Social Environmental Risk Factors Research Articles

Suicidal Risk Factors and Youth Population: A Study on Bangladeshi Urban and Rural areas Perspective.

Suicide is an urgent matter of public health that presents a substantial peril to young populations worldwide. This research aims to conduct a comprehensive overview of the risk factors linked with Suicide among the young population in Bangladesh. Understanding these risk factors could expand targeted prevention strategies and interventions to tackle the issue and endorse mental health. This study utilized quantitative research with a survey questionnaire design to collect data from 764 close family members who committed suicide. The data were randomly selected from Dhaka and Jhenaidah districts in Bangladesh. The study revealed that aged 23-25 years have a higher risk for Suicide, where females 62.96% are at higher risk than males 37.04%. The result finds a significant relationship between family and social environment risk factors. Further findings show that education, married status, family size, and monthly family income variables have various degrees of effect on suicide risk among young people based on their age. Despite the inherent limitations of national surveillance in this study, the research findings catalyze further investigation into delineating specific suicide risk factors. Such endeavors aim to mitigate suicidal behaviors and foster positive psychological development across the lifespan.

Self-concept among Indonesian adolescents in coastal areas: A cross-sectional study

Background: Adolescence is a transitional phase from childhood to adulthood, characterized by various biological, psychological, and social changes. Adolescents living in coastal regions are exposed to social-environmental risk factors that can affect their emotional wellbeing, primarily due to the demanding and unpredictable nature of coastal communities. These challenging and volatile circumstances can have a negative impact on adolescents’ emotions, making them more vulnerable to mental and emotional disorders. Objective: This study aimed to examine the self-concept and its differences according to sociodemographic factors among adolescents residing in coastal areas of Indonesia. Methods: A cross-sectional design was employed for this study, which involved 644 adolescents living in coastal regions of Indonesia, specifically in the West Sumatra and Bali provinces. The Tennessee Self Concept Scale (TSCS) 2nd Edition Short Form was used to assess self-concept from August to September 2022. Descriptive statistics, Independent-t-test, and One-way ANOVA were utilized for data analysis. Results: The findings revealed that adolescents in coastal areas had a high level of self-concept. A statistically significant difference was discovered in the overall self-concept according to gender (p = 0.002). Similarly, a significant difference was observed in the physical domain based on class level (p = 0.019). Regarding the personal domain, significant differences were identified according to age (p = 0.030), class level (p = 0.030), parent's marital status (p = 0.030), father's education (p = 0.05), and family income (p = 0.01). Furthermore, in the family domain, significant differences were found based on parents’ marital status (p <0.001) and adolescents’ residence status (p = 0.002). Additionally, a significant difference in the academic domain was observed with respect to gender (p = 0.001). However, no significant differences were noted in the moral ethics and social domains across all sociodemographic variables (p >0.05). Conclusion: This study emphasizes the need for attention from various stakeholders, including mental health nurses, to prioritize interventions to promote positive self-concept among adolescents, consider sociodemographic factors that influence self-concept, and address areas of dissatisfaction such as moral behavior and academic/work efficiency. Incorporating family support and nurturing positive parent-child relationships are also important for fostering a healthy self-concept in adolescents.

