Citizenship and health insurance status predict glycemic management: NHANES data 2007-2016.
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ABSTRACT:
SUBMITTER: Chasens ER
PROVIDER: S-EPMC7494527 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Objective/study questionTo examine changes in uninsurance rates among U.S. adolescents ages 12-17 and assess whether trends over time differed by citizenship status, Latino ethnicity, and household language.Data sources/study setting2007-2016 National Health Insurance Survey (NHIS).Study designMultivariable logistic regression and postestimation marginal effects were used to assess changes in the current uninsured rate. Logistic regression models were used to determine significant trends over time for each demographic group and compare them to trends in the broader adolescent population. Marginal effects were employed to calculate adjusted outcome probabilities for each year.Principal findingsAcross all 12- to 17-year-olds, the unadjusted uninsured rate dropped significantly between 2007 and 2016, from 10.2 percent to 6.0 percent. For noncitizen youth, the probability of being uninsured increased from 26.6 percent in 2007 to 28.4 percent in 2016, after controlling for covariates. Latino youth and those in Spanish-speaking households saw declines in their adjusted uninsurance rate that was proportional to non-Latino and English-speaking youth.ConclusionsMost adolescents saw significant improvements in health insurance coverage between 2007 and 2016; however, disparities remain among Spanish-speaking and Latino adolescents and no improvements were seen among noncitizen youth. This suggests a need for equity-focused eligibility, outreach, and enrollment policies that expand insurance options for these populations.
| S-EPMC6863242 | biostudies-literature
Project description:Deportation has become more commonplace in the United States since the mid-2000s. Latin American noncitizens-encompassing undocumented and documented immigrants-are targeted for deportation. Deportation's threat also reaches naturalized and US-born citizens of Latino descent who are largely immune to deportation but whose loved ones or communities are deportable. Drawing on 6 y of data from the National Survey of Latinos, this article examines whether and how Latinos' deportation fears vary by citizenship and legal status and over time. Compared with Latino noncitizens, Latino US citizens report lower average deportation fears. However, a more complex story emerges when examining this divide over time: Deportation fears are high but stable among Latino noncitizens, whereas deportation fears have increased substantially among Latino US citizens. These trends reflect a growing national awareness of-rather than observable changes to-deportation policy and practice since the 2016 US presidential election. The article highlights how deportation or its consequences affects a racial group that the US immigration regime targets disproportionately.
| S-EPMC7183143 | biostudies-literature
Project description:Limiting dietary sodium intake has been a consistent dietary recommendation. Using NHANES 2007-2010 data, we estimated current sodium intake and modeled the potential impact of a new sodium reduction technology on sodium intake. NHANES 2007-2010 data were used to assess current sodium intake. The National Cancer Institute method was used for usual intake determination. Suggested sodium reductions using SODA-LO (®) Salt Microspheres ranged from 20% to 30% in 953 foods and usual intakes were modeled by using various reduction factors and levels of market penetration. SAS 9.2, SUDAAN 11, and NHANES survey weights were used in all calculations with assessment across gender and age groups. Current (2007-2010) sodium intake (mg/day) exceeds recommendations across all age gender groups and has not changed during the last decade. However, sodium intake measured as a function of food intake (mg/g food) has decreased significantly during the last decade. Two food categories contribute about 2/3rd of total sodium intake: "Grain Products" and "Meat, Poultry, Fish & Mixtures". Sodium reduction, with 100% market penetration of the new technology, was estimated to be 230-300 mg/day or 7-9% of intake depending upon age and gender group. Sodium reduction innovations like SODA-LO (®) Salt Microspheres could contribute to meaningful reductions in sodium intake.
