Self-reported General Health Research Articles

NZ-RugbyHealth Study: Self-reported Injury Experience and Current Health of Former Rugby Union and Non-contact Sport Players

BackgroundThere is limited research on associations between playing rugby union and player health post-retirement.ObjectiveThis study investigated differences in self-reported sport injury history and current self-reported health characteristics between former New Zealand rugby and non-contact sport players with a view to identifying issues to be further investigated with stronger epidemiological research designs.MethodsUsing a cross-sectional design, the NZ-RugbyHealth study surveyed 470 former rugby and non-contact sport players (43.8 ± 8.1 years; 127 elite rugby, 271 community rugby, 72 non-contact sport) recruited from October 2012 to April 2014. Demographic information, engagement in sport, sport injuries, medical conditions, mood, alcohol and substance use and ratings of current health status were obtained from a self-report 58-item general health e-questionnaire. We highlighted standardised differences in means of > 0.6 and differences in relative percentages of > 1.43 for variables between groups as representing at least moderate effect sizes, and of being worthy of follow-up studies.ResultsHigher percentages of the elite rugby player group had sustained injuries of a given body-site type (e.g. neck sprain/strain, thigh bruising, hamstring strain) combination than the non-contact sports players. Higher percentages of the rugby groups reported having sustained concussion (94% for elite, 82% for community, 26% for non-contact), injuries requiring hospitalisation (73%, 46%, 25%), injuries that stopped participation in sport permanently (28%, 28%, 11%) and sport-related surgery (72%, 46%, 32%) during their playing career. Both rugby groups had a higher prevalence of osteoarthritis (37%, 18%, 6%) than non-contact athletes and community rugby players had higher levels of hazardous alcohol consumption (38%, 40%, 25%) in retirement than non-contact athletes. There was little difference between rugby players and non-contact sports athletes in self-reported mood, substance use and current physical or psychological health ratings.ConclusionsFormer rugby player groups were at higher risk than the non-contact player group for most injuries during their playing careers, and in retirement had greater prevalence of osteoarthritis and hazardous alcohol consumption. The relative youth of the groups (43.8 years on average) means that health issues that typically do not emerge until later life may not have yet manifested.

Oral health practices and self-reported adverse effects of E-cigarette use among dental students in 11 countries: an online survey

ObjectivesE-cigarette use has become popular, particularly among the youth. Its use is associated with harmful general and oral health consequences. This survey aimed to assess self-reported oral hygiene practices, oral and general health events, and changes in physiological functions (including physical status, smell, taste, breathing, appetite, etc.) due to E-cigarette use among dental students.MethodsThis online, multicounty survey involved undergraduate dental students from 20 dental schools across 11 different countries. The questionnaire included demographic characteristics, E-cigarette practices, self-reported complaints, and associated physiological changes due to E-cigarette smoking. Data were descriptively presented as frequencies and percentages. A Chi-square test was used to assess the potential associations between the study group and sub-groups with the different factors. Statistical analysis was performed using SPSS at P < 0.05.ResultsMost respondents reported regular brushing of their teeth, whereas only 70% used additional oral hygiene aids. Reported frequencies of complaints ranged from as low as 3.3% for tongue inflammation to as high as 53.3% for headache, with significant differences between E-cigarette users and non-users. Compared to non-smokers, E-cigarette users reported significantly higher prevalence of dry mouth (33.1% vs. 23.4%; P < 0.001), black tongue (5.9% vs. 2.8%; P = 0.002), and heart palpitation (26.3%% vs. 22.8%; P = 0.001). Although two-thirds of the sample reported no change in their physiological functions, E-cigarette users reported significant improvement in their physiological functions compared to never smokers or tobacco users.ConclusionDental students showed good oral hygiene practices, but E-cigarette users showed a higher prevalence of health complications.

