Significant Predictors Of Health Research Articles

The Relationship Between Forgiveness and Health Outcomes Among People Living with HIV: A Cross-Sectional Study in France

Research to date has shown that HIV infection is a highly stressful experience for individuals, and one of the key adaptive resources after such painful experiences may be forgiveness. The aim of the present study was to examine the associations between dispositional forgiveness (assessed using Mullet’s Forgivingness Questionnaire and Toussaint’s Forgiveness Scale), perceived stress (single-item measure of stress symptoms), health perception (EuroQol visual analogue version of the scale) and life satisfaction (Satisfaction With Life Scale) in people living with HIV (PLWH) in France. Paper surveys were completed by 222 PLWH aged 18–78 (57% male). Multiple regression analysis revealed that sensitivity to circumstances, unconditional forgiveness, self-forgiveness, and forgiveness of others were significant predictors of health and happiness. Mediation analysis showed that these relationships are completely mediated by perceived stress. The present findings suggest that forgiveness and perceived stress may be important variables for healing in PLWH. Interventions designed to improve forgiveness and self-forgiveness may result in improved health and life satisfaction in PLWH.

Construction of the Ohio Children's Opportunity Index.

ObjectiveTo describe the development of an area-level measure of children's opportunity, the Ohio Children's Opportunity Index (OCOI).Data Sources/Study SettingSecondary data were collected from US census based-American Community Survey (ACS), US Environmental Protection Agency, US Housing and Urban Development, Ohio Vital Statistics, US Department of Agriculture-Economic Research Service, Ohio State University Center for Urban and Regional Analysis, Ohio Incident Based Reporting System, IPUMS National Historical Geographic Information System, and Ohio Department of Medicaid. Data were aggregated to census tracts across two time periods.Study DesignOCOI domains were selected based on existing literature, which included family stability, infant health, children's health, access, education, housing, environment, and criminal justice domains. The composite index was developed using an equal weighting approach. Validation analyses were conducted between OCOI and health and race-related outcomes, and a national index.Principal FindingsComposite OCOI scores ranged from 0–100 with an average value of 74.82 (SD, 17.00). Census tracts in the major metropolitan cities across Ohio represented 76% of the total census tracts in the least advantaged OCOI septile. OCOI served as a significant predictor of health and race-related outcomes. Specifically, the average life expectancy at birth of children born in the most advantaged septile was approximately 9 years more than those born in least advantaged septile. Increases in OCOI were associated with decreases in proportion of Black (48 points lower in the most advantaged vs. least advantaged septile), p < 0.001) and Minority populations (54 points lower in most advantaged vs. least advantaged septile, p < 0.001). We found R-squared values > 0.50 between the OCOI and the national Child Opportunity Index scores. Temporally, OCOI decreased by 1% between the two study periods, explained mainly by decreases in the children health, accessibility and environmental domains.ConclusionAs the first opportunity index developed for children in Ohio, the OCOI is a valuable resource for policy reform, especially related to health disparities and health equity. Health care providers will be able to use it to obtain holistic views on their patients and implement interventions that can tackle barriers to childhood development using a more tailored approach.

Keeping it together: The role of social integration on health and psychological well-being among individuals with multiple sclerosis.

Research indicates that people with multiple sclerosis (MS) are more likely to report poorer health and well-being than their peers without MS. Fortunately, it is also known that an individual's social and lifestyle factors play a great role on maintaining and promoting one's health and overall well-being. The present study aimed to examine the role that social integration and social support, in particular have on health and psychological well-being (PWB) among individuals with MS. One hundred and eighty three individuals with MS completed measures of social and lifestyle factors, personality, physical and mental health, MS disease symptomatology and PWB. Cross sectional, regression analyses were conducted to determine the role of social and other lifestyle factors (e.g., diet/exercise) on health and PWB. A subset of this sample (108) completed a follow-up assessment. Longitudinal analyses of this sample were also conducted. Consistent with previous findings, the presence of social integration and social support were significant predictors of health and PWB even when taking into account other lifestyle factors (i.e., diet/exercise, substance use, smoking), cardiovascular risk, demographics (i.e., gender, age, education, relationship status) and personality. The role of social integration and support on health and PWB is well established. Present findings confirmed these associations among individuals with MS. These findings suggest that social integration and social support should be a crucial part of MS management and that further interventional studies aimed at improving social integration and reducing social isolation are warranted in an effort to promote and maintain overall health and well-being.

