in 4 functional clusters with 492 predicted gene targets, mainly involved in the regulation of inflammation, thrombosis and lipid metabolism. Eight miRNAs interacting pairs belonging to cluster 2 and 4 showed a similar association trend with MI risk in the HUNT study. Conclusions We report the identification of microRNA signatures predicting risk of MACE in middle-aged Scandinavian men and women. These signatures could be a valuable tool to improve CV disease prediction in the aged.

Quantitative methods for metabolomic analyses evaluated in the Children's Health Exposure Analysis Resource (CHEAR).

With advances in technologies that facilitate metabolome-wide analyses, the incorporation of metabolomics in the pursuit of biomarkers of exposure and effect is rapidly evolving in population health studies. However, many analytic approaches are limited in their capacity to address high-dimensional metabolomics data within an epidemiologic framework, including the highly collinear nature of the metabolites and consideration of confounding variables. In this Children’s Health Exposure Analysis Resource (CHEAR) network study, we showcase various analytic approaches that are established as well as novel in the field of metabolomics, including univariate single metabolite models, least absolute shrinkage and selection operator (LASSO), random forest, weighted quantile sum (WQSRS) regression, exploratory factor analysis (EFA) and latent class analysis (LCA). Here, in a Bangladeshi birth cohort (n=199), we illustrate research questions that can be addressed by each analytic method in the assessment of associations between cord blood metabolites (1H NMR measurements) and birth anthropometric measurements (birth weight and head circumference).

Risk Factors for Small Adult Height in Childhood Cancer Survivors

BACKGROUND: Between 10-20% of childhood cancer survivors (CCS) suffer impaired growth leading to small adult height (SAH). Our study aimed to quantify risk factors for SAH or growth hormone (GH) deficiency among CCS. METHODS: The FCCSS holds data on 7670 cancers survivors treated before 2001. We analyzed self-questionnaire data from 2965 CCS with clinical, chemo/radiotherapy data from medical records. SAH was defined as an adult height <2 Standard Deviation Scores (SDS) of control values obtained from a French population health study. RESULTS: After exclusion of the 189 CCS treated with GH, 9.2% (254/2776) had a SAH. Being young at the time of cancer treatment (RR 0.91 [95% CI, 0.88-0.95], by year of age), small height at diagnosis ( 40 Gy RR 19.48 [95%CI, 8.73-43.48]), having received busulfan (RR 4.53 [95%CI, 2.10- 9.77]), or more than 300 mg/m² of lomustine ([300-600]mg/m² RR 4.21 [95%CI, 1.61-11.01], >600mg/m² RR 9.12 [95%CI, 2.75-30.24]) were all independent risk factors for SAH. Irradiation of seven or more vertebrae (>15 Gy on >90% of their volume) without pituitary irradiation increased the RR of SAH by 4.62 [95%CI, 2.77-7.72]. If patients had also received pituitary irradiation, this increased the RR by an additional factor of 1.3 to 2.4. CONCLUSION: CCS are at high risk of SAH. Any CCS who has been treated with radiotherapy, busulfan, or lomustine should be closely monitored for growth, puberty onset, and potential pituitary deficiency. FUNDING STATEMENT: This work was supported by the French Society of Childhood Cancer (SFCE), the PAIR Research Program “START - INCa-ARC-Ligue_11902, the PAIR Research Program “Mr Robot” – INCa-ARCLIGUE_11909, the Electricite de France (EDF), the Pfizer Foundation for childhood and adolescent health, the Ligue Nationale Contre le Cancer (LNCC), the Institut de Recherche en Sante Publique (IRESP), and the French “Agence Nationale Pour la Recherche Scientifique” (Hope-Epi Project). DECLARATION OF INTERESTS: All authors declared to have no conflict of interest with this study. ETHICS APPROVAL STATEMENT: The study has been approved by the French Data Protection Authority (CNIL) and the ethics committee of the National Institute of Medical Research and Health (INSERM).

Cohort Profile: East London Genes & Health (ELGH), a community-based population genomics and health study in British Bangladeshi and British Pakistani people.

