Annals of Epidemiology最新文献

{"title":"Examining bias due to method of follow-up for cancer incidence in a large U.S. cohort: Self-report versus registry linkage","authors":"Danping Liu ,&nbsp;Martha S. Linet ,&nbsp;Paul S. Albert ,&nbsp;Cato M. Milder ,&nbsp;Annelie M. Landgren ,&nbsp;Allison Iwan ,&nbsp;Lynn Penberthy ,&nbsp;Bruce H. Alexander ,&nbsp;Amy Berrington de González ,&nbsp;Cari M. Kitahara","doi":"10.1016/j.annepidem.2025.05.006","DOIUrl":"10.1016/j.annepidem.2025.05.006","url":null,"abstract":"<div><h3>Background</h3><div>Cancer incidence follow-up of many U.S. cohort studies relies on self-report due to the lack of a national cancer registry.</div></div><div><h3>Methods</h3><div>In the U.S. Radiologic Technologists (USRT) Study, cancer incidence has been captured via self-report approximately every 10 years between the mid-1980s and mid-2010s and via linkages with state cancer registries during 1999–2012. We compared associations of smoking and lung cancer (rapidly fatal) and body mass index and thyroid cancer (rarely fatal) according to method of cancer incidence follow-up: self-report versus registry-based. Simulation studies were performed to quantify bias and assess relative efficiency of cancer ascertainment methods.</div></div><div><h3>Results</h3><div>During 1999–2012, hazard ratio (HR) estimates were similar regardless of cancer follow-up method, although self-reported data yielded the widest confidence intervals (CIs). Simulation studies showed that registry data yielded the least-biased HRs. The usefulness of self-reported data depends mostly on its specificity: with perfect specificity, self-reported data led to nearly unbiased inference. However, with imperfect specificity, self-reported data resulted in 3–9 % bias and lower than nominal CI coverage.</div></div><div><h3>Conclusions</h3><div>These findings highlight the benefits of registry-based cancer incidence follow-up compared to self-report in contemporary U.S. cohort studies assuming high coverage by registries of the study population.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"107 ","pages":"Pages 44-50"},"PeriodicalIF":3.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Joint associations of physical activity and body mass index on the prevalence of hypertension among a nationally representative sample of 1.9 million U.S. adults: A cross-sectional study","authors":"David Abernethy ,&nbsp;Jason Bennie ,&nbsp;Toby Pavey","doi":"10.1016/j.annepidem.2025.05.002","DOIUrl":"10.1016/j.annepidem.2025.05.002","url":null,"abstract":"<div><h3>Purpose</h3><div>This study examines the joint associations of physical activity (PA) and body mass index (BMI) on the prevalence of hypertension in a nationally representative sample of 1.9 million U.S. adults.</div></div><div><h3>Methods</h3><div>Data were pooled from five U.S. Behavioural Risk Factor Surveillance System surveys from 2011 to 2019. Cross-sectional associations between self-reported PA and BMI status (independent variables) and hypertension (dependent variable) were analysed using Poisson log-linear regression with a robust-error variance, reported by adjusted prevalence ratios (APRs).</div></div><div><h3>Results</h3><div>Data was available for 1,909,597 individuals (≥18 years). Compared to normal weight, highly active individuals (reference category), there was an association with decreased PA, increased BMI and prevalence of hypertension. Adjusted prevalence ratios (APRs) ranged from APR= 1.05, 95 % CI= 1.05–1.05 (Non-Active, Normal Weight) to APR= 1.83, 95 % CI= 1.82–1.83 (Non-Active, Obesity Class III).</div></div><div><h3>Conclusion</h3><div>A high body mass and low levels of PA were associated with a substantially increased prevalence of hypertension. Being highly active was associated with minor differences in the prevalence of hypertension for individuals who were living with obesity; however, this association was not observed among those who were living with normal weight or overweight. Due to likely bias in this cross-sectional study, findings regarding PA should be replicated in longitudinal studies with objective measures. These findings nonetheless highlight the public health relevance of maintaining a healthy body weight in relation to hypertension prevalence and the importance of PA for weight loss and management.