| S-EPMC4708647 | biostudies-other
Project description:ObjectiveTo investigate the relationship between uric acid to high-density lipoprotein cholesterol ratio (UHR) and circulating α-klotho levels in U.S. adults.MethodsA cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2016. Circulating α-klotho was defined as the dependent variable and UHR was defined as the independent variable. Multivariable linear regression was performed to assess the relationship between the independent and dependent variables. The nonlinear relationship and effect size between UHR and α-klotho were evaluated using smooth curve fitting and threshold effect analysis. Subgroup analysis and sensitivity analysis were conducted to determine the stability of the results. The diagnostic performance of UHR and α-klotho in common elderly diseases was compared using ROC (Receiver Operating Characteristic) analysis.ResultsAmong 12,849 participants, there was a negative relationship between the UHR and circulating α-klotho. In the fully adjusted overall model, each unit increase in UHR was associated with a decrease of 4.1 pg/mL in α-klotho. The threshold effect analysis showed that before the inflection point of 8.2, each unit increase in UHR was associated with a decrease of 15.0 pg/mL in α-klotho; beyond the inflection point of 8.2, each unit increase in UHR was associated with a decrease of 2.8 pg/mL in α-klotho. Subgroup analyses and sensitivity analysis indicated that the relationship between UHR and α-klotho remained stable across most populations. The ROC diagnostic test indicated that the evaluative efficacy of UHR in diagnosing age-related diseases was comparable to that of α-klotho.ConclusionThis study revealed that the UHR was associated with the circulating α-klotho concentration, with a negative association observed in most cases. This finding suggested that the UHR might be a promising indicator for evaluating circulating α-klotho levels.
| S-EPMC11312937 | biostudies-literature
Project description:BackgroundHalf of the adults with current asthma among the US National Health and Nutrition Examination Survey (NHANES) participants could be classified in more than one hypothesis-driven phenotype. A data-driven approach applied to the same subjects may allow a more useful classification compared to the hypothesis-driven one.AimTo compare previously defined hypothesis-driven with newly derived data-driven asthma phenotypes, identified by latent class analysis (LCA), in adults with current asthma from NHANES 2007-2012.MethodsAdults (≥ 18 years) with current asthma from the NHANES were included (n = 1059). LCA included variables commonly used to subdivide asthma. LCA models were derived independently according to age groups: < 40 and ≥ 40 years old.ResultsTwo data-driven phenotypes were identified among adults with current asthma, for both age groups. The proportions of the hypothesis-driven phenotypes were similar among the two data-driven phenotypes (p > 0.05). Class A < 40 years (n = 285; 75%) and Class A ≥ 40 years (n = 462; 73%), respectively, were characterized by a predominance of highly symptomatic asthma subjects with poor lung function, compared to Class B < 40 years (n = 94; 25%) and Class B ≥ 40 years (n = 170; 27%). Inflammatory biomarkers, smoking status, presence of obesity and hay fever did not markedly differ between the phenotypes.ConclusionBoth data- and hypothesis-driven approaches using clinical and physiological variables commonly used to characterize asthma are suboptimal to identify asthma phenotypes among adults from the general population. Further studies based on more comprehensive disease features are required to identify asthma phenotypes in population-based studies.
| S-EPMC6419396 | biostudies-literature
Project description:Studies of relationships between eating frequency and/or timing and energy intake have not examined associations with low-calorie sweeteners (LCS). We assessed the frequency of eating behavior related to LCS consumption emphasizing timing, calorie intake, and body mass index (BMI) among United States (US) adults aged ≥19 years. Using the National Health and Nutrition Examination Survey (NHANES) 2007-2016, we defined eating episodes as food and/or beverage intake within 15 min of one another over the first 24-h dietary recall. We coded items ingested during episodes (n = 136,938) and assessed LCS presence using US Department of Agriculture (USDA) food files. Episode analysis found intakes of foods only (27.4%), beverages only (29.5%), and foods with beverages (43.0%). LCS items were consumed without concurrent calories from other sources in fewer than 2.7% of all episodes. Within participants having normal weight (29.4%), overweight (33.6%) and obese (37.1%) BMIs, LCS consumers (35.2% overall) evidenced: more episodes/day; and fewer: calories, carbohydrates, fats, and protein per episode. Per person, those consuming LCS had lower total calories and higher fiber intake per day. LCS consumption was associated with higher BMI. Number of eating episodes/day and longer hours when eating episodes occurred were also consistently associated with higher BMI. Consuming LCS did not modify these relationships. These results did not show that LCS consumption was associated with increased caloric intake from other dietary sources.
