Intersectionality matters for hispanic health: A replication study using the All of Us Research Program.

BACKGROUND: Despite research dedicated to understanding the health profiles and health-related outcomes of Hispanic individuals, the prevailing body of literature frequently homogenizes the Hispanic population, failing to address the role of race in Hispanic health discourse. Thus, the current study applies an intersectional lens to identify health differences and similarities among Hispanic subgroups. METHODS: Sociodemographic characteristics and health domain variables (i.e., health status, health services, and health behaviors) from participants (N = 11,192) were included in the analyses. Bivariate Chi-squared tests examined the relationship between sociodemographic and health domain variables Black Hispanic individuals, white Hispanic individuals, and non-Hispanic Black individuals. RESULTS: Findings suggest that Non-Hispanic Black American individuals reported the highest rates of hypertension (49.09%) and diabetes (19.62%) compared to Black-Hispanic individuals (22.45% and 12.98%) and white Hispanic individuals (22.22% and 8.02%). Black Hispanic individuals reported the greatest proportion of asthma diagnoses (35.10%) and those who saw a doctor in the previous year (95.52%) compared to white Hispanic individuals (26.84%, and 91.10%, respectively) and non-Hispanic Black individuals ( 21.74%, and 94.69%, respectively). CONCLUSION: Specifically, we found that several health behaviors and health-related outcomes significantly varied across different racial/ethnic groups, demonstrating the advantage of an intersectional approach to identify health disparities among racially diverse ethnic groups. PUBLIC HEALTH SIGNIFICANCE: We encourage the development of health care services with an awareness of the complexities resulting from racial differences within the Hispanic diaspora.

Health status assessment of pump station units based on spatio-temporal fusion and uncertainty information.

An effective health status assessment (HSA) for pump station units (PSUs) is crucial for accurately determining their real status and providing technical support for safe operational decisions. Due to the limitations of existing data-driven HSA methods, which primarily focus on the temporal dependencies of monitoring signals and fail to explore the complex interconnections among signals comprehensively. Moreover, when constructing performance degradation indices based on linear differences, these methods do not effectively integrate heterogeneous signals, resulting in an incomplete and inaccurate assessment of the overall system degradation. This paper proposes a real-time comprehensive HSA method for PSUs based on multi-source heterogeneous uncertainty information. Initially, a health benchmark model (HBM) is built using CrossGNN, which possesses cross-scale and cross-variable interaction capabilities, to precisely capture the temporal dependencies and dynamic relationships among variables in monitoring signals. Subsequently, key measurement points that reflect the operational status of the PSUs are identified through correlation analysis to establish multi-source evaluation indices. Then, considering the uncertainty in signal changes, a novel health degradation index (HDI) is developed using Mahalanobis distance (MD) and the Gaussian Cloud Model (GCM) to analyze changes in unit status. Furthermore, a weighting calculation method based on the non-dominated sorting genetic algorithm (NSGA-II) is proposed to establish a real-time comprehensive health index (RCHDI) for a thorough assessment of PSUs status. Finally, the effectiveness of the proposed method is validated through a case study using data from a pump station in the South-to-North Water Diversion Project in China. The results show that, compared to other studies, the proposed method significantly improves the stability and smoothness of the state assessment curve, with increases of 21.5% and 47.1% respectively, providing a new perspective for comprehensively assessing the health status of PSUs.V.

Self-rated health in late adolescence as a predictor for mortality between 46 and 70 years of age.

Self-rated health is a common assessment used in epidemiological research and an independent predictor of morbidity and mortality. We investigate if a single measure of self-rated health in late adolescence predict mortality between 46 and 70 years of age. This study was based on 47 286 Swedish men that conscribed 1969-1970 at age 18-20 and that were still alive in 1997. Self-rated health and data on potential explanatory factors (psychological factors, health status markers and health behaviors) were collected at conscription. Adult socioeconomic position in 1990 was derived from registries. Death and cause of death (cancer, cardiovascular disease, violent and alcohol abuse related disorders) were derived from the Causes of Death Register between 1997 and 2019. Conscripts that rated their health as fair or poor/very poor had significantly higher hazard of all-cause mortality than conscript that rated their health as very good (HRfair = 1.27, 95%CI:1.18-1.37 and HRpoor = 1.25, 95%CI:1.11-1.41) and disease-specific mortality. Adjusting for all explanatory factors attenuated the risk estimates by 9-100%. In conclusion, poor self-rated health reported in late adolescence predicts all-cause and disease-specific mortality between the ages of 46 and 70 years. Psychological factors and health behaviors measured at conscription may serve as potential explanatory factors underlying the predictive ability of self-rated health in late adolescence.

