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Background: Food insecurity remains a major public health concern in the United States. Studies have noted that food insecurity can lead to lower healthcare utilization and poorer health status. Despite the continuous burden of asthma, little research has shown whether food insecurity serves as a social determinant to poor asthma care. In this study, we specifically focused on whether food insecurity can lead to delay in prescription medication for adults with asthma in California.Methods: We utilized the California Health Interview Survey. Survey weighted descriptive, univariate, and multivariable logistic regression analyses were conducted. A total of 11,645 observations, representing an average annual population size of 1,085,481 was included in this study.Results: Nearly 15% and 8% of participants were food insecure and had current asthma, respectively. Based on adjusted odds ratio, food insecure adults were 148% more likely to report delay in asthma prescription, as compared to those who were food secure (adjusted odds ratio =2.48; 95% CI: 1.58, 3.89).Conclusions: Given the delay in prescription, and thus appropriate health care, demonstrated in our study, targeted measures at point of care should be implemented to identify such at-risk patients early and provide resources for food aid to ensure optimal health outcomes.
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Antiasmáticos/uso terapêutico , Asma/tratamento farmacológico , Asma/epidemiologia , Insegurança Alimentar , Adolescente , Adulto , Antiasmáticos/administração & dosagem , Asma/terapia , California , Estudos Transversais , Feminino , Nível de Saúde , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Determinantes Sociais da Saúde , Estados Unidos , Adulto JovemRESUMO
BACKGROUND: Little research exists on the association between food insecurity and mild to moderate psychological distress (MPD) among Black/African-Americans. In this study, we assess the relationship between food insecurity with and without hunger to that of both MPD and serious psychological distress (SPD) among this population. METHODS: 2009 and 2011/2012 adult public-use data from African-American respondents of the California Health Interview Survey were utilized for this study (n = 4003). Descriptive statistics were utilized to identify prevalence of psychological distress among sociodemographic and mental-health associated variables. Bivariate analyses were conducted between these variables and psychological distress using survey-weighted chi-square analyses. To evaluate the association between psychological distress, our primary exposure variable of food security, and other variables, we utilized survey-weighted multinomial logistic regression. RESULTS: Prevalence of mild to MPD was higher among those reporting food insecurity while SPD was highest for those with food insecurity and hunger. Results of multinomial logistic regression analysis demonstrate that while MPD was significantly associated with food insecurity, Black/African-Americans with food insecurity and hunger displayed over sixfold odds of higher serious psychological distress, as compared to those living at or above 200% federal poverty level. CONCLUSION: Our findings add to this growing segment of the literature on psychological distress and food insecurity. Further focus should be placed on improving the efficacy and reach of both formal and informal food support networks to improve the collective health and well-being of poor Black/African-American communities.
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Negro ou Afro-Americano/estatística & dados numéricos , Abastecimento de Alimentos/estatística & dados numéricos , Pobreza/etnologia , Estresse Psicológico/etnologia , Adolescente , Adulto , Negro ou Afro-Americano/psicologia , Idoso , California , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Pobreza/psicologia , Fatores Socioeconômicos , Estados Unidos , Adulto JovemRESUMO
OBJECTIVE: US veterans (hereafter, 'veterans') are at risk for being overweight or obese and associated unhealthy behaviours, including poor diet; although limited studies have examined the underlying factors associated with such outcomes. As such, the present study evaluated the association between food insecurity and dietary practices among veterans. DESIGN: A secondary analysis of cross-sectional data from the California Health Interview Survey (2009, 2011/2012) was conducted. Survey weights were applied to identify univariate means, population estimates and weighted percentages. Bivariate analyses followed by survey-weighted negative binomial regression were used to model the association between food insecurity and dietary practices of fruit, vegetable, fast food and soda intakes. SETTING: California Health Interview Survey 2009-2011/2012. SUBJECTS: The present study included a total of 11 011 veterans from California. RESULTS: Nearly 5 % of the studied veteran population reported living in poverty with food insecurity. Compared with those at or above the poverty level and those in poverty but food secure, the mean intakes of fruits and vegetables were lower, while the mean intakes of soda and fast foods (P for trend <0·05) were higher among veterans living in poverty with food insecurity. Food insecurity was associated with 24 and 142 % higher average consumption of fast foods and soda, respectively, and 24 % lower fruit intake. CONCLUSIONS: Food insecurity remains a burden among veterans and is associated with unhealthy dietary practices. Targeted interventions to improve diet quality are imperative.