Cohort profile in a nutshell: - East London Genes & Health (ELGH) is a large scale, community genomics and health study (to date >30,000 volunteers; target 100,000 volunteers). - ELGH was set up in 2015 to gain deeper understanding of health and disease, and underlying genetic influences, in people of British-Bangladeshi and -Pakistani heritage living in east London. - ELGH prioritises studies in areas important to, and identified by, the community it represents. Current priorities include cardiometabolic diseases and mental illness, these being of notably high prevalence and severity. However studies in any scientific area are possible, subject to community advisory group and ethical approval. - ELGH combines health data science (using linked UK National Health Service (NHS) electronic health record data) with exome sequencing and SNP array genotyping to elucidate the genetic influence on health and disease, including the contribution from high rates of parental relatedness on rare genetic variation and homozygosity (autozygosity), in two understudied ethnic groups. Linkage to longitudinal health record data enables both retrospective and prospective analyses. - Through stage 2 studies, ELGH offers researchers the opportunity to undertake recall-by-genotype and/or recall-by-phenotype studies on volunteers. Sub-cohort, trial-within-cohort, and other study designs are possible. - ELGH is a fully collaborative, open access resource, open to academic and life sciences industry scientific research partners.

Was it worth it? Older adults\u2019 experiences of participating in a population-based cohort study \u2013 a focus group study

BackgroundAt present, we know relatively little about priorities and problems with topics that older adults experience when completing different examinations in longitudinal population-based studies. To examine these topics, research must be adapted to investigate the meanings, motivations, and interpretations of the individual participants themselves. Therefore, the present study aimed to explore older adults’ motives, understandings and experiences regarding participating in the Gothenburg H70 Birth Cohort Studies (the H-70 study).MethodsFocus group discussions were used. A total of thirty-eight persons, 19 women and 19 men participated in nine focus groups. A strategic sampling technique was used to ensure that the focus group participants represented the larger population.ResultsThe results supported the overall theme: “It was well worth the effort,” which summarized how the participants felt about the population health study. The following specific themes were also identified: an intense event, for the benefit of oneself and others, confidence in health research and the researcher, key decisions about test outcomes and the survey raising questions and providing few answers.ConclusionsKnowledge of priorities and problems with topics experienced by older adults completing different examinations when participating in longitudinal population-based studies is crucial for research to improve the health and wellbeing of older people. To date, older people’s involvement in population-based cohort studies has largely been as research subjects. This study is a first step toward the participants taking a more active part by allowing them to share their experiences which can be used to improve the research procedures. This requires the participation of older adults in collaboration with the researchers, to ensure the quality of longitudinal studies of older adults. Therefore, our intention when it comes to future research will be to involve older adults—the target group—in the research procedure.

The relationship between anthropometric measures and cardiometabolic health in shift work: findings from the Atlantic PATH Cohort Study.

To evaluate the relationship between anthropometric measures and cardiometabolic health in shift workers compared to non-shift workers. A population health study was conducted with 4155 shift workers and 8258 non-shift workers from the Atlantic Partnership for Tomorrow's Health (PATH) cohort. Linear and logistic regression models were used to assess the differences in anthropometric measures (body adiposity) and self-reported cardiometabolic disease outcomes (obesity, diabetes, and cardiovascular disease) between shift workers and non-shift workers. There was a significant increased risk of cardiovascular disease, obesity, and diabetes among shift workers compared to matched controls despite higher levels of physical activity and lower levels of sedentary behaviour. Shift workers were 17% more likely to be obese (95% CI 7-27) and 27% more likely to have diabetes (95% CI 8-51). The strength of this association was demonstrated by also controlling for body mass index and fat mass index. Shift work is associated with obesity, cardiovascular disease, and diabetes despite higher levels of physical activity and lower levels of sedentary behaviour. The association between shift work and cardiometabolic health was independent of body mass index for cardiovascular disease and diabetes, and independent of fat mass index for diabetes.

