Ssm-Population Health最新文献

{"title":"Annual medical expenditure associated with short sleep in China: estimates from a nationally representative sample","authors":"Xumeng Yan ,&nbsp;Fang Han ,&nbsp;Ichiro Kawachi ,&nbsp;Xiaoyu Li","doi":"10.1016/j.ssmph.2025.101808","DOIUrl":"10.1016/j.ssmph.2025.101808","url":null,"abstract":"<div><h3>Background</h3><div>Short sleep is associated with increased morbidity risks and therefore can induce substantial medical costs. This study estimates the total and out-of-pocket amount of medical expenditure associated with short sleep among Chinese adults.</div></div><div><h3>Methods</h3><div>We used nationally representative data from the China Family Panel Studies (CFPS) in 2018. Two-part regression models were used to examine the associations between short sleep and an individual's annual total or out-of-pocket medical expenditure. Counterfactual estimations were used to estimate individual and population medical cost due to very short sleep.</div></div><div><h3>Results</h3><div>Individuals with very short sleep duration (&lt;6h for 18–64 years; &lt; 5h for 65+ years) were more likely to have medical expenditure (OR = 1.38, 95 % CI: 1.23–1.56), and when they did, they spent 1822.80 CNY more than those sleeping recommended hours (7–9h for 18–64 years; 7–8h for 65+ years). The corresponding estimates for out-of-pocket medical expenditure were 1.40 (OR, 95 % CI: 1.24–1.58) and 1138.66 CNY. The estimated cost of very short sleep contributed to 2.73 % of the expected total medical expenditure and 2.74 % of the expected out-of-pocket medical expenditure for an average person. The share of medical spending due to very short sleep is higher in groups who were female, divorced/widowed, less educated, rural, and working on farming jobs. The total national medical expenditure associated with very short sleep in 2018 was estimated to be 87.85 billion CNY (13.52 billion USD), including 55.25 billion CNY (8.50 billion USD) out-of-pocket expenditure (62.89 %).</div></div><div><h3>Conclusions</h3><div>Short sleep was associated with increased total and out-of-pocket medical expenses in China. Our results have implications for public advice to get sufficient sleep, as it could help reduce medical expenditure, especially for disadvantaged groups.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"30 ","pages":"Article 101808"},"PeriodicalIF":3.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Teacher unfairness in adolescence, educational attainment, and adult Health: The role of school- and individual-level perceptions tested in a national cohort study","authors":"Shanting Chen ,&nbsp;Stephanie Koning ,&nbsp;Jessica Polos ,&nbsp;Phoebe Lam ,&nbsp;Taylor Hargrove ,&nbsp;Natalie Ebner ,&nbsp;Jacob Aronoff ,&nbsp;Thomas McDade","doi":"10.1016/j.ssmph.2025.101810","DOIUrl":"10.1016/j.ssmph.2025.101810","url":null,"abstract":"","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"30 ","pages":"Article 101810"},"PeriodicalIF":3.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health insurance and epigenetic aging: Trends in a United States adult population","authors":"Jamaji C. Nwanaji-Enwerem ,&nbsp;Dennis Khodasevich ,&nbsp;Nicole Gladish ,&nbsp;Hanyang Shen ,&nbsp;Saher Daredia ,&nbsp;Belinda L. Needham ,&nbsp;David H. Rehkopf ,&nbsp;Andres Cardenas","doi":"10.1016/j.ssmph.2025.101806","DOIUrl":"10.1016/j.ssmph.2025.101806","url":null,"abstract":"<div><h3>Background</h3><div>Health insurance plays an important role in reducing morbidity and mortality. Still, there is limited data examining the relationships of health insurance with biomarkers of aging that reflect morbidity and mortality risk.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional study of United States adults using data from the National Health and Nutrition Examination Survey (NHANES) to examine the relationships of health insurance with seven DNA methylation-based biomarkers of aging (epigenetic age): HannumAge, HorvathAge, SkinBloodAge, PhenoAge, GrimAge2, DNAm Telomere Length, and DunedinPoAm.</div></div><div><h3>Results</h3><div>Our analyses included 2315 participants with available health insurance and epigenetic aging data (mean [sd] age, 65.1 [9.3] years). Compared to the uninsured, having health insurance was associated with a 2.25-year lower GrimAge2 (95 %CI: -3.49, −1.02, <em>P</em> = 0.001) and a slower DunedinPoAm pace of aging (β = −0.04, 95 %CI: -0.06, −0.02, <em>P</em> &lt; 0.001) in basic demographic-adjusted models. GrimAge2 (β = −1.42, 95 %CI: -2.75, −0.09, <em>P</em> = 0.04) and DunedinPoAm (β = −0.03, 95 %CI: -0.06, −0.01, <em>P</em> = 0.02) relationships were attenuated after additional adjustments for general health, body mass index (BMI), education, occupation, and poverty-to-income ratio. Model estimates were larger if insurance plans were more comprehensive and included dental coverage and/or single service plans. When considering categories of insurance, similar trends were observed with private insurance and public insurance plans (i.e. Medicare, Medicaid/CHIP, and other government plans), although private insurance relationships were more often statistically significant.