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Article Reference Troff document (with manpage macros)The COVID-19 epidemic in rural U.S. counties
Having first reached epidemic proportions in coastal metropolitan areas, COVID-19 has spread 4 around the country. Reported case rates vary across counties from zero to 125 per thousand 5 population (around a state prison in the rural county of Trousdale, Tennessee). Overall, rural 6 counties are underrepresented relative to their share of the population, but a growing proportion 7 of all daily cases and deaths have been reported in rural counties. This analysis uses daily 8 reports for all counties to present the trends and distribution of COVID-19 cases and deaths in 9 rural counties, from late March to May 16, 2020. I describe the relationship between population 10 density and case rates in rural and non-rural counties. Then I focus on noteworthy outbreaks 11 linked to prisons, meat and poultry plants, and nursing homes, many of which are linked to 12 high concentrations of Hispanic, American Indian, and Black populations. The growing 13 epidemic in rural counties is apparently driven by outbreaks concentrated in these institutional 14 settings, which are conducive to transmission. The impact of the epidemic in rural areas may 15 be heightened due to their weaker health infrastructure and more vulnerable populations, 16 especially due to age, socioeconomic status, and health conditions. As a result, the epidemic 17 may contribute to the ongoing decline of health, economic, and social conditions in rural areas.
Located in MPRC People / Philip Cohen, Ph.D. / Philip Cohen Publications
Article Reference Troff document (with manpage macros)Park Spaces and the User Experience: Reconsidering the Body in Park Analysis Tools
As a strategy for combating physical inactivity, obesity, and other health conditions, the apperception of greenspace and importance of human-nature relationships have increased in recent decades. With this raised awareness in greenspace, the development of park auditing tools has been positioned primarily in the material conditions (e.g., physical environmental conditions) of parks. An examination of existing park auditing tools has shown that by focusing on particular material conditions, built environment and active living scholars have set aside other characteristics, namely, those that consider the user (e.g., the active human), as a separate concern from the focus of these tools. We have sought to engage with these tools to examine how they can be more effective in analyzing both the physical and human elements of parks and other natural environments.
Located in MPRC People / Jennifer D. Roberts, Dr.P.H., M.P.H. / Jennifer D. Roberts Publications
Article Reference Troff document (with manpage macros)Creating Supportive Environments for LGBT Older Adults: An Efficacy Evaluation of Staff Training in a Senior Living Facility
Supportive housing later in life tends to be a key concern for lesbian, gay, bisexual, and transgender (LGBT) elders. Most senior care providers are un(der)prepared to meet the needs of older LGBT adults. This study evaluated the efficacy of a 4 h, face-to-face, research-based, LGBT-diversity training designed to improve senior housing facility staff’s cultural competency regarding the needs of LGBT elders. Findings from this study found a significant increase in LGBT content knowledge between pre- and post-intervention assessments and a significant decrease in perceived preparedness when working with LGBT elders. These effects remained significant after controlling for staff designation, religion, educational attainment, and training session. Findings suggest that staff’s cultural competence affected their perceived readiness to address LGBT elders’ needs. Implications are related to the concept of cultural humility or the lifelong process of understanding others’ experiences based on the recognition of lack of un(der)preparedness to create a culturally supportive residential environment.
Located in MPRC People / Jessica N Fish, Ph.D. / Jessica N Fish Publications
Article Reference Troff document (with manpage macros)Long-term exposure to particulate air pollution and brachial artery flow-mediated dilation in the Old Order Amish
Background Atmospheric particulate matter (PM) has been associated with endothelial dysfunction, an early marker of cardiovascular risk. Our aim was to extend this research to a genetically homogenous, geographically stable rural population using location-specific moving-average air pollution exposure estimates indexed to the date of endothelial function measurement. Methods We measured endothelial function using brachial artery flow-mediated dilation (FMD) in 615 community-dwelling healthy Amish participants. Exposures to PM < 2.5 μm (PM 2.5 ) and PM < 10 μm (PM 10 ) were estimated at participants’ residential addresses using previously developed geographic information system-based spatio-temporal models and normalized. Associations between PM exposures and FMD were evaluated using linear mixed-effects regression models, and polynomial distributed lag (PDL) models followed by Bayesian model averaging (BMA) were used to assess response to delayed effects occurring across multiple months. Results Exposure to PM 10  was consistently inversely associated with FMD, with the strongest (most negative) association for a 12-month moving average (− 0.09; 95% CI: − 0.15, − 0.03). Associations with PM 2.5  were also strongest for a 12-month moving average but were weaker than for PM 10  (− 0.07; 95% CI: − 0.13, − 0.09). Associations of PM 2.5  and PM 10  with FMD were somewhat stronger in men than in women, particularly for PM 10 . Conclusions Using location-specific moving-average air pollution exposure estimates, we have shown that 12-month moving-average estimates of PM 2.5  and PM 10  exposure are associated with impaired endothelial function in a rural population.