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Dieta , Abastecimento de Alimentos , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Adolescente , Adulto , Idoso , California/epidemiologia , Bebidas Gaseificadas , Estudos Transversais , Fast Foods , Feminino , Assistência Alimentar , Frutas , Comportamentos Relacionados com a Saúde , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Prevalência , Fatores Socioeconômicos , Verduras , Veteranos , Adulto JovemRESUMO
The objective of this study was to assess the prevalence of and factors associated with sleep apnea among US male veterans. We used data from the 2005-2014 National Survey on Drug Use and Health to conduct survey-weighted descriptive, bivariate, and regression analyses. The prevalence of sleep apnea increased from 3.7% to 8.1% (P for trend <.001 for adjusted model) from 2005 through 2014. Increasing severity of psychological distress and unmet mental health care need were associated with increased odds of sleep apnea, as was a diagnosis of asthma. Increased screening of sleep health is critical to improve the health outcomes of veterans.
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Síndromes da Apneia do Sono/epidemiologia , Síndromes da Apneia do Sono/etiologia , Veteranos , Adulto , Idoso , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Estados Unidos/epidemiologiaRESUMO
OBJECTIVE: In this study, we evaluated the association between both current and lifetime asthma to that of mental illness among veterans in the USA. METHODS: We utilized the 2005-2013 National Survey on Drug Use and Health data, a national population-based survey in the USA. Mental illness was defined as past year major depressive episode and doctor diagnosis of depression. Survey-weighted univariate and multivariable regression analyses were utilized. A total of 20,581 veterans were included in the study. RESULTS: A 4.00% and 7.50% prevalence of current and lifetime asthma were noted among veterans, respectively. A significantly higher prevalence of major depressive episode was noted among veterans with current asthma (8.23%), as compared to those without (4.68%), with a similar trend noted among those with lifetime asthma versus those without (7.84% vs. 4.58%). Doctor diagnosis of depression among veterans was higher among those with current asthma (11.83% vs. 5.86%) and lifetime asthma (10.32% vs. 5.76%), as compared to those without asthma. Upon adjusting for confounders, current asthma was significantly associated with past year major depressive episode [adjusted odds ratio (aOR) = 1.65) and depression diagnosis (aOR = 1.88). Similarly, veterans with lifetime asthma, as compared to those without, had higher odds of past year major depressive episode (aOR = 1.56) and depression diagnosis (aOR = 1.66). CONCLUSION: The asthma/mental health nexus is significant among the US veterans. Such results warrant the need for integrated care to address mental health burden among veterans with asthma.
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Asma/epidemiologia , Depressão/epidemiologia , Transtorno Depressivo Maior/epidemiologia , Veteranos/estatística & dados numéricos , Adolescente , Adulto , Idoso , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Estados Unidos/epidemiologia , Adulto JovemRESUMO
OBJECTIVE: Empirical evidence demonstrates the comorbidity of asthma and mental illness, though limited studies have evaluated the patient and hospital outcomes associated with such conditions. As such, this study evaluated the burden of this comorbidity on health resource utilization and patient disposition among asthma hospitalizations. METHODS: A secondary analysis of the Nationwide Inpatient Sample (2009-2011) was conducted, with study population of asthma hospitalizations limited to those 18 years of age and older. International Classification of Disease, 9th Revision, Clinical Modification codes were utilized to identify asthma and mental illness discharges. Length of stay was defined as number of days stayed in the hospital, total charges were inflation-adjusted, and patient disposition was defined as routine versus not routine. All analyses were survey-weighted and adjusted for patient and hospital characteristics. RESULTS: Approximately 29% of the asthma hospitalizations reported mental illness. Any mental illness was associated with increased length of stay in the hospital (10% increase), total costs (11% increase), and lower odds of routine disposition (21% decrease). Substance-related disorder also increased length of stay in the hospital (4% increase), costs (9% increase), and lower odds of routine disposition (29% decrease). Age-stratified analyses further demonstrated similar trends among most age groups. CONCLUSION: The results of this study complement the extant literature by demonstrating the burden of the asthma-mental health nexus on health resource utilization and patient outcomes. The increased length of stay, cost, and decreased likelihood of routine disposition associated with mental illness highlight the need for integrated care to address mental illness as part of routine care.
