Racial, socioeconomic, and neighborhood characteristics in relation to COVID-19 severity of illness for adolescents and young adults
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PROVIDER: S-EPMC10682970 | biostudies-literature | 2023 Nov
REPOSITORIES: biostudies-literature
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Project description:IntroductionContextual factors representing chronic stressors, such as neighborhood crime characteristics, have been repeatedly linked to compromised mental and physical health, and may contribute to the pathologizing of normative/non-clinical experiences. However, the impact of such structural factors has seldom been incorporated in Clinical High Risk (CHR) for psychosis research. Understanding how context can influence the presence or severity of symptoms such as suspiciousness/paranoia may have important relevance for promoting valid and reliable assessment, as well as for understanding ways in which environment may be related to illness development and expression.MethodsA total of 126 adolescents and young adults (nCHR = 63, ncontrol = 63) underwent clinical interviews for Clinical High-Risk syndromes. Neighborhood crime indices and socioeconomic status were calculated through geocoding and extracting of publicly available Census and Federal Bureau of Investigation (FBI) data. Analyses examined presence of associations between neighborhood crime indices, socioeconomic status, suspiciousness and total symptoms.ResultsGreater neighborhood crime was related to increased suspiciousness in CHR individuals, even after controlling for neighborhood socioeconomic status, r = 0.27, p = .03. Neighborhood crime was not related to total symptoms, and neither was neighborhood socioeconomic status.DiscussionResults suggest neighborhood crime uniquely related to suspiciousness symptoms in CHR individuals, while this was not the case for healthy volunteers (HV). Future work will be critical for determining the extent to which assessors are pathologizing experiences that are normative for a particular context, or rather, if a stressful context is serving as a sufficient environmental stressor to unmask emerging psychosis.
| S-EPMC7036021 | biostudies-literature
Project description:BackgroundDisparities in survival by race/ethnicity, socioeconomic status (SES), and geography in adolescent and young adult (AYA) patients with central nervous system (CNS) tumors have not been well studied.ProcedureA retrospective cohort study utilizing the Surveillance, Epidemiology, and End Results (SEER) database was conducted for AYA patients diagnosed with primary CNS tumors. Adjusted hazard ratios (aHR) were calculated using a multivariate Cox proportional hazard model to evaluate the association between race/ethnicity, SES, rurality, and hazard of death.ResultsAll minority groups showed an increased hazard of death with greatest disparities in the high-grade glioma cohort. Lower SES was associated with an increased hazard of death in non-Hispanic White (NHW) patients (aHR 1.12; 95% confidence interval [CI] 1.01-1.24), non-Hispanic Black (NHB) patients (aHR 1.34; 95% CI 1.00-1.80), and patients aged 25-29 years (aHR 1.29; 95% CI 1.07-1.55). Mediation analysis showed an indirect effect of SES on the effect of race/ethnicity on the hazard of death only among NHB patients, with SES accounting for 33.7% of the association between NHB and hazard of death. Rurality was associated with an increased hazard of death for patients in the lowest SES tertile (aHR 1.31; 95% CI 1.08-1.59) and NHW patients (aHR 1.20; 95% CI 1.08-1.34).ConclusionsPatients identified as a racial/ethnic minority, patients with a lower SES, and patients residing in rural areas had an increased hazard of death. Further studies are needed to understand and address the biological, psychosocial, societal, and economic factors that impact AYA neuro-oncology patients at highest risk of experiencing poorer outcomes.
