Religious Attendance and the Social Support Trajectories of Older Mexican Americans.

In this paper, we directly assessed the extent to which the association between religious attendance and the social support trajectories of older Mexican Americans is due to selection (spurious) processes related to personality, health status, and health behavior. We employed seven waves of data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly (1993-2010) to examine the association between religious attendance and perceived social support trajectories (n = 2479). We used growth mixture modeling to estimate latent classes of social support trajectories and multivariate multinomial logistic regression models to predict membership in the social support trajectory classes. Growth mixture estimates revealed three classes of social support trajectories: high, moderate, and low. Multinomial logistic regression estimates showed that the odds of membership in the low support trajectory class (versus the high social support trajectory class) were lower for respondents who attended religious services yearly, monthly, weekly, and more than weekly than for respondents who never attend religious services. Religious attendance could not distinguish between membership in the moderate and high support trajectory classes. These results persisted with adjustments for age, gender, immigrant status, language proficiency, education, income, religious affiliation, marital status, living arrangements, contact with family/friends, secular group memberships, self-esteem, smoking, heavy drinking, depression, cognitive functioning, and physical mobility. We conclude that the association between religious attendance and the social support trajectories of older Mexican Americans is primarily driven by processes related to social integration, not selection.

Racial/Ethnic Disparities in Influenza Vaccination Coverage Among US Adolescents, 2010-2016.

OBJECTIVE: Although research suggests racial/ethnic disparities in influenza vaccination and mortality rates, few studies have examined racial/ethnic trends among US adolescents. We used national cross-sectional data to determine (1) trends in influenza vaccination rates among non-Hispanic white (hereinafter, white), non-Hispanic black (hereinafter, black), and Hispanic adolescents over time and (2) whether influenza vaccination rates among adolescents varied by race/ethnicity. METHODS: We analyzed provider-reported vaccination histories for 2010-2016 from the National Immunization Survey-Teen. We used binary logistic regression models to determine trends in influenza vaccination rates by race/ethnicity for 117 273 adolescents, adjusted for sex, age, health insurance, physician visit in the previous 12 months, vaccination facility type, poverty status, maternal education level, children in the household, maternal marital status, maternal age, and census region of residence. We calculated adjusted probabilities for influenza vaccination for each racial/ethnic group, adjusted for the same demographic characteristics. RESULTS: Compared with white adolescents, Hispanic adolescents had higher odds (adjusted odds ratio [aOR] = 1.11; 95% confidence interval [CI], 1.06-1.16) and black adolescents had lower odds (aOR = 0.95; 95% CI, 0.90-1.00) of vaccination. Compared with white adolescents, Hispanic adolescents had significantly higher adjusted probabilities of vaccination for 2011-2013 (2011: 0.22, P < .001; 2012: 0.23, P < .001; 2013: 0.26, P < .001). Compared with white adolescents, black adolescents had significantly lower probabilities of vaccination for 2016 (2016: 0.21, P < .001). CONCLUSIONS: Targeted interventions are needed to improve adolescent influenza vaccination rates and reduce racial/ethnic disparities in adolescent vaccination coverage.

Social determinants of HPV vaccination delay rationales: Evidence from the 2011 National Immunization Survey-Teen.

OBJECTIVE: To examine social variations in parental rationales for delaying or forgoing human papillomavirus vaccination in their U.S. adolescent children. METHODS: Using data from the 2011 National Immunization Survey-Teen, we estimated a series of binary logistic regression models to predict the odds of reporting (1) any vaccine delay (n = 25,229) and (2) specific rationales among parents who reported that they were "not likely at all" to vaccinate their teen (n = 9,964). RESULTS: The odds of not receiving a recommendation to vaccinate were higher in parents of boys (OR = 2.57; CI = 2.20-3.01). The odds of reporting a lack of knowledge were higher in parents who identified as Hispanic (OR = 1.39; CI = 1.11-1.72), Black (OR = 1.49; CI = 1.19-1.85), and other races (OR = 1.43; CI = 1.13-1.80) than parents who identified as non-Hispanic White. Socioeconomic disparities in parental rationales for delaying human papillomavirus vaccination in their teen children were sporadic and inconsistent. CONCLUSION: Our results suggest that interventions should focus on increasing information about the benefits of the human papillomavirus vaccine among parents of minority youth. Our findings also suggest that interventions targeting health care providers may be a useful strategy for improving vaccine uptake among adolescent males.

Neighborhood context and breastfeeding behaviors among urban mothers.