HEALTH-RELATED QUALITY OF LIFE MEASUREMENT USING EQ-5D-3L QUESTIONNAIRE

Health-related quality of life is becoming the standard measure of personal well-being and human’s health worldwide. Indicators of the population quality of life allow taking into account the subjective incidence, which is often overlooked during routine medical care. In Russia, the health-related quality of life is becoming particularly relevant in connection with the problems of an ageing population, the development of national strategies and programs in the social and healthcare systems, and the increasing prevalence of chronic diseases. The basis of the HRQoL measurement should be based on a proven and reliable methodology that generates comparable estimates of human well-being. Like any complex subjective indicator, HRQoL does not have an unambiguous direct method of measurement. The aim of this paper is a comprehensive description of the methodology for conducting and presenting the results of the study of the HRQoL using the European Quality of Life Questionnaire, EQ-5D. The paper discusses the measurement of HRQoL as a critical component of a modern health care system, describes in detail the administration of HRQoL data using the EQ-5D-3L questionnaire, and provides a methodology for analyzing and presenting the collected data in studies of population and patient health. We address the discussion to clinicians, healthcare providers, and researchers dealing with the problems of studying and measuring the health-related quality of life.

Sex ratios of migrating southern hemisphere humpback whales: A new sentinel parameter of ecosystem health

Southern hemisphere humpback whales have evolved energetically demanding capital breeding and migratory life-history behaviours. It has been hypothesised that not all individuals of a population participate in the seasonal migration each year, or only undertake partial migrations. Given the cost of migration and reproduction, we explored the possibility that specifically, not all mature females participate in the seasonal migration every year, or significantly delay or shorten their migration, in response to poor feeding conditions. That is, females must attain a minimum threshold of accumulated energy reserves to commit to a reproductive event that likely occurs as a product of mating during migration. With a 1:1 male to female birth ratio, yet a male bias observed along the main migratory corridor; this study utilised inter-annual migratory cohort sex ratios to explore their potential to serve as measures of population fecundity, as a function of ecosystem health. The sex ratios of randomly biopsied adult humpback whales, sampled at a defined location and set time-points along the main migratory corridor from 2008 to 2016 were investigated. Northward migration sex ratios in 2009, 2014 and 2016 revealed a lower male bias suggesting good female participation in the migration and therefore apparent optimal provisioning during the two preceding summers. By contrast, the 2011 southward migration, revealed the highest male bias recorded of 5.75:1. Southward migration sex ratios were found to oscillate closely with measures of population adiposity, a sentinel parameter employed for long-term surveillance of the Antarctic sea-ice ecosystems under the Southern Ocean Observing System-endorsed Humpback Whale Sentinel Program. Anomalously poor humpback whale body condition recorded in 2011 was attributed to poor Antarctic feeding conditions during the extreme La Niña event of 2010/11. These findings lend support for the application of migratory cohort sex ratios, standardised by time and location, as a measure of relative inter-annual population fecundity. This work therefore contributes a new non-lethal tool for the study of population health, as a function of ecosystem productivity, and facilitates the inclusion of fecundity as a sentinel parameter into long-term Antarctic ecosystem surveillance under the Humpback Whale Sentinel Program.

Maternal depression and acculturative stress impacts on Mexican-origin children through authoritarian parenting

Depression and acculturative stress are common among Latina mothers, yet little is known about how these variables are related to parenting practices and in turn, to the mental health functioning of their young children. The present study used a sample of Mexican-origin mothers of 3- to 6-year-old children (N = 175) to test a model of maternal depression and acculturative stress as predictors of child internalizing and externalizing problems, mediated by authoritarian and authoritative parenting practices. Results showed that maternal depressive symptoms and acculturative stress were associated with child internalizing, but not externalizing, problems. Only authoritarian practices mediated these associations. Results highlight the importance of considering sociocultural context in the study of child mental health in Mexican-origin populations.

Multilevel regression and poststratification as a modeling approach for estimating population quantities in large population health studies: A simulation study.