Challenging (-Hindering) Employment and Employee Health

Research has struggled with the task of distinguishing high from low-quality employment. Making the distinction between challenging and hindering job demands in a context of social exchange, our study develops a generalizable heuristic for employment quality research. Latent class analysis with mixture modelling was applied to a sample of 2,143 adults from a diversity of occupations. A two-factor model provided substantial support for the distinction between challenging and hindering employment. Challenging employment was characterized by hard and emotionally demanding work and by provision of greater resources. Hindering employment involved several hindering demands and fewer resources. As predicted, challenging employment was associated with better self-reported general health and less psychological distress. The positive associations between higher education levels and longer work experience and challenging employment also supported the challenging/hindering heuristic. Abstract Research has struggled with the task of distinguishing high from low-quality employment. Making the distinction between challenging and hindering job demands in a context of social exchange, our study develops a generalizable heuristic for employment quality research. Latent class analysis with mixture modelling was applied to a sample of 2,143 adults from a diversity of occupations. A two-factor model provided substantial support for the distinction between challenging and hindering employment. Challenging employment was characterized by hard and emotionally demanding work and by provision of greater resources. Hindering employment involved several hindering demands and fewer resources. As predicted, challenging employment was associated with better self-reported general health and less psychological distress. The positive associations between higher education levels and longer work experience and challenging employment also supported the challenging/hindering heuristic.

How Food Insecurity and Financial Difficulty Relate to Emotional Well-Being and Social Functioning.

Medically uninsured individuals living in poverty experience poor health and face social barriers that negatively affect their health. The purpose of this study was to examine the association between social barriers, particularly healthy food availability and financial difficulty, and well-being among uninsured free clinic patients in the United States. Data were collected using a self-administered paper survey at a free clinic from adult patients who spoke and read English or Spanish (N = 666) from January to April 2019. Better neighborhood healthy food availability is associated with better self-reported general health. Food security is related to better emotional well-being and social functioning. Having difficulty paying rent or a mortgage is linked to worse emotional well-being and social functioning. Providing health education programs may not be sufficient to promote healthy eating among underserved populations because of the social barriers that they experience, such as food insecurity and financial difficulty. Future research could be performed to determine how these social factors influence those of different social and cultural backgrounds than the participants in this study.

Prevalence of SARS-CoV-2 antibodies during phased access to vaccination: results from a population-based survey in New York City, September 2020-March 2021.

Repeated serosurveys are an important tool for understanding trends in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and vaccination. During 1 September 2020-20 March 2021, the NYC Health Department conducted a population-based SARS-CoV-2 antibody prevalence survey of 2096 NYC adults who either provided a blood specimen or self-reported the results of a previous antibody test. The serosurvey, the second in a series of surveys conducted by the NYC Health Department, aimed to estimate SARS-CoV-2 antibody prevalence across the city and for different groups at higher risk for adverse health outcomes. Weighted citywide prevalence was 23.5% overall (95% confidence interval (CI) 20.1-27.4) and increased from 19.2% (95% CI 14.7-24.6) before coronavirus disease 2019 vaccines were available to 31.3% (95% CI 24.5-39.0) during the early phases of vaccine roll-out. We found no differences in antibody prevalence by age, race/ethnicity, borough, education, marital status, sex, health insurance coverage, self-reported general health or neighbourhood poverty. These results show an overall increase in population-level seropositivity in NYC following the introduction of SARS-CoV-2 vaccines and highlight the importance of repeated serosurveys in understanding the pandemic's progression.

Determinants of Lifestyle Choices Among South Korean College Students: An Experimental Analysis.

PurposeBased on theoretical predictions from human capital theory, the aim of this exploratory study is to analyze the relationship between experimentally elicited, incentivized economic preference parameters, Big Five and Grit personality traits, cognitive ability, and the Alameda Seven lifestyles: smoking, drinking excessively, being overweight or obese, experiencing stress, following a healthy diet, exercising, and sleeping enough. In addition, self-reported general physical and mental health are analyzed.Materials and MethodsData collection took place in an incentivized paper-and-pencil experiment. Undergraduate students were recruited as subjects, with the requirement that they be freshmen, but no restrictions based on gender, major, or age. A pre-test and three experimental sessions were conducted in March and in April 2018, with a total of 178 subjects participating. After deleting observations with missing values, a total of n = 138 subjects remained. Regression analysis (multivariate probit models, resulting marginal effects and changes in predicted probabilities of adopting a lifestyle for “ideal types”) was used to analyze and compare the determinants of the Alameda Seven health behaviors.ResultsFindings suggest that preference parameters, a measure of cognitive ability, and Big Five personality traits are statistically significantly estimated in regressions for the determinants of adopting Alameda Seven health behaviors, but the Grit score is only statistically significantly estimated in a regression for the determinants of reported better general mental health.ConclusionThe findings regarding preference parameters partly lend support to predictions from human capital theory and partly confirm previous findings in health psychology. Those results might be explained by the relatively small sample size and the inclusion of a measure of cognitive ability in addition to personality traits and preferences.