Post­recovery symptoms of infected cases after Omicron pandemic: a quick online cross-sectional study based on C19-YRSm in China.

BACKGROUND: The post COVID-19 health condition of Chinese residents infected with Omicron is not clear after the change of epidemic prevention policies. This study aimed to clarify the epidemiology and associated factors about health status of rehabilitation patients. METHODS: A quick questionnaire study based on C19-YRSm was conducted in mainland China through internet from May 1, 2023, to May 7, 2023. Chinese native speakers infected with Omicron variant agreed to participate were included. Persisting symptom and living habits were simultaneously inquired. Logistic regression analysis was used to identify the associated factors. RESULTS: In this study 753 individuals were included. Of whom 57.90% were males, 89.38% did not seek medical service, 99.47% recovered within less than 120 days. Breathlessness (47.68%), cognitive impairment (44.89%), Anxiety/mood changes (33.20%), pain/discomfort (32.94%), fatigue or tiredness not improved by rest (32.27%) and post-exertional malaise (30.01%) were the top reported key symptoms. Less than 10% respondents reported functional limitations. The prevalence of fever was reported greater than that of other symptoms, with dry eyes at 14.87%, appetite change at 14.34%, and hair loss at 12.22%. Middle age (OR: 2.353, 95%CI: 1.171 ~ 4.729), underlying diseases (OR: 2.293, 95%CI: 1.216 ~ 4.324), severe key symptom (OR: 6.168, 95%CI: 1.376 ~ 27.642) and at least one other symptom (OR: 1.847, 95%CI: 1.225 ~ 2.718)during the recovery were the risk factors of poor overall health after infection (current overall health score <8; 74.10%), while daily exercise in recovery period (OR: 0.457, 95%CI: 0.229 ~ 0.913), a low-fat diet (OR: 0.600, 95%CI: 0.401 ~ 0.898) and the recovery time from 2 to 4 months (OR: 0.639, 95%CI: 0.445 ~ 0.918) were the protective factors. CONCLUSION: This is the first time to use the C19-YRSm scale to evaluate the health status in China. The study revealed prevalence of persistent symptoms within 120 days after Omicron onset.

Reassessing the non-linear causal link between long-duration commuting and self-rated health: do behavioral preferences and built environment matter?

Introduction: Long-duration commuting is widely recognized for its significant influence on health. However, while research has traditionally focused on direct impacts, there remains a critical need to explore the nonlinear dynamics of this relationship. This study aims to deepen our understanding of how behavioral preferences and built environments contribute to these complex interactions. Methods: This study was conducted in Jinan, China's most congested city, using data from the "Jinan Residents Commuting Survey" of 1,755 participants aged 19 to 59. We applied Generalized Propensity Score Matching (GPSM) to explore the nonlinear effects of commuting time on self-rated health, adjusting for participants' sociodemographic characteristics. Variables related to active commuting, physical activity, and perceived built environment were also examined for their potential moderating effects. Results: Commuting for less than 21 minutes enhances health, but negative effects intensify and peak at 60 minutes. Heterogeneity analysis reveals that women and older adults, especially those with higher incomes, are more susceptible to long commutes, experiencing a delayed onset of adverse effects. While active commuting offers health benefits, it may exacerbate health issues if prolonged. Conversely, regular physical activity consistently improves health outcomes related to commuting. Additionally, factors like residential greenery and walkability help alleviate commuting-related stress, improving the overall commuting-health dynamic. Discussion: This study clarifies the commuting-health relationship by identifying key time thresholds and the positive effects of active commuting and physical activity on mitigating longer commute impacts. The findings inform healthier commuting behaviors and offer practical guidelines for urban planning and policy-making to enhance commuter well-being.

How Housing Stress Affect Health Care Costs: A Panel Data Study.

As housing prices in China continue to escalate and the limitations of the "personal unlimited liability system" for housing loans become more evident, the financial stress on families has significantly increased. This stress not only impacts the physical and mental health of family members but also results in rising health care costs. This paper presents empirical research examining how housing stress influences changes in household health care costs through a panel data analysis. The study is based on the China Family Panel Study (CFPS) database and employs a panel two-way fixed effect model alongside a mediating effect model to examine the impact of housing stress, family income, and health status on health care costs. The findings reveal a significant positive correlation between housing stress and health care costs; specifically, for every 1% point increase in housing stress, health care costs rise by 0.141. Robustness tests and propensity score matching (PSM) further validate these findings, even after addressing endogeneity issues. Mediation effect analysis indicates that for every 1% point increase in housing stress, household disposable income decreases by 1.749, and health status declines by 0.468, thereby increasing household health care costs. Heterogeneity analysis demonstrates that housing stress has a more pronounced impact on health care costs among western, eastern, urban, and rental households. The government should implement various measures, such as promoting a "personal limited liability system" mortgage policy, reducing housing prices, and ensuring equal rights to rent and purchase, to alleviate housing stress, enhance family income, and improve residents' health status. These actions would contribute to the promotion of both the housing market and medical care, supporting the sustainable development of the health care sector and ultimately improving long-term social welfare.