| S-EPMC7551388 | biostudies-literature
Project description:Importance:Disparities in health insurance coverage by immigration status are well documented; however, there are few data comparing long-term changes in insurance coverage between immigrant and nonimmigrant adults as they age into older adulthood. Objective:To compare longitudinal changes in insurance coverage over 24 years of follow-up between recent immigrant, early immigrant, and nonimmigrant adults in the US. Design, Setting, and Participants:This population-based cohort study used data from the nationally representative Health and Retirement Study. Data were collected biennially from 1992 to 2016. The population included community-dwelling US adults born between 1931 and 1941 and aged 51 to 61 years at baseline. Statistical analysis was performed from February 3, 2017, to January 10, 2020. Exposures:Participants were categorized as nonimmigrants (born in the US), early immigrants (immigrated to the US before the age of 18 years), and recent immigrants (immigrated to the US from the age of 18 years onward). Main Outcomes and Measures:Self-reported data on public, employer, long-term care, and other private insurance were used to define any insurance coverage. Longitudinal changes in insurance coverage were examined over time by immigration status using generalized estimating equations accounting for inverse probability of attrition weights. The association between immigration status and continuous insurance coverage was also evaluated. Results:A total of 9691 participants were included (mean [SD] age, 56.0 [3.2] years; 5111 [52.6%] female). Nonimmigrants composed 90% (n?=?8649) of the cohort; early immigrants, 2% (n?=?201); and recent immigrants, 8% (n?=?841). Insurance coverage increased from 68%, 83%, and 86% of recent immigrant, early immigrant, and nonimmigrant older adults, respectively, in 1992 to 97%, 100%, and 99% in 2016. After accounting for selective attrition, recent immigrants were 15% less likely than nonimmigrants to have any insurance at baseline (risk ratio, 0.85; 95% CI, 0.82-0.88), driven by lower rates of private insurance. However, disparities in insurance decreased incrementally over time and were eliminated, such that insurance coverage rates were similar between groups as participants attained Medicare age eligibility. Furthermore, recent immigrants were less likely than nonimmigrants to be continuously insured (risk ratio, 0.89; 95% CI, 0.85-0.94). Conclusions and Relevance:Among community-dwelling adults who were not age eligible for Medicare, recent immigrants had lower rates of health insurance, but this disparity was eliminated over the 24-year follow-up period because of uptake of public insurance among all participants. Future studies should evaluate policies and health care reforms aimed at reducing disparities among vulnerable populations such as recent immigrants who are not age eligible for Medicare.
| S-EPMC7066476 | biostudies-literature
Project description:We use 19 billion likes on the posts of top 2000 U.S. fan pages on Facebook from 2015 to 2016 to measure the dynamic ideological positions for politicians, news outlets, and users at the national and state levels. We then use these measures to derive support rates for 2016 presidential candidates in all 50 states, to predict the election, and to compare them with state-level polls and actual vote shares. We find that: (1) Assuming that users vote for candidates closer to their own ideological positions, support rates calculated using Facebook predict that Trump will win the electoral college vote while Clinton will win the popular vote. (2) State-level Facebook support rates track state-level polling averages and pass the cointegration test, showing two time series share similar trends. (3) Compared with actual vote shares, polls generally have smaller margin of errors, but polls also often overestimate Clinton's support in right-leaning states. Overall, we provide a method to forecast elections at low cost, in real time, and based on passively revealed preference and little researcher discretion.