Worsening general health and psychosocial wellbeing of Australian hospital allied health practitioners during the COVID-19 pandemic.

Objective To describe self-reported general and psychological health for allied health practitioners at an Australian acute public health service over three time points within the coronavirus disease 2019 (COVID-19) pandemic. Methods This study collected data from cross-sectional online surveys at three time points: May-June 2020 (T 1 ), October-November 2020 (T 2 ) and November-December 2021 (T 3 ). The self-report questionnaire consisted of demographic questions, a general health question and the 21-item version of the Depression Anxiety Stress Scales (DASS-21). Results A total of 308 responses were received (T 1 n = 135, T 2 n = 78, T 3 n = 95) from representatives of eight allied health professions. The proportion of allied health practitioners reporting poor general health significantly increased over time, as did mean scores on all DASS-21 sub-scales. General health status was also significantly associated with DASS-21 subscale scores. Anxiety scores increased significantly between T 1 and T 2 , while depression scores increased significantly between T 2 and T 3 . Significant increases in stress scores were recorded across all time intervals. Between T 1 and T 3 , the proportion of allied health practitioners reporting moderate, severe, or extremely severe symptoms increased for depression (10.3-30.9%), anxiety (5.2-18.2%) and stress (13.3-36.3%). Conclusion The general and psychological health of allied health practitioners appears to be worsening as the COVID-19 pandemic continues. Organisational strategies to support the health of the allied health workforce in acute care settings must address the cumulative effects of prolonged pressure on their general and psychosocial health. Support strategies need to be responsive to changes in psychological wellbeing at different phases of the pandemic.

More than a year into the pandemic: Do higher education students still practice protective behaviors against COVID-19?

BACKGROUND:The exponential increase of cases and the emergence of the new COVID-19 variants continue to be a challenge. It remains crucial to assess whether or not minimum health standards against COVID-19 are consistently followed. This study determined the higher education students' practice of protective measures against COVID-19 of more than a year into the pandemic.MATERIALS AND METHODS:A questionnaire web survey, cross-sectional study was conducted among higher education students (n = 2309) of a public university in the Philippines. Data were analyzed using the SPSS software.RESULTS:Results indicated that students generally had a high practice of COVID-19 preventive measures. However, only 45.9% always practice physical distancing measures, and only 35.9% always seek information related to COVID-19 after more than a year into the pandemic. Female, married, graduate level, with a monthly family income of PHP 10,000 and above, and personal knowledge of someone who tested for COVID-19 had a significantly higher practice of COVID-19 protective measures. Older age, higher general self-reported health status, and higher intention to comply with recommended protective health behaviors were significantly correlated with higher practice of preventive measures against COVID-19.CONCLUSION:After more than a year of being into the pandemic, students still practice preventive health behaviors, however, this is not done consistently. As the pandemic is still not over in the country and many parts of the world, continuous monitoring and a reminder to practice minimum protective health protocols are needed to mitigate and prevent the spread of COVID-19.

Satisfaction with life among university students from nine countries: Cross-national study during the first wave of COVID-19 pandemic