Health related quality of life and associated factors among patients treated for ischaemic heart disease in two public sector hospitals of Karachi, Pakistan.

Objectives: To determine the level of health-related quality of life among patients treated for ischaemic heart disease in two public-sector tertiary care settings. METHODS: The analytical cross-sectional study was conducted from July to September 2021 at two tertiary care hospitals in Karachi after approval from the ethics review boards of the National Institute of Cardiovascular Diseases and the Dow University of Health Sciences, and comprised patients of either gender treated for ischaemic heart disease after being diagnosed within the preceding year who were coming for follow-up in the outpatient department. Data was collected using the short version of the World Health Organisation quality of life tool. Association of socio-demographic and clinical variables with health-related quality of life was explored. Data was analysed using SPSS 21. RESULTS: Of the 300 patients aged 25-85 years, 212(70.7%) were males and 88(29.3%) were females. The mean total quality of life score was 6.1+/-1.4, while mean general health was 52.6+/-10.5. The lowest score among quality of life subscales was for environmental 44.7+/-15.1, while the highest score was for psychological 60.1+/-10.7 domains. Quality of life was significantly associated with patients' age, education, comorbidities, marital status, monthly income, body mass index, activities of daily living and smoking status (p<0.05). CONCLUSIONS: ischaemic heart disease patients had average health-related quality of life in all domains, but showed low quality of life in the environmental domain.

The association of ideal cardiovascular health and its change with subclinical atherosclerosis according to glucose status: A prospective cohort study.

BACKGROUND: An updated definition was developed to better evaluate cardiovascular health (CVH). We aimed to investigate whether optimal or improvement of six CVH metrics defined by new Life's Essential 8 (LE8) may counteract the risk of subclinical atherosclerosis among patients with hyperglycemia. METHODS: We conducted a prospective analysis of 5225 participants without prior cardiovascular diseases, of whom 4768 had complete data on CVH change. Subjects with CVH scores of 0-49, 50-79, and 80-100 points were categorized as having low, moderate, or high CVH, respectively. Subclinical atherosclerosis was evaluated by brachial-ankle pulse wave velocity, pulse pressure and albuminuria, both separately and in combination. RESULTS: Of the 5225 participants, 1937 (37.1%) had normal glucose regulation, while 3288 (62.9%) had hyperglycemia. The multivariable-adjusted odds ratio (OR) for composite subclinical atherosclerosis was 2.34 (95% confidence interval [CI], 1.88-2.91), 1.43 (95% CI, 1.21-1.70), and 0.74 (95% CI, 0.46-1.18), for participants with hyperglycemia who had low, moderate, or high overall CVH scores, respectively, compared with participants with normal glucose regulation. In addition, compared with those with stable CVH and normal glucose regulation, participants who exhibited greater improvements in overall CVH from 2010 to 2014 had a reduced risk of composite subclinical atherosclerosis with an OR of 0.72 (95% CI, 0.53-0.98) for those with normal glucose regulation, and 1.13 (95% CI, 0.87-1.48) for those with hyperglycemia. CONCLUSIONS: The novel defined CVH using six metrics was inversely associated with subsequent risk of subclinical atherosclerosis. Both the status of CVH and its changes modified the relationship between hyperglycemia and subclinical atherosclerosis.

Cardiovascular Health Among Young Men and Women in Puerto Rico as Assessed by the Life's Essential 8 Metrics.

BACKGROUND: Cardiovascular health (CVH) in young adulthood is associated with CVD in later life, yet CVH in young adults in the United States falls below ideal levels, with noticeable sex differences. Research on CVH in young adults in Puerto Rico is scarce. This study examined CVH and sex differences in CVH in a large cohort of young adults in Puerto Rico. METHODS AND RESULTS: Data from 2162 Puerto Rican young adults aged 18 to 29 residing in PR were obtained from the PR-OUTLOOK (Puerto Rico Young Adults' Stress, Contextual, Behavioral, and Cardiometabolic Risk) study (2020-2023). Participants were recruited through various media and community outreach. CVH scores, graded on a 0 (worst) to 100 (best) scale, were derived from survey responses, physical exams, and laboratory assays. Linear regression with the margins postestimation command was used to determine adjusted means (95% CIs) for CVH scores by sex, controlling for age, marital status, education, childhood material deprivation, subjective social status, health insurance, and depressive symptoms. CVH was less than ideal (score<80) in 72.6% of the cohort (70.5% of women, 75.9% of men, P<0.05). Men had a significantly lower adjusted mean overall CVH score than women (70.7 versus 73.0) and lower adjusted mean scores for nicotine exposure (78.3 versus 86.7), non-high-density lipoprotein cholesterol (80.6 versus 86.4), and blood pressure (79.5 versus 92.2). Women had a significantly lower adjusted mean physical activity score compared with men (50.4 versus 59.5). CONCLUSIONS: Less-than-ideal CVH is notable among young adults, with men having worse CVH than women. These identified sex differences warrant further investigation and the design of interventions to enhance and preserve CVH.