</div></div><div><h3>Conclusion</h3><div>Our findings suggest that epigenetic aging measures may be useful for examining the relationship between health insurance and population health, with potential implications for policy decisions.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"30 ","pages":"Article 101806"},"PeriodicalIF":3.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143886783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between stock market volatility and severe mental disorders: a multi-city time-series study","authors":"Jiangli Hu ,&nbsp;Yantao Yin ,&nbsp;Ruiqing Guo ,&nbsp;Yunqiong Wang ,&nbsp;Shuming Ji ,&nbsp;Jinyu Wang ,&nbsp;Benying Feng ,&nbsp;Jian Qian ,&nbsp;Bo Zhou ,&nbsp;Hui Li ,&nbsp;Fang Liao","doi":"10.1016/j.ssmph.2025.101807","DOIUrl":"10.1016/j.ssmph.2025.101807","url":null,"abstract":"<div><h3>Background</h3><div>Stock market volatility was commonly considered as a psychological stressor. However, the association between stock market volatility and severe mental disorders (SMD) has not been investigated.</div></div><div><h3>Methods</h3><div>Daily numbers of SMD hospital admissions and Shanghai Stock Exchange Composite (SSEC) Index in 7 cities in southwestern China from 2020 to 2023 were collected. A two-stage time-series analysis was conducted to reveal the association between stock volatility and the risk of hospital admission for SMD. Stratified analyses were performed by age, gender, and ICD-10 codes to explore potential high-risk groups.</div></div><div><h3>Results</h3><div>The association between the SSEC percentage change, SSEC closing price and SMD hospital admissions both exhibit a U-shaped curve. A 1 % decrease in SSEC is associated with a 7.2 % (95 %CI: 4.1 %–10.4 %) increase in the SMD admission, while a 1 % increase in SSEC is associated with a 2.6 % (95 %CI: 0.1 %–5.2 %) increase in the SMD admissions. With 3400 points as the dividing point, every 10-point increase in SSEC closing price is associated with a 9 % (95 %CI: 3.6 %–14.7 %) increase in the SMD hospital admissions, while each 10-point decrease is associated with a 4.4 % (95 %CI: 0.6 %–8.3 %) increase in the SMD hospital admissions. Furthermore, these associations tended to be stronger in the female and non-schizophrenia patients.</div></div><div><h3>Conclusion</h3><div>These associations indicate that both rise and fall in stock prices increase the risk of SMD. This finding suggests that it is an effective way to take the stock speculation behavior into consideration when managing and treating the SMD patients.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"30 ","pages":"Article 101807"},"PeriodicalIF":3.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does partnership predict mortality? Evidence from a twin fixed effects study design","authors":"Øyvind Nicolay Wiborg ,&nbsp;Alexi Gugushvili","doi":"10.1016/j.ssmph.2025.101805","DOIUrl":"10.1016/j.ssmph.2025.101805","url":null,"abstract":"<div><div>This study examines the association between partnership status and mortality, addressing methodological concerns such as selection effects and unobserved heterogeneity. Utilizing Norwegian administrative data on birth cohorts from 1955 to 1975, we analyze mortality outcomes using Kaplan-Meier survival analyses and Cox proportional hazards regression models. The dataset includes over 1.2 million individuals and distinguishes between partnered and non-partnered individuals. While results for the general population show that non-partnered individuals face significantly higher mortality risks, with hazard ratios of 1.59 for men and 1.47 for women, twin fixed effects models reveal no significant relationship between partnership status and mortality. This finding suggests that much of the observed association may be due to shared genetic and environmental factors rather than a direct causal effect of partnership status. By leveraging the twin fixed effects research design, this study provides a robust test of the partnership-mortality hypothesis, highlighting the importance of controlling for unobserved heterogeneity in observational research. Our results underscore the complexity of the partnership-health nexus and call for caution in interpreting simple associations as evidence of causality.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"30 ","pages":"Article 101805"},"PeriodicalIF":3.