| S-EPMC8221084 | biostudies-literature
Project description:ObjectivesFactors common to socioeconomically disadvantaged neighborhoods, such as low availability of transportation, may limit access to restorative care services for critical illness survivors. Our primary objective was to evaluate whether neighborhood socioeconomic disadvantage was associated with an increased disability burden after critical illness. Our secondary objective was to determine if the effect differed for those discharged to the community compared with those discharged to a facility.DesignLongitudinal cohort study with linked Medicare claims data.SettingUnited States.PatientsOne hundred ninety-nine older adults, contributing to 239 ICU admissions, who underwent monthly assessments of disability for 12 months following hospital discharge in 13 different functional tasks from 1998 to 2017.Measurements and main resultsNeighborhood disadvantage was assessed using the area deprivation index, a 1-100 ranking evaluating poverty, housing, and employment metrics. Those living in disadvantaged neighborhoods (top quartile of scores) were less likely to self-identify as non-Hispanic White compared with those in more advantaged neighborhoods. In adjusted models, older adults living in disadvantaged neighborhoods had a 9% higher disability burden over the 12 months following ICU discharge compared with those in more advantaged areas (rate ratio, 1.09; 95% Bayesian credible interval, 1.02-1.16). In the secondary analysis adjusting for discharge destination, neighborhood disadvantage was associated with a 14% increase in disability burden over 12 months of follow-up (rate ratio, 1.14; 95% credible interval, 1.07-1.21). Disability burden was 10% higher for those living in disadvantaged neighborhoods and discharged home as compared with those discharged to a facility, but this difference was not statistically significant (interaction rate ratio, 1.10; 95% credible interval, 0.98-1.25).ConclusionsNeighborhood socioeconomic disadvantage is associated with a higher disability burden in the 12 months after a critical illness. Future studies should evaluate barriers to functional recovery for ICU survivors living in disadvantaged neighborhoods.
| S-EPMC9001742 | biostudies-literature
Project description:BackgroundInadequate hydration is associated with cardiovascular and kidney disease morbidity and all-cause mortality. Compared with White individuals, Black individuals exhibit a higher prevalence of inadequate hydration, which may contribute to racial health disparities. However, the underlying reasons for these differences in hydration remain unclear.ObjectiveThis cross-sectional study aimed to investigate whether neighborhood deprivation contributes to racial differences in hydration status.MethodsWe assessed 24 Black and 30 White college students, measuring 24-hour urine osmolality, urine flow rate, urine specific gravity, and plasma copeptin concentration. Participants recorded their food and fluid intake for 3 d to assess total water intake from food and beverages. Neighborhood socioeconomic deprivation was measured using a tract-level Area Deprivation Index.ResultsBlack participants exhibited higher urine osmolality (640 [314] compared with 440 [283] mOsm/kg H2O, respectively, P = 0.006) and lower urine flow rate (1.06 [0.65] compared with 1.71 [0.89] ml/min, respectively, P = 0.009) compared with White participants, indicating greater hypohydration among Black participants. Black participants reported lower total water intake from food and beverages than White participants (2.3 ± 0.7 compared with 3.5 ± 1.1 L/day, respectively, P < 0.01). Black participants exhibited higher copeptin than White participants (6.3 [3.1] compared with 4.5 [2.3] pmol/L, P = 0.046), and urine osmolality mediated 67% of the difference (P = 0.027). Black participants reported greater cumulative exposure to neighborhood deprivation during childhood (ages 0-18 y). Furthermore, neighborhood deprivation during childhood was associated with urine specific gravity (P = 0.031) and total water intake from food and beverages (P = 0.042) but did not mediate the racial differences in these measures.ConclusionOur data suggest that compared with White young adults, Black young adults are hypohydrated and exhibit higher plasma copeptin concentration, and that greater neighborhood deprivation is associated with chronic underhydration irrespective of race. This trial was registered at clinicaltrials.gov as NCT04576338.
| S-EPMC10579046 | biostudies-literature
Project description:PurposeThe purpose of this study is to identify distinct neighborhood profiles patterned by key structural, physical, and social characteristics and test whether living in different profiles are associated with body mass index trajectories during adolescence in racial/ethnic minority female youth.MethodsParticipants were 1,328 sexually active female adolescents and young adults aged 14-23 years, predominately Hispanic and black, enrolled in an human papillomavirus type 4 vaccine (Gardasil) surveillance study at a large adolescent health clinic in New York City between 2007 and 2018. Body mass index was calculated from weight and height every 6 months. A comprehensive set of neighborhood structural, social, and physical characteristics from multiple national and state datasets was linked to each participant based on home address.ResultsLatent profile analysis revealed five distinct neighborhood profiles in New York City: High Structural/High Social Advantage, Moderate Advantage/Low Crime, Low SES (Socioeconomic Status)/High Activity, Low SES/High Social Advantage, and High Disadvantage. Results from multilevel growth curve analysis revealed that living in Low SES/High Activity neighborhoods was associated with a lower BMI at age 22 (b = -1.32, 95% confidence interval -2.49, -.16), as well as a slower increase in BMI from age 14 to 22 years (b = -.22, 95% confidence interval -.46, .02), compared to the High Disadvantage profile.ConclusionsOur findings suggest that improving neighborhood structural, social, and physical environments may help promote healthy weight and reduce health disparities during adolescence and young adulthood.