There are now a growing number of applications of multilevel regression and poststratification (MRP) in population health and epidemiological studies. MRP uses multilevel regression to model individual survey responses as a function of demographic and geographic covariates. Estimated mean outcome values for each demographic-geographic respondent subtype are then weighted by the proportions of each subtype in the population to produce an overall population-level estimate. We recently reported an extensive case study of a large nationwide survey and found that MRP performed favorably compared to conventional survey sampling weights for the estimation of population descriptive quantities in a highly selected sample. In this study, we aimed to evaluate, by way of a simulation experiment, both the accuracy and precision of MRP versus survey sampling weights in the context of large population health studies. While much of the research into MRP has been focused on U.S. political and social science, we considered an alternative population structure of smaller size and with notably fewer geographic subsets. We explored the impact on MRP performance of sample size, model misspecification, interactions, and the addition of a geographic-level covariate. MRP was found to achieve generally superior performance in both accuracy and precision at both the national and state levels. Results were generally robust to model misspecification, and MRP performance was further improved by the inclusion of a geographic-level covariate. These findings offer further evidence that MRP provides a promising analytic approach for addressing participation bias in the estimation of population descriptive quantities from large-scale health surveys and cohort studies.

The methodology of complex social hygienic investigation of various groups of population and families (In memoriam of professor O. V. Grinina)

The article expounds main principal positions of professor O. V. Grinina scientific educational methodological school of social hygienic investigations of health of population and family. The methodological analysis of scientific works of professor O. V. Grinina and her disciples was implemented to demonstrate key positions and results of studies constituting scientific school of program methodological basics of complex social hygienic studies of population health, health care and conditions of life of families. The purpose of publication is to characterize indications of the school of complex social hygienic investigations of priority population groups and families. These issues are covered by thematic fundamental works substantiating patterns of formation and estimation of health of families, program methodological issues of complex medical social studies of family and its individual members, availability of large group за disciples developing priority issues of investigation of population health at the level of family and organization of medical care based on the principles of per family observations, general (family) medical practice. The results are demonstrated and patterns are established containing in implemented complex social hygienic per family studies of various population groups, women, children and families in 1970s-1990s. The methodological significance of valid family-focused technologies in new social economic conditions of development of society and health care and principles of curative preventive activities in conditions of mandatory medical insurance are demonstrated. The professor O. V. Grinina substantiated and developed program of medical social characteristic of family. its sections and methodology of long-term continuous monitoring of family. She also determined characteristics of health of family as a group patient, principles of work of out-patient physicians with families directly at the polyclinic district.

Gender differences in the bidirectional relationship between alcohol consumption and sleeplessness: the Troms\xf8 study

BackgroundThe degree to which the relationship between alcohol use and sleeplessness is unidirectional or reciprocal is unclear due to great variation among the results of previous studies. The aim of the present study was to investigate if the relationship between alcohol use and sleeplessness is bidirectional by exploring how the change in and stability of alcohol use were related to sleeplessness, and vice versa, how the change in and stability of sleeplessness were related to alcohol use, in a longitudinal study spanning 13 years.MethodData were collected from 9941 adults who participated in two waves (T1: 1994–1995, and T2: 2007–2008) of the Tromsø Study, a Norwegian general population health study. Alcohol use was measured by questions asking about the frequency of drinking, amounts of alcohol normally consumed and the frequency of binge drinking, whereas sleeplessness was measured by one item asking about the frequency of experiencing sleeplessness. Variables representing change in and stability of consumption of alcohol and sleeplessness from T1 to T2 were created. Logistic regression analyses, stratified by gender, were used to analyze the data.ResultsMen reporting stable high (OR = 2.11, p. < .001) or increasing (OR = 1.94, p. < .01) consumption of alcohol from T1 to T2 had a significantly higher risk of reporting sleeplessness at T2. Likewise, men experiencing stable (OR = 1.84, p. < .01) or increasing (OR = 1.78, p. < .001) sleeplessness from T1 to T2 had a significantly higher risk of reporting high consumption of alcohol at T2. No significant effects were detected among women.ConclusionThe findings indicate a bidirectional relationship between high consumption of alcohol and sleeplessness only among men. Thus, healthcare professionals ought to be informed about the health risks associated with excessive drinking and struggling with sleeplessness, especially in men.