Migration, perceived discrimination and the development of psychosis

IntroductionMigration is a rapidly growing phenomenon in European countries and its association with psychotic disorders is a public health concern. Psychosis is more prevalent among migrants, which suggests that adverse social experiences play an important role in its pathogenesis. Throughout the migration process, migrants are exposed to several social disadvantages, including in the post-immigration context, where perceived discrimination appears to be an important stressor. In fact, the highest incidence rates of psychosis occur in the most discriminated populations, namely migrants with darker skin complexion, particularly when living in low-ethnic-density neighborhoods, where both discrimination and social isolation are more prominent.ObjectivesTo conduct an updated review about the association between migration, perceived discrimination and psychosis, aiming to better understand the mechanisms involved.MethodsNarrative literature review using the keywords “migration”; “psychosis”; “discrimination”; “racism” on PubMed database, in conjunction with presentation of a clinical case concerning a patient from Guinea-Bissau, admitted to our hospital in the context of first-episode psychosis (FEP), with onset months after completing the Mediterranean migration route to Europe.ResultsLiterature suggests that experiences of racism and social exclusion contribute to feelings of imminent danger, fear and general anxiety, which may develop into paranoid ideas of ubiquitous persecution. Furthermore, intense social defeat experiences, common in migrants, are associated with more distressing forms of delusional content, with delusions of psychological persecution being more common. However, there is also evidence that migrants with FEP have better occupational and social functioning profiles compared to natives, suggesting that, in these patients, there is a higher burden of social-environmental risk factors, with the onset of psychosis occurring only when this burden overcomes a higher threshold. Our patient fits this description. After completing his migratory route and while living in an Italian refugee camp, he described suffering experiences of severe discrimination. Real or not, these experiences escalated to become delusional ideas of persecution involving European governments, thought to seek for his humiliation. Despite the presence of psychotic symptoms, this patient was able to maintain a reasonable level of functioning during years, up to his psychiatric admission.ConclusionsGiven the notorious effect of perceived discrimination and racism on the increased risk of psychosis in immigrants, it is urgent to adopt policies that promote the social protection of these vulnerable groups, namely through enhancing their integration in the host countries.Disclosure of InterestNone Declared

Abstract P263: Associations Between Dimensions of the Social Environment and Cardiometabolic Risk Factors

Introduction: Although the social environment, including social contacts, norms and support, likely has a significant impact on cardiometabolic disease (CMD) risk, a comprehensive summary of the available evidence is lacking. Hypothesis: Exposure to unfavorable social environments is associated with greater CMD risk. Methods: We conducted a systematic review and meta-analysis on the association between social environmental characteristics and risk factors of CMD. We systematically searched PubMed, Scopus and Web of Science Core Collection from inception to 16 February 2021. Studies that used a risk factor of CMD, e.g., lipids, HbA1c or blood pressure as outcome and social environmental factors such as area-level deprivation, neighborhood racial segregation or social network size as independent variables were included. Titles and abstracts were screened in duplicate. Study quality was assessed using the Newcastle-Ottawa Scale. Data appraisal and extraction were based on the study protocol published in PROSPERO (CRD42021223035). Data were synthesized through vote counting and random effects meta-analyses, the latter if three or more associations investigated the same exposure-outcome combination. Results: A total of 168 studies reporting on 1050 associations were included in this review. Social and Economic Disadvantage was the most studied exposure (45%), followed by Social Relationships and Norms (35%), with less evidence for other social environmental dimensions. Four meta-analyses based on 24 associations suggested that an unfavorable social environment was associated with increased risk of cardiometabolic risk factors, with three of them being statistically significant. For example, individuals that experienced more economic and social disadvantage had a higher CVD risk scores (OR=1.54, 95%CI: 1.35;1.84). Meta-analyzed sex-specific associations showed inconsistent results. Of the 458 associations included in the vote counting, 323 (71%) pointed towards unfavorable social environments being associated with higher CMD risk. Conclusion: Higher economic and social disadvantage seem to contribute to unfavorable CMD risk factor profiles, while evidence for other dimensions of the social environment is limited.

Self-concept among Indonesian adolescents in coastal areas: A cross-sectional study.

Adolescence is a transitional phase from childhood to adulthood, characterized by various biological, psychological, and social changes. Adolescents living in coastal regions are exposed to social-environmental risk factors that can affect their emotional wellbeing, primarily due to the demanding and unpredictable nature of coastal communities. These challenging and volatile circumstances can have a negative impact on adolescents' emotions, making them more vulnerable to mental and emotional disorders. This study aimed to examine the self-concept and its differences according to sociodemographic factors among adolescents residing in coastal areas of Indonesia. A cross-sectional design was employed for this study, which involved 644 adolescents living in coastal regions of Indonesia, specifically in the West Sumatra and Bali provinces. The Tennessee Self Concept Scale (TSCS) 2nd Edition Short Form was used to assess self-concept from August to September 2022. Descriptive statistics, Independent-t-test, and One-way ANOVA were utilized for data analysis. The findings revealed that adolescents in coastal areas had a high level of self-concept. A statistically significant difference was discovered in the overall self-concept according to gender (p = 0.002). Similarly, a significant difference was observed in the physical domain based on class level (p = 0.019). Regarding the personal domain, significant differences were identified according to age (p = 0.030), class level (p = 0.030), parent's marital status (p = 0.030), father's education (p = 0.05), and family income (p = 0.01). Furthermore, in the family domain, significant differences were found based on parents' marital status (p <0.001) and adolescents' residence status (p = 0.002). Additionally, a significant difference in the academic domain was observed with respect to gender (p = 0.001). However, no significant differences were noted in the moral ethics and social domains across all sociodemographic variables (p >0.05). This study emphasizes the need for attention from various stakeholders, including mental health nurses, to prioritize interventions to promote positive self-concept among adolescents, consider sociodemographic factors that influence self-concept, and address areas of dissatisfaction such as moral behavior and academic/work efficiency. Incorporating family support and nurturing positive parent-child relationships are also important for fostering a healthy self-concept in adolescents.