Exploration of the relationship between general health-related problems and subclinical coronary artery disease: a cross-sectional study in a general population.

OBJECTIVE: To explore associations between general health-related problems and subclinical coronary artery disease (CAD), determined by CT coronary calcium score (CT-CCS), in a general population. DESIGN: A cross-sectional design. SETTING: This study was performed in a prospective population-based cohort, examining the health and health-related behaviour of individuals living in the Northern Netherlands. PARTICIPANTS: The initial cohort comprised 6763 participants ≥45 years of age who underwent CT-scanning. Participants were included for the current analysis if they filled in three validated questionnaires (Symptomatic Checklist-90, Research and Development Survey-36 and Reviving the Early Diagnosis of CardioVascular Diseases questionnaire (RED-CVD)) and did not have a history of cardiovascular disease. The final analysis included 6530 participants. PRIMARY OUTCOME MEASURE: Backward-stepwise and forward-stepwise logistic regression analyses were performed to determine associations between general health-related problems and subclinical CAD (CCS≥100 and ≥300). RESULTS: The median age was 53 years (25th, 75th percentile: 48, 58); 57% were women. CRCS≥100 was found in 1236 (19%) participants, 437 (12%) in women and 799 (29%) men and CCS≥300 in 643 (9.9%) participants of which 180 (4.8%) were women and 463 (16.6%) men. In univariate analysis, in women the expectation of health to worsen (OR=1.13, 95% CI: 1.05 to 1.21), and in men reduced exercise intolerance (OR=1.14, 95% CI: 1.06 to 1.23) were associated with CCS≥100. The total RED-CVD score in women (OR=1.06, (95% CI: 1.05 to 1.08) and men (OR=1.07, 95% CI: 1.06 to 1.09), and in men also reduced exercise intolerance (OR=1.15, 95% CI: 1.06 to 1.25) and headache (OR=0.55, 95% CI: 0.38 to 0.79) were associated with CCS≥300. In multivariate analyses, only general health expectation in women was still significantly associated with subclinical CAD (CCS≥300) (OR=1.92, 95% CI: 1.56 to 2.37). CONCLUSION: Only a few general health-related problems were associated with the presence of subclinical CAD in the general population, however, these problems showed no strong association. Therefore, using health-related symptoms does not seem useful to pre-select for CT-CCS. TRIAL REGISTRATION NUMBER: CCMO Register, NL17981.042.07 and NL58592.042.16.

Health, economic and social impacts of the Brazilian cash transfer program on the lives of its beneficiaries: a scoping review.

BACKGROUND: The Bolsa Família cash transfer Program (BFP) aims to break the poverty cycle by providing a minimum income to poor families conditioned on their investment in human capital (such as, education and health) and currently is the largest Program in the world in terms of the number of beneficiaries. Because there is a scarcity of reviews grouping studies on the impacts of the BFP, the objective of this scoping review was to identify and describe studies which evaluate the impact of the BFP on poverty, health, education, and other related outcomes. METHODS: We searched for quantitative, qualitative, and mixed-method articles that assessed the impact of the BFP on any aspect of the beneficiaries' lives between 2003 and March 2021. We included quantitative articles that used experimental, quasi-experimental or pre and post comparison designs. We excluded articles that analyzed impacts on political outcomes. There was no age restriction for the participants. The search was done in seven electronic databases. RESULTS: One thousand five hundred forty-six papers were identified and 94 fulfilled the inclusion criteria. Poverty and health outcomes were the most common outcomes studied. We found consistent evidence of the positive impact of the BFP on poverty reduction, as well as employment outcomes. We also found positive impacts in relation to mortality rates for children and adults, school dropout and school attendance among children and adolescents, and violence related outcomes such as homicide, suicide, crime, and hospitalization. However, we also found some evidence that BFP increased intimate partner violence and gender stereotypes among women and no evidence of impact on teenage pregnancy. CONCLUSIONS: Overall, the studies included found that BFP showed positive impacts on most poverty, health and education outcomes. More studies are needed to confirm some results, especially about violence and stereotype against women as there were few evaluations on these outcomes.