BackgroundA cross-sectional study was performed to examine life satisfaction differences between university students from nine countries during the first wave of the COVID-19 pandemic. A cross-national comparison of the association between life satisfaction and a set of variables was also conducted.MethodsParticipants in the study were 2349 university students with a mean age of 23 years (M = 23.15, SD = 4.66). There was a predominance of women (69.26%) and individuals studying at the bachelor level (78%). The research was conducted between May and July 2020 in nine countries: Slovenia (n=209), the Czech Republic (Czechia)(n=308), Germany (n=267), Poland (n=301), Ukraine (n=310), Russia (n=285), Turkey (n=310), Israel (n=199), and Colombia (n=153). Participants completed an online survey involving measures of satisfaction with life (SWLS), exposure to COVID-19, perceived negative impact of coronavirus (PNIC) on students' well-being, general self-reported health (GSRH), physical activity (PA), and some demographics (gender, place of residence, level of study). A one-way ANOVA was used to explore cross-national differences in life satisfaction. The χ2 independence test was performed separately in each country to examine associations between life satisfaction and other variables. Bivariate and multivariate logistic regressions were used to identify life satisfaction predictors among a set of demographic and health-related variables in each of the nine countries.ResultsThe level of life satisfaction varied between university students from the nine countries. The results for life satisfaction and the other variables differed between countries. Numerous associations were noted between satisfaction with life and several variables, and these showed cross-national differences. Distinct predictors of life satisfaction were observed for each country. However, poor self-rated physical health was a predictor of low life satisfaction independent of the country.ConclusionsThe association between life satisfaction and subjective assessment of physical health seems to be universal, while the other variables are related to cross-cultural differences. Special public health attention should be focused on psychologically supporting people who do not feel healthy.

COVID-19-Related Concerns and Symptoms of Anxiety: Does Concern Play a Role in Predicting Severity and Risk?

ObjectiveRates of anxiety have increased during the coronavirus disease 2019 (COVID-19) pandemic, partially attributable to the experience of COVID-19 related concerns. It remains pivotal to determine the implications of such concerns on the severity of anxiety as they may represent opportune targets for public health preventative or therapeutic efforts. The current study evaluated COVID-19 related concerns as predictors of anxiety symptom severity. It also assessed the relative risk associated with sub-types of COVID-19 concerns, the role of age, sex, and minority status as potential moderators; and the unique contribution of COVID-19 concerns beyond sociodemographics, perceived stress, and self-reported general mental health.MethodsThe data source was obtained from the publicly available ”Crowdsourcing: Impacts of COVID-19 on Canadians-Your Mental Health survey” conducted by Statistics Canada. Participants were Canadians aged 15 and older living in ten provinces or three territories. Only participants that completed the self-reported sociodemographics, COVID-19 concerns, and general anxiety symptoms measures were included (n = 44549). Multivariate linear regression was used to evaluate continuous reports of anxiety symptoms, and the relative risk of meeting anxiety cut-off levels was determined using chi-square non-parametric testing.ResultsWithin the sample, 29.1% met cut-off levels of anxiety. Levels of coping and security (R2 = 0.205, p < 0.001), distal (R2 = 0.043, p < 0.001), and proximal concerns (R2 = 0.122, p < 0.001) were found to predict the severity of anxiety experiences, which was determined to be robust to statistical control for sociodemographics, perceived stress and self-reported general mental health (ΔR2 = 0.0625, p < 0.001). Minority status and sex were significant moderating variables, although the interaction accounted for less than 0.1% of the observed variance. Family stress from confinement, support during and after the crisis and personal health concerns significantly predicted more than a 200% increase in the risk of meeting anxiety cut-off levels.ConclusionThe current study represents a novel examination of COVID-19-related concerns as risk factors for the experience of anxiety amongst a sizeable Canadian cohort. Coping and security-related concerns represented robust predictors of anxiety symptom experiences. Participants who experienced concerns relating to their proximal social groups were two times more at risk for meeting cut-off anxiety levels than individuals without such concerns. Longitudinal and evidence synthesis remains essential for identifying therapeutic targets and developing pandemic-related public health prevention and care.

