Social Sciences › Health

Health disparities and outcomes

Works Count: 87081

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Description

This cluster of papers explores the impact of social determinants, such as social relationships, socioeconomic inequalities, loneliness, and neighborhood effects, on health outcomes and mortality risk. It delves into the complex interplay between social factors and health disparities, emphasizing the importance of addressing these issues for achieving health equity and improving public health.

Keywords

Social Relationships; Socioeconomic Inequalities; Loneliness; Health Disparities; Neighborhood Effects; Mortality Risk; Social Support; Life Course Epidemiology; Health Equity; Public Health

Social support: An interactional view.

1990-01-01

Barbara R. Sarason , Irwin G. Sarason , Gregory R. Pierce

DEFINING AND ASSESSING SOCIAL SUPPORT: Traditional Views of Social Support and Their Impact on Assessment Social Support in Young Children: Measurement, Structure and Bahavioral Impact SOCIAL SUPPORT IN THE CONTEXT … DEFINING AND ASSESSING SOCIAL SUPPORT: Traditional Views of Social Support and Their Impact on Assessment Social Support in Young Children: Measurement, Structure and Bahavioral Impact SOCIAL SUPPORT IN THE CONTEXT OF PERSONAL RELATIONSHIPS Social Support: The Sense of Acceptance and the Role of Relationships From Self to Health: Self-Verification and Identity Disruption Social Relationships as a Source of Companionship: Implications for Older Adults' Psychological Well-Being SOCIAL SUPPORT AND STRESS COPING: Social Support, Stress and the Immune System Differentiating the Cognitive and Behavioral Aspects of Social Support SOCIAL SUPPORT APPLICATIONS AND INTERVENTIONS IN CLINICAL AND COMMUNITY SETTINGS: The Role of Coping in Support Provision: The Self- Presentational Dilemma of Victims of Life Crises Social Support During Extreme Stress: Consequences and Intervention.

The Sociological Study of Stress

1989-09-01

Leonard I. Pearlin

This paper presents a critical overview of current concepts and analytic practices in stress research and considers how they can be changed to make the research more consistent with core … This paper presents a critical overview of current concepts and analytic practices in stress research and considers how they can be changed to make the research more consistent with core sociological interests. An overarching concern of the paper is the analytic use of basic information about people's social and institutional affiliations and statuses. It is important that such information be treated not simply as data that need to be controlled statistically; we must examine the bearing of these data on each domain of the stress process: the exposure to and meaning of stressors, access to stress mediators, and the psychological, physical, and behavioral manifestations of stress. The conceptualization and measurement of stressors should move away from their focus on particular events or chronic strains and should seek instead to observe and assess over time constellations of stressors made up of both events and strains. Moreover, the effects of the mediators--coping and social support--are evaluated most fruitfully in terms of their effects in limiting the number, severity, and diffusion of stressors in these constellations. Finally, sociological stress researchers should not be bound to outcomes that better serve the intellectual interests of those who work with biomedical and epidemiological models of stress, nor should the research be committed exclusively to a single outcome.

The Danish Civil Registration System as a tool in epidemiology

2014-06-25

Morten Schmidt , Lars Pedersen , Henrik Toft Sørensen

Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010

2013-08-29

Harvey Whiteford , Louisa Degenhardt , Colin D. Rehm +7 more

Social Support as a Moderator of Life Stress

1976-09-01

Sidney Cobb

Social support is defined as information leading the subject to believe that he is cared for and loved, esteemed, and a member of a network of mutual obligations. The evidence … Social support is defined as information leading the subject to believe that he is cared for and loved, esteemed, and a member of a network of mutual obligations. The evidence that supportive interactions among people are protective against the health consequences of life stress is reviewed. It appears that social support can protect people in crisis from a wide variety of pathological states: from low birth weight to death, from arthritis through tuberculosis to depression, alcoholism, and the social breakdown syndrome. Furthermore, social support may reduce the amount of medication required, accelerate recovery, and facilitate compliance with prescribed medical regimens.

Self-Rated Health and Mortality: A Review of Twenty-Seven Community Studies

1997-03-01

Ellen Idler , Yael Benyamini

We examine the growing number of studies of survey respondents' global self-ratings of health as predictors of mortality in longitudinal studies of representative community samples. Twenty-seven studies in U.S. and … We examine the growing number of studies of survey respondents' global self-ratings of health as predictors of mortality in longitudinal studies of representative community samples. Twenty-seven studies in U.S. and international journals show impressively consistent findings. Global self-rated health is an independent predictor of mortality in nearly all of the studies, despite the inclusion of numerous specific health status indicators and other relevant covariates known to predict mortality. We summarize and review these studies, consider various interpretations which could account for the association, and suggest several approaches to the next stage of research in this field.

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The MOS 36-Item Short-Form Health Survey (SF-36)

1993-03-01

Colleen A. McHorney , WARE JOHNE , RACZEK ANASTASIAE

Cross-sectional data from the Medical Outcomes Study (MOS) were analyzed to test the validity of the MOS 36-Item Short-Form Health Survey (SF-36) scales as measures of physical and mental health … Cross-sectional data from the Medical Outcomes Study (MOS) were analyzed to test the validity of the MOS 36-Item Short-Form Health Survey (SF-36) scales as measures of physical and mental health constructs. Results from traditional psychometric and clinical tests of validity were compared. Principal components analysis was used to test for hypothesized physical and mental health dimensions. For purposes of clinical tests of validity, clinical criteria defined mutually exclusive adult patient groups differing in severity of medical and psychiatric conditions. Scales shown in the components analysis to primarily measure physical health (physical functioning and role limitations-physical) best distinguished groups differing in severity of chronic medical condition and had the most pure physical health interpretation. Scales shown to primarily measure mental health (mental health and role limitations-emotional) best distinguished groups differing in the presence and severity of psychiatric disorders and had the most pure mental health interpretation. The social functioning, vitality, and general health perceptions scales measured both physical and mental health components and, thus, had the most complex interpretation. These results are useful in establishing guidelines for the interpretation of each scale and in documenting the size of differences between clinical groups that should be considered very large.

Social Relationships and Mortality Risk: A Meta-analytic Review

2010-07-27

Julianne Holt‐Lunstad , Timothy B. Smith , J. Bradley Layton

In a meta-analysis, Julianne Holt-Lunstad and colleagues find that individuals' social relationships have as much influence on mortality risk as other well-established risk factors for mortality, such as smoking. In a meta-analysis, Julianne Holt-Lunstad and colleagues find that individuals' social relationships have as much influence on mortality risk as other well-established risk factors for mortality, such as smoking.

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Social capital, income inequality, and mortality.

1997-09-01

Ichiro Kawachi , Bruce P. Kennedy , Kimberly Lochner +1 more

OBJECTIVES: Recent studies have demonstrated that income inequality is related to mortality rates. It was hypothesized, in this study, that income inequality is related to reduction in social cohesion and … OBJECTIVES: Recent studies have demonstrated that income inequality is related to mortality rates. It was hypothesized, in this study, that income inequality is related to reduction in social cohesion and that disinvestment in social capital is in turn associated with increased mortality. METHODS: In this cross-sectional ecologic study based on data from 39 states, social capital was measured by weighted responses to two items from the General Social Survey: per capita density of membership in voluntary groups in each state and level of social trust, as gauged by the proportion of residents in each state who believed that people could be trusted. Age-standardized total and cause-specific mortality rates in 1990 were obtained for each state. RESULTS: Income inequality was strongly correlated with both per capita group membership (r = -.46) and lack of social trust (r = .76). In turn, both social trust and group membership were associated with total mortality, as well as rates of death from coronary heart disease, malignant neoplasms, and infant mortality. CONCLUSIONS: These data support the notion that income inequality leads to increased mortality via disinvestment in social capital.

The MOS 36-ltem Short-Form Health Survey (SF-36): III. Tests of Data Quality, Scaling Assumptions, and Reliability Across Diverse Patient Groups

1994-01-01

Colleen A. McHorney , John E. Ware , Jing Lu +1 more

The widespread use of standardized health surveys is predicated on the largely untested assumption that scales constructed from those surveys will satisfy minimum psychometric requirements across diverse population groups. Data … The widespread use of standardized health surveys is predicated on the largely untested assumption that scales constructed from those surveys will satisfy minimum psychometric requirements across diverse population groups. Data from the Medical Outcomes Study (MOS) were used to evaluate data completeness and quality, test scaling assumptions, and estimate internal-consistency reliability for the eight scales constructed from the MOS SF-36 Health Survey. Analyses were conducted among 3,445 patients and were replicated across 24 subgroups differing in sociodemographic characteristics, diagnosis, and disease severity. For each scale, item-completion rates were high across all groups (88% to 95%), but tended to be somewhat lower among the elderly, those with less than a high school education, and those in poverty. On average, surveys were complete enough to compute scale scores for more than 96% of the sample. Across patient groups, all scales passed tests for item-internal consistency (97% passed) and item-discriminant validity (92% passed). Reliability coefficients ranged from a low of 0.65 to a high of 0.94 across scales (median=0.85) and varied somewhat across patient subgroups. Floor effects were negligible except for the two role disability scales. Noteworthy ceiling effects were observed for both role disability scales and the social functioning scale. These findings support the use of the SF-36 survey across the diverse populations studied and identify population groups in which use of standardized health status measures may or may not be problematic.

The Multidimensional Scale of Perceived Social Support

1988-03-01

Gregory D. Zimet , Nancy Wray Dahlem , Sara G. Zimet +1 more

Abstract The development of a self-report measure of subjectively assessed social support, the Multidimensional Scale of Perceived Social Support (MSPSS), is described. Subjects included 136 female and 139 male university … Abstract The development of a self-report measure of subjectively assessed social support, the Multidimensional Scale of Perceived Social Support (MSPSS), is described. Subjects included 136 female and 139 male university undergraduates. Three subscales, each addressing a different source of support, were identified and found to have strong factorial validity: (a) Family, (b) Friends, and (c) Significant Other. In addition, the research demonstrated that the MSPSS has good internal and test-retest reliability as well as moderate construct validity. As predicted, high levels of perceived social support were associated with low levels of depression and anxiety symptomatology as measured by the Hopkins Symptom Checklist. Gender differences with respect to the MSPSS are also presented. The value of the MSPSS as a research instrument is discussed, along with implications for future research.

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From social integration to health: Durkheim in the new millennium

2000-09-01

Lisa Berkman , Thomas A. Glass , Ian Brissette +1 more

The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection.

1992-06-01

John E. Ware , Cathy D. Sherbourne

A 36-item short-form (SF-36) was constructed to survey health status in the Medical Outcomes Study. The SF-36 was designed for use in clinical practice and research, health policy evaluations, and … A 36-item short-form (SF-36) was constructed to survey health status in the Medical Outcomes Study. The SF-36 was designed for use in clinical practice and research, health policy evaluations, and general population surveys. The SF-36 includes one multi-item scale that assesses eight health concepts: 1) limitations in physical activities because of health problems; 2) limitations in social activities because of physical or emotional problems; 3) limitations in usual role activities because of physical health problems; 4) bodily pain; 5) general mental health (psychological distress and well-being); 6) limitations in usual role activities because of emotional problems; 7) vitality (energy and fatigue); and 8) general health perceptions. The survey was constructed for self-administration by persons 14 years of age and older, and for administration by a trained interviewer in person or by telephone. The history of the development of the SF-36, the origin of specific items, and the logic underlying their selection are summarized. The content and features of the SF-36 are compared with the 20-item Medical Outcomes Study short-form.

Stress, social support, and the buffering hypothesis.

1985-09-01

Sheldon Cohen , Thomas A. Wills

Examines whether the positive association between social support and well-being is attributable more to an overall beneficial effect of support (main- or direct-effect model) or to a process of support … Examines whether the positive association between social support and well-being is attributable more to an overall beneficial effect of support (main- or direct-effect model) or to a process of support protecting persons from potentially adverse effects of stressful events (buffering model). The review of studies is organized according to (1) whether a measure assesses support structure (the existence of relationships) or function (the extent to which one's interpersonal relationships provide particular resources) and (2) the degree of specificity (vs globality) of the scale. Special attention is given to methodological characteristics that are requisite for a fair comparison of the models. It is concluded that there is evidence consistent with both models. Evidence for the buffering model is found when the social support measure assesses the perceived availability of interpersonal resources that are responsive to the needs elicited by stressful events. Evidence for a main effect model is found when the support measure assesses a person's degree of integration in a large social network. Both conceptualizations of social support are correct in some respects, but each represents a different process through which social support may affect well-being. Implications for theories of social support processes and for the design of preventive interventions are discussed.