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Asma/complicações , Asma/terapia , Efeitos Psicossociais da Doença , Recursos em Saúde/estatística & dados numéricos , Hospitalização/economia , Hospitalização/estatística & dados numéricos , Transtornos Mentais/complicações , Adolescente , Adulto , Idoso , Asma/economia , Feminino , Humanos , Masculino , Transtornos Mentais/economia , Pessoa de Meia-Idade , Avaliação de Resultados da Assistência ao Paciente , Adulto JovemRESUMO
OBJECTIVE: Identify the association between current asthma status and serious psychological distress among males who served in the U.S. Armed Forces as compared to civilians. METHODS: A secondary analysis was performed utilizing the 2009 and 2011 California Health Interview Survey, including 9993 veteran males and 26,999 civilian males. All analyses used replicate weights to account for complex survey design. Descriptive statistics and chi-square analyses were generated to describe the population. Multivariable logistic regression analyses were utilized to model the effect of asthma and other covariates on past year and past month serious psychological distress, stratified by veteran status. RESULTS: After model adjustment, current asthma status was significantly associated with past month and year serious psychological distress among veterans only. In addition, while race/ethnicity and risk behaviors of smoking and/or binge drinking were significantly associated with distress among civilians, no such association was noted among veterans. CONCLUSION: To the authors' knowledge, this was the first study to demonstrate that the relationship between asthma and serious psychological distress varies by veteran status. Several unique correlates among veterans were also noted. Future preventive strategies for mental health disorders should incorporate these reported differences, including that of asthma co-morbidity among veterans.
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Asma/epidemiologia , Asma/psicologia , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Veteranos/psicologia , Veteranos/estatística & dados numéricos , Adulto , Idoso , Consumo Excessivo de Bebidas Alcoólicas/epidemiologia , California/epidemiologia , Inquéritos Epidemiológicos , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Militares , Fatores de Risco , Fumar/epidemiologiaRESUMO
BACKGROUND: Clostridium difficile infection (CDI) remains one of the major hospital acquired infections in the nation, often attributable to increased antibiotic use. Little research, however, exists on the prevalence and impact of CDI on patient and hospital outcomes among populations requiring such treatment. As such, the goal of this study was to examine the prevalence, risk factors, and impact of CDI among pneumonia and urinary tract infection (UTI) hospitalizations. METHODS: The Nationwide Inpatient Sample (2009-2011), reflecting a 20% stratified sample of community hospitals in the United States, was used. A total of 593,038 pneumonia and 255,770 UTI discharges were included. Survey-weighted multivariable regression analyses were conducted to assess the predictors and impact of CDI among pneumonia and UTI discharges. RESULTS: A significantly higher prevalence of CDI was present among men with UTI (13.3 per 1,000) as compared to women (11.3 per 1,000). CDI was associated with higher in-hospital mortality among discharges for pneumonia (adjusted odds ratio [aOR] for men = 3.2, women aOR = 2.8) and UTI (aOR for men = 4.1, women aOR = 3.4). Length of stay among pneumonia and UTI discharges were also double upon presence of CDI. In addition, CDI increased the total charges by at least 75% and 55% among pneumonia and UTI discharges, respectively. Patient and hospital characteristics associated with CDI included being 65 years or older, Charlson Deyo index for comorbidity of 2 or more, Medicare as the primary payer, and discharge from urban hospitals, among both pneumonia and UTI discharges. CONCLUSION: CDI occurs frequently in hospitalizations among those discharged from hospital for pneumonia and UTI, and is associated with increased in-hospital mortality and health resource utilization. Interventions to mitigate the burden of CDI in these high-risk populations are urgently needed.