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"107 ","pages":"Pages 29-36"},"PeriodicalIF":3.3,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Within-partner concordance of hypertension and overweight/obesity among sexual minority couples","authors":"Samuel C.O. Opara ,&nbsp;Caitlin A. Moran ,&nbsp;Shivani A. Patel ,&nbsp;Anandi N. Sheth ,&nbsp;Sophia A. Hussen ,&nbsp;Jithin Sam Varghese","doi":"10.1016/j.annepidem.2025.05.004","DOIUrl":"10.1016/j.annepidem.2025.05.004","url":null,"abstract":"<div><h3>Purpose</h3><div>The role of partners on an individual's cardiometabolic risk status in same-sex relationships is underexplored to date, despite significant health disparities impacting sexual minority individuals. This study investigated cardiometabolic risk concordance in same-sex older adult couples in the United States.</div></div><div><h3>Methods</h3><div>We conducted a pooled analysis of seven study waves of the University of Michigan Health and Retirement Survey (2006–2019) and estimated concordance of hypertension and overweight/obesity among same-sex couples.</div></div><div><h3>Results</h3><div>Among 81 same-sex couples, we observed high concordance of hypertension and overweight/obesity among sexual minority male couples (39 couples, hypertension: 72.4 %, overweight/obesity: 64.2 %) and sexual minority female couples (42 couples, hypertension: 61.0 %, overweight/obesity: 35.6 %).</div></div><div><h3>Conclusions</h3><div>Our findings signify a need for longitudinal studies among same-sex couples to better characterize mechanisms of influence on partners’ cardiometabolic health, as well as a potential role for couple-level interventions targeting cardiometabolic risk.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"107 ","pages":"Pages 8-12"},"PeriodicalIF":3.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trajectories of food bank use among new users in Quebec, Canada: Evidence from the pathways study","authors":"Rajib Dey ,&nbsp;Federico Roncarolo ,&nbsp;Geneviève Mercille ,&nbsp;Mylene Riva ,&nbsp;Elsury J. Perez ,&nbsp;Rosanne Blanchet ,&nbsp;Mabel Carabali ,&nbsp;Caroline Adam ,&nbsp;Louise Potvin ,&nbsp;Marie-Pierre Sylvestre","doi":"10.1016/j.annepidem.2025.05.003","DOIUrl":"10.1016/j.annepidem.2025.05.003","url":null,"abstract":"<div><h3>Purpose</h3><div>This study describes trajectories of food bank (FB) use among new users in relation with change in food insecurity status.</div></div><div><h3>Methods</h3><div>The Pathways Study followed 1001 new FB users across four regions of Québec, Canada, over a two-year period, from September 2018 to January 2020. Participants reported past-month FB use in two consecutive interviews following a baseline assessment, leading to 24 consecutive measures of monthly FB use. Household food insecurity was measured using the Household Food Security Survey Module. Group-based trajectory analysis was used to identify trajectories of FB use.</div></div><div><h3>Results</h3><div>Six trajectories were identified, including chronic use (30 % of the sample), infrequent use (11 %), withdrawal after recruitment (22 %), fast withdrawal (14 %), slow withdrawal (15 %), and intermittent (8 %). Chronic FB usage was associated with lower education levels and rural residency, suggesting economic challenges and limited opportunities in such areas. About a third of FB users changed their status from food insecure at baseline to food secure at the end of follow-up.</div></div><div><h3>Conclusions</h3><div>These findings challenge the perception of FB users as a homogenous group and emphasize the need for tailored approaches to address food insecurity.