Alcohol as a Non-UV Social-Environmental Risk Factor for Melanoma.

Simple SummaryMalignant melanoma is an aggressive cancer of the skin and the leading cause of death from skin cancer. One major risk factor linked to melanoma development is exposure to UV radiation. However, the sharp increase in melanoma cases cannot be explained only by more UV exposure. Identifying additional modifiable social-environmental risk factors for melanoma beyond UV exposure would greatly impact public health initiatives and the methods of patient outreach and education. Recent studies have shown the link between melanoma and alcohol consumption. This perspective review paper aims to understand the mechanisms underlying ethanol’s ability to induce human cancers, including melanoma.Although cancer mortality has declined among the general population, the incidence of melanoma continues to rise. While identifying high-risk cohorts with genetic risk factors improves public health initiatives and clinical care management, recognizing modifiable risk factors such as social-environmental risk factors would also affect the methods of patient outreach and education. One major modifiable social-environmental risk factor associated with melanoma is ultraviolet (UV) radiation. However, not all forms of melanoma are correlated with sun exposure or occur in sun-exposed areas. Additionally, UV exposure is rarely associated with tumor progression. Another social-environmental factor, pregnancy, does not explain the sharply increased incidence of melanoma. Recent studies have demonstrated that alcohol consumption is positively linked with an increased risk of cancers, including melanoma. This perspective review paper summarizes epidemiological data correlating melanoma incidence with alcohol consumption, describes the biochemical mechanisms of ethanol metabolism, and discusses how ethanol and ethanol metabolites contribute to human cancer, including melanoma.

Social environment risk factors for violence, family context, and trajectories of social-emotional functioning among Latinx adolescents.

High social-emotional functioning, including emotion regulation and nonviolent conflict resolution, constitute developmental competencies of adolescence that promote health and well-being. We used prospective longitudinal data from a predominantly Latinx population to understand how family context and social environment risk factors for violence related to patterns of social-emotional functioning during the transition between middle school and high school. We prospectively interviewed 599 8th graders every 6 months for 2 years. We used trajectory models to explore longitudinal patterns of emotion regulation and nonviolent problem solving and multinomial regression to distinguish how these groups were associated with family context, partner and peer gang involvement, and neighborhood social disorder. Youth reporting lower neighborhood disorder in 8th grade were more likely to be in the high emotion regulation trajectory group. Youth without exposure to gangs through peers and partners in 8th grade were more likely to be in the high nonviolent problem-solving skills trajectory group. Family cohesion was associated with being in the high trajectory groups for both emotional regulation and problem-solving skills. Emotion regulation and nonviolent problem-solving skills had different associations with the social environment risk factors for violence examined, indicating that mechanisms of influence and strategies for intervention may vary. The association between problem-solving skills and exposure to gangs through peers and partners shows that social norms may be important targets of change. Additionally, interventions with parents that build family cohesion during adolescence may buffer environmental exposures that shape adolescents' ability to practice protective social-emotional behaviors.

Individual-based modeling of COVID-19 transmission in college communities.