Precarious employment and self-reported health: a cross-sectional analysis

BackgroundAssociations between precarious employment and poorer health outcomes are well documented. However, which components of this multidimensional construct are associated with adverse health is unknown. The primary aim of this study was to examine associations between the different domains of precarious employment and self-reported health. MethodsWe used data from 1016 respondents (634 women and 382) to the COVID-19 Employment and Health in Wales Study, a nationally representative household survey of the so-called working-age population (18–64 years). The study was done on May 25 and June 22, 2020, using a push-to-web approach (letter invitation to an online survey; response rate: 6·9%). Respondents provided details of their main job in February, 2020, including information on their contract type and different domains of employment precariousness as assessed by the Employment Precariousness Scale. These domains were: temporariness (length of time working under temporary arrangements); disempowerment (control over work schedule); vulnerability (perceived treatment at work); wages (pay and ability to afford basic and unexpected expenses); and rights. Health measures were self-reported pre-existing health conditions, general health, and mental wellbeing (calculated with the Short Warwick Edinburgh Mental Wellbeing Score). To examine associations between domains of precarious employment and health, chi-squared analysis and multinomial logistic regression (adjusted for sex, age, deprivation, contract type, and self-reported health) were done. The Health Research Authority approved this study (Integrated Research Application System reference: 282223). FindingsThe domains of precarious employment that showed the strongest associations with poor health, independently of contract type, were high vulnerability precariousness (associated with pre-existing condition: adjusted odds ratio 2·44 [95% CI 1·32–4·49], p=0·004; poor general health: 2·35 [1·23–4·51], p=0·010; low mental wellbeing: 2·74 [1·30–5·75], p=0·008); high wage precariousness (associated with pre-existing condition: 1·66 [1·08–2·57], p=0·022; poor general health: 2·21 [1·33–3·69], p=0·002; low mental wellbeing: 3·16 [1·54–6·45], p=0·002); and moderate wage precariousness (associated with pre-existing condition: 1·68 [1·20–2·36], p=0·003; and low mental wellbeing: 2·25 [1·19–4·29], p=0·013). InterpretationBefore the COVID-19 pandemic, tackling poverty in those in work and perceived fair treatment in the workplace appear to have been important in improving the health of the working-age population of the UK. Longitudinal analyses are required to establish the effect of the pandemic on employment conditions and on whether these domains remain adversely associated with health. FundingNo funding to declare.

COVID-19 Stress and the Health of Black Americans in the Rural South.

Black Americans have been disproportionately affected by the COVID-19 pandemic. To better understand changes in and predictors of their mental and physical health, in the current study, we used three waves of data (two prepandemic and a third during summer 2020) from 329 Black men and women in the rural South. Results indicated that health worsened after the onset of the pandemic, including increased depressive symptoms and sleep problems and decreased self-reported general health. Greater exposure to COVID-19-related stressors was significantly associated with poorer health. Prepandemic stressors (financial strain, racial discrimination, chronic stress) and prepandemic resources (marital quality, general support from family and friends) were significantly associated with exposure to COVID-19-related stressors and with health during the pandemic. Findings underscore how the pandemic posed the greatest threats to Black Americans with more prepandemic psychosocial risks and highlight the need for multifaceted interventions that address current and historical stressors among this population.

Intimate partner violence and health outcomes experienced by women who are pregnant: a cross-sectional survey in Sanma Province, Vanuatu.

BackgroundWe aimed to describe the association between ni-Vanuatu women's experiences of violence perpetrated by their intimate partner (IPV) during pregnancy, and health outcomes, including self-reported general health, antenatal care attendance, psychological distress and suicidal thoughts/behaviours.MethodsA cross-sectional survey of a consecutive cohort of women attending the antenatal clinic at Northern Provincial Hospital, Vanuatu from May to July 2019. Psychological, physical and sexual IPV were measured using the WHO Violence Against Women Instrument. Psychological distress was measured using the 20-item WHO Self-Reporting Questionnaire. Data were collected in confidential individual interviews with a trained local interviewer. Logistic regression models were used to investigate the relationship between IPV and health outcomes while controlling for confounding variables.Findings192 women contributed data, among whom 188 answered the questions about IPV. Of these, 80 women had experienced any form of IPV during the current pregnancy. Women who experienced IPV were more likely than those who did not to report poorer general health (aOR:2.97, 95%CI:1•42-6•22), higher levels of psychological distress (aOR:4.77, 95%CI:2•02-11.24) and suicidal thoughts (aOR:3•78, 95%CI:1•71–8.33) and/or behaviours (aOR:1.98, 95%CI:0•69–5.64) in the previous four weeks. Late antenatal attendance was widespread, but not related to IPV.InterpretationIPV perpetrated against women who are pregnant is a serious public health problem in Vanuatu and is related to worse antenatal physical and psychological health.FundingJF is supported by the Finkel Professorial Fellowship, funded by the Finkel Family Foundation; TT is supported by a Monash Strategic Bridging Fellowship. Monash University provided a student research grant to SMcK. Soroptimist International Gippsland provided a grant to fund small gifts for the participants.