Predictors of Latinx Youth Health and Emotional Well-being: Social Determinants of Health Perspective

Latinx youth disproportionately experience numerous negative social determinants of health (SDOH) that can have deleterious impacts on health outcomes. Yet, limited research is available on the role of SDOH on the well-being of Latinx adolescents. Utilizing data from the Fragile Families and Child Wellbeing Study, this study examined the association between variables representing five discrete domains of SDOH and health and emotional well-being outcomes among youth of Latinx mothers (N = 745). The study included 15-year-old youth of Latina mothers who were retained in the most recent wave of data collection (wave 6). Using Mplus8, we performed structural equation modeling to determine whether exogenous indicators of five domains of SDOH (economic stability, education, neighborhood and built environment, social and community context, and health care access) predicted adolescent health status and emotional well-being. SDOH specific to social, educational, and neighborhood factors emerged as significant predictors of health and well-being. Yet, variation existed in regard to which SDOH were most important for each outcome variable. Findings suggest that several SDOH, including economic stability, education, neighborhood and built environment, and social and community context, are particularly important for Latinx adolescent well-being. Implications for social work practice and policy are presented. Future studies should examine the longitudinal impact of SDOH and should examine Latinx youth by nativity.

The Language of Positive Mental Health: Findings From a Sample of Russian Facebook Users

Positive mental health is considered to be a significant predictor of health and longevity; however, our understanding of the ways in which this important characteristic is represented in users’ behavior on social networking sites is limited. The goal of this study was to explore associations between positive mental health and language used in online communication in a large sample of Russian Facebook users. The five-item World Health Organization Well-Being Index (WHO-5) was used as a self-report measure of well-being. Morphological, sentiment, and semantic analyses were performed for linguistic data. The total of 6,724 participants completed the questionnaire and linguistic data were available for 1,972. Participants’ mean age was 45.7 years ( SD = 11.6 years); 73.4% were female. The dataset included 15,281 posts, with an average of 7.67 ( SD = 5.69) posts per participant. Mean WHO-5 score was 60.0 ( SD = 19.1), with female participants exhibiting lower scores. Use of negative sentiment words and impersonal predicates (“should statements”) demonstrated an inverse association with the WHO-5 scores. No significant correlation was found between the use of positive sentiment words and the WHO-5 scores. This study expands current understanding of the association between positive mental health and language use in online communication by employing data from a non-Western sample.

Inequality in socio-emotional skills: A cross-cohort comparison

We examine changes in inequality in socio-emotional skills very early in life in two British cohorts born 30 years apart. We construct comparable scales using two validated instruments for the measurement of child behaviour and identify two dimensions of socio-emotional skills: ‘internalising’ and ‘externalising’. Using recent methodological advances in factor analysis, we establish comparability in the inequality of these early skills across cohorts, but not in their average level. We document for the first time that inequality in socio-emotional skills has increased across cohorts, especially for boys and at the bottom of the distribution. We also formally decompose the sources of the increase in inequality and find that compositional changes explain half of the rise in inequality in externalising skills. On the other hand, the increase in inequality in internalising skills seems entirely driven by changes in returns to background characteristics. Lastly, we document that socio-emotional skills measured at an earlier age than in most of the existing literature are significant predictors of health and health behaviours. Our results show the importance of formally testing comparability of measurements to study skills differences across groups, and in general point to the role of inequalities in the early years for the accumulation of health and human capital across the life course.

Workplace relationships impact self-rated health: A survey of Swedish municipal health care employees.

The impact of positive social relationships on the health of municipal employees in the elder care sector in Sweden needs further examination. To explore the association between health and relationships among elderly care employees using a salutogenic perspective. Survey of all employees (n = 997) in special housing, home care and Disabled Support and Services in a Swedish municipality. The questionnaire, which had a salutogenic perspective, included information on self-rated health from the previously validated SHIS (Salutogenic Health Indicator Scale), psychosocial work environment and experiences, social climate, and health-promoting workplace relationships. The response rate was 69% . Results of a multivariable linear regression model showed four significant predictors of health: general work experiences, colleague belongingness and positive relationships with managers and care recipients. In another model, colleague belongingness was significantly related to satisfaction with care recipients, work, length of employment as well as general work experiences and relationships with managers. Strengthening of positive work relationships, not only between workmates but also with managers and care recipients, seems to be an essential area for employee health promotion. Colleague belongingness may be deepened by development of a positive work climate, including satisfactory work experiences, positive manager relationships and a stable work force.

