To explore the relationship between daytime napping and incidence of chronic diseases over the past 6 months among adults in China.
Based on data collected from 13,469 respondents over age 40 in the ...Chinese Family Panel Studies in 2010, logistic regression models were estimated to examine the association between daytime napping and the incidence of any chronic diseases and 3 specific chronic diseases (hypertension, diabetes, and heart disease) after adjusting for confounders. Differences of risks by sex and age were also investigated.
In the sample, 50.8% were women and 32.2% were over 60 years old. Adjusted estimates show respondents with daytime napping had elevated odds of developing any chronic diseases, hypertension, and diabetes compared to those who did not nap; having over 60 minutes of daytime napping had weaker association compared with shorter duration of daytime napping. The association between daytime napping and hypertension was found in women but not in men.
Daytime napping appears to be associated with elevated risk of incidence of any chronic diseases, hypertension, and diabetes.
Little is known about leisure-time physical activity (LTPA) correlates in high-risk youth prone to obesity, insulin resistance, and associated morbidities. This study examined LTPA correlates among ...Latino youth identified with acanthosis nigricans (AN), a skin condition typically caused by metabolic impairment. Data were collected on 305 AN-positive Latino youth of ages 5–15 and one of their biological parents in 2012 from Texas. Ordinal logit regression was performed to analyze the data. Five health and behavioral LTPA correlates were identified, including child time spent in TV watching or videogame playing (OR of highest quartile vs. lowest quartile = 0.45; p = 0.01), child fair/poor health (OR 0.42; p = 0.01), parent obesity (OR 0.63; p = 0.06), parent daily physical exercise for more than 30 min (OR 2.20; p < 0.01), and parent housework time (OR 0.76; p < 0.05). Parent socioeconomic status was insignificant. For at-risk Latino youth, physical activity intervention strategies should take both behavioral and health factors into account.
Racial discrimination has intensified in the U.S. during the COVID-19 pandemic, but how it disrupted healthcare is largely unknown. This study investigates the association of racial discrimination ...with delaying or forgoing care during the pandemic based on data from a nationally representative survey, the Health, Ethnicity and Pandemic (HEAP) study (n = 2552) conducted in October 2020 with Asians, Hispanics and non-Hispanic Blacks oversampled. Racial discrimination during the pandemic was assessed in three domains: experienced racial discrimination, race-related cyberbullying, and Coronavirus racial bias beliefs. Respondents answered whether they had delayed or forgone any type of healthcare due to the pandemic. Overall, 63.7% of respondents reported delaying or forgoing any healthcare during the pandemic. About 20.3% East/Southeast Asians, 18.6% non-Hispanic Blacks and 15.9% Hispanics reported experiences of racial discrimination, compared with 2.8% of non-Hispanic Whites. Experienced racial discrimination was associated with delaying/forgoing care among non-Hispanic Blacks (Adjusted odds ratiosAOR = 4.58, 95% confidence intervalCI: 2.22–9.45), Hispanics (AOR = 3.88, 95%CI: 1.51–9.98), and East/Southeast Asians (AOR = 2.14, 95%CI: 1.22–3.77). Experiencing race-related cyberbullying was significantly associated with delaying/forgoing care among non-Hispanic Blacks (AOR = 1.34, 95%CI: 1.02–1.77) and East/Southeast Asians (AOR = 1.51, 95%CI: 1.19–1.90). Coronavirus racial bias was significantly associated with delaying/forgoing care among East/Southeast Asians (AOR = 1.55, 95%CI: 1.16–2.07). The three domains of racial discrimination were consistently associated with delayed or forgone health care among East/Southeast Asians during the COVID-19 pandemic; some of the associations were also seen among non-Hispanic Blacks and Hispanics. These results demonstrate that addressing racism is important for reducing disparities in healthcare delivery during the pandemic and beyond.
•Approximately two thirds of Americans reported delaying or forgoing healthcare during the pandemic.•Experience of racial discrimination were prevalent among Asian Americans, Blacks and Hispanics during the pandemic.•Multiple domains of racial discrimination were associated with delayed or forgone health care among East/Southeast Asians.•Some of the associations were also seen among Blacks and Hispanics.
