Dataset Information

Psychological Distress and Heart Disease Mortality in the United States: Results from the 1997-2014 NHIS-NDI Record Linkage Study.

ABSTRACT: Objective:Despite the long-term decline, heart disease has remained the leading cause of death in the United States (US) over the past eight decades, accounting for 23% of all deaths in 2017. Although psychological distress has been associated with cardiovascular disease mortality, the relationship between different psychological distress levels and heart disease mortality in the US has not been analyzed in detail. Using a national longitudinal dataset, we examined the association between levels of psychological distress and US heart disease mortality. Methods:We analyzed the Kessler 6-item psychological distress scale as a risk factor for heart disease mortality using the pooled 1997-2014 data from the National Health Interview Survey (NHIS) linked to National Death Index (NDI) (N=513,081). Cox proportional hazards regression was used to model survival time as a function of psychological distress and sociodemographic and behavioral covariates. Results:In Cox models with 18 years of mortality follow-up, the heart disease mortality risk was 121% higher (hazard ratio [HR]=2.21; 95% CI=1.99,2.45) in adults with serious psychological distress (SPD) (p<0.001), controlling for age, and 96% higher (HR=1.96; 95% CI=1.77,2.18) in adults with SPD (p<0.001), controlling for age, gender, race/ethnicity, immigrant status, education, marital status, poverty status, housing tenure, and geographic region when compared with adults without psychological distress. The relative risk of heart disease mortality associated with SPD decreased but remained significant (HR=1.14, 95% CI=1.02,1.28) after controlling for additional covariates of smoking, alcohol consumption, self-assessed health, activity limitation, and body mass index. There was a dose-response relationship, with relative risks of heart disease mortality increasing consistently at higher levels of psychological distress. Moreover, the association varied significantly by gender and race/ethnicity. The relative risk of heart disease mortality for those who experienced SPD was 2.42 for non-Hispanic Whites and 1.76 for non-Hispanic Blacks, compared with their counterparts who did not experience psychological distress. Conclusions and Global Health Implications:US adults with serious psychological distress had statistically significantly higher heart disease mortality risks than those without psychological distress. These findings underscore the significance of addressing psychological well-being in the population as a strategy for reducing heart disease mortality.

SUBMITTER: Lee H

PROVIDER: S-EPMC7384336 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Psychological Distress and Heart Disease Mortality in the United States: Results from the 1997-2014 NHIS-NDI Record Linkage Study.

Lee Hyunjung H Singh Gopal K GK

International journal of MCH and AIDS 20200722 3

<h4>Objective</h4>Despite the long-term decline, heart disease has remained the leading cause of death in the United States (US) over the past eight decades, accounting for 23% of all deaths in 2017. Although psychological distress has been associated with cardiovascular disease mortality, the relationship between different psychological distress levels and heart disease mortality in the US has not been analyzed in detail. Using a national longitudinal dataset, we examined the association betwee ...[more]

PMID: 32742741

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Project description:IntroductionDecline in smoking in the United States has slowed over the past 25 years. Mental health problems are common among smokers, and may be an impediment to quitting and remaining abstinent. The study investigated the relationship between serious (past-30-day) psychological distress (SPD) and smoking, estimated trends in the prevalence of SPD among current, former, and never smokers in the United States from 2008 to 2014, and investigated whether heterogeneity in these trends varied by sociodemographic characteristics.MethodsData were drawn from the National Household Survey on Drug Use (NSDUH), an annual cross-sectional study of persons ages 12 and over (N = 270 227). SPD and smoking in the past 30 days were examined using logistic regression models among adults 18 and older. The prevalence of SPD was examined annually among current, former, and never smokers from 2008 to 2014.ResultsSPD increased among smokers in the United States from 2008 to 2014. An increase in SPD was more rapid among non-daily smokers than daily smokers. The prevalence of SPD was higher among younger smokers, those with less formal education and lower annual family income and higher among current smokers than former and never smokers. The relationships between SPD and smoking were stronger among smokers with higher education levels and annual family income.ConclusionsOur findings suggest an increase in SPD among smokers over time and that as smoking has declined, those with SPD are comprising a greater proportion of the remaining smokers. Results suggest that mental health must be integrated into mainstream tobacco control efforts.ImplicationsThe greater prevalence and increasing rate of Serious Psychological Distress among smokers, relative to former- and never-smokers, from 2008 to 2014 provides support that the greater mental health burden among smokers may be contributing to the slowed reduction in smoking prevalence in the United States. In addition, relationships between SPD and smoking were consistently stronger among smokers with higher levels of education and annual family income. Such results suggest the necessity of incorporating mental health treatments in tobacco use reduction efforts.

