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The epidemiology of nonspecific psychological distress in New York City, 2002 and 2003.

ABSTRACT: The 30-day prevalence of nonspecific psychological distress (NPD) is 3%, nationwide. Little is known about the prevalence and correlates of NPD in urban areas. This study documents the prevalence of NPD among adults in New York City (NYC) using population-based data from the 2002 and 2003 NYC Community Health Surveys (CHS) and identifies correlates of NPD in this population. We examined two cross-sectional random-digit-dialed telephone surveys of NYC adults (2002: N = 9,764; 2003: N = 9,802). Kessler's K6 scale was used to measure NPD. Age-adjusted 30-day prevalence of NPD declined from 6.4% [95% Confidence Interval (CI): 5.8-7.0] in 2002 to 5.1% [95% CI: 4.5-5.6] in 2003. New Yorkers who were poor, in poor health, chronically unemployed, uninsured, and formerly married had the highest prevalence of NPD. Declines occurred among those who were married, white, recently unemployed, and female. NPD prevalence in NYC is higher than national estimates. A stronger economy and recovery from September 11th attacks may have contributed to the 2003 decline observed among selected subgroups. The excess prevalence of NPD may be associated with substantial economic and societal burden. Research to understand the etiology of this high prevalence and interventions to promote mental health in NYC are indicated.

SUBMITTER: McVeigh KH

PROVIDER: S-EPMC2527192 | biostudies-other | 2006 May

REPOSITORIES: biostudies-other

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Project description:Whole genome sequencing (WGS) has rapidly become an important research tool in tuberculosis epidemiology and is likely to replace many existing methods in public health microbiology in the near future. WGS-based methods may be particularly useful in areas with less diverse Mycobacterium tuberculosis populations, such as New York City, where conventional genotyping is often uninformative and field epidemiology often difficult. This study applies four candidate strategies for WGS-based identification of emerging M. tuberculosis subpopulations, employing both phylogenomic and population genetics methods.M. tuberculosis subpopulations in New York City and New Jersey can be distinguished via phylogenomic reconstruction, evidence of demographic expansion and subpopulation-specific signatures of selection, and by determination of subgroup-defining nucleotide substitutions. These methods identified known historical outbreak clusters and previously unidentified subpopulations within relatively monomorphic M. tuberculosis endemic clone groups. Neutrality statistics based on the site frequency spectrum were less useful for identifying M. tuberculosis subpopulations, likely due to the low levels of informative genetic variation in recently diverged isolate groups. In addition, we observed that isolates from New York City endemic clone groups have acquired multiple non-synonymous SNPs in virulence- and growth-associated pathways, and relatively few mutations in drug resistance-associated genes, suggesting that overall pathoadaptive fitness, rather than the acquisition of drug resistance mutations, has played a central role in the evolutionary history and epidemiology of M. tuberculosis subpopulations in New York City.Our results demonstrate that some but not all WGS-based methods are useful for detection of emerging M. tuberculosis clone groups, and support the use of phylogenomic reconstruction in routine tuberculosis laboratory surveillance, particularly in areas with relatively less diverse M. tuberculosis populations. Our study also supports the use of wider-reaching phylogenomic and population genomic methods in tuberculosis public health practice, which can support tuberculosis control activities by identifying genetic polymorphisms contributing to epidemiological success in local M. tuberculosis populations and possibly explain why certain isolate groups are apparently more successful in specific host populations.

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The epidemiology of nonspecific psychological distress in New York City, 2002 and 2003.

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