Patterns of Atopic Eczema Disease Activity From Birth Through Midlife in 2 British Birth Cohorts

Atopic eczema is characterized by a heterogenous waxing and waning course, with variable age of onset and persistence of symptoms. Distinct patterns of disease activity such as early-onset/resolving and persistent disease have been identified throughout childhood; little is known about patterns into adulthood. This study aimed to identify subtypes of atopic eczema based on patterns of disease activity through mid-adulthood, to examine whether early life risk factors and participant characteristics are associated with these subtypes, and to determine whether subtypes are associated with other atopic diseases and general health in mid-adulthood. This study evaluated members of 2 population-based birth cohorts, the 1958 National Childhood Development Study (NCDS) and the 1970 British Cohort Study (BCS70). Participant data were collected over the period between 1958 and 2016. Data were analyzed over the period between 2018 and 2020. Subtypes of atopic eczema were identified based on self-reported atopic eczema period prevalence at multiple occasions. These subtypes were the outcome in models of early life characteristics and an exposure variable in models of midlife health. Latent class analysis identified 4 subtypes of atopic eczema with distinct patterns of disease activity among 15 939 individuals from the NCDS (51.4% male, 75.4% White) and 14 966 individuals from the BCS70 (51.6% male, 78.8% White): rare/no (88% to 91%), decreasing (4%), increasing (2% to 6%), and persistently high (2% to 3%) probability of reporting prevalent atopic eczema with age. Sex at birth and early life factors, including social class, region of residence, tobacco smoke exposure, and breastfeeding, predicted differences between the 3 atopic eczema subtypes and the infrequent/no atopic eczema group, but only female sex differentiated the high and decreasing probability subtypes (odds ratio [OR], 1.99; 95% CI, 1.66-2.38). Individuals in the high subtype were most likely to experience asthma and rhinitis, and those in the increasing subtype were at higher risk of poor self-reported general (OR, 1.29; 95% CI, 1.09-1.53) and mental (OR 1.45; 95% CI, 1.23-1.72) health in midlife. The findings of this cohort study suggest that extending the window of observation beyond childhood may reveal clear subtypes of atopic eczema based on patterns of disease activity. A newly identified subtype with increasing probability of activity in adulthood warrants additional attention given observed associations with poor self-reported health in midlife.

Olfaction and Physical Functioning in Older Adults: A Longitudinal Study.

Poor olfaction is associated with worse functional performance in older adults, but longitudinal evidence is lacking. We investigated poor olfaction in relation to longitudinal changes in physical functioning among community-dwelling older adults. The analysis included 2 319 participants from the Health, Aging and Body Composition study (aged 71-82 years, 47.9% men, and 37.3% Blacks) who completed the Brief Smell Identification Test in 1999-2000. Olfaction was defined as good (test score 11-12), moderate (9-10), or poor (0-8). Physical functioning was assessed up to 4 times over 8 years, using the Short Physical Performance Battery (SPPB) and the Health Aging and Body Composition Physical Performance Battery (HABCPPB). We conducted joint model analyses and reported the differences in annual declines across olfaction groups. During the follow-up, compared to those with good olfaction, older adults with poor olfaction had greater annual declines in both the SPPB score (-0.137, 95% CI: -0.186, -0.088) and all its subscales: standing balance (-0.068, 95% CI: -0.091, -0.044), chair stand (-0.046, 95% CI: -0.070, -0.022), and gait speed (-0.022, 95% CI: -0.042, -0.001). A similar observation was made for the HABCPPB score (difference in annual decline: -0.032, 95% CI: -0.042, -0.021). These findings are robust and cannot be explained by measured confounding from demographics, lifestyle factors, and chronic diseases or by potential biases due to death and loss of follow-up. Similar associations were observed across subgroups of sex, race, and self-reported general health status. This study provides the first epidemiological evidence that poor olfaction predicts a faster decline in physical functioning. Future studies should investigate potential mechanisms.