Located in MPRC People / Robin Puett, Ph.D. / Robin Puett Publications
Article ReferenceComparing National Probability and Community‑Based Samples of Sexual Minority Adults: Implications and Recommendations for Sampling and Measurement
Scientific evidence regarding sexual minority populations has generally come from studies based on two types of samples: community-derived samples and probability samples. Probability samples are lauded as the gold standard of population research for their ability to represent the population of interest. However, while studies using community samples lack generalizability, they are often better able to assess population-specific concerns (e.g., minority stress) and are collected more rapidly, allowing them to be more responsive to changing population dynamics. Given these advantages, many sexual minority population studies rely on community samples. To identify how probability and community samples of sexual minorities are similar and different, we compared participant characteristics from two companion samples from the  Generations Study , each designed with the same demographic profile of U.S. sexual minority adults in mind. The first sample was recruited for a national probability survey, whereas the second was recruited for a multicommunity sample from four U.S. cities. We examined sociodemographic differences between the samples. Although there were several statistical differences between samples, the effect sizes were small for sociodemographic characteristics that defined the sample inclusion criteria: sex assigned at birth, race/ethnicity, and age cohort. The samples differed across other characteristics: bisexual respondents, respondents with less education, and those living in non-urban areas were underrepresented in the community sample. Our findings offer insights for recruiting community samples of sexual minority populations and for measuring sexual identity on probability surveys. They also bolster confidence in well-designed community samples as sources for data on sexual minority populations.
Located in MPRC People / Jessica N Fish, Ph.D. / Jessica N Fish Publications
Article Reference Troff document (with manpage macros)A Longitudinal Assessment of Parental Caregiving and Blood Pressure Trajectories: Findings from the China Health and Nutrition Survey for Women 2000–2011
Background Few studies have investigated the consequences of caregiving on the objectively measured physiological health outcomes in China. This study used population-based longitudinal data to examine the association between parental caregiving and blood pressure among Chinese women. Method This is a retrospective analysis of 2586 women using five waves of data from the Ever-Married Women Survey component of the China Health and Nutrition Survey (2000, 2004, 2006, 2009, and 2011). We applied growth curve models to examine trajectories of systolic blood pressure (SBP) and diastolic blood pressure (DBP) associated with parental caregiving among women in China. Results In multivariable analyses of blood pressure trajectories adjusting for potential confounders, parental caregivers had higher systolic (β-coefficient (β) = 1.16; p ≤ 0.01) and diastolic blood pressure (β = 0.75; p ≤ 0.01) compared with non-caregivers across multiple waves. Caregivers and non-caregivers had similar levels of systolic blood pressure at baseline, but caregivers exhibited relatively higher growth rate over time. Diastolic blood pressure was much higher among caregivers at the baseline measure, and across time relative to non-caregivers. Moreover, low-intensity but not high-intensity caregivers showed higher growth rate compared with non-caregivers for both SBP and DBP. Discussion Our results demonstrate the negative cardiovascular consequences of parental caregiving among Chinese women. Findings from the study can be used to develop future stress management interventions to decrease hypertension risk within women who provide care to their parents.
Located in MPRC People / Sunmin Lee, Sc.D. / Sunmin Lee Publications
Article Reference Troff document (with manpage macros)Reconsidering Approaches to Estimating Health Disparities Across Multiple Measures of Sexual Orientation
Purpose:  We propose a new theoretically grounded approach for estimating sexual orientation-related health risk that accounts for the unique and shared variance of sexual identity across other measures of sexual orientation (i.e., attraction and behavior). We argue and illustrate that this approach provides specificity not demonstrated by approaches that independently estimate and compare health risk based on sexual identity, attraction, and behavior. Methods:  Data were from the National Epidemiologic Survey on Alcohol and Related Conditions-III, collected in 2012–2013 (N = 36,309, ages 18 and older). The Karlson-Holm-Breen method tested the degree to which attraction- and behavior-based disparities in mental health and substance use disorders change after adjusting for sexual identity. Results:  Sexual attraction- and behavior-based disparities in mental health and substance use disorders statistically varied when comparing models that did and did not adjust for sexual identity. Adjusting for sexual identity appeared to have a larger influence on attraction- and behavior-based health associations among men; sexual minority and majority differences were attenuated on nearly every outcome after adjusting for sexual identity. This attenuation was less common among women. Among women, some behavior-based disparities were wider in sexual identity-adjusted models relative to unadjusted models. Conclusion:  We demonstrate more accurate approaches to capturing and comparing sexual orientation-related health disparities across multiple measures of sexual orientation, which account for the shared variance between sexual identity and measures of attraction and behavior. Adjusted estimates provide more specificity regarding relative health risk across specific subgroups of sexual minority people, and the intervention and prevention strategies needed to address them.