Social Relationships and Health.

2004-11-01

Sheldon Cohen

The author discusses 3 variables that assess different aspects of social relationships—social support, social integration, and negative interaction. The author argues that all 3 are associated with health outcomes, that … The author discusses 3 variables that assess different aspects of social relationships—social support, social integration, and negative interaction. The author argues that all 3 are associated with health outcomes, that these variables each influence health through different mechanisms, and that associations between these variables and health are not spurious findings attributable to our personalities. This argument suggests a broader view of how to intervene in social networks to improve health. This includes facilitating both social integration and social support by creating and nurturing both close (strong) and peripheral (weak) ties within natural social networks and reducing opportunities for negative social interaction. Finally, the author emphasizes the necessity to understand more about who benefits most and least from socialconnectedness interventions.

A gradient of childhood self-control predicts health, wealth, and public safety

2011-01-24

Terrie E. Moffitt , Louise Arseneault , Daniel W. Belsky +7 more

Policy-makers are considering large-scale programs aimed at self-control to improve citizens’ health and wealth and reduce crime. Experimental and economic studies suggest such programs could reap benefits. Yet, is self-control … Policy-makers are considering large-scale programs aimed at self-control to improve citizens’ health and wealth and reduce crime. Experimental and economic studies suggest such programs could reap benefits. Yet, is self-control important for the health, wealth, and public safety of the population? Following a cohort of 1,000 children from birth to the age of 32 y, we show that childhood self-control predicts physical health, substance dependence, personal finances, and criminal offending outcomes, following a gradient of self-control. Effects of children's self-control could be disentangled from their intelligence and social class as well as from mistakes they made as adolescents. In another cohort of 500 sibling-pairs, the sibling with lower self-control had poorer outcomes, despite shared family background. Interventions addressing self-control might reduce a panoply of societal costs, save taxpayers money, and promote prosperity.

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Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

2012-12-01

Christopher J L Murray , Theo Vos , Rafael Lozano +7 more

Mechanisms Linking Social Ties and Support to Physical and Mental Health

2011-06-01

Peggy A. Thoits

Over the past 30 years investigators have called repeatedly for research on the mechanisms through which social relationships and social support improve physical and psychological well-being, both directly and as … Over the past 30 years investigators have called repeatedly for research on the mechanisms through which social relationships and social support improve physical and psychological well-being, both directly and as stress buffers. I describe seven possible mechanisms: social influence/social comparison, social control, role-based purpose and meaning (mattering), self-esteem, sense of control, belonging and companionship, and perceived support availability. Stress-buffering processes also involve these mechanisms. I argue that there are two broad types of support, emotional sustenance and active coping assistance, and two broad categories of supporters, significant others and experientially similar others, who specialize in supplying different types of support to distressed individuals. Emotionally sustaining behaviors and instrumental aid from significant others and empathy, active coping assistance, and role modeling from similar others should be most efficacious in alleviating the physical and emotional impacts of stressors.

Health inequalities among British civil servants: the Whitehall II study

1991-06-01

Michael Marmot , S. Stansfeld , Chandra Patel +7 more

SOCIAL NETWORKS, HOST RESISTANCE, AND MORTALITY: A NINE-YEAR FOLLOW-UP STUDY OF ALAMEDA COUNTY RESIDENTS

1979-02-01

Lisa Berkman , S. Leonard Syme

Journal Article SOCIAL NETWORKS, HOST RESISTANCE, AND MORTALITY: A NINE-YEAR FOLLOW-UP STUDY OF ALAMEDA COUNTY RESIDENTS Get access LISA F. BERKMAN, LISA F. BERKMAN 1 1Reprint requests to Dr. Berkman. … Journal Article SOCIAL NETWORKS, HOST RESISTANCE, AND MORTALITY: A NINE-YEAR FOLLOW-UP STUDY OF ALAMEDA COUNTY RESIDENTS Get access LISA F. BERKMAN, LISA F. BERKMAN 1 1Reprint requests to Dr. Berkman. Search for other works by this author on: Oxford Academic PubMed Google Scholar S. LEONARD SYME S. LEONARD SYME 2Program in Epidemiology, School of Public Health, University of CaliforniaBerkeley, CA Search for other works by this author on: Oxford Academic PubMed Google Scholar American Journal of Epidemiology, Volume 109, Issue 2, February 1979, Pages 186–204, https://doi.org/10.1093/oxfordjournals.aje.a112674 Published: 01 February 1979 Article history Received: 03 April 1978 Accepted: 25 July 1978 Published: 01 February 1979

Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

2012-12-01

Theo Vos , Abraham D Flaxman , Mohsen Naghavi +7 more

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A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

2012-12-01

Stephen S Lim , Theo Vos , Abraham D Flaxman +7 more

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The MOS social support survey

1991-01-01

Cathy D. Sherbourne , Anita L. Stewart

Validating the SF-36 health survey questionnaire: new outcome measure for primary care.

1992-07-18

John Brazier , Robert A. Harper , Nev Jones +4 more

OBJECTIVES--To test the acceptability, validity, and reliability of the short form 36 health survey questionnaire (SF-36) and to compare it with the Nottingham health profile. DESIGN--Postal survey using a questionnaire … OBJECTIVES--To test the acceptability, validity, and reliability of the short form 36 health survey questionnaire (SF-36) and to compare it with the Nottingham health profile. DESIGN--Postal survey using a questionnaire booklet together with a letter from the general practitioner. Non-respondents received two reminders at two week intervals. The SF-36 questionnaire was retested on a subsample of respondents two weeks after the first mailing. SETTING--Two general practices in Sheffield. PATIENTS--1980 patients aged 16-74 years randomly selected from the two practice lists. MAIN OUTCOME MEASURES--Scores for each health dimension on the SF-36 questionnaire and the Nottingham health profile. Response to questions on recent use of health services and sociodemographic characteristics. RESULTS--The response rate for the SF-36 questionnaire was high (83%) and the rate of completion for each dimension was over 95%. Considerable evidence was found for the reliability of the SF-36 (Cronbach9s alpha greater than 0.85, reliability coefficient greater than 0.75 for all dimensions except social functioning) and for construct validity in terms of distinguishing between groups with expected health differences. The SF-36 was able to detect low levels of ill health in patients who had scored 0 (good health) on the Nottingham health profile. CONCLUSIONS--The SF-36 is a promising new instrument for measuring health perception in a general population. It is easy to use, acceptable to patients, and fulfils stringent criteria of reliability and validity. Its use in other contexts and with different disease groups requires further research.

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A Short Scale for Measuring Loneliness in Large Surveys

2004-09-20

Mary Elizabeth Hughes , Linda J. Waite , Louise C. Hawkley +1 more

Most studies of social relationships in later life focus on the amount of social contact, not on individuals' perceptions of social isolation. However, loneliness is likely to be an important … Most studies of social relationships in later life focus on the amount of social contact, not on individuals' perceptions of social isolation. However, loneliness is likely to be an important aspect of aging. A major limiting factor in studying loneliness has been the lack of a measure suitable for large-scale social surveys. This article describes a short loneliness scale developed specifically for use on a telephone survey. The scale has three items and a simplified set of response categories but appears to measure overall loneliness quite well. The authors also document the relationship between loneliness and several commonly used measures of objective social isolation. As expected, they find that objective and subjective isolation are related. However, the relationship is relatively modest, indicating that the quantitative and qualitative aspects of social relationships are distinct. This result suggests the importance of studying both dimensions of social relationships in the aging process.

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Cohort Profile: The China Health and Retirement Longitudinal Study (CHARLS)

2012-12-12

Yaohui Zhao , Yisong Hu , James P. Smith +2 more

The China Health and Retirement Longitudinal Study (CHARLS) is a nationally representative longitudinal survey of persons in China 45 years of age or older and their spouses, including assessments of … The China Health and Retirement Longitudinal Study (CHARLS) is a nationally representative longitudinal survey of persons in China 45 years of age or older and their spouses, including assessments of social, economic, and health circumstances of community-residents. CHARLS examines health and economic adjustments to rapid ageing of the population in China. The national baseline survey for the study was conducted between June 2011 and March 2012 and involved 17 708 respondents. CHARLS respondents are followed every 2 years, using a face-to-face computer-assisted personal interview (CAPI). Physical measurements are made at every 2-year follow-up, and blood sample collection is done once in every two follow-up periods. A pilot survey for CHARLS was conducted in two provinces of China in 2008, on 2685 individuals, who were resurveyed in 2012. To ensure the adoption of best practices and international comparability of results, CHARLS was harmonized with leading international research studies in the Health and Retirement Study (HRS) model. Requests for collaborations should be directed to Dr Yaohui Zhao ([email protected]). All data in CHARLS are maintained at the National School of Development of Peking University and will be accessible to researchers around the world at the study website. The 2008 pilot data for CHARLS are available at: http://charls.ccer.edu.cn/charls/. National baseline data for the study are expected to be released in January 2013.

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Social Relationships and Health

1988-07-29

James S. House , Karl R. Landis , Debra Umberson

Recent scientific work has established both a theoretical basis and strong empirical evidence for a causal impact of social relationships on health. Prospective studies, which control for baseline health status, … Recent scientific work has established both a theoretical basis and strong empirical evidence for a causal impact of social relationships on health. Prospective studies, which control for baseline health status, consistently show increased risk of death among persons with a low quantity, and sometimes low quality, of social relationships. Experimental and quasi-experimental studies of humans and animals also suggest that social isolation is a major risk factor for mortality from widely varying causes. The mechanisms through which social relationships affect health and the factors that promote or inhibit the development and maintenance of social relationships remain to be explored.

The disablement process

1994-01-01

Lois M. Verbrugge , Alan M. Jette

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Socioeconomic Inequalities in Health in 22 European Countries

2008-06-04

Johan P. Mackenbach , Irina Stirbu , Albert‐Jan Roskam +4 more

Comparisons among countries can help to identify opportunities for the reduction of inequalities in health. We compared the magnitude of inequalities in mortality and self-assessed health among 22 countries in … Comparisons among countries can help to identify opportunities for the reduction of inequalities in health. We compared the magnitude of inequalities in mortality and self-assessed health among 22 countries in all parts of Europe.We obtained data on mortality according to education level and occupational class from census-based mortality studies. Deaths were classified according to cause, including common causes, such as cardiovascular disease and cancer; causes related to smoking; causes related to alcohol use; and causes amenable to medical intervention, such as tuberculosis and hypertension. Data on self-assessed health, smoking, and obesity according to education and income were obtained from health or multipurpose surveys. For each country, the association between socioeconomic status and health outcomes was measured with the use of regression-based inequality indexes.In almost all countries, the rates of death and poorer self-assessments of health were substantially higher in groups of lower socioeconomic status, but the magnitude of the inequalities between groups of higher and lower socioeconomic status was much larger in some countries than in others. Inequalities in mortality were small in some southern European countries and very large in most countries in the eastern and Baltic regions. These variations among countries appeared to be attributable in part to causes of death related to smoking or alcohol use or amenable to medical intervention. The magnitude of inequalities in self-assessed health also varied substantially among countries, but in a different pattern.We observed variation across Europe in the magnitude of inequalities in health associated with socioeconomic status. These inequalities might be reduced by improving educational opportunities, income distribution, health-related behavior, or access to health care.

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The revised UCLA Loneliness Scale: Concurrent and discriminant validity evidence.

1980-01-01

Daniel W. Russell , Letitia Anne Peplau , Carolyn E. Cutrona

The development of an adequate assessment instrument is a necessary prerequisite for social psychological research on loneliness. Two studies provide methodological refinement in the measurement of loneliness. Study 1 presents … The development of an adequate assessment instrument is a necessary prerequisite for social psychological research on loneliness. Two studies provide methodological refinement in the measurement of loneliness. Study 1 presents a revised version of the self-report UCLA (University of California, Los Angeles) Loneliness Scale, designed to counter the possible effects of response bias in the original scale, and reports concurrent validity evidence for the revised measure. Study 2 demonstrates that although loneliness is correlated with measures of negative affect, social risk taking, and affiliative tendencies, it is nonetheless a distinct psychological experience.