Comparing Social Isolation in Older Adults With and Without Physical Health Challenges During COVID-19: Church and Church Friends Matter.

Older adults were disproportionately affected by COVID-19. The purpose of this study was to explore experiences of sudden-onset social isolation and factors that influenced it among social isolation in two groups of older adults. A qualitative thematic study with a survey component was conducted comparing 18 older adults in two groups: 12 reporting physical health challenges and 6 reporting no physical health challenges. Three qualitative themes describe experiences of (a) avoiding risk to personal health as the reason to postpone healthcare, (b) grieving church and church friends as a lost social connection, and (c) compound stress due to converging factors related to personal health, public health, racial justice movement and critical national events. Those with physical health challenges were less able to postpone seeking healthcare, suffered from compound stress, and were more likely to feel isolated when unable to participate in church activities. Religious, faith, or spiritual supports may be important buffers against social isolation during public health emergencies, especially for older adults with physical health challenges and when there is concurrent social unrest.

Serum selenium concentrations in neonatal calves: Influence of postnatal selenium injection and health status.

Background: Selenium supply plays a major role in calf rearing, as a deficiency can lead to health problems, economic loss, and even death. Therefore, postnatal selenium injections are often administered as a preventive measure. Objective: In this study, we examined the serum selenium concentrations of healthy and sick calves within the first days of life. Further, serum concentrations after injection with selenium were determined. Animals and procedure: Serum selenium concentrations from 75 calves were measured until the 10th d of life and the differences between sick and healthy calves were investigated. The variations in selenium concentration were analyzed 3 and 6 d after subcutaneous injection of 5.5 mg sodium selenite in 32 calves.To compare serum concentrations between healthy and sick calves, an independent samples t-test was used. For unequal variances, the Satterthwaite method was used; and for equal variances, the pooled sample variance was used. To analyze the statistical differences between the concentrations at different time points, the data were log-transformed and the Bonferroni correction was used. Results: The mean initial selenium concentration was 46 ± 37 µg/L. There was no statistically significant difference (P = 0.60) between sick (46 ± 34 µg/L) and healthy (46 ± 47 µg/L) calves. Serum selenium concentrations 3 and 6 d after injection of calves over 3 samples were 62 ± 19 µg/L and 50 ± 13 µg/L, respectively. Calves with an initial serum concentration of ≥ 72 µg/L showed a decrease of serum selenium concentration despite the injection. Conclusion and clinical relevance: Newborn calves showed a high variation in selenium concentration that was not influenced by health status. A single injection of 5.5 mg of sodium selenite did increase the selenium concentration in calves with selenium undersupply. After injection, none of the calves showed serum concentrations above the reference range for adult cattle. Therefore, the indication for a selenium injection can be interpreted generously if selenium undersupply is suspected.

Concentrations sériques de sélénium chez les veaux nouveau-nés : influence de l'injection postnatale de sélénium et de l'état de santé. Contexte: L'apport en sélénium joue un rôle majeur dans l'élevage des veaux, car une carence peut entraîner des problèmes de santé, des pertes économiques et même la mort. Par conséquent, des injections postnatales de sélénium sont souvent administrées à titre préventif. Objectif: Dans cette étude, nous avons examiné les concentrations sériques de sélénium de veaux sains et malades au cours des premiers jours de vie. De plus, les concentrations sériques après injection de sélénium ont été déterminées. Animaux et procédure: Les concentrations sériques de sélénium de 75 veaux ont été mesurées jusqu'au 10e jour de vie et les différences entre les veaux malades et sains ont été étudiées. Les variations de concentration en sélénium ont été analysées 3 et 6 jours après l'injection sous-cutanée de 5,5 mg de sélénite de sodium chez 32 veaux.Pour comparer les concentrations sériques entre les veaux sains et malades, un test t sur échantillons indépendants a été utilisé. Pour les variances inégales, la méthode de Satterthwaite a été utilisée; et pour des variances égales, la variance de l'échantillon groupé a été utilisée. Pour analyser les différences statistiques entre les concentrations à différents moments, les données ont été transformées par logarithme et la correction de Bonferroni a été utilisée. Résultats: La concentration initiale moyenne en sélénium était de 46 ± 37 µg/L. Il n'y avait pas de différence statistiquement significative (P = 0,60) entre les veaux malades (46 ± 34 µg/L) et sains (46 ± 47 µg/L). Les concentrations sériques de sélénium 3 et 6 jours après l'injection des veaux sur 3 échantillons étaient respectivement de 62 ± 19 µg/L et de 50 ± 13 µg/L. Les veaux avec une concentration sérique initiale ≥ 72 µg/L ont montré une diminution de la concentration sérique en sélénium malgré l'injection. Conclusion et pertinence clinique: Les veaux nouveau-nés ont montré une forte variation de la concentration en sélénium qui n'était pas influencée par l'état de santé. Une injection unique de 5,5 mg de sélénite de sodium a augmenté la concentration de sélénium chez les veaux présentant un apport insuffisant en sélénium. Après l'injection, aucun veau n'a présenté de concentrations sériques supérieures à la plage de référence pour les bovins adultes. Par conséquent, l'indication d'une injection de sélénium peut être interprétée de manière généreuse si un apport insuffisant en sélénium est suspecté.(Traduit par Dr Serge Messier).

