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Economic opportunity, health behaviours, and health outcomes in the USA: a population-based cross-sectional study.

ABSTRACT: BACKGROUND:Inequality of opportunity, defined as differences in the prospects for upward social mobility, might have important consequences for health. Diminished opportunity can lower the motivation to invest in future health by reducing economic returns to health investments and undermining hope. We estimated the association between county-level economic opportunity and individual-level health in young adults in the general US population. METHODS:In this population-based cross-sectional study, we used individual-level data from the 2009-12 United States Behavioral Risk Factor Surveillance Surveys. Our primary outcomes were current self-reported overall health and the number of days of poor physical and mental health in the last month. Economic opportunity was measured by the county-averaged national income rank attained by individuals born to families in the lowest income quartile. We restricted our sample to adults aged 25-35 years old to match the data used to assign exposure. Multivariable ordinary least squares and probit models were used to estimate the association between the outcomes and economic opportunity. We adjusted for a range of demographic and socioeconomic characteristics, including age, sex, race, education, income, access to health care, area income inequality, segregation, and social capital. FINDINGS:We assessed nearly 147?000 individuals between the ages of 25 years and 35 years surveyed from 2009 to 2012. In models adjusting for individual-level demographics and county-level socioeconomic characteristics, increases in county-level economic opportunity were associated with greater self-reported overall health. An interdecile increase in economic opportunity was associated with 0·76 fewer days of poor mental health (95% CI -1·26 to -0·25) and 0·53 fewer days of poor physical health (-0·96 to -0·09) in the last month. The results were robust to sensitivity analyses. INTERPRETATION:Economic opportunity is independently associated with self-reported health and health behaviours. Policies seeking to expand economic opportunities might have important spillover effects on health. FUNDING:Robert Wood Johnson Foundation Health and Society Scholars Program.

SUBMITTER: Venkataramani AS

PROVIDER: S-EPMC5947845 | biostudies-literature | 2016 Nov

REPOSITORIES: biostudies-literature

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Economic opportunity, health behaviours, and health outcomes in the USA: a population-based cross-sectional study.

Venkataramani Atheendar S AS Brigell Rachel R O'Brien Rourke R Chatterjee Paula P Kawachi Ichiro I Tsai Alexander C AC

The Lancet. Public health 20161003 1

<h4>Background</h4>Inequality of opportunity, defined as differences in the prospects for upward social mobility, might have important consequences for health. Diminished opportunity can lower the motivation to invest in future health by reducing economic returns to health investments and undermining hope. We estimated the association between county-level economic opportunity and individual-level health in young adults in the general US population.<h4>Methods</h4>In this population-based cross-s ...[more]

PMID: 29253376

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Project description:BACKGROUND:Playing video games, a form of sedentary behaviour, is associated with poor well-being and increased risk of morbidity due to chronic disease. However, the association between health behaviours and video gaming is poorly understood. The purpose of this population-based study was to reveal the differences in dietary habits and physical activity for adolescent men with high amount of video games on weekdays, as compared to their peers who play less often. METHODS:Seven hundred ninety-six adolescent men (age: mean?=?17.8, SD?=?0.6) attended compulsory conscription for military service in 2013 and completed a questionnaire regarding the amount and frequency of their video gaming. They also participated in a medical examination and underwent physiological measurements. The participants who played video games more than 3?h/d on weekdays were compared with those who played 3h/d or less. The association between health behaviours and the amount of playing video gaming was analysed using multivariable logistic regression analysis. RESULTS:24.1% (n?=?192) of the participants reported video gaming in excess of 3?h/d. This group had higher incidence of having low physical fitness, having poor eating habits, and being obese. No differences were found in smoking or alcohol drinking habits. Other factors, including low leisure-time physical activity (OR?=?1.94; 95% CI, 1.29-2.91), low consumption of vegetables and fruits (OR?=?0.83; 95% CI, 0.72-0.97), high consumption of sweetened soft drinks (OR?=?1.28; 95% CI, 1.06-1.55) and high amount of sitting time (OR?=?1.40; 95% CI, 1.28-1.52), explained one-fourth of the difference. CONCLUSION:In this population-based study, adolescent men who played video games a lot on weekdays had lower physical fitness, were more often obese, and had poorer dietary habits, as compared to their peers who played less often. Because playing video games typically adds to a person's total sedentary time, this activity may be associated with adverse health outcomes at a very young age- especially in combination with poor health behaviours. The results of this study can be utilized to promote health interventions targeted at adolescent men so as to raise their awareness of the disadvantages of excessive video gaming.