Is Living in a U.S. Coastal City Good for One's Health?

Background: Evidence suggests that living close to “blue spaces” (water features), particularly coastlines, has salutary effects on human health. Methods: We analyzed five years of annual, self-reported general health and unhealthy days data from the Behavioral Risk Factor Surveillance System of the U.S. Centers for Disease Control and Prevention for 165 urban areas across the contiguous U.S. We compared health self-reports for people living in coastal vs. non-coastal urban areas and for residents of the disaster-prone Gulf of Mexico region vs. other locations. Coastal urban areas were defined as those having ≥50% of their population living within 20 km of a coast. Results: We found no overall health advantage of residing in a coastal urban location when all urban areas were considered. However, residents from non-Gulf of Mexico coastal urban areas reported modestly better health than residents from non-coastal areas. In contrast, self-reported health of Gulf coastal urban residents was significantly poorer than that of residents from other urban areas. Conclusions: The frequency of disasters and history of health and socioeconomic disparities in the Gulf region may be responsible, at least in part, for the apparent lack of health promoting effects of coastal location there.

Long-term solid fuel use and risks of major eye diseases in China: A population-based cohort study of 486,532 adults.

Over 3.5 billion individuals worldwide are exposed to household air pollution from solid fuel use. There is limited evidence from cohort studies on associations of solid fuel use with risks of major eye diseases, which cause substantial disease and economic burden globally. The China Kadoorie Biobank recruited 512,715 adults aged 30 to 79 years from 10 areas across China during 2004 to 2008. Cooking frequency and primary fuel types in the 3 most recent residences were assessed by a questionnaire. During median (IQR) 10.1 (9.2 to 11.1) years of follow-up, electronic linkages to national health insurance databases identified 4,877 incident conjunctiva disorders, 13,408 cataracts, 1,583 disorders of sclera, cornea, iris, and ciliary body (DSCIC), and 1,534 cases of glaucoma. Logistic regression yielded odds ratios (ORs) for each disease associated with long-term use of solid fuels (i.e., coal or wood) compared to clean fuels (i.e., gas or electricity) for cooking, with adjustment for age at baseline, birth cohort, sex, study area, education, occupation, alcohol intake, smoking, environmental tobacco smoke, cookstove ventilation, heating fuel exposure, body mass index, prevalent diabetes, self-reported general health, and length of recall period. After excluding participants with missing or unreliable exposure data, 486,532 participants (mean baseline age 52.0 [SD 10.7] years; 59.1% women) were analysed. Overall, 71% of participants cooked regularly throughout the recall period, of whom 48% used solid fuels consistently. Compared with clean fuel users, solid fuel users had adjusted ORs of 1.32 (1.07 to 1.37, p < 0.001) for conjunctiva disorders, 1.17 (1.08 to 1.26, p < 0.001) for cataracts, 1.35 (1.10 to 1.66, p = 0.0046) for DSCIC, and 0.95 (0.76 to 1.18, p = 0.62) for glaucoma. Switching from solid to clean fuels was associated with smaller elevated risks (over long-term clean fuel users) than nonswitching, with adjusted ORs of 1.21 (1.07 to 1.37, p < 0.001), 1.05 (0.98 to 1.12, p = 0.17), and 1.21 (0.97 to 1.50, p = 0.088) for conjunctiva disorders, cataracts, and DSCIC, respectively. The adjusted ORs for the eye diseases were broadly similar in solid fuel users regardless of ventilation status. The main limitations of this study include the lack of baseline eye disease assessment, the use of self-reported cooking frequency and fuel types for exposure assessment, the risk of bias from delayed diagnosis (particularly for cataracts), and potential residual confounding from unmeasured factors (e.g., sunlight exposure). Among Chinese adults, long-term solid fuel use for cooking was associated with higher risks of not only conjunctiva disorders but also cataracts and other more severe eye diseases. Switching to clean fuels appeared to mitigate the risks, underscoring the global health importance of promoting universal access to clean fuels.

The Khoekhoegowab Personality Inventory: The Comparative Validity of a Locally Derived Measure of Traits.