The MOS Short-form General Health Survey

1988-07-01

Anita L. Stewart , Ron D. Hays , John E. Ware

Social Ties and Mental Health

2001-09-01

Ichiro Kawachi

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UCLA Loneliness Scale (Version 3): Reliability, Validity, and Factor Structure

1996-02-01

Daniel W. Russell

Abstract In this article I evaluated the psychometric properties of the UCLA Loneliness Scale (Version 3). Using data from prior studies of college students, nurses, teachers, and the elderly, analyses … Abstract In this article I evaluated the psychometric properties of the UCLA Loneliness Scale (Version 3). Using data from prior studies of college students, nurses, teachers, and the elderly, analyses of the reliability, validity, and factor structure of this new version of the UCLA Loneliness Scale were conducted. Results indicated that the measure was highly reliable, both in terms of internal consistency (coefficient alpha ranging from .89 to .94) and test-retest reliability over a 1-year period (r = .73). Convergent validity for the scale was indicated by significant correlations with other measures of loneliness. Construct validity was supported by significant relations with measures of the adequacy of the individual's interpersonal relationships, and by correlations between loneliness and measures of health and well-being. Confirmatory factor analyses indicated that a model incorporating a global bipolar loneliness factor along with two method factors reflecting direction of item wording provided a very good fit to the data across samples. Implications of these results for future measurement research on loneliness are discussed.

Social Support and Health.

1986-03-01

Catherine E. Ross , Sheldon Cohen , S. Leonard Syme

Loneliness and Social Isolation as Risk Factors for Mortality

2015-03-01

Julianne Holt‐Lunstad , Timothy B. Smith , M. Douglas Baker +2 more

Actual and perceived social isolation are both associated with increased risk for early mortality. In this meta-analytic review, our objective is to establish the overall and relative magnitude of social … Actual and perceived social isolation are both associated with increased risk for early mortality. In this meta-analytic review, our objective is to establish the overall and relative magnitude of social isolation and loneliness and to examine possible moderators. We conducted a literature search of studies (January 1980 to February 2014) using MEDLINE, CINAHL, PsycINFO, Social Work Abstracts, and Google Scholar. The included studies provided quantitative data on mortality as affected by loneliness, social isolation, or living alone. Across studies in which several possible confounds were statistically controlled for, the weighted average effect sizes were as follows: social isolation odds ratio (OR) = 1.29, loneliness OR = 1.26, and living alone OR = 1.32, corresponding to an average of 29%, 26%, and 32% increased likelihood of mortality, respectively. We found no differences between measures of objective and subjective social isolation. Results remain consistent across gender, length of follow-up, and world region, but initial health status has an influence on the findings. Results also differ across participant age, with social deficits being more predictive of death in samples with an average age younger than 65 years. Overall, the influence of both objective and subjective social isolation on risk for mortality is comparable with well-established risk factors for mortality.

Loneliness Matters: A Theoretical and Empirical Review of Consequences and Mechanisms

2010-07-21

Louise C. Hawkley , John T. Cacioppo

As a social species, humans rely on a safe, secure social surround to survive and thrive. Perceptions of social isolation, or loneliness, increase vigilance for threat and heighten feelings of … As a social species, humans rely on a safe, secure social surround to survive and thrive. Perceptions of social isolation, or loneliness, increase vigilance for threat and heighten feelings of vulnerability while also raising the desire to reconnect. Implicit hypervigilance for social threat alters psychological processes that influence physiological functioning, diminish sleep quality, and increase morbidity and mortality. The purpose of this paper is to review the features and consequences of loneliness within a comprehensive theoretical framework that informs interventions to reduce loneliness. We review physical and mental health consequences of loneliness, mechanisms for its effects, and effectiveness of extant interventions. Features of a loneliness regulatory loop are employed to explain cognitive, behavioral, and physiological consequences of loneliness and to discuss interventions to reduce loneliness. Loneliness is not simply being alone. Interventions to reduce loneliness and its health consequences may need to take into account its attentional, confirmatory, and memorial biases as well as its social and behavioral effects.

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Global, regional, and national age–sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

2014-12-19

Gbd Mortality And Causes of Death Collaborators , Victor Aboyans

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Burden of Depressive Disorders by Country, Sex, Age, and Year: Findings from the Global Burden of Disease Study 2010

2013-11-05

Alize J Ferrari , Fiona J Charlson , Rosana Norman +5 more

Background Depressive disorders were a leading cause of burden in the Global Burden of Disease (GBD) 1990 and 2000 studies. Here, we analyze the burden of depressive disorders in GBD … Background Depressive disorders were a leading cause of burden in the Global Burden of Disease (GBD) 1990 and 2000 studies. Here, we analyze the burden of depressive disorders in GBD 2010 and present severity proportions, burden by country, region, age, sex, and year, as well as burden of depressive disorders as a risk factor for suicide and ischemic heart disease. Methods and Findings Burden was calculated for major depressive disorder (MDD) and dysthymia. A systematic review of epidemiological data was conducted. The data were pooled using a Bayesian meta-regression. Disability weights from population survey data quantified the severity of health loss from depressive disorders. These weights were used to calculate years lived with disability (YLDs) and disability adjusted life years (DALYs). Separate DALYs were estimated for suicide and ischemic heart disease attributable to depressive disorders. Depressive disorders were the second leading cause of YLDs in 2010. MDD accounted for 8.2% (5.9%–10.8%) of global YLDs and dysthymia for 1.4% (0.9%–2.0%). Depressive disorders were a leading cause of DALYs even though no mortality was attributed to them as the underlying cause. MDD accounted for 2.5% (1.9%–3.2%) of global DALYs and dysthymia for 0.5% (0.3%–0.6%). There was more regional variation in burden for MDD than for dysthymia; with higher estimates in females, and adults of working age. Whilst burden increased by 37.5% between 1990 and 2010, this was due to population growth and ageing. MDD explained 16 million suicide DALYs and almost 4 million ischemic heart disease DALYs. This attributable burden would increase the overall burden of depressive disorders from 3.0% (2.2%–3.8%) to 3.8% (3.0%–4.7%) of global DALYs. Conclusions GBD 2010 identified depressive disorders as a leading cause of burden. MDD was also a contributor of burden allocated to suicide and ischemic heart disease. These findings emphasize the importance of including depressive disorders as a public-health priority and implementing cost-effective interventions to reduce its burden. Please see later in the article for the Editors' Summary

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Socioeconomic Status and Child Development

2002-02-01

Robert H. Bradley , Robert F. Corwyn

▪ Abstract Socioeconomic status (SES) is one of the most widely studied constructs in the social sciences. Several ways of measuring SES have been proposed, but most include some quantification … ▪ Abstract Socioeconomic status (SES) is one of the most widely studied constructs in the social sciences. Several ways of measuring SES have been proposed, but most include some quantification of family income, parental education, and occupational status. Research shows that SES is associated with a wide array of health, cognitive, and socioemotional outcomes in children, with effects beginning prior to birth and continuing into adulthood. A variety of mechanisms linking SES to child well-being have been proposed, with most involving differences in access to material and social resources or reactions to stress-inducing conditions by both the children themselves and their parents. For children, SES impacts well-being at multiple levels, including both family and neighborhood. Its effects are moderated by children's own characteristics, family characteristics, and external support systems.

A 12-Item Short-Form Health Survey

1996-03-01

John E. Ware , Mark Kosinski , Susan Keller

Regression methods were used to select and score 12 items from the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) to reproduce the Physical Component Summary and Mental Component Summary … Regression methods were used to select and score 12 items from the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) to reproduce the Physical Component Summary and Mental Component Summary scales in the general US population (n = 2,333). The resulting 12-item short-form (SF-12) achieved multiple R squares of 0.911 and 0.918 in predictions of the SF-36 Physical Component Summary and SF-36 Mental Component Summary scores, respectively. Scoring algorithms from the general population used to score 12-item versions of the two components (Physical Component Summary and Mental Component Summary) achieved R squares of 0.905 with the SF-36 Physical Component Summary and 0.938 with the SF-36 Mental Component Summary when cross-validated in the Medical Outcomes Study. Test-retest (2-week) correlations of 0.89 and 0.76 were observed for the 12-item Physical Component Summary and the 12-item Mental Component Summary, respectively, in the general US population (n = 232). Twenty cross-sectional and longitudinal tests of empirical validity previously published for the 36-item short-form scales and summary measures were replicated for the 12-item Physical Component Summary and the 12-item Mental Component Summary, including comparisons between patient groups known to differ or to change in terms of the presence and seriousness of physical and mental conditions, acute symptoms, age and aging, self-reported 1-year changes in health, and recovery from depression. In 14 validity tests involving physical criteria, relative validity estimates for the 12-item Physical Component Summary ranged from 0.43 to 0.93 (median = 0.67) in comparison with the best 36-item short-form scale. Relative validity estimates for the 12-item Mental Component Summary in 6 tests involving mental criteria ranged from 0.60 to 1.07 (median = 0.97) in relation to the best 36-item short-form scale. Average scores for the 2 summary measures, and those for most scales in the 8-scale profile based on the 12-item short-form, closely mirrored those for the 36-item short-form, although standard errors were nearly always larger for the 12-item short-form.

Social class and mental illness: Community study.

1958-01-01

August B. Hollingshead , Fredrick C. Redlich

Ecological systems theory.

2000-01-01

Urie Bronfenbrenner

Multilevel Analysis

2010-09-13

Joop J. Hox , Mirjam Moerbeek , Rens van de Schoot

This practical introduction helps readers apply multilevel techniques to their research. Noted as an accessible introduction, the book also includes advanced extensions, making it useful as both an introduction and … This practical introduction helps readers apply multilevel techniques to their research. Noted as an accessible introduction, the book also includes advanced extensions, making it useful as both an introduction and as a reference to students, researchers, and methodologists. Basic models and examples are discussed in non-technical terms with an emphasis on understanding the methodological and statistical issues involved in using these models. The estimation and interpretation of multilevel models is demonstrated using realistic examples from various disciplines. For example, readers will find data sets on stress in hospitals, GPA scores, survey responses, street safety, epilepsy, divorce, and sociometric scores, to name a few. The data sets are available on the website in SPSS, HLM, MLwiN, LISREL and/or Mplus files. Readers are introduced to both the multilevel regression model and multilevel structural models. Highlights of the second edition include: Two new chapters—one on multilevel models for ordinal and count data (Ch. 7) and another on multilevel survival analysis (Ch. 8). Thoroughly updated chapters on multilevel structural equation modeling that reflect the enormous technical progress of the last few years. The addition of some simpler examples to help the novice, whilst the more complex examples that combine more than one problem have been retained. A new section on multivariate meta-analysis (Ch. 11). Expanded discussions of covariance structures across time and analyzing longitudinal data where no trend is expected. Expanded chapter on the logistic model for dichotomous data and proportions with new estimation methods. An updated website at http://www.joophox.net/ with data sets for all the text examples and up-to-date screen shots and PowerPoint slides for instructors. Ideal for introductory courses on multilevel modeling and/or ones that introduce this topic in some detail taught in a variety of disciplines including: psychology, education, sociology, the health sciences, and business. The advanced extensions also make this a favorite resource for researchers and methodologists in these disciplines. A basic understanding of ANOVA and multiple regression is assumed. The section on multilevel structural equation models assumes a basic understanding of SEM.

Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

2018-11-01

Jeffrey D Stanaway , Ashkan Afshin , Emmanuela Gakidou +7 more

BackgroundThe Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for … BackgroundThe Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk–outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk–outcome pairs, and new data on risk exposure levels and risk–outcome associations.MethodsWe used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk–outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017.FindingsIn 2017, 34·1 million (95% uncertainty interval [UI] 33·3–35·0) deaths and 1·21 billion (1·14–1·28) DALYs were attributable to GBD risk factors. Globally, 61·0% (59·6–62·4) of deaths and 48·3% (46·3–50·2) of DALYs were attributed to the GBD 2017 risk factors. When ranked by risk-attributable DALYs, high systolic blood pressure (SBP) was the leading risk factor, accounting for 10·4 million (9·39–11·5) deaths and 218 million (198–237) DALYs, followed by smoking (7·10 million [6·83–7·37] deaths and 182 million [173–193] DALYs), high fasting plasma glucose (6·53 million [5·23–8·23] deaths and 171 million [144–201] DALYs), high body-mass index (BMI; 4·72 million [2·99–6·70] deaths and 148 million [98·6–202] DALYs), and short gestation for birthweight (1·43 million [1·36–1·51] deaths and 139 million [131–147] DALYs). In total, risk-attributable DALYs declined by 4·9% (3·3–6·5) between 2007 and 2017. In the absence of demographic changes (ie, population growth and ageing), changes in risk exposure and risk-deleted DALYs would have led to a 23·5% decline in DALYs during that period. Conversely, in the absence of changes in risk exposure and risk-deleted DALYs, demographic changes would have led to an 18·6% increase in DALYs during that period. The ratios of observed risk exposure levels to exposure levels expected based on SDI (O/E ratios) increased globally for unsafe drinking water and household air pollution between 1990 and 2017. This result suggests that development is occurring more rapidly than are changes in the underlying risk structure in a population. Conversely, nearly universal declines in O/E ratios for smoking and alcohol use indicate that, for a given SDI, exposure to these risks is declining. In 2017, the leading Level 4 risk factor for age-standardised DALY rates was high SBP in four super-regions: central Europe, eastern Europe, and central Asia; north Africa and Middle East; south Asia; and southeast Asia, east Asia, and Oceania. The leading risk factor in the high-income super-region was smoking, in Latin America and Caribbean was high BMI, and in sub-Saharan Africa was unsafe sex. O/E ratios for unsafe sex in sub-Saharan Africa were notably high, and those for alcohol use in north Africa and the Middle East were notably low.InterpretationBy quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning.FundingBill & Melinda Gates Foundation and Bloomberg Philanthropies.