This study analyzes differences among Americans in their trust in COVID-19 information from governmental sources and how trust is associated with personal adoption of preventative measures under the ...Trump administration. Based on our analysis of data from a nationally representative survey conducted in October 2020 (effective sample size after weighting = 2615), we find that Americans in general have more trust in COVID-19 information from state/local governments than from the federal government. Variables such as age, party affiliation, religiosity, and race are significantly associated with Americans' trust or lack of trust in COVID-19 information from governmental sources. During the study period, Republicans had more trust in the federal government as a COVID-19 information source than Democrats did, while Democrats had more trust in state/local governments. African Americans had the least trust in the federal and state/local governments as COVID-19 information sources, while Asian Americans had the most trust in both institutions. Trust in the state/local governments as COVID-19 information sources was positively associated with physical distancing and mask-wearing while trust in the federal government as a COVID-19 information source was negatively associated with physical distancing and mask-wearing, suggesting the distinctive roles that state/local governments and the federal government played in mobilizing Americans to adopt preventive measures.
Health services from Mexico constitute an important source of care for U.S. residents living along the U.S.-Mexico border. Data from The Cross-Border Utilization of Health Care Survey (n = 966) were ...used to estimate logit models that related acculturation, as measured by generational status, to the use of medication, physician, dental, and inpatient services from Mexico by U.S. residents in the Texas border region. Relative to first-generation Mexican immigrants, later-generation Mexican–Americans were progressively less likely to go to Mexico for health services. This finding holds with or without adjusting for the effects of selected demographic and socioeconomic variables. Addressing unmet needs in medical care in the southwestern U.S. border area should go beyond a simple expansion of health insurance coverage—it is also important to deliver health services that are sensitive to generational differences within the population in terms of linguistic and cultural barriers to health care access.
Background
While hate crimes rose during the COVID-19 pandemic, few studies examined whether this pandemic-time racial discrimination has led to negative health consequences at the population level.
...Objective
We examined whether experienced and perceived racial discrimination were associated with mental or behavioral health outcomes during the pandemic.
Design
In October 2020, we conducted a national survey with minorities oversampled that covered respondents’ sociodemographic background and health-related information.
Participants
A total of 2709 participants responded to the survey (response rate: 4.2%).
Main Measures
The exposure variables included (1) experienced and encountered racial discrimination, (2) experienced racial and ethnic cyberbullying, and (3) perceived racial bias. Mental health outcomes were measured by psychological distress and self-rated happiness. Measures for behavioral health included sleep quality, change in cigarette smoking, and change in alcohol consumption. Weighted logistic regressions were performed to estimate the associations between the exposure variables and the outcomes, controlling for age, gender, race and ethnicity, educational attainment, household income, eligibility to vote, political party, COVID-19 infection, and geographic region. Separate regressions were performed in the six racial and ethnic subgroups: non-Hispanic White, non-Hispanic Black, Hispanic, East Asian, South Asian, and Southeast Asian respondents.
Key Results
Experienced racial discrimination was associated with higher likelihood of psychological distress (adjusted odds ratio AOR = 2.18, 95% confidence interval 95% CI: 1.34–3.55). Experienced racial discrimination (AOR = 2.31, 95% CI: 1.34–3.99) and perceived racial bias (AOR = 1.05, 95% CI: 1.00–1.09) were both associated with increased cigarette smoking. The associations between racial discrimination and mental distress and substance use were most salient among Black, East Asian, South Asian, and Hispanic respondents.
Conclusions
Racial discrimination may be associated with higher likelihood of distress, and cigarette smoking among racial and ethnic minorities. Addressing racial discrimination is important for mitigating negative mental and behavioral health ramifications of the pandemic.