To Keep this Disease from Killing You: Cultural Competence, Consonance, and Health among HIV-positive Women in Kenya.

The HIV/AIDS crisis continues in sub-Saharan Africa, where nearly 70% of infections are found. Despite recent efforts to supply antiretroviral therapy to those infected, most are not receiving medication and are forced to rely on self-management to remain healthy. In Kenya, many of those infected are women living in extreme poverty. This article presents the findings of research among poor women in Nairobi that examined the relationship between knowledge of a cultural model of self-managing HIV/AIDS, cultural consonance, and health. This biocultural study expands on earlier findings showing that knowledge of the model (competence) is a significant predictor of health by examining here how behavior consistent with that knowledge (consonance) affects health outcomes, as measured by CD4 counts, perceived stress, depressive symptoms, and recent illnesses.

Identifying Predictors of Health in Adults with an Intellectual Disability

Body mass index (BMI) and age are well-known predictors of an individual’s health (Peter et al., 2015). However, many studies recently suggest that there should be additional factors between BMI and health to strengthen the relationship (McAuley et al., 2014). This complicated process might apply to adults with an intellectual disability (ID), but there have been limited understanding on what other factors influence health over BMI and age in this underserved population. PURPOSE: To identify health predictors in adults with ID, controlling for BMI and age. METHODS: We employed secondary data analysis using 6814 adults with ID (age 18–96 years; 56% men) from the 2013–14 Adult Consumer Survey by National Core Indicators to reveal the potential predictors. Tested variables included personal, health, residence, employment, daytime activities, home, friends/family/staff support, service satisfaction, community participation, and choice-related variables. Considering a type of the outcome variable (i.e., four health categories from poor to excellent), a forward model selection method based on ordinal multiple regression was employed to find out the best model explaining health in adults with ID. RESULTS: Mobility, moderate physical activity (PA) engagement, tobacco use, staff support, having a job, eating out in the past month, and having a vacation in the past year were all significant predictors of health in this population (p <. 001), and the model containing those predictors explained 17% of variance on health of adults with ID, after accounting for BMI and age. Those who moved without mobility aids, engaged in PA, didn’t smoke, had a job, received less staff support, ate out, and had vacation were significantly healthier than their counterparts. For instance, the ordered logit for adults with ID who didn’t routinely engage in moderate PA being a less heathy category is .49 more than their counterparts. The goodness-of-fit test (Pearson x2 = 20241.5, p > .05) revealed that this model fits well. CONCLUSION: Apart from BMI and age, we have to consider various personal, social and environmental predictors to better explain health of adults with ID. Interestingly, the health predictors found in this study are closely aligned with the International Classification of Functioning, Disability and Health (WHO, 2001).

Four Decades of Educational Inequalities in Hospitalization and Mortality among Older Swedes.

BackgroundThe inverse association between education and mortality has grown stronger the last decades in many countries. During the same period, gains in life expectancy have been concentrated to older ages; still, old-age mortality is seldom the focus of attention when analyzing trends in the education-mortality gradient. It is further unknown if increased educational inequalities in mortality are preceded by increased inequalities in morbidity of which hospitalization may be a proxy.MethodsUsing administrative population registers from 1971 and onwards, education-specific annual changes in the risk of death and hospital admission were estimated with complimentary log-log models. These risk changes were supplemented by estimations of the ages at which 25, 50, and 75% of the population had been hospitalized or died (after age 60).ResultsThe mortality decline among older people increasingly benefitted the well-educated over the less well-educated. This inequality increase was larger for the younger old, and among men. Educational inequalities in the age of a first hospital admission generally followed the development of growing gaps, but at a slower pace than mortality and inequalities did not increase among the oldest individuals.ConclusionsEducation continues to be a significant predictor of health and longevity into old age. That the increase in educational inequalities is greater for mortality than for hospital admissions (our proxy of overall morbidity) may reflect that well-educated individuals gradually have obtained more possibilities or resources to survive a disease than less well-educated individuals have the last four decades.