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Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

2018-11-01

Spencer L James , Degu Abate , Kalkidan Hassen Abate +7 more

BackgroundThe Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in … BackgroundThe Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data.MethodsWe estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting.FindingsGlobally, for females, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and haemoglobinopathies and haemolytic anaemias in both 1990 and 2017. For males, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and tuberculosis including latent tuberculosis infection in both 1990 and 2017. In terms of YLDs, low back pain, headache disorders, and dietary iron deficiency were the leading Level 3 causes of YLD counts in 1990, whereas low back pain, headache disorders, and depressive disorders were the leading causes in 2017 for both sexes combined. All-cause age-standardised YLD rates decreased by 3·9% (95% uncertainty interval [UI] 3·1–4·6) from 1990 to 2017; however, the all-age YLD rate increased by 7·2% (6·0–8·4) while the total sum of global YLDs increased from 562 million (421–723) to 853 million (642–1100). The increases for males and females were similar, with increases in all-age YLD rates of 7·9% (6·6–9·2) for males and 6·5% (5·4–7·7) for females. We found significant differences between males and females in terms of age-standardised prevalence estimates for multiple causes. The causes with the greatest relative differences between sexes in 2017 included substance use disorders (3018 cases [95% UI 2782–3252] per 100 000 in males vs s1400 [1279–1524] per 100 000 in females), transport injuries (3322 [3082–3583] vs 2336 [2154–2535]), and self-harm and interpersonal violence (3265 [2943–3630] vs 5643 [5057–6302]).InterpretationGlobal all-cause age-standardised YLD rates have improved only slightly over a period spanning nearly three decades. However, the magnitude of the non-fatal disease burden has expanded globally, with increasing numbers of people who have a wide spectrum of conditions. A subset of conditions has remained globally pervasive since 1990, whereas other conditions have displayed more dynamic trends, with different ages, sexes, and geographies across the globe experiencing varying burdens and trends of health loss. This study emphasises how global improvements in premature mortality for select conditions have led to older populations with complex and potentially expensive diseases, yet also highlights global achievements in certain domains of disease and injury.FundingBill & Melinda Gates Foundation.

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Screening for Depression in Well Older Adults: Evaluation of a Short Form of the CES-D

1994-03-01

Elena M. Andresen , Judith A. Malmgren , William B. Carter +1 more

We derived and tested a short form of the Center for Epidemio-logic Studies Depression Scale (CES-D) for reliability and validity among a sample of well older adults in a large … We derived and tested a short form of the Center for Epidemio-logic Studies Depression Scale (CES-D) for reliability and validity among a sample of well older adults in a large Health Maintenance Organization. The 10-item screening questionnaire, the CESD-10, showed good predictive accuracy when compared to the full-length 20-item version of the CES-D (x = .97, P < .001). Cutoff scores for depressive symptoms were ≥16 for the full-length questionnaire and ≥10 for the 10-item version. We discuss other potential cutoff values. The CESD-10 showed an expected positive correlation with poorer health status scores (r = .37) and a strong negative correlation with positive affect (r = —.63). Retest correlations for the CESD-10 were comparable to those in other studies (r = .71). We administered the CESD-10 again after 12 months, and scores were stable with strong correlation of r — .59.

Social Support and Social Strain Sources as Predictors of Multimorbidity Changes in Middle-Aged and Older Adults

2025-06-25

Jason T. Newsom , Jennifer Saucedo , Mallory R. Kroeck +7 more | Journal of Aging and Health

Objectives This study examines whether social strain and support from various sources are associated with accumulation of chronic conditions in older adults. Methods Growth mixture modeling was used to investigate … Objectives This study examines whether social strain and support from various sources are associated with accumulation of chronic conditions in older adults. Methods Growth mixture modeling was used to investigate which network sources of support and strain were related to morbidity accumulation over 12 years among 5,321 individuals over age 50 in the Health and Retirement Study. Results Higher overall social support—comfort provided by others—was associated with a greater likelihood of belonging to the low morbidity trajectory class versus the high and increasing morbidity classes, but overall social strain—tense or conflictual interactions—was not. The source of support/strain mattered, and support from children was a more consistent predictor of trajectory classes than support from other sources. Discussion The importance of social support, particularly from children, suggests that psychosocial interventions could be developed and tailored to the children of older adults to promote healthier aging.

The association between socioeconomic factors and obstetric dimensions in pregnancy: an online cross-sectional study

2025-06-25

Barbara Schildberger , Th Forstner , Wolfgang Schimetta +1 more | Journal of Public Health

“Being alone is no fun”- experiences with loneliness by older people: a qualitative study

2025-06-25

Katja Goetz , Johanna Bergsträsser , Teresa Schmahl +1 more | International Journal of Qualitative Studies on Health and Well-Being

Loneliness is increasingly prevalent in all age groups and has become a public health problem for older people. Moreover, loneliness can have a negative impact on psychological and physical well-being. … Loneliness is increasingly prevalent in all age groups and has become a public health problem for older people. Moreover, loneliness can have a negative impact on psychological and physical well-being. This qualitative study aimed to evaluate older adults' experiences of loneliness and explore their barriers and strategies to overcome their loneliness. A purposive sample of older adults (aged ≥60 years) participated in a semi-structured interview. The interviews were conducted between May and July 2024. The interviews were analysed using a qualitative content approach. Overall, 27 older people were interviewed in this study. Loneliness was perceived as a temporary or permanent condition and was influenced by biographical context, health, and retirement pay status. Individual coping strategies and external support services were found to help avoid loneliness. Barriers were intra-individual factors such as shame and anxiety, their own health-related situation, and the public transportation situation. Money aspects, successful digital integration, and mobility-limiting diseases might be barriers that need to be considered when strategies against loneliness are developed. Moreover, it would be helpful to announce, use, and develop local structures at the community level to bring people together especially for people who are difficult to reach or feel stigmatized.

Exploring the Sociobiological Mechanisms of Diseases

2025-06-25

Salvatore Mazzeo , Maria Salsone | Neurology

Gender-Specific Population Attributable Fractions for Cardiovascular Disease and All-Cause Mortality Associated with Living Arrangement in Community-Dwelling Older People

2025-06-25

Achamyeleh Birhanu Teshale , Htet Lin Htun , Alice Owen +3 more | Journal of General Internal Medicine

Associations of Depressive Symptoms and Cognitive Levels Among Chinese Empty- and Non-Empty-Nesters: Exploring the Mediating Role of Residential Regions

2025-06-25

Xintong Zhao , Yalu Zhang , Meijun Wan | The International Journal of Aging and Human Development

Using panel data from the 2020 China Health and Retirement Longitudinal Study, we explored the impact of depressive symptoms on cognitive levels among middle-aged and older Chinese adults while considering … Using panel data from the 2020 China Health and Retirement Longitudinal Study, we explored the impact of depressive symptoms on cognitive levels among middle-aged and older Chinese adults while considering the potential mediating role of residential regions in this relationship. Our findings consistently demonstrate a negative impact of depressive symptoms on cognitive levels, with variations among middle-aged and older adults in urban and rural areas of China. Mediation analysis indicated that residential regions altered the extent of influence exerted by depressive symptoms on cognitive levels, thus serving as a mediator. Specifically, our investigation into the relationships of residential regions, depressive symptoms, and cognitive levels among empty-nesters revealed more pronounced effects and stronger underlying mechanisms. Based on these results, we advocate targeted interventions and subsidies tailored to the specific needs of empty-nesters and socially isolated older individuals. These interventions should aim to mitigate and prevent cognitive decline in this vulnerable population.

Association of Age-Friendly Communities With Health and Well-Being Among Older Adults: An Ecological and Multilevel Analysis From the Japan Gerontological Evaluation Study

2025-06-25

Taiji Noguchi , Satoko Fujihara , Kazushige Ide +4 more | Journal of Applied Gerontology

This cross-sectional study examined the association of age-friendly communities (AFC) with health and well-being among older adults, using the Japan Gerontological Evaluation Study 2016 data. Ecological and multilevel analyses of … This cross-sectional study examined the association of age-friendly communities (AFC) with health and well-being among older adults, using the Japan Gerontological Evaluation Study 2016 data. Ecological and multilevel analyses of 71,824 older adults across 145 communities revealed that the community’s age-friendliness consistently showed associations with health and well-being. Age-friendly physical environments (accessibility to barrier-free outdoor spaces, buildings, and transportation resources) exhibited an inverse association with functional health deficits. Social engagement and communication (participation in community groups, volunteer engagement, and information use) were inversely associated with depressive symptoms. Social inclusion and dementia-friendliness (respect and inclusion for older adults and positive attitudes toward people with dementia) were positively associated with happiness. Community’s age-friendliness is well-linked to the multiple aspects of older adults’ health and well-being, underscoring the AFC promotion for healthy aging.

From evidence to practice: Rethinking depression risk in older adults

2025-06-24

Ruijuan Li , Xueneng Yang | Geriatrics and gerontology international/Geriatrics & gerontology international

The Hidden Cost: Unveiling the Public Health Impact of Social Security Overpayments

2025-06-24

Naomi Alvarado | Undergraduate Journal of Public Health

Overpayments by the Social Security Administration (SSA), totaling $72 billion between 2015 and 2022, pose a threat to public health. Overpayments often result in sudden demands for repayment and suspension … Overpayments by the Social Security Administration (SSA), totaling $72 billion between 2015 and 2022, pose a threat to public health. Overpayments often result in sudden demands for repayment and suspension of benefits, disproportionately impacting low-income beneficiaries and exacerbating health disparities. Financial insecurity not only hinders access to life-sustaining resources like food and housing but also raises mental and physical health concerns. The SSA's handling of overpayments raises ethical concerns, violating principles of veracity and beneficence, and undermining public trust. Despite some progress, such as the introduction of the Social Security Overpayment Fairness Act, the SSA continues to prioritize financial recovery over beneficiaries' well-being. Framing overpayments solely as a financial issue overlooks their severe public health implications. This crisis underscores the interconnection between social policy and health policy, emphasizing the need for a collaborative, evidence-based approach that integrates population health perspectives. By addressing health concerns alongside financial factors, the SSA can reduce overpayment errors, enhance well-being, and restore trust among the 70.6 million Americans who depend on its benefits.

Non-random patterns in the co-occurrence and accumulation of adverse life events in two national panel datasets

2025-06-24

Kyra Evers , Denny Borsboom , Eiko I. Fried +3 more

<title>Abstract</title> Adverse life events (ALEs), such as illness, bereavement, and accidents, can have profound consequences for physical and mental health. Although existing research highlights structural predictors of ALEs, such as … <title>Abstract</title> Adverse life events (ALEs), such as illness, bereavement, and accidents, can have profound consequences for physical and mental health. Although existing research highlights structural predictors of ALEs, such as personality and socioeconomic status, less is known about patterns in ALEs themselves. How do events cluster and accumulate over time? Using generalized linear mixed-effects models, we study yearly self-reported ALEs in two panel datasets, the Swiss Household Panel (n = 16,946, 210,031 person-years) and the Household, Income and Labour Dynamics in Australia (n = 25,803, 113,605 person-years). We identify widespread contemporaneous and lag-1 associations between ALEs. The twenty-year accumulation of ALE counts deviates substantially from a random process and is better described by a self-reinforcing process, in which ALEs increase the risk of future ALEs. For all analyses, variance in ALE risk was explained largely by unobserved heterogeneity between individuals and households. Structural patterns in ALEs should inform our conceptual and statistical models, as well as our prevention strategies.