Objective: This study explores a personality inventory derived from the results of an indigenous lexical study of personality. From the 272 most commonly used personality descriptors in Khoekhoegowab, the most-spoken of extant Khoesan click languages of southern Africa, an 11-factor model of personality-trait structure was identified. Here, the Khoekhoegowab Personality Inventory (KPI) was created based on those results. Its psychometric properties, the convergent and divergent validity of its scales, and its incremental validity over Big Five and Six traits for predicting physical and mental health, religious practice and attitudes, and income are reported.Methods: Two to five key terms were selected for each of 10 KPI scales: Temperance, Prosocial Diligence, Gossip, Honesty/Morality, Temper, Implacability, Humility, Vanity, Resiliency vs. Agitation, and Courage vs. Fear. These 38 total items were administered to a large sample of adult speakers of Khoekhoegowab in Namibia (N = 632), together with five imported inventories translated into Khoekhoegowab: the 30-item Questionnaire Big Six (QB6), General Self-Reported Health, the Cascades Mental Health Assessment, the Satisfaction with Life Scale, the Duke Religion Index. The properties and intercorrelations of KPI subscales are explored, and their predictive ability for the other variables is compared to that of the QB6.Results: Due to the small number of items on each scale, poor internal consistency was anticipated, but the KPI scales' properties were somewhat better than those of the QB6. R-square change by the inventories as a whole, after accounting for age and gender, indicted that the KPI scales explained more variance than the QB6 scales in almost all criterion variables. Replication of established associations for Big Six traits was mixed: associations were largely as expected for Resiliency, Conscientiousness, and Honesty, but less so for Agreeableness and Extraversion.Conclusions: The KPI had some advantages over the QB6 in predicting physical and mental health. In particular, the four items of Resiliency vs. Agitation predicted lower scores on all physical and mental problem scales. Given psychological-care needs in Namibia, this might be used as a non-intrusive screener. Measurement challenges common to both surveys are discussed, possible solutions, and the utility of higher-order structures are discussed.

The Ecology of Unsheltered Homelessness: Environmental and Social-Network Predictors of Well-Being among an Unsheltered Homeless Population.

People experiencing homelessness (PEH) face extreme weather exposure and limited social support. However, few studies have empirically assessed biophysical and social drivers of health outcomes among unsheltered PEH. Social network, health, and outdoor exposure data were collected from a convenience sample of unsheltered PEH (n = 246) in Nashville, TN, from August 2018–June 2019. Using multivariate fixed-effects linear regression models, we examined associations between biophysical and social environments and self-reported general health and emotional well-being. We found that study participants reported the lowest general health scores during winter months—Nashville’s coldest season. We also found a positive association between the number of nights participants spent indoors during the previous week and general health. Participants who spent even one night indoors during the past week had 1.8-point higher general health scores than participants who spent zero nights indoors (p < 0.01). Additionally, participants who experienced a conflict with a social contact in the past 30 days had lower emotional well-being scores than participants who experienced no conflict. Finally, women had worse general health and emotional well-being than men. Ecologically framed research about health and well-being among PEH is critically needed, especially as climate change threatens to increase the danger of many homeless environments.

Oral Health and Psychosocial Predictors of Quality of Life and General Well-Being among Adolescents in Lesotho, Southern Africa.

Background: Adolescents’ quality of life is reported to be significantly associated with physical and social wellbeing. Although adolescents are 30% of the Southern African population, no previous studies have focused on this group in relation to oral health and quality of life. Methods: A 40-item survey and clinical oral examinations were conducted in public schools in Maseru from 10 to 25 August 2016. Simple, bivariate, and multivariate regressions were used to evaluate the associations of oral health and psychosocial factors with self-reported general health status and quality of life. Results: A total of 526 participants, aged 12–19 years old, responded to the survey and participated in the clinical examinations. The majority reported a good (good/very good/excellent) quality of life (84%) and general health (81%). Bivariate results showed that self-reported general health in this population was significantly influenced by age. The presence of toothache and sensitivity in the adolescents were significantly associated with poor (fair/poor) self-reported general health and were found to be the best predictors for self-general health and quality of life. Conclusions: The absence of dental conditions such as toothache and tooth sensitivity can lead to a better perception of general health and Quality of Life in adolescents.