A nationally representative study of emotional competence and health.

Emotional competence (EC; also called "emotional intelligence"), which refers to individual differences in the identification, understanding, expression, regulation, and use of one's emotions and those of others, has been found to be an important predictor of individuals' adaptation to their environment. Higher EC is associated with greater happiness, better mental health, more satisfying social and marital relationships, and greater occupational success. Whereas a considerable amount of research has documented the significance of EC, 1 domain has been crucially under investigated: the relationship between EC and physical health. We examined the relationship between EC and objective health indicators in 2 studies (N1 = 1,310; N2 = 9,616) conducted in collaboration with the largest Mutual Benefit Society in Belgium. These studies allowed us (a) to compare the predictive power of EC with other well-known predictors of health such as age, sex, Body Mass Index, education level, health behaviors (diet, physical activity, smoking and drinking habits), positive and negative affect, and social support; (b) to clarify the relative weight of the various EC dimensions in predicting health; and (c) to determine to what extent EC moderates the effect of already known predictors on health. Results show that EC is a significant predictor of health that has incremental predictive power over and above other predictors. Findings also show that high EC significantly attenuates (and sometimes compensates for) the impact of other risk factors. Therefore, we argue that EC deserves greater interest and attention from health professionals and governments.

Social Cohesion and Self‐Rated Health: The Moderating Effect of Neighborhood Physical Disorder

Using data from the Los Angeles Family and Neighborhood Survey and its companion datasets, we examined how neighborhood disorder, perceived danger and both individually perceived and contextually measured neighborhood social cohesion are associated with self-rated health. Results indicate that neighborhood disorder is negatively associated with health and the relationship is explained by perceived cohesion and danger, which are both also significant predictors of health. Further, individually perceived cohesion emerges as a more important explanation of self-rated health than neighborhood-level social cohesion. Finally, neighborhood disorder and perceived cohesion interact to influence health, such that cohesion is especially beneficial when residents live in neighborhoods characterized by low to moderate disorder; once disorder is at high levels, cohesion no longer offers protection against poor health. We interpret our findings as they relate to prior research on neighborhoods, psychosocial processes, and health, and discuss their implications for intervention efforts that address disorder in urban communities.

Long-term Impact of Parental Well-Being on Adult Outcomes and Dementia Status in Individuals With Down Syndrome

Parental characteristics were significant predictors of health, functional abilities, and behavior problems in adults with Down syndrome (n = 75) over a 22-year time span, controlling for initial levels and earlier changes in these outcomes. Lower levels of behavior problems were predicted by improvements in maternal depressive symptoms. Higher levels of functional abilities were predicted by prior measures of and improvements in maternal depressive symptoms. Better health was predicted by prior measures of maternal depressive symptoms, paternal positive psychological well-being, relationship quality between fathers and their adult children, and improvements in maternal positive psychological well-being. Dementia status was also predicted by parental characteristics. The study suggests the importance of the family context for healthy aging in adults with Down syndrome.

The Impact of Sleep Complaints on Physical Health and Immune Outcomes in Rescue Workers

The present study evaluated the extent to which sleep assessed soon after a trauma predicted subsequent physical health and immune functioning in rescue workers. Participants included 159 men and women who performed rescue and clean-up operations at the site of a major airplane crash. One hundred twenty-eight participants were retained for a 1-year follow-up. Self-report measures of sleep quality and psychological distress were obtained within 2 months of the crash, and a physical health questionnaire was completed at 1-year follow-up. Natural killer cell number and cytotoxicity were assessed using blood samples collected from a subset of participants (n=51) at 1-year follow-up. After adjustment for sex, age, body mass index, and initial distress, initial sleep quality complaints were associated with more physical symptoms (β=.32; p<.001), poorer perceived health (β=-.27; p=.009), and increased healthcare utilization (β=.31; p=.003) on follow-up. In contrast, initial sleep quality was not associated with natural killer cell number (r=0.10; p=.55) or activity (r=0.02; p=.90). Change in sleep quality during the year after the crash was not a significant predictor of health or immune outcomes. These data suggest that poor sleep quality in the aftermath of trauma signals an increased risk for future adverse physical health outcomes and underscore the importance of addressing sleep complaints soon after trauma to mitigate negative impact on physical health.