Midlife health in Britain and the United States: a comparison of two nationally representative cohorts.

BACKGROUND: Older adults in the USA have worse health and wider socioeconomic inequalities in health compared with those in Britain. Less is known about how health in the two countries compares in mid-life, a time of emerging health decline, including inequalities in health. METHODS: We compare measures of current regular smoking status, obesity, self-rated health, cholesterol, blood pressure and glycated haemoglobin using population-weighted modified Poisson regression in the 1970 British Cohort Study (BCS70) in Britain (N = 9665) and the National Longitudinal Study of Adolescent to Adult Health (Add Health) in the USA (N = 12 300), when cohort members were aged 34-46 and 33-43, respectively. We test whether associations vary by early- and mid-life socioeconomic position. RESULTS: US adults had higher levels of obesity, high blood pressure and high cholesterol. Prevalence of poor self-rated health and current regular smoking was worse in Britain. We found smaller socioeconomic inequalities in mid-life health in Britain compared with the USA. For some outcomes (e.g. smoking), the most socioeconomically advantaged group in the USA was healthier than the equivalent group in Britain. For other outcomes (hypertension and cholesterol), the most advantaged US group fared equal to or worse than the most disadvantaged groups in Britain. CONCLUSIONS: US adults have worse cardiometabolic health than British counterparts, even in early mid-life. The smaller socioeconomic inequalities and better overall health in Britain may reflect differences in access to health care, welfare systems or other environmental risk factors.

Enhancement or suppression: a double-edged sword? Differential association of digital literacy with subjective health of older adult-evidence from China.

Background: The emergence of an aging society and the digital age makes healthy aging a hot topic in Chinese society. This paper explores the associations between digital literacy and the subjective health of older adult individuals in PR China, offering insights that May assist policymakers and service providers in developing strategies and interventions suited to the digital era, potentially enhancing the healthy aging process for this demographic in China. Methods: This study utilized data from the China Longitudinal Aging Social Survey. Initially, demographic variables of 2086 individuals in the sample were analyzed. Subjective health differences among different populations and correlations between core variables were examined. Subsequently, multivariate linear regression and chain mediation methods were utilized to examine the relationships and potential pathways among the three dimensions of digital literacy and the subjective health of older adult individuals. Results: (1) The subjective health status of older adult individuals in China was generally favorable, with an average score of 3.406 ± 0.764. (2) There was no direct correlation observed between the frequency of digital information use and the subjective health of the older adult (b = -0.032, p > 0.1). Digital entertainment information (b = 0.294, p > 0.1) did not show a significant effect, whereas life management information (b = 0.437, p < 0.01) demonstrated a positive association. Similarly, the use of smart healthcare devices (b = 0.842, p < 0.001) indicated a positive association (3) The frequency of digital information use indirectly enhanced the subjective health of the older adult through life management digital information and the use of smart healthcare devices, but had no indirect effect through entertainment and leisure digital information. Conclusion: Digital literacy is significantly correlated with the subjective health of the older adult, especially when they acquire life management information and utilize smart healthcare devices. However, a potential negative relationship is suggested between digital entertainment information and the subjective health of older adult individuals. Therefore, digital infrastructure should have prioritized the provision of high-quality, age-friendly digital applications for the older adult. This approach could have better harnessed the potential of digitalization to enhance health and well-being in older adults.

Oral health status and factors associated with oral health of primary school children in Gulu district, northern Uganda.

