Ssm-Population Health最新文献

{"title":"The potential of early years’ childcare to reduce mental health inequalities of school age children in Scotland","authors":"Elaine Robertson,&nbsp;Alastair Leyland,&nbsp;Anna Pearce","doi":"10.1016/j.ssmph.2024.101682","DOIUrl":"10.1016/j.ssmph.2024.101682","url":null,"abstract":"<div><p>Preschool childcare is considered an important policy for reducing inequalities in children's cognitive and socio-emotional development, although the population-level benefits for children under three years, is less clear. We examined the potential for childcare across the whole early years' period to benefit mental health and reduce inequalities, under different hypothetical policy scenarios, in the Growing Up in Scotland study.</p><p>Marginal structural logistic regression models estimated odds ratios (ORs) to quantify inequalities in mental health and consider how these would be altered under different hypothetical scenarios. Mental health (the outcome) was measured using the total Strengths and Difficulties Questionnaire score at the start of primary school. Socioeconomic circumstances (the exposure) were represented by maternal educational measured in infancy. Sequence analysis identified common patterns of childcare usage from 10 months to four years (the mediator). Confounders were adjusted for using inverse probability of treatment weights and analyses accounted for sampling design and attrition (complete case sample, <em>n</em> = 3205).</p><p>With virtually universal uptake of government-funded childcare at 3–4 years, most variation was seen before age three. Four groups were identified: ‘Parents, family &amp; friends’ (35.8%), ‘Grandparents’ (32.7%), ‘Private group childcare’ (e.g. nurseries 23.5%), ‘Single professional care’ (e.g. childminders 8.1%). Children whose mothers had low, compared to high, educational qualifications were 3.18 times more likely to have mental health problems (95% CI: 1.88–5.37). In a hypothetical scenario where everyone received private group childcare, inequalities increased slightly to 3.78 (95%CI: 1.46–9.76). In an alternative scenario, where everyone received single professional childcare, inequalities in mental health reduced to 2.42 (95% CI: 0.20–28.76), albeit with wide confidence intervals.</p><p>Universal childcare provision before three years may widen or narrow socioeconomic inequalities in children's mental health, depending on the childcare type provided. Further research is required to understand the role of childcare quality, which we were unable to account for.</p></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"26 ","pages":"Article 101682"},"PeriodicalIF":4.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352827324000831/pdfft?md5=9e0439bf2d9dcc37be2ba111655cc795&pid=1-s2.0-S2352827324000831-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141130845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Health disparities in past influenza pandemics: A scoping review of the literature” [SSM – Population Health (2023) 21C 101314]","authors":"Angela D'Adamo ,&nbsp;Alina Schnake-Mahl ,&nbsp;Pricila H. Mullachery ,&nbsp;Mariana Lazo ,&nbsp;Ana V. Diez Roux ,&nbsp;Usama Bilal","doi":"10.1016/j.ssmph.2023.101516","DOIUrl":"10.1016/j.ssmph.2023.101516","url":null,"abstract":"","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"26 ","pages":"Article 101516"},"PeriodicalIF":4.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352827323001817/pdfft?md5=32925f0d6ad909e7f6c50b67ea8a3398&pid=1-s2.0-S2352827323001817-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135347606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An evolution of socioeconomic inequalities in self-rated health in Korea: Evidence from Korea National Health and Nutrition Examination Survey (KNHANES) 1998–2018","authors":"Daseul Moon ,&nbsp;Roman Pabayo ,&nbsp;Jongnam Hwang","doi":"10.1016/j.ssmph.2024.101689","DOIUrl":"https://doi.org/10.1016/j.ssmph.2024.101689","url":null,"abstract":"<div><p>Reducing socioeconomic inequalities in health has become an important health policy agenda. This study aimed to measure socioeconomic inequalities in health in Korea over the past two decades and identify the contributing factors to the observed inequalities. Data from the Korea National Health and Nutrition Examination Survey (KNHANES) from 1998 to 2016/2018 were utilized. The concentration index (CI) was calculated to measure health inequalities, and decomposition analysis was applied to identify and quantify the contributing factors to the observed inequalities in health. The results indicated that health inequalities exist, suggesting that poor health was consistently more