The impact of social capital on health behaviors: evidence from urban China

2025-06-24

Long Niu , Chuntian Lu , Xiaojuan Quan | Frontiers in Public Health

Background Social capital plays a crucial role in sustaining individual health behaviors. While numerous studies have confirmed the positive impact of social capital on individual health outcomes, limited research has … Background Social capital plays a crucial role in sustaining individual health behaviors. While numerous studies have confirmed the positive impact of social capital on individual health outcomes, limited research has explored its influence on specific health behaviors. Based on data from Job Search and Social Networks 2014 (JSNET 2014) in eight China cities, this study assesses social capital through the occupational heterogeneity of the Bainian Network and the breadth of participation in the Dining Network, aiming to analyze the influence of social capital on health behaviors. Methods First, given that the dependent variable is ordinal, this study employs an ordinal logistic regression model (ordered logistic model) to estimate the cumulative odds of social capital affecting health behaviors. Second, it examines the relationship between social capital and positive health behaviors, including exercise frequency and routine health checkups. Finally, it explores the association between social capital and negative health behaviors, specifically the frequency of alcohol consumption and smoking. All data analyses were conducted using Stata 17.0. Results (1) Social capital significantly influences both positive and negative health behaviors. (2) There is a positive correlation between social capital and health-promoting behaviors, such as physical activity and routine medical checkups. (3) The relationship between social capital and negative health behaviors-such as increased alcohol consumption and smoking frequency-underscores the dual nature of social networks, which can either foster positive behaviors or reinforce unhealthy habits. Conclusion The findings suggest that social capital has a dual impact: it promotes positive health behaviors such as physical exercise and regular health checkups, while also reinforcing negative health behaviors like drinking and smoking. Nonetheless, these findings are limited to urban population, and future research should extend to rural population to provide a more comprehensive understanding.

Sex differences in the impact of social isolation and loneliness on mortality

2025-06-24

Alexandre Vallée | Public Health

Travel, physical activity, perceived accessibility and mental health during Crisis: Insights from the COVID-19 pandemic

2025-06-24

Lars Böcker , Lars E. Olsson , Margareta Friman +1 more | Journal of Transport & Health

Prevalence and factors associated with anxiety and depression among the older people in ethnic minority areas in southern China: a cross-sectional study

2025-06-24

Sihan Wu , Yang Liu , H.‐Y. Mo +3 more | Frontiers in Public Health

Background Mental health issues among the older people are increasingly becoming a focus of societal concern, with depression and anxiety being common psychological problems that affect their quality of life … Background Mental health issues among the older people are increasingly becoming a focus of societal concern, with depression and anxiety being common psychological problems that affect their quality of life and physical health. However, research on anxiety and depression among ethnic minorities in China remains relatively limited. This study investigates ethnic disparities in mental health among older adults (≥65 years) in China’s Guangxi Zhuang Autonomous Region, employing a Social Determinants of Health (SDH) framework. Methods A cross-sectional study was conducted using a multi-stage stratified sampling method among 1,671 older individuals aged 65 and above in five communities in Guangxi from April to May 2024. A total of 1,550 completed questionnaires were collected. Descriptive analysis, univariate analysis, and two-factor logistic regression analysis were employed to explore the influencing factors of depression and anxiety among the older people in ethnic minority areas. Results The prevalence rates of anxiety and depression were 11.42 and 15.94%, respectively. Logistic regression analysis indicated that being female, belonging to ethnic minorities (such as Jing, Yao, Mulao, and Zhuang), cognitive impairment, holding negative attitudes towards aging, and poor psychological resilience were common and significant predictors of both anxiety and depression. Support from children and access to medical insurance emerged as common protective factors against anxiety and depression. Conclusion The incidence of anxiety and depression symptoms among the older people in the Guangxi Zhuang Autonomous Region is relatively high. Specifically, ethnic minorities such as Jing, Yao, Mulao, and Zhuang exhibited a higher likelihood of experiencing anxiety and depression compared to non-ethnic minorities like Han. This finding highlights the multiple mental health challenges faced by these groups in terms of socioeconomic status, culture, education, and healthcare access. The government should prioritize the mental health of ethnic minorities by optimizing the allocation of social resources and promoting culturally adapted mental health services to address these challenges.

Analysis of Geospatial Variations in Healthcare Across Rural Communities in the US Using Machine Learning

2025-06-24

Radion Svynarenko , Hyun Jung Kim , Tracey Stansberry +3 more | Healthcare

Background/Objectives: Rural public health is significantly impacted by social drivers of health (SDOH), a set of community-level factors, with rural areas facing challenges such as a higher rate of aging … Background/Objectives: Rural public health is significantly impacted by social drivers of health (SDOH), a set of community-level factors, with rural areas facing challenges such as a higher rate of aging population, fewer jobs, lower income, higher mortality, and poor healthcare access. While much research exists on rurality and SDOH, methodological issues remain, including a narrow definition of SDOH that often overlooks the critical location aspect of healthcare. Methods: This study utilized county-level data from the 2020 Agency of Healthcare Research and Quality SDOH database to investigate geospatial variations in healthcare across the spectrum of rurality. This study employed a set of novel spatial–statistical methods: gradient boosting machines (GBM), Shapley additive explanations (SHAP), and multiscale geographically weighted regression (MGWR). Results: The analysis of 262 variables across 1976 counties identified 20 key variables related to rural healthcare. These variables were grouped into three categories: health insurance status, access to care, and the volume of standardized Medicare payments. The MGWR model further revealed both global and local effects of specific healthcare characteristics on rurality, demonstrating that geographically varying relationships were strongly associated with socio-geographical factors. Conclusions: To improve the SDOH in vulnerable rural communities, particularly in Southern states without Medicaid expansion, policymakers must develop and implement equitable and innovative care models to address social determinants of health and access-to-care issues, especially given the potential cuts to public health programs.

Bridging Healthcare and Prevention: Community-based Health Education for Improving Older Adults’ Health

2025-06-24

Cangcang Jia , Yang Yi , Qinglin Xu | Journal of Applied Gerontology

This study examines the effects of community-based health education (CBHE) on the well-being of older adults in China. Using data from the 2018 wave of the Chinese Longitudinal Healthy Longevity … This study examines the effects of community-based health education (CBHE) on the well-being of older adults in China. Using data from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), we first estimate ordinary least square (OLS) regressions to assess the association between CBHE participation and three health outcomes—self-rated health, self-rated quality of life, and anxiety. To ensure robustness, we complement our main analyses with entropy balancing, ordered logit models, propensity score matching (PSM), and alternative health indicators. Results indicate that CBHE participants report significantly better self-rated health, higher quality of life, and lower anxiety than non-participants. These benefits are most pronounced among rural residents, young-old adults (aged 65–79), and those with lower incomes. We conclude that early and targeted CBHE interventions—particularly focused on vulnerable subgroups in rural and low-income areas—are vital for improving health equity among China’s aging population.

Birth cohort data and life-course social risks

2025-06-24

Valérie Frey , Chris Clarke , Richie Poulton +2 more | OECD social employment and migration working papers

Analysis of young students' perception of loneliness: a cross-sectional study

2025-06-24

Rogelio Hernández-Díaz , Lucas Navarro-Vásquez , Alejandra Aguilar‐Latorre +3 more | Frontiers in Psychology

Introduction Loneliness, a multidimensional emotional experience resulting from unmet social needs, affects individuals across demographics and is particularly prevalent among youth. It can be social or emotional and is linked … Introduction Loneliness, a multidimensional emotional experience resulting from unmet social needs, affects individuals across demographics and is particularly prevalent among youth. It can be social or emotional and is linked to developmental transitions, reduced social networks, mental health conditions, and excessive social media use. Unlike desired solitude, loneliness is involuntary and associated with significant physical and mental health risks, including depression, suicide, and chronic illnesses. Despite its public health impact, youth loneliness remains underrecognized, necessitating tailored interventions. This study examines its prevalence and relationship with sociodemographic factors, social support, social media use, self-esteem, and health among students in Aragon. Methods This cross-sectional study investigated loneliness among adolescents and young adults (14–30 years) studying in Zaragoza, Spain, using online surveys conducted in March–April 2024. A sample of 536 participants was selected based on inclusion criteria, including informed consent. Loneliness was assessed using the UCLA Loneliness Scale and the De Jong Gierveld Loneliness Scale, alongside sociodemographic, social, and psychological variables such as self-esteem, health, mental health, and social media use. Descriptive, correlational, and regression analyses were performed to identify predictors of loneliness. Results The study sample comprised 73.7% women, with an average age of 20 years. Among participants, 45.9% were high school students and 54.1% university students. Higher loneliness levels are associated with spending more time on social media, fewer and lower-quality relationships, lower self-esteem, poorer self-perceived health, and having mental health problems. While no significant gender or age differences were found, the UCLA Loneliness Scale identified 31.2% of participants as lonely, and the De Jong Gierveld Loneliness Scale classified 49.1% with moderate loneliness and 27.1% with severe loneliness. Discussion This study highlights the high prevalence of loneliness among young individuals, affecting approximately two-thirds of the population aged 14–30. The findings underscore the importance of addressing loneliness as a public health concern, with particular attention to vulnerable groups. Further research is needed to develop effective prevention, detection, and intervention strategies tailored to youth, which could be implemented through Primary Care and educational institutions.

Associations between neighbourhood socioeconomic disadvantage and psychological distress among Australian adults: longitudinal analysis of the HILDA survey (2007–2021)

2025-06-24

Rebecca A. Reid , Suzanne Mavoa , Julia Gilmartin‐Thomas +2 more | Journal of Epidemiology & Community Health

Background Mental disorders contribute substantially to the global burden of disease. The neighbourhood socioeconomic environment is a key determinant of mental health, even after accounting for individual-level socioeconomic factors. However, … Background Mental disorders contribute substantially to the global burden of disease. The neighbourhood socioeconomic environment is a key determinant of mental health, even after accounting for individual-level socioeconomic factors. However, few longitudinal studies have examined this relationship. This study examined longitudinal associations between neighbourhood socioeconomic disadvantage and psychological distress from three perspectives: overall associations, trends over time and changing neighbourhood exposures. Methods Data were from the Household, Income and Labour Dynamics in Australia Survey wave 7 (2007) to wave 21 (2021), a nationally representative household-based cohort study, including 109 604 observations. Mental health was assessed using the Kessler Psychological Distress Scale (K10), analysed as a continuous variable, score range 10–50. Neighbourhood socioeconomic disadvantage was measured using derived spatially and temporally consistent census-based data, analysed in quintiles. Multilevel and fixed effects linear regression models were used. Results Psychological distress increased with neighbourhood socioeconomic disadvantage, with K10 scores 1.35 points higher (95% CI 1.14 to 1.55) in the most disadvantaged neighbourhoods compared with the least. However, the rate of change in distress over time did not vary by neighbourhood disadvantage. An association was observed between changes in disadvantage and changes in psychological distress for the most socioeconomically disadvantaged neighbourhoods. Conclusion The findings from nationally representative longitudinal data show that individuals living in more disadvantaged neighbourhoods consistently experienced higher psychological distress compared with those in less disadvantaged neighbourhoods. These inequalities remained stable over time, and limited evidence of change suggests that the association may reflect persistent differences between individuals living in different neighbourhoods.

Home settings are associated with less functional decline among older adults compared to community-care foster homes and skilled nursing facilities in Hawaii

2025-06-23

Hua Zan , Yan Yan Wu , Yan Luo +3 more | PLoS ONE

Medicaid-funded home and community-based services (HCBS) allow older adults with disabilities to avoid long-term institutionalization in nursing homes or hospitals. Past research has shown mixed results on the positive impacts … Medicaid-funded home and community-based services (HCBS) allow older adults with disabilities to avoid long-term institutionalization in nursing homes or hospitals. Past research has shown mixed results on the positive impacts of HCBS. These inconsistent results may stem from studies combining varied HCBS settings, obscuring their differential impacts on older adults' health and well-being. In Hawaii, HCBS settings primarily include private residences and community care foster homes. There is very little research on adult foster homes, and it remains unclear whether adult foster homes are associated with differential rates of functional decline over time compared to private homes or nursing homes. This research contributes to these literature gaps by comparing functional decline (measured using Hawaii Medicaid level-of-care assessments) across three settings: private homes, adult foster homes, and nursing homes from 2014 to 2021. Among 5,315 dual eligible Medicaid recipients, we found distinct characteristics in initial placement. Individuals placed at home were younger and had lower functional impairment scores compared to individuals in foster homes or nursing homes. To increase comparability despite these differences, we matched older adults (n = 852) on baseline functional status, age, sex, marital status, and race/ethnicity using propensity score matching and performed sensitivity analyses on cognitive status. After matching, linear mixed-effects modeling revealed a notably slower rate of functional decline at home compared to nursing homes or foster homes. Individuals at home had fairly stable functional status (low deterioration) over the eight years. Nursing home residents had the fastest rate of decline, followed closely by individuals in foster homes. These findings of the varying functional outcomes across care settings can inform policymakers, families, and caregivers in selecting effective care options.