BACKGROUND: Globally, oral diseases remain a major public health problem. However, there is limited information about the oral health status and factors associated with oral disease among children in Uganda. The aim of this study was to examine the oral health status and factors associated with oral health of primary school children in urban and rural areas of the Gulu district of northern Uganda. METHODS: A comparative cross-sectional study was conducted among 356 school children aged 11-13 years attending six schools located in urban and rural areas. The children received a clinical oral examination and participated in a questionnaire survey that collected information on sociodemographic and oral health knowledge, attitude, and practices. All data were entered and analysed using IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp statistical software. Logistic regression analyses examined factors associated with dental caries and gingival bleeding. RESULTS: Of the 356 children (11-13 years) included, the mean age was 12.2 years, 140 (39.3%) were male and 176 (49.4%) were from urban areas. The proportion of school children with dental caries was 33.6% (n = 119), with the mean decayed, missing due to caries, and filled teeth (DMFT) index of 0.81 (25th percentile = 0; 75th percentile = 1.00). There was no significant difference in caries prevalence between rural and urban children (31.6% versus 35.6%, p = 0.33). Of the children involved in the study, 141(39.8%) had gum bleeding. The mean oral knowledge score was 2.85 ± 1.53 (range, 0-7), while the mean attitude, hygiene practice, frequency of sweets consumption, and oral health related impact scores were 4.25 ± 1.23 (range, 1-6), 5.40 ± 1.81 (range, 0-9), 25.66 ± 4.29 (range 9-54) and 2.1 ± 1.65 (range, 0-6), respectively. Using logistic regression analyses, as oral health knowledge score increased the odds of not having dental caries increased (aOR = 1.19, 95% CI 1.02-1.39). CONCLUSION: The prevalence of dental caries and gum bleeding of primary school children in Gulu district is high. Children lacked knowledge on causes of oral disease, and behaviour towards oral disease prevention. In addition, oral health knowledge scores were significantly associated with dental caries. Oral health education programs in schools should emphasise providing skills-based education.

Adverse Childhood Experiences and Health Conditions and Risk Behaviors Among High School Students - Youth Risk Behavior Survey, United States, 2023.

Adverse childhood experiences (ACEs) are preventable, potentially traumatic events occurring before age 18 years. Data on ACEs among adolescents in the United States have primarily been collected through parent report and have not included important violence-related ACEs, including physical, sexual, and emotional abuse. This report presents the first national prevalence of self-reported ACEs among U.S. high school students aged <18 years, estimates associations between ACEs and 16 health conditions and risk behaviors, and calculates population-attributable fractions of ACEs with these conditions and behaviors using cross-sectional, nationally representative 2023 Youth Risk Behavior Survey data. Exposures were lifetime prevalence of individual (emotional, physical, and sexual abuse; physical neglect; witnessed intimate partner violence; household substance use; household poor mental health; and incarcerated or detained parent or guardian) ACEs and cumulative ACEs count (zero, one, two or three, or four or more). Health conditions and risk behaviors included violence risk factors, substance use, sexual behaviors, weight and weight perceptions, mental health, and suicidal thoughts and behaviors. Bivariate analyses assessed associations between individual and cumulative ACEs and demographics. Adjusted prevalence ratios assessed associations between cumulative ACEs and health conditions and risk behaviors, accounting for demographics. Population-attributable fractions were calculated to determine the potential reduction in health conditions and risk behaviors associated with preventing ACEs. ACEs were common, with approximately three in four students (76.1%) experiencing one or more ACEs and approximately one in five students (18.5%) experiencing four or more ACEs. The most common ACEs were emotional abuse (61.5%), physical abuse (31.8%), and household poor mental health (28.4%). Students who identified as female; American Indian or Alaska Native; multiracial; or gay or lesbian, bisexual, questioning, or who describe their sexual identity in some other way experienced the highest number of ACEs. Population-attributable fractions associated with experiencing ACEs were highest for suicide attempts (89.4%), seriously considering attempting suicide (85.4%), and prescription opioid misuse (84.3%). ACEs are prevalent among students and contribute substantially to numerous health conditions and risk behaviors in adolescence. Policymakers and public health professionals can use these findings to understand the potential public health impact of ACEs prevention to reduce adolescent suicidal behaviors, substance use, sexual risk behaviors, and other negative health conditions and risk behaviors and to understand current effects of ACEs among U.S. high school students.

Rural-urban and regional variations in aspects of caregiving, support services and caregiver health in the USA: evidence from a national survey.