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Clostridioides difficile , Enterocolite Pseudomembranosa/epidemiologia , Pneumonia/epidemiologia , Infecções Urinárias/epidemiologia , Adolescente , Adulto , Idoso , Infecções por Clostridium/epidemiologia , Coinfecção/epidemiologia , Comorbidade , Infecção Hospitalar/epidemiologia , Bases de Dados Factuais , Feminino , Mortalidade Hospitalar , Hospitalização , Hospitais Comunitários , Humanos , Pacientes Internados , Masculino , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Análise de Regressão , Fatores de Risco , Estados Unidos/epidemiologia , Adulto JovemRESUMO
OBJECTIVE: Evaluate the racial and ethnic differences in asthma and mental health comorbidity. METHODS: A secondary analysis of 2008-2013 National Survey on Drug Use and Health was conducted, resulting in a total of 206 993 civilian adult respondents to evaluate the association between asthma and mental health (past year serious psychological distress [SPD] and doctor diagnosis of depression). Both survey weighted bivariate (chi-square) and multivariable (binary logistic) regression analyses, after accounting for control variables, were conducted to evaluate the asthma/mental health nexus. A p value of less than 0.05 was used to denote significance. RESULTS: Current asthma was significantly associated with past year SPD for non-Hispanic Whites (adjusted odds ratio [aOR] = 1.45), Hispanics (aOR = 1.68), and Black/African Americans (aOR = 1.47). A similar association was noted for current asthma and past year doctor diagnosis of depression (non-Hispanic White aOR = 1.74; Hispanics aOR = 1.77; Black/African American aOR = 1.62). Among those with lifetime asthma, higher odds of SPD were reported for non-Hispanic Whites (aOR = 1.42), Hispanics (aOR = 1.64), and Black/African Americans (aOR = 1.50). Lifetime asthma also significantly associated with past year doctor diagnosis of depression for non-Hispanic Whites (aOR = 1.42), Hispanics (aOR = 1.41), and Black/African Americans (aOR = 1.46). CONCLUSION: Our results demonstrate the significant burden of asthma and mental health comorbidity among diverse racial and ethnic groups. Improved public health efforts through promotion of integrated care for early screening and preventive measures are needed to alleviate the burden for at-risk groups.
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Asma/etnologia , Etnicidade/estatística & dados numéricos , Saúde Mental/etnologia , Grupos Raciais/estatística & dados numéricos , Adolescente , Adulto , Negro ou Afro-Americano/estatística & dados numéricos , Idoso , Comorbidade , Depressão/etnologia , Feminino , Inquéritos Epidemiológicos , Hispânico ou Latino/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Estresse Psicológico/etnologia , Estados Unidos/epidemiologia , População Branca/estatística & dados numéricos , Adulto JovemRESUMO
We evaluated the association between Asian American ethnicity and age at diagnosis for type 2 diabetes using data from the California Health Interview Survey. Survey-weighted unadjusted and adjusted linear regressions were used to obtain mean estimates of age at diagnosis. In the adjusted regression model, ages at diagnosis were 10.5, 8.7, 8.4, and 4.2 years earlier among South Asian, Vietnamese, Filipino, and Korean populations, respectively, as compared to non-Hispanic whites; no significant difference in age at diagnosis was noted for Chinese and Japanese populations. Recommendations for diabetes screening and preventive measures specific to Asian American populations are warranted.
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Asiático/etnologia , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/prevenção & controle , Diagnóstico Precoce , Disparidades nos Níveis de Saúde , Adulto , Idade de Início , California , Feminino , Inquéritos Epidemiológicos , Humanos , Entrevistas como Assunto , Modelos Lineares , Masculino , Pessoa de Meia-Idade , População Branca/estatística & dados numéricosRESUMO
INTRODUCTION: Food insecurity has been associated with negative health outcomes, but the relationship between psychological distress and food insecurity among ethnic minorities has not been extensively examined in the literature. The goal of this study was to evaluate whether low food security and very low food security were significantly associated with past month serious psychological distress (SPD) among Hispanic adults living in poverty. METHODS: We studied 10,966 Hispanic respondents to the California Health Interview Survey for 2007, 2009, and 2011-2012 whose income was below 200% of the federal poverty level. The relationship between food insecurity and SPD was evaluated by using survey-weighted univariate and logistic regression analyses. RESULTS: Nearly 30% of the study population had low food security and 13% had very low food security. Low food security and very low food security were associated with 1.99 and 4.43 odds of past month SPD, respectively, and perceived low neighborhood safety was related to 1.47 odds of past month SPD. CONCLUSIONS: We found that food insecurity was prevalent among Hispanic people living in poverty and was significantly associated with past month SPD. These results demonstrate the need for further targeted public health efforts, such as community gardens led by promotores, faith-based initiatives, and initiatives to reduce barriers to participation in food-assistance programs.