concentrated among Korean adults with lower income (1998: −0.154; 2016/2018: −0.152). Gender-stratified analyses also showed that poor health was more concentrated in lower income women and men, with the degree of inequalities slightly more pronounced among women. The decomposition approach revealed that income and educational attainment were the largest contributors to the observed health inequalities as higher income and education associated with better self-rated health. These findings suggest the importance of considering socioeconomic determinants, such as income and education, in efforts to tackling health inequalities, particularly considering that self-rated health is a predictor of future mortality and morbidity. Furthermore, it is essential to implement more egalitarian social, labour market, and health policies in order to eliminate the existing socioeconomic inequalities in health in Korea.</p></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"26 ","pages":"Article 101689"},"PeriodicalIF":4.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352827324000909/pdfft?md5=e2139052f4e5713606bd2a0649e5e17b&pid=1-s2.0-S2352827324000909-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141302584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between parenthood and health: A comparison of people in same-sex and different-sex relationships","authors":"Yuxuan Jin ,&nbsp;Deni Mazrekaj","doi":"10.1016/j.ssmph.2024.101685","DOIUrl":"https://doi.org/10.1016/j.ssmph.2024.101685","url":null,"abstract":"<div><p>Understanding social inequalities in parental health is crucial for family functioning and child development. Theoretically, the double burden of parenting and minority stress may lead to the negative association between parenthood and health outcomes being stronger for people in same-sex relationships. Moreover, drawn from the social control process and the compensation mechanism, the negative association between parenthood and health risk behaviors may become stronger for people in same-sex relationships. Yet, empirical evidence on parental health disparities between parents in same- and different-sex relationships is limited. Using linear and logistic regression models, coarsened exact matching, and entropy balancing on Dutch data between 2008 and 2021 (196 people in same-sex relationships and 6948 people in different-sex relationships), we investigate the relationship between parenthood and three health outcomes (self-rated health, physical health, and mental health) and two health risk behaviors (smoking and heavy episodic drinking). We find that parents on average are less likely to experience heavy episodic drinking than non-parents. The association between parenthood and health does not differ between people in same-sex and different-sex relationships.</p></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"26 ","pages":"Article 101685"},"PeriodicalIF":4.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352827324000867/pdfft?md5=68bab0b17f8e56b1f0cb7a573b14e773&pid=1-s2.0-S2352827324000867-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141244008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Formative reasons for state-to-state influences on firearm acquisition in the U.S.","authors":"","doi":"10.1016/j.ssmph.2024.101680","DOIUrl":"10.1016/j.ssmph.2024.101680","url":null,"abstract":"<div><h3>Objectives</h3><p>Firearm-related crimes and self-inflicted harms pose a significant threat to the safety and well-being of Americans. Investigation of firearm prevalence in the United States (U.S.) has therefore been a center of attention. A critical aspect in this endeavor is to explain whether there are identifiable patterns in firearm acquisition.</p></div><div><h3>Methods</h3><p>We view firearm acquisition patterning as a spatio-temporal dynamical system distributed across U.S. states that co-evolves with crime rates, political ideology, income levels, population, and the legal environment. We leverage transfer entropy and exponential random graph models along with publicly available data, to statistically reveal the formative factors in how each state’s temporal patterning of firearm acquisition influences other states.</p></div><div><h3>Results</h3><p>Results help to explain how and why U.S. states influence each other in their firearm acquisition. We establish that state-to-state influences, or lack thereof, in firearm acquisition patterning are explained by states’ percent of gun homicide, firearm law strictness, geographic neighborhood, and citizen ideology. Network-based characteristics, namely, mutuality and transitivity, are also important to explain such influence.