The ongoing COVID-19 pandemic has created major public health and socio-economic challenges across the United States. Among them are challenges to the educational system where college administrators are struggling with the questions of how to mitigate the risk and spread of diseases on their college campus. To help address this challenge, we developed a flexible computational framework to model the spread and control of COVID-19 on a residential college campus. The modeling framework accounts for heterogeneity in social interactions, activities, environmental and behavioral risk factors, disease progression, and control interventions. The contribution of mitigation strategies to disease transmission was explored without and with interventions such as vaccination, quarantine of symptomatic cases, and testing. We show that even with high vaccination coverage (90%) college campuses may still experience sizable outbreaks. The size of the outbreaks varies with the underlying environmental and socio-behavioral risk factors. Complementing vaccination with quarantine and mass testing was shown to be paramount for preventing or mitigating outbreaks. Though our quantitative results are likely provisional on our model assumptions, sensitivity analysis confirms the robustness of their qualitative nature.

The Social-environmental Risk Factor for Conjunctivitis

BACKGROUND: Conjunctivitis is one of the most common eye disorders in the worldwide. The incidence of conjunctivitis in Indonesia reached 73% of the population. Conjunctivitis cases in Yogyakarta City have increased from year to year. AIM: This study purposed to identify the social-environmental risk factors that influence the incidence of conjunctivitis in Yogyakarta. METHODS: Design study was an observational analytic method with a case–control research design. The population study was all the patients visited at the Eye Clinic of PKU Muhammadiyah Gamping Hospital and private hospital Yogyakarta in 2019. The total sample is 204 respondents who were divided into case and control. One hundred and four respondents were in a case while 100 were controlled. The case was a conjunctivitis patient treated at the Eye Clinic of PKU Muhammadiyah Gamping Hospital and private hospital Yogyakarta in 2019, while the control was a non-conjunctivitis patient who went to the same two hospitals as the case respondent. Data were collected by direct interviews using a structured questionnaire covering the respondents’ demographics and social-environmental conditions. Then, the data were analyzed using SPSS 15.0 univariate and bivariate using Chi-square. RESULTS: The results of the bivariate analysis showed that age, the distance between the house and the river, the distance between the place and the temporary garbage dump, contacted from a close friend, the windows of the house were always opened every day as risk factors affecting the incidence of conjunctivitis. CONCLUSION: The study’s decision is the social-environmental as a risk factor for conjunctivitis in Yogyakarta.

Differences in disease prevalence among homeless and non-homeless veterans at an urban VA hospital.

Approximately 10% of homeless adults in the US are veterans and that number is increasing. Veterans who experience homelessness tend to do so for longer periods compared to non-veterans; and homelessness is associated with more chronic disease complications. We compared the prevalence of five chronic, ambulatory-care sensitive conditions in homeless and domiciled individuals who received primary care at an urban VA hospital. Data were obtained from the Veteran's Hospital Administration clinical data warehouse. Differences in disease prevalence were compared between the two groups using chi-square analyses and then adjusted for age, gender, race/ethnicity, BMI, and other risk factors where appropriate, using logistic regression. All analyses were conducted using SAS version 9.4. Homeless individuals were 46% more likely to have asthma (OR 1.46, 95% CI 1.16-1.84) and 40% more likely to have COPD (OR 1.40, 95% CI 1.14-1.73) after adjustment for age, gender, race/ethnicity, BMI, and tobacco use status. After adjustment for covariates, there was no difference between homeless and domiciled veterans in the prevalence of diabetes, hypertension, or congestive heart failure. Future quality improvement projects should identify social-environmental risk factors like employment characteristics, and housing quality that can impact chronic respiratory illness prevalence and associated complications.

Ecological, Social, and Other Environmental Determinants of Dengue Vector Abundance in Urban and Rural Areas of Northeastern Thailand.