Located in MPRC People / Jessica N Fish, Ph.D. / Jessica N Fish Publications
Article Reference Troff document (with manpage macros)Do changes in neighborhood social context mediate the effects of the moving to opportunity experiment on adolescent mental health?
This study investigated whether changes in neighborhood context induced by neighborhood relocation mediated the impact of the Moving to Opportunity (MTO) housing voucher experiment on adolescent mental health. Mediators included participant-reported neighborhood safety, social control, disorder, and externally-collected neighborhood collective efficacy. For treatment group members, improvement in neighborhood disorder and drug activity partially explained MTO's beneficial effects on girls' distress. Improvement in neighborhood disorder, violent victimization, and informal social control helped counteract MTO's adverse effects on boys' behavioral problems, but not distress. Housing mobility policy targeting neighborhood improvements may improve mental health for adolescent girls, and mitigate harmful effects for boys.
Located in MPRC People / Quynh Nguyen, Ph.D., M.S.P.H. / Quynh Nguyen Publications
Article Reference Troff document (with manpage macros)Everyday and major experiences of racial/ethnic discrimination and sleep health in a multiethnic population of U.S. women: Findings from the Sister Study
Background Perceived racial/ethnic discrimination and poor sleep occur across all races/ethnicities in the U.S., though both are most common among racial/ethnic minorities. Few studies have investigated associations between perceived racial/ethnic discrimination and various sleep dimensions in a multiethnic population. Methods We analyzed cross-sectional associations among 40,038 eligible Sister Study participants (enrollment: 2003-2009) who reported ever/never experiencing specific types of everyday (e.g., treated unfairly at a store or restaurant) or major (e.g., unfairly stopped, threatened, or searched by police) discrimination attributed to their race/ethnicity during a follow-up survey in 2008-2012. Participants also reported short sleep duration (<7 hours), sleep debt (≥2-hour difference between longest and shortest sleep duration), frequent napping (≥3 times/week), and insomnia. Poisson regression with robust variance estimation, adjusted for sociodemographic and health characteristics, estimated prevalence ratios (PRs) and 95% confidence intervals (CIs) for the association between each type of racial/ethnic discrimination and each sleep dimension, overall and by race/ethnicity. Results Mean age was 55 ± 8.9 years, 89% were NH-white, 8% NH-black, and 3% Hispanic/Latina. NH-black participants were the most likely to report everyday (76% vs. 4% [NH-whites] and 36% [Hispanics/Latinas]) and major racial/ethnic discrimination (52% vs. 2% [NH-whites] and 18% [Hispanics/Latinas]). Participants who experienced both types versus neither were more likely to report short sleep duration (PR=1.17 [95% CI: 1.09-1.25]) and insomnia symptoms (PR=1.10 [1.01-1.20]) but not other poor sleep dimensions. Conclusions Racial/ethnic minority women were most likely to experience racial/ethnic discrimination, which was associated with certain poor sleep dimensions among women of all races/ethnicities.
Located in MPRC People / Natalie Slopen, Sc.D. / Natalie Slopen Publications
Article Reference Troff document (with manpage macros)Better a Friend Nearby Than a Brother Far Away? The Health Implications of Foreign Domestic Workers’ Family and Friendship Networks
Migrant domestic workers provide essential services to the families they live with, but they are not considered a part of the family. As a group, they are not well-integrated into the society and often suffer from social isolation. In this article, we explore the potential health buffering effects of their personal network, in terms of family and friendship ties in both the local community and their home country. Existing literature provides inconsistent evidence on who and what matters more, with regard to the nature, strength, and geographic locations of individual personal networks. Using data from the Survey of Migrant domestic Workers in Hong Kong (2017), we find that family ties are extremely important. The presence of family members in Hong Kong as well as daily contact with family, regardless of location, are associated with better self-reported health. Only daily contact with friends in Hong Kong, not with friends in other countries, promotes better health. We also find evidence that the protective effects of family and friends networks depend on each other. Those foreign domestic workers with families in Hong Kong but also maintain daily contact with friends have the best self-reported health among all.
Located in MPRC People / Feinian Chen, Ph.D. / Feinian Chen Publications