Project description:BackgroundMultimorbidity is associated with physical-mental health comorbidity (PMHC). However, the scope of overlap between physical and mental conditions, associated factors, as well as types of mental illness involved are not well described in Eastern Europe. This study aims to assess the PMHC burden in the Estonian population.MethodsIn this population-based cross-sectional study we obtained health claims data for 55 chronic conditions from the Estonian Health Insurance Fund (EHIF) database, which captures data for all publicly insured individuals (n = 1 240 927 or 94.1% of the total population as of 31 December 2017). We assessed the period-prevalence (3 years) of chronic physical and mental health disorders, as well as associations between them, by age and sex.ResultsHalf of the individuals (49.1% (95% CI 49.0-49.3)) had one or more chronic conditions. Mental health disorders (MHD) were present in 8.1% (8.1-8.2) of individuals, being higher among older age groups, women, and individuals with a higher number of physical conditions. PMHC was present in 6.2% (6.1-6.2) of the study population, and 13.1% (13.0-13.2) of the subjects with any chronic physical disorder also presented with at least one MHD. Dominating MHDs among PMHC patients were anxiety and depression. The prevalence of MHD was positively correlated with the number of physical disorders. We observed variation in the type of MHD as the number of physical comorbidities increased. The prevalence of anxiety, depression, and mental and behavioral disorders due to the misuse of alcohol and other psychoactive substances increased as physical comorbidities increased, but the prevalence of schizophrenia and dementia decreased with each additional physical disease. After adjusting for age and sex, this negative association changed the sign to a positive association in the case of dementia and mental and behavioral disorders due to psychoactive substance misuse.ConclusionsThe burden of physical-mental comorbidity in the Estonian population is relatively high. Further research is required to identify clusters of overlapping physical and mental disorders as well as the interactions between these conditions. Public health interventions may include structural changes to health care delivery, such as an increased emphasis on integrated care models that reduce barriers to mental health care.

Project description:To analyze perceptions of health-related quality of life and associated factors in populations from the Manaus Metropolitan Region.We conducted a population-based cross-sectional study from May to August 2015. Adults aged 18 years and older were selected using probabilistic three-phase cluster sampling and stratified by sex and age, based on official estimates. Quality of life data were collected using the European Quality of Life 5-Dimensions 3-Levels (EQ-5D-3L) along with socioeconomic, demographic, and health perception data. Utility scores were calculated using the Brazilian version of the EQ-5D-3L. Descriptive statistics were derived, and a multivariate Tobit regression model with correction for complex sampling was performed to identify the variables that influence utility levels.A total of 4001 participants were included. The average utility score was 0.886 (95% confidence interval [CI]: 0.881-0.890) with significant differences according to living area (the capital (0.882 ± 0.144) or inner cities (0.908 ± 0.122; p < 0.001)). The dimension for which the highest proportion of people reported moderate to severe problems was pain/discomfort (39%), followed by anxiety/depression (18%). Men had a higher quality of life than women (β = 0.041, p < 0.001). Not working was a factor that increased quality of life compared with being formally employed (β = 0.031, p = 0.037). The poorest people had a lower quality of life than the richest people (β = -0.118, p < 0.001). Better health perceptions increased utility scores (p < 0.001), while being separated decreased the scores (β = -0.052, p = 0.001).Health-related quality of life in the Manaus Metropolitan Region was high, as expected for the general population, and was higher among individuals who lived in the inner cities, men and those in higher social classes. Gender discrepancies and differences in quality of life between the capital and inner cities should be further investigated.

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Economic opportunity, health behaviours, and health outcomes in the USA: a population-based cross-sectional study.

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Economic opportunity, health behaviours, and health outcomes in the USA: a population-based cross-sectional study.

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