Exploring Factors Related to Social Isolation Among Older Adults in the Predementia Stage Using Ecological Momentary Assessments and Actigraphy: Machine Learning Approach

2025-06-23

Bada Kang , Min Kyung Park , Jennifer Ivy Kim +6 more | Journal of Medical Internet Research

As the global population ages, the economic burden of dementia continues to rise. Social isolation-which includes limited social interaction and feelings of loneliness-negatively affects cognitive function and is a significant … As the global population ages, the economic burden of dementia continues to rise. Social isolation-which includes limited social interaction and feelings of loneliness-negatively affects cognitive function and is a significant risk factor for dementia. Individuals with subjective cognitive decline and mild cognitive impairment represent predementia stages in which functional decline may still be reversible. Therefore, identifying factors related to social isolation in these at-risk groups is crucial, as early detection and intervention can help mitigate the risk of further cognitive decline. This study aims to develop and validate machine learning models to identify and explore factors related to social interaction frequency and loneliness levels among older adults in the predementia stage. The study included 99 community-dwelling older adults aged 65 years and above in the predementia stage. Social interaction frequency and loneliness levels were assessed 4 times daily using mobile ecological momentary assessment over a 2-week period. Actigraphy data were categorized into 4 domains: sleep quantity, sleep quality, physical movement, and sedentary behavior. Demographic and health-related survey data collected at baseline were also included in the analysis. Machine learning models, including logistic regression, random forest, Gradient Boosting Machine, and Extreme Gradient Boosting, were used to explore factors associated with low social interaction frequency and high levels of loneliness. Of the 99 participants, 43 were classified into the low social interaction frequency group, and 37 were classified into the high loneliness level group. The random forest model was the most suitable for exploring factors associated with low social interaction frequency (accuracy 0.849; precision 0.837; specificity 0.857; and area under the receiver operating characteristic curve 0.935). The Gradient Boosting Machine model performed best for identifying factors related to high loneliness levels (accuracy 0.838; precision 0.871; specificity 0.784; and area under the receiver operating characteristic curve 0.887). This study demonstrated the potential of machine learning-based exploratory models, using data collected from mobile ecological momentary assessment and wearable actigraphy, to detect vulnerable groups in terms of social interaction frequency and loneliness levels among older adults with subjective cognitive decline and mild cognitive impairment. Our findings highlight physical movement as a key factor associated with low social interaction frequency, and sleep quality as a key factor related to loneliness. These results suggest that social interaction frequency and loneliness may operate through distinct mechanisms. Ultimately, this approach may contribute to preventing cognitive and physical decline in older adults at high risk of dementia. RR2-10.1177/20552076241269555.

Augmenting electronic health record data with social and environmental determinant of health measures to understand regional factors associated with asthma exacerbations

2025-06-23

Alana Schreibman , K. Lactaoen , J.G. Joó +5 more | PLOS Digital Health

Electronic health records (EHRs) provide rich data for diverse populations but often lack information on social and environmental determinants of health (SEDH) that are important for the study of complex … Electronic health records (EHRs) provide rich data for diverse populations but often lack information on social and environmental determinants of health (SEDH) that are important for the study of complex conditions such as asthma, a chronic inflammatory lung disease. We integrated EHR data with seven SEDH datasets to conduct a retrospective cohort study of 6,656 adults with asthma. Using Penn Medicine encounter data from January 1, 2017 to December 31, 2020, we identified individual-level and spatially-varying factors associated with asthma exacerbations. Black race and prescription of an inhaled corticosteroid were strong risk factors for asthma exacerbations according to a logistic regression model of individual-level risk. A spatial generalized additive model (GAM) identified a hotspot of increased exacerbation risk (mean OR = 1.41, SD 0.14, p < 0.001), and inclusion of EHR-derived variables in the model attenuated the spatial variance in exacerbation odds by 34.0%, while additionally adjusting for the SEDH variables attenuated the spatial variance in exacerbation odds by 66.9%. Additional spatial GAMs adjusted one variable at a time revealed that neighborhood deprivation (OR = 1.05, 95% CI: 1.03, 1.07), Black race (OR = 1.66, 95% CI: 1.44, 1.91), and Medicaid health insurance (OR = 1.30, 95% CI: 1.15, 1.46) contributed most to the spatial variation in exacerbation odds. In spatial GAMs stratified by race, adjusting for neighborhood deprivation and health insurance type did not change the spatial distribution of exacerbation odds. Thus, while some EHR-derived and SEDH variables explained a large proportion of the spatial variance in asthma exacerbations across Philadelphia, a more detailed understanding of SEDH variables that vary by race is necessary to address asthma disparities. More broadly, our findings demonstrate how integration of information on SEDH with EHR data can improve understanding of the combination of risk factors that contribute to complex diseases.

Depression and Treatment in Low-Income Senior Housing Residents: Results from the Medicare Annual Wellness Visit

2025-06-23

N. Jennifer Klinedinst , Barbara Resnick , Sarah Holmes +1 more | Journal of Community Health Nursing

Depression affects up to 26% of low-income senior housing residents in the United States. The purpose of this cross-sectional study was to analyze the factors associated with depression (race, gender, … Depression affects up to 26% of low-income senior housing residents in the United States. The purpose of this cross-sectional study was to analyze the factors associated with depression (race, gender, marital status, subjective memory, falls, care challenges, and antidepressant use) in 186 low-income senior housing residents. Additionally, rates and factors associated with antidepressant use were explored. This is a descriptive correlational study. The Patient Health Questionnaire (PHQ)-2 was collected as part of the Medicare Annual Wellness Visit questionnaire to determine depression. Structural equation modeling using the AMOS statistical program was used to determine the factors associated with depression and antidepressant use. Most residents were Black (70%) and female (76%), with an average age of 78 years. Twenty-one residents (11.3%) screened positive for depression. Prior falls, care challenges and male gender explained 13% of the variance in depression. A total of n = 19 (10.2%) residents were taking an antidepressant. White race was the only predictor of antidepressant use and explained 7% of the variance in antidepressant use. All residents, but particularly men, those who have fallen in the past year, and those who have care challenges, should be screened for depression and treated. Treatment should be monitored for effectiveness in promoting healthy aging for low-income senior housing residents. Community health nursing services are needed in low-income senior housing settings to screen and treat residents for depression to support successful aging in place.

Correction: Determinants of height-for-age Z-score (HAZ) among Ethiopian children aged 0–59 months: a multilevel mixed-effects analysis

2025-06-23

Nebyu Daniel Amaha | BMC Public Health

Latent profiles of youth social support: a study on variations and their impact on self-esteem

2025-06-23

Jingxian Yu , Yao Guo , Yongqi Liang +4 more | Frontiers in Psychology

Introduction The current significant suicide rate reflects the urgency of addressing mental health problems among young people. At the same time, social support and self-esteem are key factors affecting young … Introduction The current significant suicide rate reflects the urgency of addressing mental health problems among young people. At the same time, social support and self-esteem are key factors affecting young people’s mental health and suicide risk. Therefore, this study aims to explore the variations in perceived social support among youth using a latent profile analysis approach and examine its association with self-esteem. Methods Questionnaires were distributed using a simple random sampling technique in Shenzhen and Shaoguan, Guangdong Province. Data were collected using the multidimensional perceived social support scale and the self-esteem scale, and descriptive analysis and potential profile analysis were performed using SPSS and R. Results This study identified three potential categories of perceived social support: “High Social Support” (55.7%), “High Friend Support and Moderate Social Support” (34.35%), and “Low Social Support” (9.95%), and young people who work in the service industry, are widowed, have two or more children, and have high academic achievement are likely to have worse perceived social support. Self-esteem was positively related to the categories of perceived social support, and the group with low social support had the lowest self-esteem. Discussion Most young people have a high level of perceived social support, but a low perceived social support group needs more attention and help. It is suggested that both social support and self-esteem should be paid attention to maintain young people’s mental health.

Racial Differences in Neighborhood Environmental Effects on Loneliness Among Older Adults

2025-06-22

Nan Zhou | The International Journal of Aging and Human Development

This study explores the relationship between neighborhood environment and loneliness among older adults of three racial groups: White, Black, and Asian, Pacific Islander, American Indian or Alaskan Native (AA & … This study explores the relationship between neighborhood environment and loneliness among older adults of three racial groups: White, Black, and Asian, Pacific Islander, American Indian or Alaskan Native (AA & NHPIs). Data from the National Social Life, Health, and Aging Project 2015–2016 Wave 3 is analyzed using multiple linear regression for each group, with seemingly unrelated estimation used to assess differences between models. Findings indicate that higher neighborhood cohesion is linked to lower loneliness levels for Whites and Blacks, while higher perceived neighborhood danger correlates with increased loneliness for AA & NHPIs. The effect of cohesion is stronger for Blacks compared to the other groups, and the impact of neighborhood danger is greater for AA & NHPIs. These results highlight the significance of neighborhood environment in addressing loneliness among older adults and emphasize the need for interventions that consider racial differences.

Comparative evaluation of Quality of Life indicators: towards developing a comprehensive standard model for measuring Quality of Life

2025-06-21

Jalal Hafeth Ahmad Abu-Alrop | European Journal of Government and Economics

This study aims to improve the understanding of quality of life (QoL) by evaluating key indicators, identifying influential factors, and assessing their relative weights. This study utilizes panel data from … This study aims to improve the understanding of quality of life (QoL) by evaluating key indicators, identifying influential factors, and assessing their relative weights. This study utilizes panel data from 181 cases across 32 European countries (2012-2017). The study employs exploratory and confirmatory factor analyses to create a comprehensive QoL measurement model. Four primary factors were found to influence QoL in Europe: economy, health, education, and governance quality. The study compares five common QoL indicators—income, GDP, life expectancy, the Human Development Index (HDI), and the Legatum Prosperity Index—against this model. Results show that the HDI is the most balanced indicator, while others exhibit biases. The study emphasizes the need for more precise and comprehensive QoL measures and recommends applying exploratory and confirmatory factor analyses to enhance them. Future research should validate the model in other regions and further improve QoL measurement.

The aging immune system and all-cause mortality in older americans: differences across sex and race/ethnicity

2025-06-21

Kate A. Duchowny , Yuan S Zhang , Rebecca C. Stebbins +5 more | Immunity & Ageing

Abstract Background As individuals age, the immune system undergoes complex changes, including an increase in the number of CD8 T cells relative to CD4 T cells, a decline in naïve … Abstract Background As individuals age, the immune system undergoes complex changes, including an increase in the number of CD8 T cells relative to CD4 T cells, a decline in naïve cell production (including T and B cells), and an accumulation of terminally differentiated cells with diminished functionality. These age-related immune alterations collectively contribute to immunosenescence, a phenotype associated with aging-related declines and diseases such as dementia, Alzheimer’s disease, osteoporosis, and diabetes. Premature mortality at older ages often results from cumulative health deterioration initiated by physiological dysregulation over the life course. Mortality risk, therefore, provides a meaningful measure of the long-term impact of physiological changes, including those related to the immune system. Examining the link between mortality risk and immune aging in older adults could illuminate the underlying pathology of aging-related health decline. This study uses data from the Health and Retirement Study (HRS), a national, population-based sample of middle-aged and older Americans, to explore the relationship between specific immune aging ratios and six-year mortality, stratified by race/ethnicity and sex. Results Using a sample of 8,259 individuals from the HRS, we found that overall, the presence, magnitude, and direction of the association differed by the specific immune ratio measure, sex, and race/ethnicity. We found particularly robust associations among Hispanic and non-Hispanic Black females. Among Hispanic females, for example, a one-unit increase in the log CD4 EMRA: Naïve ratio was associated with a nearly 50% increase in mortality for Hispanic females and a 25% increase in mortality for non-Hispanic Black females which was robust to adjustment for additional covariates. While we found little evidence of an association between immune function and mortality among non-Hispanic White and Hispanic males, we found associations in the opposite direction as what we would expect among non-Hispanic Black males. For example, a one-unit increase in the CD4, EMRA: Naïve ratio was associated with a 15% decrease in mortality among non-Hispanic Black males. Conclusions Our findings demonstrate that associations between immune aging and mortality are not uniform but instead vary in magnitude and direction across sex and racial/ethnic subgroups. The strongest and most consistent associations were observed among Hispanic and non-Hispanic Black females—groups experiencing multiple forms of marginalization—suggesting that these populations may face heightened vulnerability to the downstream consequences of immune aging. However, the absence or reversal of expected associations in some subgroups—particularly non-Hispanic Black males—underscores the complexity of immune aging processes and their interaction with social and biological contexts. These results highlight the importance of disaggregated analyses and suggest that immune aging may manifest and impact mortality risk differently across populations.