</p></div><div><h3>Conclusions</h3><p>Results suggest that state policies or programs that reduce gun homicides will also help suppress that state’s influence on the patterning of firearm acquisition in other states. Furthermore, states with stricter firearm laws are more likely to influence firearm acquisition in other states, but are themselves shielded from the effects of other states’ firearm acquisition patterns. These results inform future research in public health, criminology, and policy making.</p></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"27 ","pages":"Article 101680"},"PeriodicalIF":3.6,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352827324000818/pdfft?md5=f7dae715e2dfeb5132da1dca23d4a958&pid=1-s2.0-S2352827324000818-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141140218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individual and regional differences in the effects of school racial segregation on Black students’ health","authors":"Gabriel L. Schwartz ,&nbsp;Guangyi Wang ,&nbsp;Min Hee Kim ,&nbsp;M. Maria Glymour ,&nbsp;Justin S. White ,&nbsp;Daniel Collin ,&nbsp;Rita Hamad","doi":"10.1016/j.ssmph.2024.101681","DOIUrl":"https://doi.org/10.1016/j.ssmph.2024.101681","url":null,"abstract":"<div><h3>Background</h3><p>School racial segregation in the US has risen steadily since the 1990s, propelled by Supreme Court decisions rolling back the legacy of <em>Brown v. Board</em>. Quasi-experimental research has shown this resegregation harms Black students' health. However, whether individual or family characteristics (e.g., higher family incomes) are protective against segregation's health harms—or whether segregation is more damaging in regions of the US with fewer public sector investments—remains unclear. We leverage the quasi-random timing of school districts being released from <em>Brown</em>-era integration plans to examine heterogeneity in the association between resegregation and Black students' health.</p></div><div><h3>Methods &amp; findings</h3><p>We took an instrumental variables approach, using the timing of integration order releases as an instrument for school segregation and analyzing a pre-specified list of theoretically-motivated modifiers in the Panel Study of Income Dynamics. In sensitivity analyses, we fit OLS models that directly adjusted for relevant covariates. Results suggest resegregation may have been particularly harmful in the South, where districts resegregated more quickly after order releases. We find little evidence that the effects of school segregation differed across family income, gender, or age.</p></div><div><h3>Conclusion</h3><p>The end of court-ordered integration threatens the health of Black communities—especially in the US South. Modestly higher incomes do not appear protective against school segregation's harms. Research using larger samples and alternative measures of school segregation—e.g., between districts, instead of within districts—may further our understanding of segregation's health effects, especially in Northern states.</p></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"26 ","pages":"Article 101681"},"PeriodicalIF":4.7,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S235282732400082X/pdfft?md5=0ef73b4e72dfd1a66438d92565e763da&pid=1-s2.0-S235282732400082X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141097333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the cultural influence on online stances towards COVID-19 preventive measures and their impact on incidence and mortality: A global stance detection analysis of tweets","authors":"Wen Shan ,&nbsp;Jovan Chew Yu Quan ,&nbsp;Zhengkui Wang ,&nbsp;Anurag Sharma ,&nbsp;Aik Beng Ng ,&nbsp;Simon See","doi":"10.1016/j.ssmph.2024.101679","DOIUrl":"https://doi.org/10.1016/j.ssmph.2024.101679","url":null,"abstract":"<div><p>During the COVID-19 pandemic, nations implemented various preventive measures, triggering varying online responses. This study examines cultural influences on public online stances toward these measures and their impacts on COVID-19 cases/deaths. Stance detection analysis was used to analyze 16,428,557 Tweets regarding COVID-19 preventive measures from 95 countries, selected based on Hofstede's cultural dimensions. To ensure the variety of population, countries were chosen based on Twitter data availability and a minimum sample size of 385 tweets, achieving a 95% confidence level with a 5% margin of error. The weighted regression analysis revealed that the relationship between culture and online stances depends on the cultural congruence of each measure. Specifically, power distance positively predicted stances for all measures, while indulgence had a negative effect overall. Effects of