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparity between expected spatial accessibility and actual travel time to vaccination sites: Implications for COVID-19 immunization delays","authors":"Hossein Naderi ,&nbsp;Ziba Abbasian ,&nbsp;Yuxia Huang","doi":"10.1016/j.ssmph.2025.101804","DOIUrl":"10.1016/j.ssmph.2025.101804","url":null,"abstract":"<div><div>The COVID-19 pandemic underscored the importance of equitable and timely vaccination access. This study examined the impact of discrepancies between actual and expected travel times to vaccination centers on the timeliness of full and booster COVID-19 vaccinations in Nueces County, Texas. Drawing on vaccination data from over 171,000 individuals aged 18 and older, we employed Cox proportional hazards models and survival analysis to explore how demographic characteristics, the Social Vulnerability Index (SVI), and geographic disparities influenced vaccination delays. Results revealed that longer-than-expected travel times significantly reduced the likelihood of timely vaccination (HR = 0.95 for full vaccination, HR = 0.89 for booster doses). Seniors demonstrated higher vaccination timeliness rates, but gaps persisted across gender, ethnicity, and race, with males and Hispanics experiencing greater delays. Interaction analysis highlighted compounded challenges for seniors and vulnerable populations when travel time discrepancies were larger. These findings emphasize the critical need for geographically targeted public health interventions to address socio-economic disparities and improve vaccine accessibility during health crises.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"30 ","pages":"Article 101804"},"PeriodicalIF":3.6,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143890699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of discrimination across the life course among pregnancy planners in the United States and Canada","authors":"Sharonda M. Lovett ,&nbsp;Lauren A. Wise ,&nbsp;Jasmine Abrams ,&nbsp;Amelia K. Wesselink ,&nbsp;Erika L. Sabbath ,&nbsp;Ruth J. Geller ,&nbsp;Chad M. Coleman ,&nbsp;Andrea S. Kuriyama ,&nbsp;Molly N. Hoffman ,&nbsp;U. Vivian Ukah ,&nbsp;Renée Boynton-Jarrett ,&nbsp;Collette N. Ncube","doi":"10.1016/j.ssmph.2025.101803","DOIUrl":"10.1016/j.ssmph.2025.101803","url":null,"abstract":"<div><div>Little is known about discrimination among pregnancy planners. We used questionnaire data from Pregnancy Study Online (PRESTO), a preconception cohort study, to characterize experiences, attributions, and responses to discrimination (n = 10,460). Eligible participants were assigned female at birth, aged 21–45 years, U.S. or Canadian residents, and not using contraception or fertility treatment. Participants completed a supplemental questionnaire (2013–2024) that included the Philadelphia Urban ACE Survey, Williams' Everyday Discrimination and Major Experiences of Discrimination scales, and Krieger's instrument on responses to discrimination. Mean age at enrollment was 30.9 years. Overall, 83.8 % of participants identified as non-Hispanic White, and 50.4 % had ≥17 years education. Discrimination across the life course varied: 11 % of participants reported childhood racial discrimination, 80.3 % reported ever experiencing everyday discrimination, and 47.2 % reported ever experiencing lifetime discrimination. The most prevalent types of everyday discrimination included being perceived as not smart (63.4 %) and being treated with disrespect (62.6 %), while job-related discrimination was the most frequently-reported lifetime experience (33.9 %). Most Black participants (non-Hispanic and Hispanic) reported their race or ethnicity as one of the main reasons they were discriminated against (87.7 % and 80 %, respectively), while sex or gender was most commonly-reported by other racial and ethnic groups (range: 75.9–82.4 %). Most participants responded passively to discrimination: keeping it to themselves and accepting it as a fact of life (37.4 %). All participants other than non-Hispanic White reported greater exposure to discrimination across the life course, and attributions for discrimination (<em>e.g.,</em> race, gender, education, income level) varied across racial and ethnic groups.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"30 ","pages":"Article 101803"},"PeriodicalIF":3.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143851455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neighborhood socioeconomic contexts mediate the association between adverse childhood experiences and social risk and health outcomes in adulthood","authors":"Nicole Pereira,&nbsp;Xi Zhu","doi":"10.1016/j.ssmph.2025.101802","DOIUrl":"10.1016/j.ssmph.2025.101802","url":null,"abstract":"<div><div>Although childhood adversity's long-term effects on health are well recognized, few studies examine how community-level conditions shape the relationships between adverse childhood experiences (ACEs) and social risk and health outcomes in adulthood. Understanding these relationships can inform targeted, place-based interventions to improve health and social risk outcomes decades after ACEs exposure. This study explored how neighborhood socioeconomic contexts influence the relationships between childhood adversity and adulthood social risk and health outcomes. Using data from the 2021 California Health Interview Survey (CHIS), we analyzed a sample of 18,612 adults, representative of California's adult population. The Karlson-Holm-Breen (KHB) method decomposed childhood adversity's effects into direct and indirect effects mediated by neighborhood socioeconomic contexts in adulthood. Findings indicated higher ACE scores were associated with increased housing and food insecurity, and poorer self-rated health, particularly among individuals with four or more ACEs. The neighborhood socioeconomic context mediated a small but significant portion of the relationship between ACEs and the outcomes. Policy initiatives addressing ACEs should consider the importance of neighborhood contexts in addressing social risk and health outcomes.