Predicting Internet Use as a Source of Health Information: A “Language Divide” Among the Hispanic Population in the United States

AbstractSpurred by the rapid diffusion of information technology and advances in e‐Health initiatives, the Internet is increasingly viewed as an important tool for health promotion and health education as well as a platform for the delivery of public health interventions. The Internet also holds promise in eliminating health disparities through increased access to health information. Using the Pew 2007 Hispanic Healthcare Survey, we examined the factors that are associated with each of the four media channels (Internet, radio, TV, and print media) as a source of health information among 4,013 Hispanic adults. The most significant predictor of health information‐seeking behavior on the Internet was English proficiency. Policy implications include the need to address both the “digital divide” and the “language divide” by increasing Internet access, improving e‐Health literacy, and creating high quality and culturally tailored websites in Spanish for Hispanic adults who have low levels of English proficiency and education.

The Mental Vulnerability Questionnaire: A psychometric evaluation

The Mental Vulnerability Questionnaire was originally a 22 item scale, later reduced to a 12 item scale. In population studies the 12 item scale has been a significant predictor of health and illness. The scale has not been psychometrically evaluated for more than 30 years, and the aim of the present study was both to evaluate the psychometric properties of the 22 and 12 item scales and of three new scales. The main study sample was a community sample comprising more than 6,000 men and women. In this sample the coefficients of homogeneity were all over 0.30 for the three new scales, but below 0.30 for the 12 and the 22 item scales. All five Mental Vulnerability scales had positively skewed score distributions which were associated significantly with both SCL-90-R symptom scores and NEO-PI-R personality scales (primarily Neuroticism and Extraversion). Coefficient alpha was highest for the 22 and 12 item scales, and the two scales also showed the highest long-term stability. The three new scales reflect relatively independent dimensions of Psychosomatic Symptoms, Mental Symptoms, and Interpersonal Problems, but because of reliability problems it remains an open question whether they will prove useful as predictors of health and morbidity.

AAFP–AAHA: Feline Life Stage Guidelines

1Although most owners consider their cats to be family members, cats are substantially underserved, compared with dogs. In 2006, owners took their dogs to veterinarians more than twice as often as cats, averaging 2.3 times/year, compared with 1.1 times/year for cats, and significantly more dogs (58%) than cats (28%) were seen by a veterinarian one or more times/year. 2 Cat owners often express a belief that cats ‘do not need medical care’. Two reasons for this misconception are that signs of illness are often difficult to detect, and cats are perceived to be self-sufficient. 2 One role of the veterinarian is to develop a partnership with cat owners that will pave the way for a lifelong health care plan. These guidelines aim to outline an evidence-based life stage wellness program to aid the veterinary medical team in delivering the best comprehensive care for cats. Specific goals are to provide: ✜ Recommendations for optimal health care for cats throughout the different life stages. ✜ Practical suggestions and tools to facilitate improved veterinary visits and to enhance the client–veterinarian clinical encounter. ✜ A foundation from which to access sources of additional information. Life stage classification Distinct life stages (age groups) in cats are not well defined, in part because individual animals and body systems age at different rates, a process that is influenced by many factors. These guidelines follow one convenient classification (see box below). These age designations help to focus attention on the physical and behavioral changes that occur at different stages (eg, congenital defects in kittens, obesity prevention in the junior cat). It must be recognized, however, that any age groupings are inevitably arbitrary demarcations along a spectrum, and not absolutes. Evidence-based health care Supporting references for specific recommendations are supplied where possible, and any previously published guidelines on particular topics are referred to where relevant. Readers should note, however, that the guidelines panel was hampered in its efforts by the relative paucity of disease incidence data by age group that is available, and there is an urgent need for research to guide the future of evidence-based feline health care. 3

The Health and Quality of Life Outcomes Among Youth and Young Adults With Cerebral Palsy

