American journal of preventive medicine
-
Preconception and interconception health care are critical means of identifying, managing, and treating risk factors originating before pregnancy that can harm fetal development and maternal health. However, many women in the U.S. lack health insurance, limiting their ability to access such care. State-level variation in Medicaid eligibility, particularly before and after the 2014 Medicaid expansions, offers a unique opportunity to test the hypothesis that increasing healthcare coverage for low-income women can improve preconception and interconception healthcare access and utilization, chronic disease management, overall health, and health behaviors. ⋯ Expanded Medicaid coverage may improve access to and utilization of health care among women of reproductive age, which could ultimately improve preconception health.
-
Various built environment factors might influence certain health behaviors and outcomes. Reliable, resource-efficient methods that are feasible for assessing built environment characteristics across large geographies are needed for larger, more robust studies. This paper reports the item response prevalence, reliability, and rating time of a new virtual neighborhood audit protocol, drop-and-spin auditing, developed for assessment of walkability and physical disorder characteristics across large geographic areas. ⋯ Compared with segment-based protocols, drop-and-spin virtual neighborhood auditing is quicker and similarly reliable for assessing built environment characteristics. Assessment of large geographies may be more feasible using drop-and-spin virtual auditing.
-
Food insecurity during young adulthood affects physical health, mental health, and academic performance. However, little is known about parental and behavioral factors during childhood that may contribute to risk of food insecurity during young adulthood. ⋯ Spending time in food preparation during childhood and high parental nutritional knowledge each have a protective effect against food insecurity during young adulthood. Greater investment in teaching cooking skills during childhood may be beneficial, particularly for individuals at high risk for food insecurity.
-
Sexual minorities are disproportionately more likely than heterosexuals to suffer from substance use disorders, but relatively little is known about differences in substance use disorders across diverse sexual minority subgroups. There is also limited understanding of how different social stressors account for sexual orientation disparities in substance use disorders. ⋯ Sexual minority subgroups have a greater prevalence of substance use disorders, mediated through both stressful life events and lesbian, gay, and bisexual discrimination. More research is needed to comprehensively assess the processes underlying sexual orientation substance use disparities.
-
Alcohol misuse, cigarette smoking, poor diet, and physical inactivity, known as the "big four" contributors to chronic conditions and mortality, typically co-occur or cluster together, with their synergistic effect more detrimental to health than their cumulative individual effects. Little research has been reported on race/ethnicity-specific analyses of the clustering of these behaviors in the U.S. This study identified clustered risk behaviors among whites, blacks, and Hispanics and examined whether unhealthy clusters were associated with lower SES (assessed by education level and family income) and poor health status. ⋯ Multi-behavior interventions are warranted to address inactivity and obesity in all 3 groups and unhealthy clusters involving smoking in each group.