Preventive medicine
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Preventive medicine · Apr 2021
Disparities in infant mortality by payment source for delivery in the United States.
In this study, we hypothesized that infant mortality varies among health insurance status. Furthermore, we examined whether there are racial and ethnic disparities in the association between infant death and payment source for delivery. Our study used US national linked birth and infant death data for 2013 and 2017 collected by the National Center for Health Statistics and included 3,311,504 and 3,218,168 live births for each year. ⋯ Overall infant mortality was lower in mothers who paid with private insurance than in those who paid with Medicaid insurance (RR = 0.87, 95% CI 0.84-0.90 in 2013; RR = 0.91, 95% CI 0.87-0.94 in 2017), but it was higher in self-paid women than in Medicaid-insured women at delivery (RR = 1.25, 95% CI 1.17-1.33 in 2013; RR = 1.16, 95% CI 1.08-1.24 in 2017). Non-Hispanic black (RR = 1.67, 95% CI 1.47-1.90 in 2013; RR = 1.16, 95% CI 1.00-1.35 in 2017) and Hispanic (RR = 1.30, 95% CI 1.17-1.44 in 2013; RR = 1.22, 95% CI 1.09-1.36 in 2017) mothers with self-payment had a higher risk for infant mortality than those with Medicaid at delivery. Newborns whose mothers have no health insurance would be more vulnerable to infant mortality than Medicaid beneficiaries, and non-white ethnic groups with self-payment would have an elevated risk of infant mortality among other racial and ethnic groups.
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Preventive medicine · Apr 2021
Unhealthy environments are associated with adverse mental health and psychological distress: Cross-sectional evidence from nationally representative data in New Zealand.
This study combines data on the location of health-constraining 'bads' (i: fast-food outlets, ii: takeaway outlets, iii: dairy outlets and convenience stores, iv: alcohol outlets, and v: gaming venues) and health-promoting 'goods' (i: green spaces, ii: blue spaces, iii: physical activity facilities, and iv: fruit and vegetable outlets) into a nationwide Healthy Living Index. This was applied to pooled (2015/16-2017/18) nationally representative New Zealand Health Survey data, with mental health conditions (depression, bipolar, and anxiety) and psychological distress as population-level outcomes. Mental health was associated with proximity to environmental 'goods' and 'bads'. Compared to those individuals who reside within the unhealthiest environments, there was a steady reduction in the odds of adverse mental health outcomes and psychological distress as the environment became more health-promoting.
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Preventive medicine · Apr 2021
Associations between mentally-passive and mentally-active sedentary behaviours during adolescence and psychological distress during adulthood.
It is unclear if different types of sedentary behaviour during the adolescence are differentially associated with psychological distress during adolescence and adulthood. It is also unknown what may mediate this potential proposed association. The current study aimed to analyse the association of mentally-active and mentally-passive sedentary behaviours during adolescence (16y) with subsequent psychological distress during adulthood (42y), and to examine the role of potential mediators (42y). ⋯ Adult TV-viewing during weekends (24.7%), and self-rated health (19.0%) mediated the association between mentally-passive sedentary behaviour during adolescence and psychological distress during adulthood. However, the mediation was not clear in the models with multiple imputation. Mentally-passive sedentary behaviour during adolescence was associated with elevated psychological distress during adulthood and this association was mediated TV-viewing and self-rated health in adulthood.
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Preventive medicine · Apr 2021
Exploring neighborhood socioeconomic disparity in self-rated health: a multiple mediation analysis.
There is still a need for more empirical investigations to better understand the causal pathways by which neighborhood socioeconomic contexts translate into states of health. This study explored the relationship between neighborhood socioeconomic position and health, as well as the role of social cohesion, violence, places to buy healthy food, and sports and leisure spaces in mediating this relationship in a diverse set of neighborhoods in Brazil. We applied a general multiple mediation approach to analyze a cross-sectional survey of 4.046 adults living in 149 neighborhoods in 2008 and 2009. ⋯ We did not ascertain as mediators social cohesion, places to buy healthy food, and sports and leisure spaces. Violence perception mediates the relationship between neighborhood socioeconomic position and self-rated health. Targeted interventions designed to improve the health status of the population could usefully focus on reducing the level of violence in which people live.
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Preventive medicine · Apr 2021
Expectant parents' vaccine decisions influenced by the 2018 Chinese vaccine crisis: A cross-sectional study.
Immunization programs have been challenged by vaccine crises. Between 2013 and 2018, China has experienced three major vaccine scandals and crises, which has partly impaired Chinese public trust in domestically produced vaccines. This study aims to explore the associations between parental trust toward CDC-released crisis communication information, parents' critical understanding of crisis information, parental confidence in vaccine efficacy, and parental vaccine decisions. ⋯ Additionally, parents with lower levels of confidence in vaccine efficacy were more likely to became vaccine hesitant but were also more likely to maintain their vaccine intentions after the crisis. It is crucial to guarantee the safety of vaccines, maintain parental confidence in vaccine efficacy, and eliminate the potential risks that result in parental vaccine hesitancy. Future crisis communication strategies are encouraged to ensure timely responses to sustain public confidence.