Project description:IntroductionThe current study examined the relationship between acute (past 30 day) and recent (past year but not past 30 day) serious psychological distress (SPD) and smoking during pregnancy among women in the United States overall, stratified by demographic characteristics, and described the change in the prevalence of prenatal smoking among women with and without SPD, from 2008 to 2014.MethodsData were drawn from the National Survey on Drug Use and Health (NSDUH), an annual cross-sectional study of US persons aged 12 and over. SPD and smoking in the past 30 days among pregnant women, aged 18 and older, were examined using logistic regression models. Heterogeneity in this association by demographic characteristics, trends over time, and level of cigarette consumption was also examined.ResultsPrenatal smoking was common. Almost 40% of pregnant women with acute SPD reported smoking, 23% of pregnant women with recent SPD smoked, and 11.7% of pregnant women without recent SPD smoked. No significant change was found in the prevalence of prenatal smoking from 2008 to 2014 in any of these groups. Robust relationships were found between acute (OR = 5.05 [3.64-6.99]) and recent SPD (OR = 2.37 [1.74-3.24]) and smoking; these findings remained after adjusting for demographics.ConclusionsSPD and smoking during pregnancy are strongly associated; this relationship is present across all sociodemographic groups and the prevalence of smoking in pregnancy has remained relatively unchanged over the past decade both in the presence and absence of SPD.ImplicationsSPD and smoking in pregnancy are robustly linked; the prevalence of smoking in pregnancy is extremely high in women with SPD. Screening women with mental health problems for prenatal smoking, as well as screening pregnant smokers for mental health problems, seems warranted and may assist more women in seeking and utilizing treatment options. Efforts to reduce the prevalence of smoking during pregnancy might specifically target women with SPD, where the potential for impact is substantial.

Project description:IntroductionCigarette use is declining yet remains common among adults with mental health conditions. In contrast, e-cigarette use may be on the rise. This study investigated the relationship between serious psychological distress (SPD) and the exclusive and dual use of cigarettes and e-cigarettes among US adults from 2014 to 2017.Aims and methodsData came from 2014 to 2017 National Health Interview Survey, an annual, cross-sectional survey of nationally representative samples of US adults (total combined analytic sample n = 125 302). Past-month SPD was assessed using the Kessler Psychological Distress Scale (K6) and cigarette and e-cigarette use were assessed at each wave. Logistic regressions examined product use by SPD status in 2017 and trends in product use by SPD status from 2014 to 2017. Analyses adjusted for demographic covariates.ResultsThe prevalence of cigarette use, e-cigarette use, and dual use was higher among adults with SPD than without SPD in each year including the most recent data year 2017 (cigarette use, 39.50% vs. 13.40%, p < .001; e-cigarette use, 7.41% vs. 2.65%, p < .001; dual use, 5.30% vs. 1.26%, p < .001). Among adults with SPD, the prevalence of cigarette, e-cigarette, and dual product use did not change from 2014 to 2017 in contrast to a decreasing prevalence in cigarette, e-cigarette, and dual product use among individuals without SPD.ConclusionsUS adults with SPD report higher levels of cigarette, e-cigarette, and dual product use than adults without SPD. Use of these products has not declined over the past several years in contrast to decreasing trends among adults without SPD.ImplicationsThese data extend our knowledge of tobacco product use and mental health disparities by showing that in addition to higher levels of cigarette use, US adults with SPD also use e-cigarettes and dual products (cigarette and e-cigarette) more commonly than those without SPD. Furthermore, the use of these products has not declined over the past several years in contrast to continuing declines among adults without SPD. More research is needed to understand the potential positive and negative consequences of e-cigarette use among adults with SPD.

Project description:ObjectivesSocioeconomic disparities in life expectancy in the United States (US) are marked and have widened over time. However, there is limited research using individual-level socioeconomic variables as such information is generally lacking or unreliable in vital records used for life table construction. Using longitudinal cohort data, we computed life expectancy for US adults by social determinants such as education, income/poverty level, occupation, and housing tenure.MethodsWe analyzed the 1997-2014 National Health Interview Survey prospectively linked to mortality records in the National Death Index (N=1,146,271). Standard life table methodologies were used to compute life expectancy and other life table functions at various ages according to socioeconomic variables stratified by sex and race/ethnicity.ResultsAdults with at least a Master's degree had 14.7 years higher life expectancy at age 18 than those with less than a high school education and 8.3 years higher life expectancy than those with a high school education. Poverty was inversely related to life expectancy. Individuals living in poverty had 10.5 years lower life expectancy at age 18 than those with incomes ≥400% of the poverty threshold. Laborers and those employed in craft and repair occupations had, respectively, 10.9 years and 8.6 years lower life expectancy at age 18 than those with professional and managerial occupations. Male and female renters had, respectively, 4.0 years and 4.6 years lower life expectancy at age 18 than homeowners. Women in the most advantaged socioeconomic group outlived men in the most disadvantaged group by 23.5 years at age 18.Conclusions and global health implicationsMarked socioeconomic gradients in US life expectancy were found across all sex and racial/ethnic groups. Adults with lower education, higher poverty levels, in manual occupations, and with rental housing had substantially lower life expectancy compared to their counterparts with higher socioeconomic position.

Dataset Information

Psychological Distress and Heart Disease Mortality in the United States: Results from the 1997-2014 NHIS-NDI Record Linkage Study.

Publications

Psychological Distress and Heart Disease Mortality in the United States: Results from the 1997-2014 NHIS-NDI Record Linkage Study.

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