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"107 ","pages":"Pages 1-7"},"PeriodicalIF":3.3,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144070838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining potential bystander presence for overdose deaths in Tennessee, 2019–2022","authors":"Jessica Korona-Bailey MPH ,&nbsp;Jenna Moses MPH ,&nbsp;Mircea Lazar PhD ,&nbsp;Kristi Hall MPH ,&nbsp;Sutapa Mukhopadhyay PhD","doi":"10.1016/j.annepidem.2025.05.005","DOIUrl":"10.1016/j.annepidem.2025.05.005","url":null,"abstract":"<div><h3>Objective</h3><div>To examine potential bystander presence in fatal drug overdoses in Tennessee by assessing the type of potential bystander, type of responses carried out, reasons for lack of response, and the sociodemographic characteristics of overdose decedents in Tennessee.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional study to examine potential bystander presence in overdose deaths in Tennessee using 2019–2022 data from the State Unintentional Drug Overdose Reporting System. Descriptive statistics were calculated to compare potential bystander presence by demographic breakdown of decedents, type of potential bystander, and reasons for no response.</div></div><div><h3>Results</h3><div>We identified 11,970 accidental and undetermined fatal drug overdoses in Tennessee from 2019 to 2022. A potential bystander was present in 24.8 % of deaths. Most potential bystanders were family members (27.4 %), intimate partners (26.5 %), or friends (21.1 %). Overall, potential bystanders called 911 or attempted another type of response in 94.5 % of overdose events. The most frequent reason for no response was being spatially separated from the decedent (34.2 %).</div></div><div><h3>Conclusions</h3><div>A quarter of drug overdose deaths in Tennessee had a potential bystander present who could have intervened. Continued education about how to identify and respond to an overdose as well as the availability of naloxone should be delivered to potential bystanders. Future qualitative studies should assess bystander knowledge and barriers to responding. Messaging should also encourage people who use substances to avoid using alone, given that most overdose deaths occurred without a bystander present</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"107 ","pages":"Pages 13-19"},"PeriodicalIF":3.3,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality from cardiovascular disease subtypes among Asian groups in the United States","authors":"Nilay S. Shah MD, MPH ,&nbsp;Xin Tong MPH ,&nbsp;Fleetwood Loustalot PhD ,&nbsp;Rebecca C. Woodruff PhD, MPH","doi":"10.1016/j.annepidem.2025.05.001","DOIUrl":"10.1016/j.annepidem.2025.05.001","url":null,"abstract":"<div><h3>Purpose</h3><div>To characterize contemporary mortality for detailed cardiovascular disease (CVD) subtypes in individual Asian populations in the US.</div></div><div><h3>Methods</h3><div>With vital statistics for non-Hispanic Asian decedents aged ≥ 18 years (overall and individual ethnic groups), age-standardized mortality rates (ASMR) were calculated for ischemic heart disease, cerebrovascular disease, heart failure, arrhythmia, hypertensive heart disease, valvular heart disease, and pulmonary heart disease, with rate ratios for subtype ASMR in individual Asian groups relative to the Asian group overall.</div></div><div><h3>Results</h3><div>During 2018–2022, 123,566 CVD deaths occurred in Asian adults overall (15 % Asian Indian; 24 % Chinese; 20 % Filipino; 12 % Japanese; 8 % Korean; 10 % Vietnamese). Filipino adults had higher ASMR than Asian adults overall for all CVD subtypes. Asian Indian adults had higher ASMR than Asian adults overall for all CVD subtypes except valvular heart disease and cerebrovascular disease. Japanese adults had higher ASMR than Asian adults overall for heart failure and valvular heart disease. Vietnamese adults had a higher cerebrovascular disease ASMR than Asian adults overall. Chinese adults and Korean adults had ASMRs that were similar to or lower than Asian adults overall for all CVD subtypes.</div></div><div><h3>Conclusions</h3><div>CVD ASMRs for Asian adults in aggregate obscures important variability across individual Asian groups.