| S-EPMC8612950 | biostudies-literature
Project description:INTRODUCTION:Although epidemiologic studies suggest low levels of cigarette use among African American adolescents relative to White U.S. adolescents, it is not known whether this may be due to racial differences in the relative contribution of genes and environment to cigarette use initiation and progression to regular use. METHODS:Using data from White (n=2665) and African American (n=809) twins and full siblings sampled in the National Longitudinal Study of Adolescents, we fitted age-, sex- and race-specific variance decomposition models to estimate the magnitude of genetic and environmental effects on cigarette use initiation and cigarette use quantity in Whites and African Americans across adolescence and adulthood. We employ a causal-contingent-common pathway model to estimate the amount of variance explained in quantity of cigarettes smoked contingent on cigarette use initiation. RESULTS:African Americans had lower cigarette use prevalence from adolescence through adulthood, and used cigarettes less heavily than Whites. Race-specific causal-contingent-common pathway models indicate that racial differences in genetic and environmental contributions to cigarette use initiation and cigarette use quantities are not present in adolescence but appear in young adulthood. Additive genetic factors were an important risk factor for cigarette use initiation for White but not African American young adults and adults. CONCLUSIONS:Genetic and environmental contributions for cigarette use are similar by race in adolescence. In adulthood, genes have a stronger influence for cigarette use among White adolescents while the influence of the environment is minimal. For African Americans, both genetic and environmental influences are important in young adulthood and adulthood.
| S-EPMC4983522 | biostudies-literature
Project description:Background and objectivesNeighborhood walkability can influence walking behaviors in older adults. However, its associations of walkability with walking may differ by demographic, socioeconomic, health, social, and residential characteristics due to factors such as increased vulnerability to environmental factors or increased resilience.Research design and methodsIn a sample of older adults (n = 493, median age = 82 [range 78-89], 56% female, 31% Black), a walkability index was derived from audits of Google Street View images of participants' immediate neighborhoods. Walking was self-reported in the past week. Effect modifiers by demographic (age, race, gender, marital status), socioeconomic (education, income), health (gait speed, falls, knee pain, depressive symptoms, cognitive status, perceived energy), social (driving status, social engagement), and residential/neighborhood (residence type, neighborhood socioeconomic status [SES], population density) characteristics were assessed by interaction terms in logistic regression models, adjusted for gender, race, gait speed, prior falls, high depressive symptoms, currently driving, and cognitive status. When effect modification was suggested (p for interaction <.1), adjusted analyses of walkability with walking stratified on the effect modifier were conducted.ResultsIn this sample, 59% walked in the past week and greater walkability was associated with greater odds of walking (odds ratio [OR] = 1.16, 95% confidence interval [CI]: 1.01-1.34). This association (p for interaction range 0.002-0.07) was present for those who were not currently married (OR = 1.35, 95% CI: 1.17-1.56), who reported knee pain (OR = 1.40, 95% CI: 1.14-1.72) or high depressive symptoms (OR = 1.30, 95% CI: 1.06-1.60), or who had declining cognitive function (OR = 1.30, 95% CI: 1.09-1.55).Discussion and implicationsHigh walkability may influence physical activity, particularly for those with vulnerabilities related to social, pain, and brain health characteristics. These results should inform neighborhood planning and targeted interventions for vulnerable older adults.