OBJECTIVES: Due to substantial regional variability in available caregiving services and supports, culture and health status among informal caregivers in the USA, the study objective was to explore how rural-urban differences in aspects of caregiving-caregiving intensity, distance to care recipient, caregiver burden, caregiver health and caregiving support-vary by US Census region (Northeast, South, Midwest and West) after accounting for other social determinants of health. DESIGN: This study was a secondary analysis of multiwave, cross-sectional study data. SETTING: The data were collected on a representative sample of informal, unpaid caregivers to older adults. PARTICIPANTS: A sample of n=3551 informal caregivers from the National Study of Caregiving identified by older adult care recipients from waves 1 (2011) and 5 (2015) of the National Health and Aging Trends Study. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcome measures were caregiving intensity (provided support for/with the number of activities of daily living (ADLs) and instrumental ADL (IADLs)) caregiver assisted with, hours of caregiving per month), caregiver burden (physical, emotional and financial), support services sought (types and total number), caregivers' self-reported health and health status (individual comorbidities and a total number of comorbidities). Analyses were stratified by US Census region and rural-urban status, as defined by the US Census Bureau, of census tract of caregiver residence. RESULTS: Urban caregivers provided higher levels of ADL support in the Northeast (beta=0.19, 95% CI 0.03, 0.35) and West (beta=0.15, 95% CI 0.05,0.26) regions. Urban caregivers provided significantly higher levels of ADL support (p=0.020), IADL support (p=0.033) and total ADLs plus IADLs (p=0.013) than rural caregivers. Caregivers living in the South had higher amounts of monthly hours spent caregiving, ADL support, IADL support and combined ADLs plus IADLs and were more likely to have obesity, report poor or fair health, have heart conditions and experience emotional difficulty from caregiving (all p<0.001). CONCLUSIONS: Study findings underscore caregiving's multifaceted and complex nature and identify important urban-rural and regional differences in caregiving in the USA. Healthcare providers and healthcare organisations can have an important role in identifying and mitigating the negative impacts of caregiving on caregivers' overall health. Interventions and support should be tailored to caregivers' demographic backgrounds, addressing regional differences.

Deriving disability weights for the Netherlands: findings from the Dutch disability weights measurement study.

BACKGROUND: The aims of this study were to establish national disability weights based on the health state preferences of a Dutch general population sample, examine the relation between results and respondent's characteristics, and compare disability weights with those estimated in the European disability weights study. METHODS: In this cross-sectional study, a web-based survey was administered to a general population 18-75 years from the Netherlands. The survey included paired comparison questions. Paired comparison data were analysed using probit regression and located results onto the 0-to-1 disability weight scale using non-parametric regression. Bootstrapping was used to estimate 95% uncertainty intervals (95%UI). Spearman's correlation was used to investigate the relation of probit regression coefficients between respondent's characteristics. RESULTS: 3994 respondents completed the questionnaire. The disability weights ranged from 0.007 (95%UI: 0.003-0.012) for mild distance vision impairment to 0.741 (95% UI: 0.498-0.924) for intensive care unit admission. Spearman's correlation of probit coefficients between sub-groups based on respondent's characteristics were all above 0.95 (p < 0.001). Comparison of disability weights of 140 health states that were included in the Dutch and European disability weights study showed a high correlation (Spearman's correlation: 0.942; p < 0.001); however, for 76 (54.3%) health states the point estimate of the Dutch disability weight fell outside of the 95%UI of the European disability weights. CONCLUSIONS: Respondent's characteristics had no influence on health state valuations with the paired comparison. However, comparison of the Dutch disability weights to the European disability weights indicates that health state preferences of the general population of the Netherlands differ from those of other European countries.

Climate change distress and impairment in Germany.

Introduction: Climate change has been widely recognized as one of the most challenging problems facing humanity and it imposes serious mental health threats. It is important, however, to differentiate between the affective experience of distress over climate change and the functional impairments associated with climate change. Such a distinction is crucial because not all negative affective states are pathological, and they might even motivate pro-environmental behavior. Functional impairments, like not being able to work or maintaining social relationships, however, might require immediate treatment. This study assesses climate change distress and climate change impairment within the population of Germany using a population-representative sample. The results identify vulnerable subgroups and thereby can help to facilitate the development of target group specific intervention programs. Furthermore, this study explores whether climate change distress and climate change impairment are associated with general health, physical health, mental health, and diverse health behaviors. Methods: Study participants were drawn from a panel which is representative of the German-speaking population in Germany with Internet access. Participants answered a series of questionnaires regarding their climate change distress, climate change impairment, general health, physical health, mental health, and diverse health behaviors. To evaluate differences between subgroups, Bayesian independent samples t-tests were calculated. To evaluate associations between constructs, Bayesian correlations were calculated. Results: Especially women, younger people, people from West Germany, and people with a high level of formal education seem to experience higher levels of climate change distress. Regarding climate change impairment, the results suggest that especially women, older people, people from West Germany, people with a low level of formal education, people with a low or middle social status, and people with an inadequate/problematic health literacy seem to experience higher levels of climate change impairment. Furthermore, climate change distress and climate change impairment were weakly and differently associated with general health, physical health, mental health, and diverse health behaviors. Discussion: Climate change distress and impairment are not evenly distributed within German society. The results of this study provide a starting point for the development of target group specific intervention programs.