Housing Plus Services, IADL Impairment, and Healthcare Expenditures: Evidence From the Medicare Current Beneficiaries Survey.

Despite enthusiasm for the potential cost savings of embedding supportive services in senior housing, few population health studies have empirically examined such associations. We investigated the extent to which associations between housing plus services in senior housing and healthcare expenditures depend upon residents' instrumental activities of daily living (IADL) impairment and the level of services available. We used data from 2,601 participants aged 65 or older in the 2001-2013 Medicare Current Beneficiary Survey, who reported living in senior or retirement housing. Based on survey self-reports, we created a measure of housing with different levels of services, including the categories of housing without services, housing plus services (i.e., assistance with IADLs, but not with medications), and housing plus enhanced services (i.e., assistance with IADLs including medications). Administrative and survey data were used to create measures of healthcare expenditures paid by all sources. We estimated generalized linear models based on pooled data from participants across the 13 years of data collection. Residents with IADL impairment-who lived in housing plus enhanced services-had lower total healthcare expenditures than their counterparts in housing without services and housing plus services. Upon examining component healthcare costs, this pattern of results was similar for inpatient/subacute care, as well as ambulatory care, but not for home health care. Findings indicate the importance of studies on the cost savings of housing-based service programs to consider resident IADL status and the types of services available.

3483 Glycemic Control and Diabetic Peripheral Neuropathy Among Patients on Prescription Opioid Pain Medications in Western New York: Using Data Analytics for Quality Assessment

OBJECTIVES/SPECIFIC AIMS: I would like to make clinicians aware about prescription opioid use and glycemic control among patients with diabetes. This is a quality of care issue that increases the disease burden for two conditions opioid dependence and diabetic complications. Big data analytics can bring out this quality of care issue and help in changing clinical practice through precision medicine METHODS/STUDY POPULATION: This is a population health study of patients on prescription opioid pain medications in Erie county medical center and local out patient clinic. The electronic data from the hospital records and Outpatient were collected, merged and de identified. The database was saved in a protected environment and made accessible to researchers through a secure login. The data was queried for the number of patients with diabetes. The glycohemoglobin levels were collected and then the analysis was made RESULTS/ANTICIPATED RESULTS: It was found that only 63 of the 89 patients with DPN and 156 of the 570 patients without DPN had any measurement of HbA1c in our data. It was found that 86 out of 156 patients without DPN had suboptimal glycemic control with a glycohemoglobin level &gt; 7% while 36 out of 63 patients with DPN had a glycohemoglobin &gt; 6.7%. The odds of patients with DPN having poor glycemic control is 0.57 while the odds of having poor glycemic control without DPN is.55. The relative risk being 1.03. DISCUSSION/SIGNIFICANCE OF IMPACT: Our population study revealed suboptimal glycemic control among a large set of patients in Western New York with a diagnosis of diabetes mellitus and a concurrent prescription for an opioid pain medication. A significant percentage of patients in our study population with a diagnosis of DPN might benefit in terms of decreased painful symptoms of neuropathy from monitoring and attempting to improve glycemic control. Additionally, in our patient population, there were no patients with diabetic peripheral neuropathy prescribed pregabalin or duloxetine, the first-line FDA-approved medications for painful DPN, Based on our population study, the quality of care for diabetic patients with DPN who are prescribed opioid pain medications should be monitored closely. First-line, FDA approved anticonvulsants and antidepressants should be considered for the treatment of painful symptoms when necessary. Attention should be directed towards monitoring and improving glycemic control in patients without DPN receiving opioid pain medications to attempt to prevent or delay the microvascular complications of diabetes, including the onset of painful peripheral neuropathy.