Young NL, Rochon TG, McCormick A, Law M, Wedge JH, Fehlings D. The health and quality of life outcomes among youth and young adults with cerebral palsy. Objectives To describe the health and quality of life (QoL) of youth and young adults who have cerebral palsy (CP), and to assess the impact of 3 key factors (severity, age, and sex) on these outcomes. Design Cross-sectional survey. Setting Participants were identified from 6 children's treatment centers in Ontario. Participants The sample of participants (N=199) included youth (n=129; age, 13–17y) and adults (n=70; age, 23–33y) with a broad range of severity: 35% mild, 19% moderate, and 47% severe. Intervention Not applicable. Main Outcome Measures Health Utilities Index (HUI 3), Assessment of Quality of Life (AQoL), and Self-Rated Health (SRH). Results SRH was reported to be excellent or very good by 57% of youth and 46% of adults. Mean HUI 3 scores were .30 for youth and .31 for adults. Mean AQoL scores were .28 for youth and adults. Severity of CP in childhood predicted 55% of the variance in HUI 3 scores and 45% of the variance in AQoL scores. Age and sex were not significant predictors of health or QoL. Conclusions The observed health and QoL scores were much lower than those previously reported in the literature. This is likely a result of the inclusion of those with severe CP. The scores for youth were similar to those for adults and suggest that health and QoL outcomes were relatively stable across the transition to adulthood. Youth and adults with CP have limited health status and will require health care support throughout their lives to help them optimize their well being. Longitudinal follow-up studies are essential to understand better the patterns of health in this population over time.

Home telecare for COPD/CHF patients: outcomes and perceptions

We evaluated the use of home telehealth for patients with chronic obstructive pulmonary disease (COPD) and/or congestive heart failure (CHF). Patients diagnosed with COPD and/or CHF who were prescribed home health-care services were randomly assigned to an experimental group where they received home health care through a combination of traditional face-to-face and telemedicine visits (n = 83), and a control group where only conventional home care was employed (n = 78). Data were collected via the Short Form 36 (SF-36), Outcome and Assessment Information Set (OASIS) and patient charts. In the experimental group, patient perceptions of the home telecare services were collected via telephone interviews. Overall, the addition of telehealth to COPD/CHF patient care was not a significant predictor of health and wellbeing, either positively or negatively. Although those receiving telehealth had worse ratings on the SF-36 general health subscale after the intervention, this measure was only significant when controlling for a number of key variables in the model. In regard to patient perceptions of home telecare, patients were satisfied with the technology and the way that care was delivered via this modality.

Personality disorders in the community: results from the Australian National Survey of Mental Health and Wellbeing Part II. Relationships between personality disorder, Axis I mental disorders and physical conditions with disability and health consultations.

The aims of this study were threefold. First, to ascertain whether personality disorder (PD) was a significant predictor of disability (as measured in a variety of ways) over and above that contributed by Axis I mental disorders and physical conditions. Second, whether the number of PD diagnoses given to an individual resulted in increasing severity of disability, and third, whether PD was a significant predictor of health and mental health consultations with GPs, psychiatrists, and psychologists, respectively, over the last 12 months. Data were obtained from the National Survey of Mental Health and Wellbeing, conducted between May and August 1997. A stratified random sample of households was generated, from which all those aged 18 and over were considered potential interviewees. There were 10,641 respondents to the survey, and this represented a response rate of 78 %. Each interviewee was asked questions indexing specific ICD-10 PD criteria. Five measures of disability were examined. It was found that PD was a significant predictor of disability once Axis I and physical conditions were taken into account for four of the five disability measures. For three of the dichotomously-scored disability measures, odds ratios ranged from 1.88 to 6.32 for PD, whilst for the dimensionally-scored Mental Summary Subscale of the SF-12, a beta weight of -0.17 was recorded for PD. As regards number of PDs having a quasi-linear relationship to disability, there was some indication of this on the SF-12 Mental Summary Subscale and the two role functioning measures, and less so on the other two measures. As regards mental consultations, PD was a predictor of visits to GPs, psychiatrists and psychologists, over and above Axis I disorders and physical conditions. The study reports findings from a nationwide survey conducted within Australia and as such the data are less influenced by the selection and setting bias inherent in other germane studies. However, it does support previous findings that PD is a significant predictor of disability and mental health consultations independent of Axis I disorders and physical conditions.