BACKGROUND: Research consistently shows that breastfeeding behaviors vary according to individual-level sociodemographic characteristics, yet few studies examine contextual variations in breastfeeding. OBJECTIVE: The purpose of this study is to examine the association between neighborhood context and breastfeeding among a sample of predominately unmarried urban mothers, a group with relatively low rates of breastfeeding. METHODS: This study combines census tract information with data from 2 waves of the Fragile Families and Child Wellbeing Study (n = 4228) to predict the odds of initiating and sustaining breastfeeding. RESULTS: Findings indicate that neighborhood socioeconomic composition, rather than racial or ethnic concentration, is associated with breastfeeding behaviors. More specifically, living in a highly educated neighborhood is associated with higher odds of initiating and sustaining breastfeeding. CONCLUSION: These results suggest that the breastfeeding behaviors of urban mothers vary according to neighborhood educational context. Understanding how breastfeeding behaviors are shaped by one's neighborhood environment will allow public health initiatives to more effectively target vulnerable populations.

Household disrepair and the mental health of low-income urban women.

We employ longitudinal survey data from the Welfare, Children, and Families project (1999, 2001) to examine the effects of household disrepair (e.g., living with leaky structures, busted plumbing, broken windows, and pests) on psychological distress among low-income urban women with children. Building on previous research, we adjust for related housing concepts, neighborhood disorder, financial hardship, and a host of relevant background factors. We also formally test the mediating influences of social support and self-esteem. Our cross-sectional analysis indicated that household disrepair is positively associated with recent symptoms of psychological distress. Our longitudinal change score analysis demonstrates two important patterns. First, women living with household disrepair at baseline are not necessarily vulnerable to increases in symptoms of psychological distress over the 2-year study period. Second, women who report an increase in disrepair over the study period are also likely to report a concurrent increase in symptoms of distress. Although social support and self-esteem favor mental health in our cross-sectional and longitudinal analyses, these psychosocial resources fail to mediate or explain the association between disrepair and distress.

Does sleep quality mediate the association between neighborhood disorder and self-rated physical health?

OBJECTIVES: We examine the association between perceived neighborhood disorder and self-rated physical health. Building on previous research, we test whether this association is mediated by sleep quality. METHODS: We use data from the 2004 Survey of Texas Adults (n=1323) to estimate a series of ordinary least squares regression models. We formally assess mediation by testing for significant changes in the effect of neighborhood disorder before and after adjusting for sleep quality. RESULTS: We find that residence in a neighborhood that is perceived as noisy, unclean, and crime-ridden is associated with poorer self-rated physical health, even with controls for irregular exercise, poor diet quality, smoking, binge drinking, obesity and a host of relevant sociodemographic factors. Our results also indicate that the relationship between neighborhood disorder and self-rated physical health is partially mediated by lower sleep quality. CONCLUSION: Targeted interventions designed to promote sleep quality in disadvantaged neighborhoods may help to improve the physical health of residents in the short-term. Policies aimed at solving the problem of neighborhood disorder are needed to support sleep quality and physical health in the long-term.

Blessed assurance: religion, anxiety, and tranquility among US adults.

A growing body of research investigates the possible relationships between religion and mental health. After developing a series of arguments linking various aspects of religion with anxiety and tranquility, we test relevant hypotheses using data from the 1996 Genera Social Survey. Results show that frequency of religious attendance and the belief in an afterlife are inversely associated with feelings of anxiety and positively associated with feelings of tranquility. However, frequency of prayer has no direct association with either outcome. Strong beliefs in the pervasiveness of sin are positively linked with anxiety but unrelated to tranquility. Finally, belief in an afterlife and frequency of prayer buffer the adverse effects of poor health and financial decline on anxiety. Implications of these find ings are discussed along with study limitations and promising directions for future research.

Religious involvement and healthy lifestyles: evidence from the survey of Texas adults.

BACKGROUND: Although research shows that religious involvement is associated with a wide range of individual health behaviors, it has yet to be determined whether the effect of religious involvement extends to an overall pattern of regular health practices that may constitute a lifestyle. PURPOSE: Building on prior research, we test whether religious individuals tend to engage in healthier lifestyles than individuals who are less religious. METHODS: Using data collected from a statewide probability sample of 1,369 Texas adults, we estimate a series of ordinary least squares regression models to assess the net effect of religious involvement on overall healthy lifestyle scores. RESULTS: The results of our study indicate that religious individuals do tend to engage in healthier lifestyles, and this pattern is similar for men and women and across race/ethnic groups. We also find some evidence to suggest that the association between religious involvement and healthy lifestyles may be less pronounced in old age. CONCLUSIONS: Assuming that religious involvement is associated with healthier lifestyles, additional research is needed to account for these patterns. Future studies should also consider whether healthy lifestyles may serve as a mechanism through which religious involvement might favor health and longevity.