Despite the growing importance of community health workers (CHWs) in public health, it has been difficult to characterize the roles and scope of services for this workforce in part because of the ...variability in the employment status of CHWs, ranging from full-time, part-time, to volunteer. Based on analysis of survey data from a statewide assessment of the CHW workforce in Nebraska (n = 142) conducted between 2019 and 2020, the proportions of CHWs who worked full-time, part-time, or volunteer were respectively 64%, 12%, and 21%. Over three quarters (76.7%) of volunteer CHWs were primarily working with Hispanic communities, as compared to less than 30% among full-time and part-time CHWs. About 80% of volunteer CHWs received training before becoming a CHW, substantially higher than the corresponding proportions among full-time (46.2%) and part-time CHWs (52.9%). In terms of tasks performed, the proportion of volunteer CHWs who provided health screenings (70%) were much higher than full or part-time CHWs (41.8% and 11.8% respectively, p < 0.001); whereas the latter two groups were significantly more likely than volunteer CHWs to provide other tasks such as coordinating care, health coaching, social support, transportation, interpretation, data collection, advocacy, and cultural awareness. Volunteer CHWs may hold potential for serving non-Hispanic communities. Future development of the CHW workforce can benefit from understanding and leveraging the significant differences in roles and scope of services among CHWs with various employment statuses.
This study compares and contrasts how key factors influence Americans' trust in different types of media (broadcast, print, and social) as COVID-19 information sources and how people's media trust is ...associated with their adoption of preventive measures. Our results from a national survey (sample = 2571) showed that age, political party affiliation, and race and ethnicity and income level were significantly associated with people's trust in different media types as COVID information sources. Elder adults trusted print and broadcast media more, while younger adults trusted social media more. Democrats and Lean Democrats had more trust in all three forms of media than Republicans and Lean Republicans. Asians had the highest levels of trust in all three media types, while Whites had the lowest level of trust in broadcast and social media. Trust in broadcast media was found to be associated with facial mask wearing, but trust in social media, however, did not contribute to the adoption of any COVID-19 preventive measures. This study contributes to a general understanding of media trust and mediated health communication and provides nuanced understanding of how demographic factors shape media trust and the consequence of media trust during a historical pandemic.
This study examines the relation between risk exposures in early life and hazard of mortality among 11,978 Union Army veterans aged 50 and over in 1900. Veterans' risk exposures prior to ...enlistment-as approximated by birth season, country of birth, residential region, city size, and height at enlistment-significantly influenced their chance of survival after 1900. These effects are robust irrespective of whether socioeconomic well-being in 1900 has been taken into account; however, they are sensitive to the particular age periods selected for survival analysis. Whereas some of the effects such as being born in Ireland and coming from large cities became apparent in the first decade after 1900 and then dissipated over time, the effects of birth season, being born in Germany, residential region in the United States, and height at enlistment were more salient in the post-1910 periods. Height at enlistment shows a positive association with risk of mortality in the post-1910 periods. Compared to corresponding findings from more recent cohorts, the exceptional robustness of the effects of risk exposures prior to enlistment on old-age mortality among the veterans highlights the harshness of living conditions early in their lives.
Unauthorized immigrants and other immigrants who have been in the United States for less than five years have few options for accessing health care through public programs. In light of the ongoing ...national debate about immigration reform and the impact of the Affordable Care Act on immigrants, we examined differences in health care spending by nativity and legal status using Medical Expenditure Panel Survey data for the period 2000-09. We found that unauthorized, legal, and naturalized immigrants together accounted for $96.5 billion in average annual health care spending, compared to slightly more than $1 trillion for US natives. Unauthorized immigrants' share of health care spending was $15.4 billion-the smallest of the groups. Just 7.9 percent of unauthorized immigrants benefited from public-sector health care expenditures (receiving an average of $140 per person per year), compared to 30.1 percent of US natives (who received an average of $1,385). Policy solutions could include extending coverage to unauthorized immigrants for the prevention and treatment of infectious diseases or granting them access to the Affordable Care Act's insurance marketplaces, which start in 2014. The final version of federal immigration reform might also include strategies to expand immigrants' access to health care.
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