other cultural indices varied across measures. Individualism negatively affected face coverings stances. Uncertainty avoidance influenced lockdown and vaccination stances negatively but had a positive effect on social distancing stances. Long-term orientation negatively affected lockdown and social distancing stances but positively influenced quarantine stances. Cultural tightness only negatively affected face coverings and quarantine stances. Online stances toward face coverings mediated the relationship between cultural indices and COVID-19 cases/deaths. As such, public health officials should consider cultural profiles and use culturally congruent communication strategies when implementing preventive measures for future pandemics. Furthermore, leveraging digital tools is vital in navigating and shaping online stances to enhance the effectiveness of these measures.</p></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"26 ","pages":"Article 101679"},"PeriodicalIF":4.7,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352827324000806/pdfft?md5=c241ae3cbed3d743fd71895bda5daeb3&pid=1-s2.0-S2352827324000806-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140948013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI-Enhanced evaluation of YouTube content on post-surgical incontinence following pelvic cancer treatment","authors":"Alvaro Manuel Rodriguez-Rodriguez ,&nbsp;Marta De la Fuente-Costa ,&nbsp;Mario Escalera-de la Riva ,&nbsp;Borja Perez-Dominguez ,&nbsp;Gustavo Paseiro-Ares ,&nbsp;Jose Casaña ,&nbsp;Maria Blanco-Diaz","doi":"10.1016/j.ssmph.2024.101677","DOIUrl":"https://doi.org/10.1016/j.ssmph.2024.101677","url":null,"abstract":"<div><h3>Background</h3><p>Several pelvic area cancers exhibit high incidence rates, and their surgical treatment can result in adverse effects such as urinary and fecal incontinence, significantly impacting patients' quality of life. Post-surgery incontinence is a significant concern, with prevalence rates ranging from 25 to 45% for urinary incontinence and 9–68% for fecal incontinence. Cancer survivors are increasingly turning to YouTube as a platform to connect with others, yet caution is warranted as misinformation is prevalent.</p></div><div><h3>Objective</h3><p>This study aims to evaluate the information quality in YouTube videos about post-surgical incontinence after pelvic area cancer surgery.</p></div><div><h3>Methods</h3><p>A YouTube search for \"<em>Incontinence after cancer surgery</em>\" yielded 108 videos, which were subsequently analyzed. To evaluate these videos, several quality assessment tools were utilized, including DISCERN, GQS, JAMA, PEMAT, and MQ-VET. Statistical analyses, such as descriptive statistics and intercorrelation tests, were employed to assess various video attributes, including characteristics, popularity, educational value, quality, and reliability. Also, artificial intelligence techniques like PCA, t-SNE, and UMAP were used for data analysis. HeatMap and Hierarchical Clustering Dendrogram techniques validated the Machine Learning results.</p></div><div><h3>Results</h3><p>The quality scales presented a high level of correlation one with each other (<em>p</em> &lt; 0.01) and the Artificial Intelligence-based techniques presented clear clustering representations of the dataset samples, which were reinforced by the Heat Map and Hierarchical Clustering Dendrogram.</p></div><div><h3>Conclusions</h3><p>YouTube videos on \"<em>Incontinence after Cancer Surgery</em>\" present a \"<em>High</em>\" quality across multiple scales. The use of AI tools, like PCA, t-SNE, and UMAP, is highlighted for clustering large health datasets, improving data visualization, pattern recognition, and complex healthcare analysis.</p></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"26 ","pages":"Article 101677"},"PeriodicalIF":4.7,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352827324000788/pdfft?md5=887685caf3578fea52fd95dedb4380e9&pid=1-s2.0-S2352827324000788-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140906728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of lifestyles and multimorbidity with mortality among individuals aged 60 years or older: Two prospective cohort studies","authors":"Jianfeng Zhong ,&nbsp;Lianhong Chen ,&nbsp;Chengping Li ,&nbsp;Jing Li ,&nbsp;Yingying Niu ,&nbsp;Xuerui Bai ,&nbsp;Huiyan Wen ,&nbsp;Zhiquan Diao ,&nbsp;Haoyu Yan ,&nbsp;Miao Xu ,&nbsp;Wenqi Huang ,&nbsp;Zhitong Xu ,&nbsp;Xiaofeng Liang ,&nbsp;Dan Liu","doi":"10.1016/j.ssmph.2024.101673","DOIUrl":"https://doi.org/10.1016/j.ssmph.2024.101673","url":null,"abstract":"<div><p>Lifestyles are associated with all-cause mortality, yet limited research has explored the