Preventive medicine
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Preventive medicine · Jul 2018
Childhood poverty, catecholamines, and substance use among African American young adults: The protective effect of supportive parenting.
From a sample of African American families living in the rural South, this study tested the hypothesis that growing up in poverty is associated with heightened biological stress levels in youth that, in turn, forecast elevations in drug use in young adulthood. Supportive parenting during adolescence was hypothesized to protect youth's biological stress levels from rising in the context of poverty. African American youth and their primary caregivers from 385 families participated in a 14-year prospective study that began when youth were 11 years of age. ⋯ Conditional indirect effects confirmed a developmental cascade linking family poverty, youth catecholamine levels, and increases in substance use for youth who did not receive high levels of supportive parenting. Current results suggest that, for some African American youth, substance use vulnerability may develop "under the skin" from stress-related biological weathering years before elevated drug use. Receipt of supportive parenting, however, can protect rural African American youth from biological weathering and its subsequent effects on increases in substance use during adulthood.
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Preventive medicine · Jul 2018
Change in physical activity and accumulation of cardiometabolic risk factors.
This study aims to examine the association between change in physical activity over time and accumulation of cardiometabolic risk factors. Four consecutive surveys (Time 1 to 4) were conducted with 4-year intervals in 1997-2013 (the Finnish Public Sector study). Physical activity of 15,634 cardio-metabolically healthy participants (mean age 43.3 (SD 8.7) years, 85% women) was assessed using four-item survey measure and was expressed as weekly metabolic equivalent (MET) hours in Time 1, 2, and 3. ⋯ Compared to maintenance of low physical activity, increase in physical activity from low baseline activity level was associated with decreased accumulation of cardiometabolic risk factors in a dose-response manner (cumulative odds ratio [cOR] = 0.73, 95% CI 0.59-0.90 for low-to-moderate and cOR = 0.67, 95% CI 0.49-0.89 for low-to-high, P for trend 0.0007). Decrease in physical activity level from high to low was associated with increased accumulation of cardiometabolic risk factors (cOR = 1.60, 95% CI 1.27-2.01) compared to those who remained at high activity level. Thus even a modest long-term increase in physical activity was associated with reduction in cardiometabolic risk whereas decrease in physical activity was related to increased risk.
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Preventive medicine · Jul 2018
Where do U.S. households purchase healthy foods? An analysis of food-at-home purchases across different types of retailers in a nationally representative dataset.
Food shopping decisions are pathways between food environment, diet and health outcomes, including chronic diseases such as diabetes and obesity. The choices of where to shop and what to buy are interrelated, though a better understanding of this dynamic is needed. The U. ⋯ Shoppers with less than some college education made significantly less-healthy purchases, versus shoppers with more education, as did households participating in SNAP, versus those with incomes above 185% of the Federal Poverty Level. Individual, trip, and store characteristics influenced the healthfulness of foods purchased. Interventions to encourage healthy purchasing should reflect these dynamics in terms of how, where, and for whom they are implemented.
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Preventive medicine · Jul 2018
State-level minimum wage and heart disease death rates in the United States, 1980-2015: A novel application of marginal structural modeling.
Despite substantial declines since the 1960's, heart disease remains the leading cause of death in the United States (US) and geographic disparities in heart disease mortality have grown. State-level socioeconomic factors might be important contributors to geographic differences in heart disease mortality. This study examined the association between state-level minimum wage increases above the federal minimum wage and heart disease death rates from 1980 to 2015 among 'working age' individuals aged 35-64 years in the US. ⋯ In models of 'working age' adults (35-64 years old), a $1 increase in the state-level minimum wage above the federal minimum wage was on average associated with ~6 fewer heart disease deaths per 100,000 (95% CI: -10.4, -1.99), or a state-level heart disease death rate that was 3.5% lower per year. In contrast, for older adults (65+ years old) a $1 increase was on average associated with a 1.1% lower state-level heart disease death rate per year (b = -28.9 per 100,000, 95% CI: -71.1, 13.3). State-level economic policies are important targets for population health research.