Aedes aegypti is the main vector of dengue globally. The variables that influence the abundance of dengue vectors are numerous and complex. This has generated a need to focus on areas at risk of disease transmission, the spatial-temporal distribution of vectors, and the factors that modulate vector abundance. To help guide and improve vector-control efforts, this study identified the ecological, social, and other environmental risk factors that affect the abundance of adult female and immature Ae. aegypti in households in urban and rural areas of northeastern Thailand. A one-year entomological study was conducted in four villages of northeastern Thailand between January and December 2019. Socio-demographic; self-reported prior dengue infections; housing conditions; durable asset ownership; water management; characteristics of water containers; knowledge, attitudes, and practices (KAP) regarding climate change and dengue; and climate data were collected. Household crowding index (HCI), premise condition index (PCI), socio-economic status (SES), and entomological indices (HI, CI, BI, and PI) were calculated. Negative binomial generalized linear models (GLMs) were fitted to identify the risk factors associated with the abundance of adult females and immature Ae. aegypti. Urban sites had higher entomological indices and numbers of adult Ae. aegypti mosquitoes than rural sites. Overall, participants’ KAP about climate change and dengue were low in both settings. The fitted GLM showed that a higher abundance of adult female Ae. aegypti was significantly (p < 0.05) associated with many factors, such as a low education level of household respondents, crowded households, poor premise conditions, surrounding house density, bathrooms located indoors, unscreened windows, high numbers of wet containers, a lack of adult control, prior dengue infections, poor climate change adaptation, dengue, and vector-related practices. Many of the above were also significantly associated with a high abundance of immature mosquito stages. The GLM model also showed that maximum and mean temperature with four-and one-to-two weeks of lag were significant predictors (p < 0.05) of the abundance of adult and immature mosquitoes, respectively, in northeastern Thailand. The low KAP regarding climate change and dengue highlights the engagement needs for vector-borne disease prevention in this region. The identified risk factors are important for the critical first step toward developing routine Aedes surveillance and reliable early warning systems for effective dengue and other mosquito-borne disease prevention and control strategies at the household and community levels in this region and similar settings elsewhere.

Loneliness is associated with poor mental health, social-environmental factors, and health risk behaviours among national samples of in-school adolescents in four Caribbean countries

ABSTRACT The goal of the study was to estimate associations of loneliness with poor mental health, social-environmental and health risk behaviour indicators among adolescents in the Caribbean. Cross-sectional national ‘Global School-Based Student Health Survey (GSHS)’ data of four Caribbean countries (N = 9,143 adolescents) in 2016–2017 were analysed. In adjusted logistic regression analysis, loneliness was significantly positively associated with all five poor mental health outcomes (having no close friends, anxiety-induced sleep disturbance, suicidal ideation, suicide plan and suicide attempt). Regarding social-environmental outcomes, loneliness was significantly positively associated with bullying victimization, having been physically attacked, involvement in fighting, frequent experiences of hunger and passive smoking (in particular among boys). In terms of health risk behaviour outcomes, loneliness significantly increased the odds for current tobacco use, ever drunk, trouble from alcohol use, ever amphetamine use, multiple sexual partners, leisure-time sedentary behaviour, injury and frequent soft drink consumption. In addition, among boys, loneliness increased the likelihood for current cannabis use. Loneliness is associated with poorer mental health, social-environmental risk factors and health risk behaviours. Results show the importance of taking loneliness into account in a number of mental, social, and physical health factors.

Neural responses to social evaluative threat in the absence of negative investigator feedback and provoked performance failures.

Functional neuroimaging of social stress induction has considerably furthered our understanding of the neural risk architecture of stress‐related mental disorders. However, broad application of existing neuroimaging stress paradigms is challenging, among others due to the relatively high intensity of the employed stressors, which limits applications in patients and longitudinal study designs. Here, we introduce a less intense neuroimaging stress paradigm in which subjects anticipate, prepare, and give speeches under simulated social evaluation without harsh investigator feedback or provoked performance failures (IMaging Paradigm for Evaluative Social Stress, IMPRESS). We show that IMPRESS significantly increases perceived arousal as well as adrenergic (heart rate, pupil diameter, and blood pressure) and hormonal (cortisol) responses. Amygdala and perigenual anterior cingulate cortex (pACC), two key regions of the emotion and stress regulatory circuitry, are significantly engaged by IMPRESS. We further report associations of amygdala and pACC responses with measures of adrenergic arousal (heart rate, pupil diameter) and social environmental risk factors (adverse childhood experiences, urban living). Our data indicate that IMPRESS induces benchmark psychological and endocrinological responses to social evaluative stress, taps into core neural circuits related to stress processing and mental health risk, and is promising for application in mental illness and in longitudinal study designs.