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Abastecimento de Alimentos/economia , Abastecimento de Alimentos/estatística & dados numéricos , Saúde das Minorias , Pobreza/estatística & dados numéricos , Estresse Psicológico/etnologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Sistema de Vigilância de Fator de Risco Comportamental , California/etnologia , Feminino , Hispânico ou Latino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Fatores de Risco , Distribuição por Sexo , Adulto JovemRESUMO
Our objective was to study the comorbidity of asthma and obesity among foreign-born Asian Americans, by subgroups. Public data from the California Health Interview Survey, 2001-2011, were analyzed by using independent logistic regressions, yielding the association between asthma and obesity (Asian and standard cutoffs for body mass index [BMIs]) of 19,841 Asian American immigrant respondents. Chinese, Filipino, South Asian, and Japanese immigrants had a positive association between lifetime asthma and obesity, whereas among Korean immigrants, a positive association was found between lifetime asthma and overweight status (standard BMI cutoffs). Routine screening for this comorbidity is warranted among immigrant Asian Americans.
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Asiático , Asma/complicações , Asma/epidemiologia , Emigrantes e Imigrantes , Obesidade/complicações , Obesidade/epidemiologia , Adulto , California/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: The COVID-19 pandemic, caused by a highly contagious novel virus called SARS-CoV-2, has led to significant global morbidity and mortality, with disproportionate burden among frontline workers. While the current empirical body of evidence highlights reported depression, burnout, moral injury, compassion fatigue, and post-traumatic stress among healthcare workers, similar assessment among the public health workforce is limited. Given work-related pressure of rapid pandemic management strategies, risk of exposure, potential fatigue, etc., understanding the caregiver burden of the public health workforce is critical. Methods: This study used a convergent parallel mixed-methods design. Participants were recruited using a mix of both convenience and snowball sampling. All data were collected virtually and kept anonymous. All statistical analyses were conducted using SPSS version 28, and all qualitative results were thematically analyzed using the grounded theory approach. Results: Among the study participants, nearly 65% reported that their personal lives were impacted due to providing COVID-19 related services. Furthermore, a majority (88%) reported poor sleep health, including low daytime wakefulness, while 24% reported serious psychological distress. Qualitative analysis demonstrated several emergent themes, with central themes indicative of the need for paradigm shift in capacity building for public health emergency preparedness that integrates caregiver support. Conclusions: Results highlight the importance of addressing the caregiver burden experienced by public health and related workforces during public health emergencies.
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COVID-19 , Humanos , COVID-19/epidemiologia , SARS-CoV-2 , Pandemias , Saúde Pública , Mão de Obra em Saúde , Pessoal de Saúde/psicologia , PercepçãoRESUMO
The purpose of this cross-sectional short report study was to evaluate the perception of pulmonologist working in noninterstitial lung disease centers on challenges (COE) encountered in daily practice. Results of this survey revealed that only 40% of their patients are referred to an ILD COE, out of 69% who have access to an ILDCOE. Of these patients who were referred, the perceived benefits were rated high when it comes to having an accurate diagnosis.
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OBJECTIVE: This study aimed to determine the long-term outcomes of patients with chronic refractory cough (CRC) following treatment for cough suppression therapy (CST). Currently, there is a lack of objective data regarding the long-term outcome of behavioral treatment for CRC. METHODS: From the charts of 106 adult patients diagnosed with CRC, 24 patients were identified as having long-term data at least 3 months post-CST in the form of otolaryngologic examination, Voice Handicap Index-10 (VHI-10), and Cough Severity Index (CSI) scores. Patients underwent otolaryngologic evaluation and completed the VHI-10 and CSI assessments during pretreatment, posttreatment, and long-term follow-up visits. Patients were also divided into two groups based on their number of comorbidities. RESULTS: Twenty of the 24 patients had significant reduction in cough severity after completing CST (P < 0.001). A significant difference was also found in CSI scores from pretherapy to the long-term follow-up visits (P = 0.001). No significant difference was found in CSI scores from posttherapy to long-term follow-up visits (P = 0.93). No significant difference was found in VHI-10 scores over time (P = 0.83). No correlation was found between changes in cough and voice severity and number of comorbidities at the tested level. CONCLUSIONS: Findings of no significant change in CRC over the long term compared to posttherapy measures suggest that patients were able to maintain improvement in cough over the long term despite various comorbidities. The current results suggest that CST represents a satisfactory approach to treating CRC and provides patients with an ongoing tool to maintain reduced cough severity. No significant correlations between number of comorbidities and mean CSI or VHI-10 scores were found over the long term.