| S-EPMC8635376 | biostudies-literature
Project description:Objective:Evidence regarding the relationship between vitamin A and HPV infection was limited. Therefore, this study is designed to investigate whether vitamin A was independently related to HPV infection in 13412 American women from NHANES for seven cycles. Methods:The present study is a cross-sectional study. A total of 13412 eligible participants who had available HPV tests and vitamin A intake data were registered in the NHANE database from 2003 to 2016. The targeted independent variable and the dependent variable were vitamin A measured at baseline and HPV infection, respectively. We analyzed the association between dietary vitamin A intake and the prevalence of HPV infection. Besides, GAM and smooth curve fittings were used to address the nonlinear relationship between vitamin A and HPV infection to determine the effect of HPV infection. Results:The result of fully adjusted binary logistic regression showed vitamin A was not associated with the risk of HPV infection after adjusting confounders (odds ratio?=?0.97, 95% confidence interval: 0.97-1.02). A nonlinear relationship was detected between vitamin A and HPV infection, whose inflection point was 10.5 of log2 vitamin A (by the recursive algorithm). One unit increase of log2 vitamin A is associated with the 10% reduced risk of HPV infection when dietary vitamin A is < 1448.155mcg. Conversely, when the dietary vitamin A intake is ?1448.155?mcg, for each additional log2 of vitamin A, the risk of HPV infection increased by 70%. Conclusions:We found that dietary vitamin A was quite different from the trend of HPV infection in different confidence intervals. The results suggested that an appropriate amount (95% CI: 0.9-1.0, <10.5 of log2 transformer, i.e., 1448.155?mcg) of dietary vitamin A may be beneficial to prevent HPV infection. However, excessive intake of dietary vitamin A (95% CI: 1.1-2.8, ?10.5 of log2 transformer, i.e., 1448.155?mcg) may increase the risk of HPV infection.
| S-EPMC7201492 | biostudies-literature
Project description:BackgroundIt remains to be determined whether the Alternate Healthy Eating Index 2010 (AHEI-2010) or the Healthy Eating Index 2010 (HEI-2010) is preferably recommended as means to assess dietary quality in people with type 2 diabetes (T2DM).MethodsThe purpose of this study was to determine whether the AHEI-2010 provides a more accurate assessment of dietary quality than the HEI-2010 in relation to diabetes status, while controlling for health markers, sociodemographic and lifestyle factors. The 2007-2010 National Health and Nutrition Examination Survey (NHANES) was used as a representative sample of U.S. adults age 20+ years (n = 4097). HEI-2010 and the AHEI-2010 scores were used as measures of dietary quality and were calculated using data from the first 24-h dietary recall. Health markers evaluated include anthropometrics, blood pressure, lipid and inflammatory markers, and presence of co-morbid diseases. Least Squares Means were computed to determine differences across diabetes status (nondiabetes, prediabetes, T2DM) for total and sub-component HEI-2010 and AHEI-2010 scores, and to determine differences across total HEI-2010 and AHEI-2010 quartiles for health markers. Covariate-adjusted logistic regression was used to examine the association between total HEI-2010 and AHEI-2010 scores and diabetes status.ResultsAdults with T2DM showed higher HEI-2010 and AHEI-2010 scores compared to adults with prediabetes and nondiabetes but did not have better health markers. For HEI-2010 component scores, adults with T2DM had highest consumption (highest score) of total protein foods and lowest consumption (highest score) for empty calories (p < 0.01). For AHEI-2010 component scores, adults with T2DM had the lowest consumption (highest score) for sugar-sweetened beverages and fruit juice, sodium, and alcohol (lowest score). In addition, adults with T2DM had the highest consumption (lowest score) for red and/or processed meats (p < 0.01). However, neither total HEI-2010 nor AHEI-2010 scores were significantly associated with diabetes status (p > 0.05). Results suggest that neither index was clearly superior to the other in terms of its predictive ability in relation to T2DM.ConclusionNeither total HEI-2010 nor AHEI-2010 scores performed better in terms of their relationship with diabetes status. However, the significant relationships between 1) diabetes status and health markers and 2) between HEI-2010 and AHEI-2010 scores and health markers suggest that diet has some influence on T2DM.
| S-EPMC6471947 | biostudies-literature