Strengthening connections: A randomized controlled trial examining the impact of a supervisor support intervention on loneliness and military couple relationships

2025-06-20

Cynthia D. Mohr , AnnaMarie S. O’Neill , Jacquelyn M. Brady +3 more | Journal of Social and Personal Relationships

Social connection has been declining across the general population (i.e., the “loneliness epidemic”), though some groups, including military personnel, are experiencing particularly high rates. This has led to calls for … Social connection has been declining across the general population (i.e., the “loneliness epidemic”), though some groups, including military personnel, are experiencing particularly high rates. This has led to calls for a multilevel national strategy, including workplaces, to build social connection (U.S. Surgeon General, 2023). To answer this call, the present study draws on the wise intervention approach (Walton, 2014), multidimensional model of social connection (Holt-Lunstad, 2022), and models of the bidirectional relationship between sleep health and relationship functioning (Gordon et al., 2017; Troxel et al., 2007), to deliver a workplace intervention that builds social connection for military employees and their romantic partners ( N = 360 couples), using a cluster randomized controlled trial. The workplace intervention, combining supportive supervisor training (for family and sleep health) with personalized sleep feedback for employees, was found to improve social connection for both partners in the treatment group compared to the control group. Specifically, employees and romantic partners reported lower loneliness, and employees reported higher perceived partner responsiveness. We also investigated potential mechanisms of intervention effects, though significant indirect effects were not detected. Broadly, this work contributes to the loneliness intervention literature by demonstrating the efficacy of cultivating social support through one’s workplace supervisor, paired with individual sleep feedback. Clinical trial registry: NCT02946736.

Loneliness and subjective cognitive concerns in daily life

2025-06-20

Martina Luchetti , Damaris Aschwanden , Yannick Stéphan +7 more | Aging & Mental Health

Loneliness is a risk factor for dementia, but its relationship with subjective cognitive concerns in daily life remains underexplored. This study investigates how loneliness relates to self-perceived cognitive function in … Loneliness is a risk factor for dementia, but its relationship with subjective cognitive concerns in daily life remains underexplored. This study investigates how loneliness relates to self-perceived cognitive function in everyday contexts. Data from 1,828 adults (Mage = 56.56; 55.7% female) in the National Study of Daily Experiences were analyzed. Respondents completed 8 days of daily assessments on loneliness, cognitive concerns (e.g. memory lapses), and other aspects of daily life. Multilevel linear and binary logistic regressions were used. The analysis indicated a significant between- and within-person association between loneliness and subjective cognition. At the between-person level, participants who felt lonelier tended to report more cognitive problems. At the within-person level, on days participants felt lonely (independent of the frequency of those feelings), they also reported more trouble concentrating and were more likely to experience memory lapses. Feeling lonely was also linked to irritation and interference related to memory lapses. In general, the associations remained significant controlling for demographic and socio-contextual factors and excluding individuals with anxiety/depression or neurodegenerative conditions. Results suggest that even transitory feelings of loneliness are associated with poor perceptions of everyday cognitive function, a marker with implications for future risk of cognitive decline.

Loneliness and Mental Health Disorders in Older Adults Living in Portugal During the COVID-19 Pandemic: A Cross-Sectional Study

2025-06-20

Odete Araújo , Lia Sousa , Francisco Sampaio +4 more | Healthcare

Background/Objectives: The COVID-19 pandemic has had a profound impact on the mental health of the general population, particularly older adults. This study aimed to explore the association between loneliness and … Background/Objectives: The COVID-19 pandemic has had a profound impact on the mental health of the general population, particularly older adults. This study aimed to explore the association between loneliness and mental health disorders in this demographic during the pandemic. Methods: A cross-sectional survey was conducted in Portugal using data from the Survey of Health, Ageing and Retirement in Europe (SHARE) database between June and August 2020, during the COVID-19 pandemic (Wave 8 COVID-19 Survey), using computer-assisted telephone interviews. Results: The final sample included 836 participants, with 387 (46.4%) men and a mean age of 74.5 years (SD = 6.7). Mental health indicators revealed that 441 (52.1%) reported feelings of nervousness, 384 (45.3%) experienced sadness or depression, 349 (41.2%) encountered sleeping difficulties, and 280 (33.1%) reported experiencing loneliness often or some of the time. Increased feelings of loneliness were notably associated with women in poorer health, those with heightened fear of falling, dizziness, fatigue, anxiety, depression, and concurrent health and sleep issues. Age and medication use did not significantly impact feelings of loneliness. Conclusions: The findings highlight a potential association between adverse mental health outcomes among older adults during the initial phase of the pandemic. Future research, employing longitudinal research designs, is warranted to explore these relationships more rigorously, in a post-pandemic context, and to inform effective intervention development and strategies to prevent mental health problems within this vulnerable population.

Unpacking the Predictors of Loneliness: An Inferential Analysis from the INTERACT Study

2025-06-20

Austen El‐Osta , Mahmoud Al Ammouri , Aos Alaa +3 more | Research Square (Research Square)

<title>Abstract</title> Background Loneliness is a pressing public health concern with wide-ranging impacts on mental, physical and social wellbeing. Building on the INTERACT Study-the largest UK-based investigation of loneliness-this paper explores … <title>Abstract</title> Background Loneliness is a pressing public health concern with wide-ranging impacts on mental, physical and social wellbeing. Building on the INTERACT Study-the largest UK-based investigation of loneliness-this paper explores demographic, social and health-related predictors of loneliness and social capital, using multiple validated measures. Methods We analysed cross-sectional data from 135,722 community-dwelling adults across England. Loneliness was assessed using both the UCLA 3-item Loneliness Scale and the ONS Direct Measure of Loneliness (DMOL). Social capital was measured using a composite scale of neighbourhood trust, cohesion and reciprocity. Multivariable ordinal logistic regression was used to examine predictors of loneliness; binary logistic regression was used to analyse correlates of high versus low social capital. Results Younger age (particularly 16–25), being single, unemployed or living with disability were consistently associated with higher loneliness across both scales. In contrast, greater social contact having nine or more friends or relatives was strongly protective (UCLA: aOR 0.09; DMOL: aOR 0.16). University education was associated with higher loneliness on the UCLA scale but lower loneliness on the DMOL. High social capital was more prevalent among older, married and retired individuals and strongly predicted lower loneliness. Respondents with long-term conditions or disability had reduced odds of high social capital (aORs 0.65 and 0.59 respectively). Conclusions This study highlights consistent sociodemographic and social predictors of loneliness, as well as the protective role of social capital. Findings support the need for targeted public health interventions that address social connection among young adults, single people, the unemployed and individuals in poor health. Strategies that invest in neighbourhood cohesion and social infrastructure are vital for mitigating loneliness and strengthening community wellbeing.

Cardiovascular risk in aging adults with double deficits in social support: A gender-sensitive, cross-sectional analysis of the CLSA cohort

2025-06-20

Annalijn Conklin , Abdollah Safari , Gerry Veenstra +1 more | PLoS ONE

Background Synergistic effects of diverse social supports (informational, tangible, emotional and belonging) on cardiovascular disease risk factors (CVRF), by gender, is unknown. Aim To quantify gender differences in the singular … Background Synergistic effects of diverse social supports (informational, tangible, emotional and belonging) on cardiovascular disease risk factors (CVRF), by gender, is unknown. Aim To quantify gender differences in the singular and combined associations of four different forms of social support with cardiovascular disease risk factors (CVRF) in aging adults. Methods Cross-sectional study of 28,779 adults (45−85 years) in the Canadian Longitudinal Study on Aging Comprehensive cohort (2011−15); independent variables were self-reported measures of informational, tangible, emotional and belonging support; dependent variables were clinically measured BMI, waist circumference and blood pressure. We used stratified multivariable linear and logistic regression with principal component regression with cross-product terms to post-estimate adjusted means and 95% CIs for combined associations. Results All low-low support combinations were consistently associated with the highest adjusted mean BMI and WC levels among women. Adjusted mean BMI differences were largest among women with low informational and low tangible supports (27.95 kg/m 2 [27.93, 27.97]), compared to women with high informational and high tangible supports (27.34 kg/m 2 [27.30, 27.38]). Similarly, the greatest difference in adjusted mean WC was seen among women with low informational and low emotional supports (88.69 cm [88.62, 88.76]) compared to the high-high combination (86.88 cm [86.75, 87.01]). Women with low availability of informational support, with or without deficits in a second support type, had the highest adjusted mean SBP levels (range: 119.94 to 119.95 mmHg). Among men, mean CVRFs were not consistently worse for combinations of dual deficits in social support. Results were null for DBP. Conclusion Women with two deficits in social supports, particularly combinations with low informational support, showed worse CVRF measures than one social support deficit. Results indicated no antagonistic/synergistic effects of social support on CVRFs. Heart health care and prevention for aging women would benefit from ensuring informational support with other supports is available.

Quality of Life among Adult Samples: Does Perceived Social Support and Health-Seeking Behavior Counts?

2025-06-20

Enyelunekpo R. Roberts , Ucheawaji J. Owoh , Sunday A. Atunwa +1 more | PHILANTHROPY Journal of Psychology

All human activities are geared towards making life more meaningful, and the desire to improve the quality of life has been taken as a fundamental and universal human drive. Studies … All human activities are geared towards making life more meaningful, and the desire to improve the quality of life has been taken as a fundamental and universal human drive. Studies that investigated quality of life using different predictors have produced varying results. Therefore, the objective of this study was to examine the predictive ability of perceived social support and health-seeking behavior on quality of life among the adult population in Port Harcourt. A cross-sectional survey design was adopted, and the study population was selected using a purposive sampling technique. A convenience sampling technique was used to select 254 participants using validated questionnaires. Data were analyzed using multiple regression analysis to test one hypothesis and were accepted at a p < .05 level of significance. The results demonstrated that perceived social support and health-seeking behavior jointly predicted quality of life among study participants [R² = .19, F(2, 252) = 5.956, p < .05], indicating a significant effect on quality of life. The implication of this finding is a wake-up call to public health professionals, community stakeholders, and urban healthcare development authorities to provide social support through empowerment programs and create centers where individuals can access information on health-seeking behavior, thereby improving their quality of life.

Factors influencing healthcare-seeking behavior and its process analysis among ethnic minority residents: a qualitative study in rural China

2025-06-20

Wei Shu , Long Hai-feng , Yu Tian | Frontiers in Public Health

Background Healthcare-seeking behavior is a crucial foundation for improving the rational use of healthcare resources and enhancing community health. Existing studies have predominantly focused on quantitative analyses of healthcare-seeking choices … Background Healthcare-seeking behavior is a crucial foundation for improving the rational use of healthcare resources and enhancing community health. Existing studies have predominantly focused on quantitative analyses of healthcare-seeking choices and their determinants based on the Homo Economicus assumption, while neglecting the analysis of sociocultural processes underlying healthcare-seeking behavior. Methods This study employed participant observation and in-depth interviews to investigate thirty-two residents from ethnic minority rural areas, with selected typical cases subjected to focused discussion. Based on the theoretical perspective of social capital, this paper explores and analyzes the healthcare-seeking behavior and its underlying logic in ethnic minority rural areas. Results The findings suggest that institutional trust and interpersonal trust influence patients’ choices between formal and informal medical systems. Medical care information, as a prerequisite for patients’ decisions, flows differently within ethnic relationship networks and community social networks. Institutional and cultural norms collectively influence healthcare service behaviors and provide support for patients’ healthcare-seeking behavior. Conclusion The adjustment of social medical policy should be guided by the advantages of the formal medical system and the informal medical system, so that the primary medical system can provide high-quality medical services for local residents.