association in the elderly population with multimorbidity. We aim to investigate the impact of adopting a healthy lifestyle on reducing the risk of all-cause mortality in older individuals with or without multimorbidity in both China and UK. This prospective study included 29,451 and 173,503 older adults aged 60 and over from Chinese Longitudinal Healthy Longevity Survey (CLHLS) and UK Biobank. Lifestyles and multimorbidity were categorized into three groups, respectively. Cox proportional hazards regression was used to estimate the Hazard Ratios (HRs), 95% confidence intervals (95% CIs), and dose-response for all-cause mortality in relation to lifestyles and multimorbidity, as well as the combination of both factors. During a mean follow-up period of 4.7 years in CLHLS and 12.14 years in UK Biobank, we observed 21,540 and 20,720 deaths, respectively. For participants with two or more conditions, compared to those with an unhealthy lifestyle, adopting a healthy lifestyle was associated with a 27%–41% and 22%–42% reduction in mortality risk in the CLHLS and UK Biobank, respectively; Similarly, for individuals without multimorbidity, this reduction ranged from 18% to 41%. Among participants with multimorbidity, individuals with an unhealthy lifestyle had a higher mortality risk compared to those maintaining a healthy lifestyle, with HRs of 1.15 (95% CI: 1.00, 1.32) and 1.27 (95% CI: 1.16, 1.39) for two conditions, and 1.24 (95% CI: 1.06, 1.45) and 1.73 (95% CI: 1.56, 1.91) for three or more conditions in CLHLS and UK Biobank, respectively. Adherence to a healthy lifestyle can yield comparable mortality benefits for older individuals, regardless of their multimorbidity status. Furthermore, maintaining a healthy lifestyle can alleviate the mortality risks linked to a higher number of diseases.</p></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"26 ","pages":"Article 101673"},"PeriodicalIF":4.7,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352827324000740/pdfft?md5=2b22795d4ad4d788acac97218d7555ec&pid=1-s2.0-S2352827324000740-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140918072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethno-racial differences in anxiety and depression impairment among emerging adults in higher education","authors":"Hans Oh ,&nbsp;Trevor A. Pickering ,&nbsp;Connor Martz ,&nbsp;Karen D. Lincoln ,&nbsp;Joshua Breslau ,&nbsp;David Chae","doi":"10.1016/j.ssmph.2024.101678","DOIUrl":"https://doi.org/10.1016/j.ssmph.2024.101678","url":null,"abstract":"<div><h3>Background</h3><p>Despite having higher exposure to stressors, many ethno-racial groups report similar or lower prevalence of clinical depression and anxiety compared to their White counterparts, despite experiencing greater psychosocial risk factors for poor mental health outcomes, thus presenting an epidemiological paradox. Ethno-racial differences in impairment, a diagnostic criterion, may in part explain this paradox.</p></div><div><h3>Methods</h3><p>We analyzed data from the Healthy Minds Study (2020–2021) and using survey-weighted linear mixed effects models, we tested whether there were ethno-racial differences in impairment across multiple ethno-racial groups at various levels of severity for anxiety and depression.</p></div><div><h3>Results</h3><p>Black students reported lower mean impairment scores relative to White students at moderate and severe anxiety. Hispanic/Latine students only reported lower impairment relative to White students at severe anxiety. Asian students reported relatively lower mean impairment than White students at mild anxiety, and this difference continued to grow as anxiety severity increased. Similar trends were observed for depression. Black and Hispanic/Latino students reported lower mean impairment scores at moderate to severe depression. Asian students reported lower mean impairment scores beginning at mild depression to severe depression.</p></div><div><h3>Conclusion</h3><p>Self-reported anxiety and depression related impairment varies by ethno-racial group, with Black, Hispanic/Latinx, and Asian students reporting lower impairment compared to White students at higher levels of symptom severity. These findings open the possibility that racial differences in the impairment criterion of clinical diagnoses may explain some of the racial paradox.</p></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"26 ","pages":"Article 101678"},"PeriodicalIF":4.7,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S235282732400079X/pdfft?md5=2ff3b7e269ab1c4dbb344da4bd1e8b97&pid=1-s2.0-S235282732400079X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140821987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}