Suggestion of a dynamic model of the development of neurodevelopmental disorders and the phenomenon of autism

The present article is a theoretical contribution suggesting a simple model of the dynamics involved in the development of neurodevelopmental disorders and the phenomenon of autism offering an explanation of why different individuals have different onset of manifest disease. The model relates to present genetic and epigenetic evidence and previous theoretical models. The dynamic model applies an individualized transdiagnostic and dimensional approach integrating several levels of influence involved in the dynamic interaction between an individual and their environment across time. The dynamic model illustrates the interaction between a basic neurobiological susceptibility, compensating mechanisms, and stress-related releasing mechanisms involved in the development of manifest clinical illness. The model has a particular focus on the dynamics of neurocognitive processes and their relationship to more basic information, psychological and social processes. A basic assumption guiding the model is that even quite normal events related to typical development may increase the risk of enduring stress in cognitively vulnerable individuals, further increasing their risk of developing manifest clinical illness. The model suggests that genetic variation, endogenous epigenetic processes of development, and epigenetic changes influenced by physical/chemical and social environmental risk and resilience factors all may contribute to phenotypical expression. A genetic susceptibility may translate into a biological susceptibility reflected in cognitive impairments. A cognitively vulnerable individual may be at increased risk of misinterpreting sensory inputs, potentially resulting in psychopathological expressions, e.g., autistic symptoms, observed across several neurodevelopmental disorders. The genetically influenced experience of an individual relates to cognitive phenomena occurring at the interfaces between the brain, mind, and society. The severity of clinical illness may differ from the severity of a disorder of reasoning. The dynamic model may help guide future development of personalized medicine in psychiatry and identify relevant points of intervention. A discussion of the implications of the model relating to epigenetic evidence and to previous theoretical models is included at the end of the paper.

Predictors of early motor trajectories from birth to 5 years in neonatal at‐risk and control children

To describe motor development in preschool children, to identify perinatal, neonatal and social environmental risk factors of poor motor development, and to replicate results in a second cohort. Two prospective samples in Germany (Bavarian Longitudinal Study, BLS) and Finland (Arvo Ylppö Longitudinal Study, AYLS) assessed 4741 and 1423 children from birth to 56months, respectively. Motor functioning was evaluated at birth, and 5, 20 and 56months. Perinatal, neonatal and social environmental information was collected at birth and 5months. Two distinct motor trajectories were identified: low (BLS: n=4486 (94.6%), AYLS: n=1391 (97.8%)) and high (BLS: n=255 (5.4%), AYLS: n=32 (2.2%)) degree of motor difficulties. High degree of motor difficulties was predicted by neonatal complications, abnormal neonatal neurological status, duration of hospitalisation and poor parent-infant relationships. Although neonatal complications and poor parent-infant relationships did not significantly predict high degree of motor difficulties in the AYLS, the trends identified were similar to those obtained from the BLS. Early identification of children at-risk of motor difficulties across infancy and toddlerhood may help referring those children to interventions earlier. Modifiable risk factors, such as parent-infant relationships, may be addressed by intervention strategies to prevent children from developing motor difficulties.

Social-environmental factors and cognitive and behavioral functioning in pediatric sickle cell disease

ABSTRACTSickle cell disease (SCD), an inherited blood disorder that primarily affects individuals of African descent, is associated with serious medical complications as well as numerous social-environmental risk factors. These social-environmental factors are linked to long-standing social inequities, such as financial hardship and racial discrimination, both of which impact cognitive and behavioral functioning in youth. Previous research on the relationship between social-environmental risk and psychological functioning has primarily relied on non-modifiable, unidimensional measures of socioeconomic status (SES), such as income and parental education, as a proxy for social-environmental risk. The current study aimed to address the limitations associated with typical SES-type measures by comparing the unique and shared association of SES and more targeted and modifiable social-environmental factors (e.g., parent and family functioning) with specific areas of cognitive and behavioral adjustment in pediatric SCD. Seventy children ages 4–8 years old and their parents completed measures of social-environmental risk and psychological adjustment. Exploratory factor analysis indicated parent and family functioning measures were largely independent of SES. Parent and family functioning predicted phonological processing and ADHD symptoms above and beyond SES alone. In addition, the predictive ability of social-environmental risk factors appears to vary by genotype severity for measures of social functioning and math problem-solving ability. Future studies are needed to explore more specific and well-supported models of modifiable social-environmental risk and the relative impact of social-environmental risk on cognitive and behavioral functioning.