Online tool for cross‐sectional and longitudinal comparison of socio‐economic status indices based on postcodes in Australia

2025-06-20

Andrzej S. Januszewski , Rachel O’Connell , Liping Li +3 more | Internal Medicine Journal

Abstract Background Socio‐economic status (SES) is strongly associated with health outcomes, yet it remains relatively difficult to measure, particularly for longitudinal comparisons. Aim We have developed an interactive online tool … Abstract Background Socio‐economic status (SES) is strongly associated with health outcomes, yet it remains relatively difficult to measure, particularly for longitudinal comparisons. Aim We have developed an interactive online tool (available at bit.ly/SEIFA-POA ) that facilitates SES assessment based on postcodes (POA). Methods By utilising percentiles of socio‐economic indices for areas (SEIFA) derived from postcode‐based rankings across Australia, this tool enables comparisons of SEIFA indices provided by the Australian Bureau of Statistics (ABS) censuses from 1986 through to 2021. A percentile‐based methodology preserves the relative socio‐economic position of areas over time, thereby circumventing the methodological inconsistencies inherent in SEIFA calculations across different census periods. The tool simplifies SES assessment, offering researchers and policymakers a practical solution for both cross‐sectional and longitudinal studies. Results In 6051 participants of the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) trial from Australia, we demonstrated that favourable SES is associated with a lower frequency of vascular complications in the participants’ medical history. The absence of an observed association between SES and on‐trial complications may be attributed to the relatively short 5‐year average time horizon of the analysis. Conclusion Our SES assessment tool provides a more nuanced understanding of SES disparities and their implications for health and well‐being.

Social Participation Among Older Immigrants: A Cross-Sectional Study in Nine Cities in Canada

2025-06-20

Sepali Guruge , Souraya Sidani , Jill Hanley | Healthcare

Background/Objectives: Social participation is important for healthy aging but challenging for older immigrants because of factors such as the loss of cultural community, language and transportation barriers, ageism, and racism. … Background/Objectives: Social participation is important for healthy aging but challenging for older immigrants because of factors such as the loss of cultural community, language and transportation barriers, ageism, and racism. This study aimed to examine (1) the type of social activities in which older immigrants from Arabic (Arab), Mandarin (East Asian), and Punjabi-speaking (South Asian) communities in Canada engage; (2) their desire for more participation in social activities; and (3) factors they perceive as preventing their engagement in more social activities. Methods: Using a cross-sectional design, we collected data, using existing measures, from 476 older immigrants between fall 2022 and winter 2023. Descriptive statistics were used to analyze the data. Results: More than 75% of participants reported engagement in three solitary activities (having a hobby, going on a day trip; and using the internet and/or email) and more than 85% participated in community-based activities with family inside and outside and with friends outside the household. Most (71%) expressed a desire to participate in more social activities in the community, but they were prevented from doing so due to factors such as language barriers or not wanting to go alone. Conclusions: Interventions are needed to facilitate community-based participation among older immigrants and improve their quality of life.

Widow and Widower Mortality in India: A Research Note

2025-06-19

Megan N. Reed , Babul Hossain , Srinivas Goli +2 more

Widowhood is associated with elevated mortality risk in many social contexts. This research note is the first to quantify and contextualize the mortality risk of widowhood for men (widowers) and … Widowhood is associated with elevated mortality risk in many social contexts. This research note is the first to quantify and contextualize the mortality risk of widowhood for men (widowers) and women (widows) in India. We do so by using data on individuals from in the first wave of the India Human Development Survey (2004-2005), whose survival status was observed seven years later in the second wave of the survey. We find no differences in mortality by widowhood status for older adults aged 60 and above. However, we do find higher mortality risk for both widowed women and men aged 25 to 59, when compared to those who are married. Despite the unique vulnerabilities experienced by Indian widows, we find similar levels of elevated mortality for widows and widowers relative to married individuals in the 25-59 age group. In this age group, we also document higher mortality for widows exposed to conservative and less egalitarian gender norms. These findings suggest that, despite India’s similarity to other contexts with elevated mortality for both widows and widowers, unequal gender norms still shape life chances for Indian widows.

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The Impact of Socioeconomic Disparities on Cardiovascular Health During The COVID-19 Pandemic

2025-06-19

Ifrah Ali | Research Square (Research Square)

<title>Abstract</title> The COVID-19 pandemic has negatively impacted cardiovascular health by raising biological risk factors among certain socioeconomic groups. This study demonstrates how socioeconomic determinants of health, including education, income, and … <title>Abstract</title> The COVID-19 pandemic has negatively impacted cardiovascular health by raising biological risk factors among certain socioeconomic groups. This study demonstrates how socioeconomic determinants of health, including education, income, and demographic disparities, collectively contribute to cardiovascular health outcomes and how these populations face significant long-term physiological detriments. Lower socioeconomic communities faced greater detriments to cardiovascular health from 2020 to 2022 because of such factors, causing more serious conditions such as hypertension and coronary artery disease, as well as aggravating underlying biological risk factors. These biological risk factors include, but are not limited to, lower ejection fraction and aggravation of less harmful cardiovascular conditions such as diabetes. Physical risk factors have also increased among lower-income populations as more and more communities during this time have turned to coping methods such as smoking and overeating to manage stress. This, in turn, also ends up compromising cardiovascular well-being that is not solely based on biological risk factors. Using data from this period, this research examines persistent inequalities in cardiovascular health outcomes across various groups, categorizing the data by demographic characteristics such as gender and age. Results highlight the connection between socioeconomic status and cardiovascular health, underscoring the need for significant intervention and policy changes to address health disparities on a global scale.

Historical Neighborhood Conditions and Modern-Day Health: Exploring Industrial Data in Redlining Maps

2025-06-19

Rebecca B. Smith , Craig Evan Pollack | Research Square (Research Square)

<title>Abstract</title> Maps created by the Home Owner’s Loan Corporation (HOLC) have increasingly been used as a proxy to measure the modern-day health impacts of practices of historical systemic racism. However, … <title>Abstract</title> Maps created by the Home Owner’s Loan Corporation (HOLC) have increasingly been used as a proxy to measure the modern-day health impacts of practices of historical systemic racism. However, the HOLC maps provide rich information about neighborhood conditions that go beyond a single letter grade. In this work, we propose a heretofore un-examined source of neighborhood variability, appraiser text describing neighborhood conditions, to examine health outcomes. Specifically, we examine whether the described presence of industry within an area is associated with modern rates of asthma prevalence. While we do not find a stastically significant association between industry and athsma, the work points to ways future research may use this snapshot of historical neighborhood conditions to better understand contemporary patterns of health inequity.

Counties with Low Employment and Education Status Are Associated with Higher Age-Adjusted Cancer Mortality

2025-06-19

Minu P. Mohan , Joel B. Epstein , Kapil Meleveedu +2 more | Cancers

Background: This study aims to evaluate the potential relationship between county-level social determinants of health (SDOH)-specifically education and job status-and cancer mortality. Methods: We utilized Social Determinants of Health (SDOH) … Background: This study aims to evaluate the potential relationship between county-level social determinants of health (SDOH)-specifically education and job status-and cancer mortality. Methods: We utilized Social Determinants of Health (SDOH) data from the Agency for Healthcare Quality (AHRQ) 2015 county database for a cross-sectional study investigating the primary independent variables-low education and low employment status-and the outcome of cancer mortality. Results: Out of 3134 counties, 906 exhibited poor employment levels, while 467 showed low educational attainment. The age-adjusted cancer death rate for non-low-education counties was 172.90 [157.00, 188.40], but for low-education counties it was 186.20 [161.72, 209.33], p < 0.001. Conversely, this was 169.15 [154.00, 183.50], compared to 189.80 [171.90, 207.10], p < 0.001, for counties with low employment. The adjusted analysis indicated that counties with low education levels were correlated with elevated age-adjusted cancer mortality (7.68, 95% CI: 5.06-10.31), and similarly, counties with low employment rates were linked to increased age-adjusted cancer mortality (4.69, 95% CI: 2.58-6.79). Conclusions: Our findings indicate that counties characterized by low educational attainment and poor employment levels are associated with elevated age-adjusted cancer death rates.

Social Participation of Frail Older People with Functional Limitations Ageing Alone in Place in Italy, and Its Impact on Loneliness: An Urban–Rural Comparison

2025-06-19

Maria Gabriella Melchiorre , Marco Socci , Giovanni Lamura +1 more | Urban Science

(1) Background: Older people ageing in place alone with functional limitations experience several difficulties in daily life, potentially hampering their social participation. This in turn could impact their perceived loneliness. … (1) Background: Older people ageing in place alone with functional limitations experience several difficulties in daily life, potentially hampering their social participation. This in turn could impact their perceived loneliness. This paper aims to investigate these issues based on findings from the IN-AGE (“Inclusive ageing in place”) study carried out in 2019 in Italy. (2) Methods: The focus of this paper is on the Marche region (Central Italy), where 40 qualitative/semi-structured interviews with seniors were administered in both urban and rural sites. A content analysis was carried out, in addition to some quantification of statements. (3) Results: Older people are mainly involved in receiving/making visits, lunches/dinners with family members and friends, religious functions, walking, and watching television (TV). Overall, the more active seniors are those living in rural sites, with lower physical impairments, and with lower perceived loneliness, even though in some cases, a reverse pattern emerged. The results also indicate some different nuances regarding urban and rural sites. (4) Conclusions: Despite the fact that this exploratory study did not have a representative sample of the target population, and that only general considerations can be drawn from results, these findings can offer some insights to policymakers who aim to develop adequate interventions supporting the social participation of older people with functional limitations ageing in place alone. This can also potentially reduce the perceived loneliness, while taking into consideration the urban–rural context.

City-Defined Neighborhood Boundaries in the United States

2025-06-19

Stephen Ansolabehere , Jacob R. Brown , Ryan Enos +3 more | Scientific Data

Neighborhoods are frequently cited as impactful for social, economic, political, and health outcomes. Measuring neighborhoods, however, is challenging, as the definition of a neighborhood may change dramatically across places. Researchers … Neighborhoods are frequently cited as impactful for social, economic, political, and health outcomes. Measuring neighborhoods, however, is challenging, as the definition of a neighborhood may change dramatically across places. Researchers lack widespread but locally-sourced data on neighborhoods, and instead often adopt widely available but arbitrary Census geographies as neighborhood proxies. Others invest in the collection of more precise definitions, but these types of data are hard to collect at scale. We address this tension between scale and precision by collecting, cleaning, and providing to researchers a new dataset of city-defined neighborhoods. Our data includes 206 of the largest cities in the United States, covering more than 77 million people. We combine these data with block-level Census demographic data and provide them along with open-source software to aid researchers in their use.

Exploring the association between self-esteem and blood pressure: A cross-sectional and longitudinal investigation

2025-06-19

Bijou C Allard , Julia K. Boehm | Journal of Health Psychology

High self-esteem is linked to favorable outcomes including better mental health and relationships, however, its impact on cardiovascular health is less understood. This study examined the relationship between self-esteem and … High self-esteem is linked to favorable outcomes including better mental health and relationships, however, its impact on cardiovascular health is less understood. This study examined the relationship between self-esteem and blood pressure levels using data from the Midlife in the United States (MIDUS) study ( M age = 54.53; 57% women; 20% non-White). We hypothesized that higher self-esteem would be associated with lower systolic and diastolic blood pressure concurrently and 10 years later. Self-esteem was measured with the Rosenberg Self-Esteem Scale, and blood pressure was clinically assessed. Cross-sectional analyses included 1194 participants; longitudinal analyses included 566 participants. Contrary to expectations, higher self-esteem was associated with increased SBP over time ( p = 0.04). However, no significant cross-sectional relationships were found. These findings suggest self-esteem may not consistently predict blood pressure, although it could be related to SBP in the long term, warranting further research into the impact of self-esteem on cardiovascular health.

How does disability contribute to deprivation in ageing process: a multidimensional analysis

2025-06-19

Kairan Zhang , Jiayi Wang | Frontiers in Public Health

Background In the context of disability and multidimensional deprivation during the ageing process, this paper aims to assess the net effect of multidimensional deprivation in older adults induced by disability … Background In the context of disability and multidimensional deprivation during the ageing process, this paper aims to assess the net effect of multidimensional deprivation in older adults induced by disability with bidirectional causality controlled. Methods Using data from the China Health and Retirement Longitudinal Study 2011–2018, this paper estimated the multidimensional deprivation in terms of economic condition, subjective well-being, and social participation caused by old age disability, which was assessed by a joint identification method, with instrumental variable employed. Results The results indicate that (1) the higher the degree of disability, the higher the probability and degree of multidimensional deprivation suffered by the old age. (2) And the level of disability has caused more significant deprivation in subjective well-being and social participation dimensions than economic condition. (3) The effect of multidimensional deprivation induced by disability also varies by urban and rural areas. Conclusion More comprehensive health and anti-deprivation policies are needed to accurately identify disability status, prevent associated socio-economic risks, and narrow the urban–rural gap in disability and deprivation.