| S-EPMC11557906 | biostudies-literature
Project description:One in 10 people die awaiting transplantation from donor shortage. Only half of Americans register as organ donors. In this cross-sectional study, we evaluated population-level associations of neighborhood socioeconomic deprivation and racial segregation on organ donor registration rates. We analyzed state identification card demographic and organ donor registration data from 5 states to estimate the association between a neighborhood socioeconomic deprivation index (range [0, 1]; higher values indicate more deprivation) and a racial index of concentration at the extreme (ICE) (range [-1, 1]; lower values indicate predominantly black neighborhoods, higher values indicate predominantly white neighborhoods) on organ donor registration rates within a specified geography (census tract or ZIP code tabulation area [ZCTA]). Among 26 720 738 registrants, 32% of the sample were registered organ donors. At the census tract level, with each 0.1 decrease in the deprivation index, the organ donor registration rate increased by 6.8% (95% confidence interval [CI]: 6.6%, 7.0%). With each 0.1 increase in the racial ICE, the rate increased by 1.5% (95% CI: 1.5%, 1.6%). These associations held true at the ZCTA level. Areas with less socioeconomic deprivation and a higher concentration of white residents have higher organ donor registration rates. Public health initiatives should consider neighborhood context and novel data sources in designing optimal intervention strategies.
| S-EPMC8191504 | biostudies-literature
Project description:In this study, we investigated associations between the characteristics of the neighborhoods in which young adults live and their feelings of loneliness, using data from different sources. Participants were drawn from the Environmental Risk Longitudinal Twin Study. Loneliness was measured via self-reports at ages 12 and 18 years and also by interviewer ratings at age 18. Neighborhood characteristics were assessed between the ages of 12 and 18 via government data, systematic social observations, a resident survey, and participants' self-reports. Greater loneliness was associated with perceptions of lower collective efficacy and greater neighborhood disorder but not with more objective measures of neighborhood characteristics. Lonelier individuals perceived the collective efficacy of their neighborhoods to be lower than did their less lonely siblings who lived at the same address. These findings suggest that feelings of loneliness are associated with negatively biased perceptions of neighborhood characteristics, which may have implications for lonely individuals' likelihood of escaping loneliness.
| S-EPMC6512157 | biostudies-literature
Project description:BackgroundNeighborhood factors of social isolation have been understudied, hindering efforts to reduce social isolation at the neighborhood level. This study aims to investigate the longitudinal effects of neighborhood social cohesion and physical disorder on social isolation in community-dwelling older adults, as well as to examine whether race/ethnicity moderates the neighborhood-isolation relationship.MethodsWe used 11-year data from the National Health and Aging Trend Study, a longitudinal national study of Medicare beneficiaries aged 65 and older. Social isolation was measured through a summary score across four domains: marital/partner status, family and friend contact, religious attendance, and club participation. A series of weighted mixed-effects logistic regression models were performed to test the study aims. Sample sizes ranged from 7,303 to 7,291 across individual domains of social isolation.ResultsApproximately 20% of participants reported social isolation. Findings indicated a negative association between neighborhood social cohesion and social isolation. Higher levels of neighborhood social cohesion were longitudinally associated with lower odds of social isolation (odds ratio [OR] = 0.52, 95% CI: 0.47-0.58). Yet, the presence of neighborhood physical disorder was associated with an increased risk of overall social isolation ([OR] = 1.2, 95% CI: 1.00, 1.44). Race/ethnicity significantly moderated the effects of neighborhood social cohesion and physical disorder on social isolation. The odds of no in-person visits associated with neighborhood social cohesion are smaller among Black adults compared to White adults. Black adults had constantly lower odds of isolation from religious attendance compared to White adults regardless of the level of neighborhood social cohesion. Hispanic adults had decreased odds of having no friends associated with signs of physical disorder, while no associations were found among older White adults. White adults had higher odds of isolation from in-person visits when living in neighborhoods with signs of physical disorder, whereas no association was observed among older Black and Hispanic adults.ConclusionsThis study elucidates the role of neighborhood characteristics in shaping social isolation dynamics among older adults. Furthermore, the observed moderation effects of race/ethnicity suggest the need for culturally sensitive interventions tailored to address social isolation within specific neighborhood and racial contexts.
| S-EPMC11414110 | biostudies-literature