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"30 ","pages":"Article 101802"},"PeriodicalIF":3.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143890692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic connectivity and clustering: The influence of social connections on maternal and infant health","authors":"Tim A. Bruckner ,&nbsp;Samantha Gailey ,&nbsp;Brenda Bustos","doi":"10.1016/j.ssmph.2025.101794","DOIUrl":"10.1016/j.ssmph.2025.101794","url":null,"abstract":"<div><div>Recent influential work in the US finds that bridging capital (i.e., friendships across socioeconomic strata) appears to increase upward economic mobility over the life course. Examinations of the role of these social connections on health, however, remain relatively unexplored. We exploit a recent effort which made publicly available ZIP-level measures of bridging capital and bonding capital (i.e., depth of friend networks within the same stratum) using Facebook information on &gt;70 million Americans. We test in California (8 million births; California Birth Cohort File 2005 to 2021) the relation between ZIP-level social connections and a wide range of maternal and infant health outcomes, including fetal and infant death, birthweight, preterm birth, pre-pregnancy smoking, and body mass index. Generalized estimating equation methods controlled for individual-level covariates as well as spatial clustering of observations. Findings indicate strong protective associations between bridging capital and the risk of fetal death, infant death, preterm birth, pre-conception maternal smoking, maternal body mass index, and infant birthweight. These protective associations are much greater in magnitude than other ZIP-level measures commonly used in the literature to assess economic and structural advantage. Bonding capital, however, appears detrimental for maternal pre-pregnancy smoking and body mass index. The potential of bridging ties (i.e., across socioeconomic strata) in promoting maternal and infant health should warrant much more scholarly consideration than it currently receives.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"30 ","pages":"Article 101794"},"PeriodicalIF":3.6,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143844730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Double vulnerability? Examining the effect of living in nonmetropolitan areas within non-expansion Medicaid states on health status among working-age adults in the United States, 2022–2024","authors":"Michael D. Segovia ,&nbsp;P. Johnelle Sparks ,&nbsp;Alexis R. Santos-Lozada","doi":"10.1016/j.ssmph.2025.101798","DOIUrl":"10.1016/j.ssmph.2025.101798","url":null,"abstract":"<div><h3>Objective</h3><div>To examine whether living in nonmetropolitan areas within a state that has not expanded Medicaid is associated with poor/fair self-reported health status among working-age adults in the United States.</div></div><div><h3>Methods</h3><div>We analyzed data from the 2022–2024 Current Population Survey (n = 220, 601, ages 25–64). Self-reported health was dichotomized as having reported poor/fair or good/very good/excellent health status. We produced a four-level measure of the overlap between residential and policy contexts indicating whether the respondent lived in a metropolitan or nonmetropolitan area within a state that had or had not expanded Medicaid coverage by 2023. Multilevel logistic regression models were fit to examine the association between our measure of residence-policy overlaps and poor/fair self-reported health status while accounting for individual and state-level characteristics.</div></div><div><h3>Results</h3><div>About 3.7 % of respondents resided in nonmetropolitan areas within non-expansion states. Approximately 11.4 % of respondents reported poor/fair self-reported health, with respondents living in nonmetropolitan areas within non-expansion states having the highest rates of poor/fair self-reported health status (18.1 %). Living in a nonmetropolitan area within non-expansion states was associated with higher odds of poor/fair self-reported health status for the overall population and by sex.</div></div><div><h3>Conclusion</h3><div>In this nationally representative and racially diverse sample, we found that individuals residing in nonmetropolitan areas in non-expansion Medicaid states were more likely to report poor/fair self-reported health status. This effect was present for the majority of the population subgroups. Our findings underscore the double vulnerability faced by populations living in these residence-policy overlaps and the need for targeted interventions.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"30 ","pages":"Article 101798"},"PeriodicalIF":3.6,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143808279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}