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Objective: In this study, we evaluated the role of minority status, as well as pandemic-related social stressors and health disparities on short- and long-term academic performances of college students. Methods: Cross-sectional analysis using descriptive and bivariate statistics were used to identify participants of minority status as well as pandemic-related prevalence of social stressors and health disparities and their roles on academic performance. Results: Poor academic performance was significantly related to being food insecure, experiences of discrimination, serious psychological distress, and low daytime wakefulness during the pandemic but only significantly based on minority status. Grade point average was significantly associated with serious psychological problems among males, independent of race/ethnicity identity. Conclusions: Institutes of higher education, when tasked with developing post-pandemic policies to address equity gaps in academic success, may benefit their students by integrating system-wide holistic approach to support, including interventions on basic needs support and health and resilience building.
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Desempenho Acadêmico , Grupos Minoritários , Masculino , Humanos , Estudos Transversais , Estudantes/psicologia , EtnicidadeRESUMO
The COVID-19 pandemic has emerged as a major public health issue, with vaccines serving as a vital preventive strategy to lower the global burden. Yet, despite national and local mandates, key sectors of the population continue to demonstrate lower compliance rates. In the United States, young adults have the lowest vaccination rates among the adult population. The goal of our study was to utilize the largest state-health survey to assess the key determinants of such hesitancy in order to create targeted interventions for the most at-risk groups to ensure equitable outcomes in disease prevention. We utilized the latest available California Health Interview Survey, a population-based complex probability survey, to evaluate determinants of vaccine hesitancy among young adults. Survey-weighted descriptive statistics, bivariate statistics, and multivariable logistic regression analyses were conducted. All statistical tests used p less than 0.05 to determine statistical significance. A total of 1203 respondents, representative of 4,027,462 young adults (ages 18-25 years) were included in our study. Our primary findings note that 24% of participants reported they would not be willing to take the COVID-19 vaccination. Prevalence of vaccine hesitancy was also significantly higher among young adults who were current smokers (including electronic cigarettes), when compared to non-current smokers (36% vs. 22%). Further, the highest prevalence was also noted among young adults who identified as African-American (51%), had a high school degree or less (34%), those who were overweight or obese (28%), and reported a poor health status (22%). Multivariable regression analysis demonstrated that current smokers, as compared to non-current smokers, had more than double the odds of reporting COVID-19 vaccine hesitancy. African-American young adults or young adults with a high school degree or less were both independently associated with at least a three-fold increase in vaccine hesitancy. Participants with psychological distress, however, were more likely to be accepting of the vaccine. Public health efforts to improve vaccine compliance need targeted efforts, including building trust in the healthcare system for African-Americans and promoting easier access and knowledge of vaccines among those with a high school degree or less, as well as young-adults who are currently smoking, with such efforts targeting behavioral interventions focused on risk aversion.
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BACKGROUND: Tobacco smoke has been associated with negative health outcomes, including those with chronic respiratory illnesses, such as asthma. This study aimed to assess the relationship between exposure to environmental tobacco smoke (ETS), as well as tobacco use (cigarette and electronic cigarettes), on asthma severity among adults with current asthma, with stratification by sex to understand potential biological sex differences. METHODS: The study population consisted of Californian adults 18 years or older with self-reported physician/health care diagnosis of asthma and still having current asthma from 2020 California Health Interview Survey. All descriptive statistics and analyses were sex-stratified and survey-weighted. Crosstabulations were used to understand the association between asthma attack and ETS or firsthand smoke exposure, while binary logistic regression models were used to assess the effect of ETS exposure, current smoking status, and control variables on asthma attack in the past 12 months, with a sub-analysis among non-smoking adults with asthma. RESULTS: Among the primary variable of interest, 35% of males and 30% of females reported ETS exposure in the past 12 months, while 13% of males and 6% of females reported being a current smoker. Past year asthma attack was reported among 43% and 55% of males and females, respectively. Among males, after adjusting for all control variables, asthma attack was significantly higher among those with ETS exposure (OR: 1.75, 95% CI: 1.01-3.02) and among current smokers (OR: 3.82, 95% CI: 1.49, 9.81). Male non-smokers with ETS exposure had a 109% higher odds of asthma attack, compared to non-exposure individuals. CONCLUSION: Using a population-based survey, our results highlight the ongoing burden of tobacco use and exposure particularly among males with current asthma, further corroborate the literature on the relationship between tobacco and asthma, and highlight putative sex-specific outcomes.