The Intersectional Discrimination Index: Development and validation of measures of self-reported enacted and anticipated discrimination for intercategorical analysis

Background and objectiveAlthough intersectional approaches have gained traction in population health research, quantitative discrimination and health studies have tended to focus on a single axis of discrimination (e.g., racism, homophobia). As few discrimination measures function across multiple social identities or positions, we developed the Intersectional Discrimination Index (InDI) for intercategorical intersectionality research, including measures of Anticipated (InDI-A), Day-to-Day (InDI-D), and Major (InDI-M) discrimination that do not require attribution to particular grounds. MethodsWe conducted a validity and reliability study with 2016 online survey panel data from Canada and the United States (n = 2583). Internal consistency and dimensionality of the InDI-A were evaluated with exploratory and confirmatory factor analyses. Construct validation included known-groups comparisons, associations with psychological distress, and convergence with existing discrimination measures. Test-retest reliability was examined in a subgroup (n = 150). ResultsWe found support for use of the InDI-A as a unidimensional scale. As hypothesized, racial and sexual/gender minorities reported higher frequencies of all discrimination types (all p < 0.001), and discrimination varied across intersectional categories. Each InDI component was significantly positively associated with psychological distress after controlling for potential confounders. Frequency scores were strongly positively correlated with existing scales. Intraclass correlation coefficients for test-retest reliability of anticipated, lifetime day-to-day, and lifetime major discrimination ranged from 0.70 to 0.72. ConclusionsFinal InDI measures include the 9-item InDI-A, 9–item InDI-D, and 13-item InDI-M, for which we have found initial evidence of construct validity and reliability. In combination with sociodemographic information, the InDI measures can be used to evaluate the role of discrimination as a mediator of intersectional health inequalities, and to monitor the prevalence and impacts of discrimination in heterogeneous populations.

Age differences in the association of nonmedical prescription opioid use and suicidality.

To examine age differences in the associations of nonmedical prescription opioid use (NMPOU) and suicidality. This is a population health study using the 2016 National Survey on Drug Use and Health. The sample included 38,136 persons 18 and older. Weighted logistic regression analyses were used to examine the odds of past year NMPOU with suicidality (suicidal thoughts, plans, and attempts in the past year), stratified by age groups. Overall, the prevalence of suicidality was higher for persons who reported past year NMPOU across all age groups. For the full sample, NMPOU was associated with increased odds of suicidal thoughts (OR = 1.71, 95% CI = 1.36, 2.14), plans (OR = 1.95, 95% CI = 1.33, 2.84), and attempts (OR = 2.25, 95% CI = 1.27, 4.00). Users 18 to 34 had greater odds for reporting yes on all three suicidality measures. Users 50 and older had greater odds for suicidal thoughts in the past year. Among younger and older age groups, there is a higher prevalence and associated odds of suicidality for those who report any misuse within the 12-month period.

THE MENTAL HEALTH OF AGING SEXUAL MINORITIES IN CANADA: FINDINGS FROM THE CANADIAN LONGITUDINAL STUDY ON AGING (CLSA)

The Canadian Longitudinal Study on Aging (CLSA) is a national population health study that will follow approximately 50,000 adults aged 45–85 over the next 20 years. At baseline, 1,057 participants (i.e., 2%) within the CLSA self-identified as lesbian, gay, or bisexual (LGB). The purpose of this presentation is to examine differences in mental health between LGB and heterosexual participants in the CLSA. Depressive symptoms were evaluated through the short form of the Centre for Epidemiologic Studies – Depression (CES-D10) scale. Results indicated that LGB participants had greater odds of being categorized as depressed. In addition, gay and bisexual males were found to have lower levels of perceived social support relative to heterosexual males. Results highlight the importance of mental health services for aging sexual minorities in order to support a diverse aging population. Following the mental health trajectories of minority participants in the CLSA as they reach older ages will be essential to better understanding the relationship between the social determinants of health and aging in Canada.

Correlated Responses in Air Pollution Regression Models

Bivariate time series responses, specifically daily mortality and morbidity outcomes, in environmental air pollution regression models are of interest in population health studies for at least 2 re...