Modifiable-risk-factors-for-premature-aging

In the present stage of knowledge and scientific development, the role played by a wide cluster of factors in accelerated ageing has been proved. Furthermore, it is possible to modify most of them. Aim: The aim of this study is the research and analysis of the major modifiable risk factors for premature ageing. Materials and methods: A direct individual anonymous survey of 340 elderly and old people (65 and over) has been conducted. Results and discussion: The analysis of the social status and health condition as a self-assessment of the respondents proves polymorbidity greatly provoked, most often by the social environment risk factors. The relative share of cardiovascular and cerebrovascular diseases is the highest. The elderly suffer from two, three and even more diseases and conditions. It is necessary to develop guidelines for the prevention of accelerated ageing on the basis of complete and accurate information on the risk factors. Conclusion: The analysis of the behavioural risk factors shows the presence of elements of objective health risks. A substantial part of the identified risk factors are subject to modification, and even to prevention provided prompt modern and efficient prophylactic actions are taken.

Urban and Rural Differences between Chemical and Social Environmental Risk Factors and Population Health, the Importance of Context

Urban and Rural Differences between Chemical and Social Environmental Risk Factors and Population Health, the Importance of Context

Health Care Use Outcomes of an Integrated Hospital-to-Home Mother–Preterm Infant Intervention

ObjectiveTo compare health care use from initial hospital discharge through 6 weeks corrected age in two groups of mother–preterm infant dyads: those who received an intervention, Hospital to Home: Optimizing Premature Infant's Environment (H-HOPE), and an attention control group. DesignProspective randomized controlled trial. SettingTwo community hospital NICUs. ParticipantsMothers (n = 147) with social–environmental risk factors and their stable preterm infants. MethodsMother–infant dyads were randomly assigned to the H-HOPE or control group. When infants reached 6 weeks corrected age, information about health care visits since their hospital discharges was collected through an interview. ResultsOnly half of all infants received all recommended well-child visits. Infants in H-HOPE were half as likely to have acute care episodes (illness visit to the clinic or emergency department or hospital readmission) as control infants (odds ratio [OR] = 0.46, 95% confidence interval [CI] [0.22, 0.95]). Infants of mothers with high trait anxiety were nearly 3 times more likely to have an acute care episode (OR = 2.78, 95% CI [1.05, 7.26]), and mothers who had low education levels (OR = .22, 95% CI [0.08, 0.60]) were less likely to have acute care episodes. There was a trend toward fewer acute care visits for infants whose mothers preferred an English interview (OR = .47, 95% CI [0.21, 1.06]). ConclusionFindings emphasize the importance of reinforcing well-child visits for vulnerable preterm infants. H-HOPE, an integrated mother–infant intervention, reduces acute care episodes (visits to the clinic or emergency department or hospital readmissions) for preterm infants.

Identifying the “truly disadvantaged”

There has been significant interest in examining the developmental factors that predispose individuals to chronic criminal offending. This body of research has identified some social-environmental risk factors as potentially important. At the same time, the research producing these results has generally failed to employ genetically sensitive research designs, thereby potentially generating biased parameter estimates. The current study addresses this gap in the literature by using both a standard social science methodology (SSSM) and two separate genetically informative research designs to examine whether parent, teacher, and peer risk factors are associated with four maladaptive outcomes: arrests, low IQ, reduced self-control, and a combined measure of the “truly disadvantaged.” Analysis of twin pairs drawn from the National Longitudinal Study of Adolescent to Adult Health revealed that the SSSMs produced upwardly biased estimates of the impact of social-environmental influences on each of the four outcomes. Once genetic factors were controlled, the effect of social-environmental risk was reduced (but remained significant in certain cases). We conclude by discussing these findings in the context of criminal justice policy and their implications for future criminological research.