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Asma , Sistemas Eletrônicos de Liberação de Nicotina , Produtos do Tabaco , Poluição por Fumaça de Tabaco , Adulto , Asma/epidemiologia , Doença Crônica , Exposição Ambiental , Feminino , Humanos , Masculino , Inquéritos e Questionários , Poluição por Fumaça de Tabaco/análiseRESUMO
Background: Experiences of discrimination are prevalent among minority populations, although often empirical evidence does not provide depth into the source and types of discrimination, such as racial/ethnic, gender-based, age, etc. The goal of this study was to assess the unique patterns, types, and sources of discrimination experiences that college students face and explore the role these experiences play in their mental health. Methods: An explanatory sequential mixed-methods study was utilized. Quantitative assessment of college students from a Hispanic and minority-serving institution was conducted to evaluate experiences of discrimination and its association to physical health and mental health (including psychological distress), as well as food insecurity, a marker for poverty. Next, qualitative data were thematically analyzed to further provide an in depth understanding on the sources of such experiences, types of discriminations, as well as the impact on mental health. Results: Results of the quantitative assessment highlight that discrimination was prevalent among the population with a higher everyday discrimination score significantly associated with serious psychological distress, low mental health status, low physical health status, and being food insecure. Further, most of the participants reported that they felt discriminated due to their appearance, with race/ethnicity and skin color as next most commonly cited reasons. Qualitative assessment further demonstrates distinct types of discrimination experiences from a variety of sources. Within a family, colorism and having an American accent while speaking a native language was a predominant source, while among peers, having a non-American accent was a primary source of discrimination experiences. Such experiences based on elitism, gender, and age (being younger) from the workplace were prevalent among the target population. Finally, feelings of isolation, not belonging, as well as negative impact on self-efficacy and self-worth were noted. Conclusion: Experiences of discrimination are prevalent among college students, including from within family and peers. To improve mental health outcomes of such a population, campus-based measures are needed to promote resiliency and social support, as well as community-based initiatives to promote workplace training to create inclusive environments for younger generations entering the workforce.
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Racismo , Estudantes , Etnicidade , Hispânico ou Latino , Humanos , Saúde Mental , Grupos Minoritários/psicologia , Racismo/psicologia , Estudantes/psicologiaRESUMO
BACKGROUND: During the COVID-19 pandemic, college students faced health disparities in addition to a negative burden on academic performance; however, little is reported in the literature regarding healthcare utilization. METHODS: A cross-sectional survey was conducted among consenting college student participants aged 18 or older from a Hispanic-serving institution. Descriptive and bivariate statistics were used to analyze demographic characteristics and the types of healthcare services needed by such characteristics. Logistic regression was used to adjust for noted sex differences in associations between reporting limited healthcare services and types of healthcare services. RESULTS: The study population of 223 participants was mostly Hispanic/Latino (65%) and female (73%). Of the population, 11% reported they could not obtain needed healthcare services, with time being reported as the most common reason. Significant associations were found between seeking general healthcare services/routine screening, seeking mental health services, and seeking sexual health services with reporting limited healthcare services, with sex-adjusted odds ratios and 95% confidence intervals of 1.90 (95% CI: 1.08, 3.36), 3.21 (95% CI: 1.44, 4.15), and 2.58 (95% CI: 1.05, 6.35), respectively. CONCLUSIONS: Availability and inability to obtain health services may exacerbate college student health disparities. Targeted interventions are needed in the population to mitigate the potential burdens of unmet healthcare needs, particularly among minority college students.