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"106 ","pages":"Pages 82-87"},"PeriodicalIF":3.3,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between screening history and prognosis of cervical carcinoma in situ and invasive cervical cancer: A population-based cohort study","authors":"Chiung-Shuan Huang MS ,&nbsp;Bo-Yu Hsiao PhD ,&nbsp;Mei-Hsuan Wu PhD ,&nbsp;Chun-Ju Chiang PhD ,&nbsp;Pei-Chun Hsieh MS ,&nbsp;Mei-Ju Chen MS ,&nbsp;Wen-Fang Cheng MD, PhD ,&nbsp;Wen-Chung Lee MD, PhD","doi":"10.1016/j.annepidem.2025.04.015","DOIUrl":"10.1016/j.annepidem.2025.04.015","url":null,"abstract":"<div><h3>Background</h3><div>Cervical cancer remains a significant public health challenge worldwide. This study examines the impact of screening history on the prognosis of cervical carcinoma in situ and invasive cervical cancer among Taiwanese women.</div></div><div><h3>Methods</h3><div>Data from the National Cervical Cancer Screening Registry and Taiwan Cancer Registry were analyzed, encompassing 13,552 cases of cervical carcinoma in situ and 6853 cases of invasive cervical cancer diagnosed between 2009 and 2013. The study examined the relationship between screening history and five-year cumulative probability of death using the Kaplan-Meier method and Cox regression model, adjusting for factors like age, cancer stage, histological type, urbanization level, and treatment received.</div></div><div><h3>Results</h3><div>Screening history was an independent prognostic factor for both invasive cervical cancer and cervical carcinoma in situ, even after adjusting for key confounders. Compared to patients diagnosed within six months of a positive screening result, those diagnosed later or with a negative screening had higher post-diagnosis mortality (adjusted hazard ratios [95 % confidence interval]: 1.42 [1.26–1.59] for invasive cervical cancer and 1.74 [0.52–5.83] for cervical carcinoma in situ), while never-screened patients had even higher mortality (1.61 [1.42–1.81] for invasive cervical cancer and 5.62 [1.29–24.51] for cervical carcinoma in situ). More advanced age at diagnosis, certain histological types, and living in less urbanized areas correlated with an increased risk of post-diagnosis death. Additionally, the absence of treatment post-diagnosis was significantly associated with worse outcomes.</div></div><div><h3>Conclusion</h3><div>Screening history is a crucial independent prognostic factor for cervical carcinoma in situ and invasive cervical cancer. Patients with a recent positive screening result have a markedly better prognosis than those diagnosed later, those with negative screenings, or unscreened individuals. This study emphasizes the importance of regular and timely cervical cancer screenings in improving prognosis and underscores the need to enhance awareness and accessibility of screening programs.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"106 ","pages":"Pages 75-81"},"PeriodicalIF":3.3,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143923925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating the population need for preexposure prophylaxis for HIV in the United States","authors":"Athena P. Kourtis ,&nbsp;Jeffrey Wiener ,&nbsp;Weiming Zhu ,&nbsp;Minttu M. Rönn ,&nbsp;Joshua Salomon ,&nbsp;Ya-Lin A. Huang ,&nbsp;Cynthia Lyles ,&nbsp;Rupa R. Patel ,&nbsp;Karen W. Hoover ,&nbsp;Robyn Neblett Fanfair ,&nbsp;Jonathan Mermin","doi":"10.1016/j.annepidem.2025.04.017","DOIUrl":"10.1016/j.annepidem.2025.04.017","url":null,"abstract":"<div><div>Preexposure prophylaxis (PrEP) is highly effective in preventing HIV infections and is recommended for people without HIV who are at ongoing risk of HIV acquisition. In 2019, the U.S. launched the “Ending the HIV Epidemic in the U.S.” initiative, which aims to reduce by 90 % the number of annual new HIV infections. To monitor progress towards this goal, several national indicators have been established, one of which is PrEP coverage. Several ways to monitor PrEP use have been developed, each with its own advantages and disadvantages. We developed a method to estimate PrEP “need” in the U.S. that could be used as a denominator to estimate PrEP coverage. The “population need for PrEP” (PPN) is estimated based on the number of people needed to treat (NNT) with PrEP to prevent an additional HIV infection in subpopulations whose annual HIV incidence is ≥ 1 %. This is done in three steps: 1) calculating NNT for each transmission group using 1 % incidence threshold and clinical trial-and cohort-generated evidence of the degree of PrEP effectiveness in each transmission group, 2) estimating the proportion of new HIV infections in subpopulations with incidence at least 1 % from epidemiologic data, 3) multiplying estimates from steps 1 and 2 with the number of new HIV infections for each transmission group from Surveillance. The estimates for each transmission group are then added together, and the number of current PrEP users is finally added to this estimate to produce PPN. This method is relatively easy to calculate and can provide public health authorities at the national, state, or local level with pragmatic estimates of PrEP “need” among different demographic or transmission groups, which can help with planning, resource allocation, and monitoring progress.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"106 ","pages":"Pages 48-54"},"PeriodicalIF":3.3,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143913022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial disparity in Non-Hodgkin Lymphoma: Parallel survival analysis with data from the DoD central cancer registry and SEER","authors":"Jie Lin ,&nbsp;Alexander A. Dew ,&nbsp;Craig D. Shriver ,&nbsp;Kangmin Zhu","doi":"10.1016/j.annepidem.2025.04.016","DOIUrl":"10.1016/j.annepidem.2025.04.016","url":null,"abstract":"<div><h3>Purpose</h3><div>Barriers to health care access may contribute to the poorer survival of Black patients with Non-Hodgkin Lymphoma (NHL) than their White counterparts in the U.S. general population. The Department of Defense’s (DoD) Military Health System (MHS) provides universal or equal health care access to all its beneficiaries. This study compared overall survival of NHL patients by race in the MHS and U.S. general population, respectively, and aimed to provide evidence on the role of universal health care in reducing racial disparity.</div></div><div><h3>Methods</h3><div>The MHS Patients were identified from the DoD’s Central Cancer Registry (CCR) and the patients from the U.S. general population were identified from the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) program. A retrospective cohort study was conducted comparing survival of major NHL subtypes by race in the CCR and the SEER cohorts, respectively.</div></div><div><h3>Results</h3><div>Non-Hispanic Black patients and Non-Hispanic White patients in the CCR cohort had similar survival in Cox regression models sequentially adjusted for different sets of confounders. The hazard ratios (HRs) and 95 % confidence intervals (CIs) comparing Black to White patients for diffuse large B-cell lymphoma (DLBCL), chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), and other NHLs were 1.25 (0.89–1.78), 0.74 (0.39–1.42), and 1.25 (0.89–1.77) in the full models, respectively. In contrast, Black patients in the SEER cohort exhibited significantly worse survival than White patients in all models adjusting for the same sets of confounders. The HRs were 1.46 (95 % CI= 1.40–1.52), 1.57 (95 % CI=1.48–1.67), and 1.61 (95 % CI=1.54–1.68) in the full models for DLBCL, CLL/SLL and other NHL, respectively.</div></div><div><h3>Conclusions</h3><div>Our study supported universal access to health care as an important factor in reducing survival racial disparity among NHL patients.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"106 ","pages":"Pages 67-74"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in all-cause mortality between urban and rural areas based on the intensity of long-term social isolation: Findings from 17-year retrospective cohort study","authors":"Jeong Min Yang ,&nbsp;Jieun Hwang ,&nbsp;Yookyung Boo PhD","doi":"10.1016/j.annepidem.2025.04.014","DOIUrl":"10.1016/j.annepidem.2025.04.014","url":null,"abstract":"<div><h3>Purpose</h3><div>Social Isolation (SI) can lead to differentiated outcomes between urban and rural areas. However, the understanding of its impact remains insufficient. Therefore, this study aimed to identify the differences in mortality risk of SI Trajectories (SIT) between urban and rural areas.</div></div><div><h3>Methods</h3><div>This study included 6284 participants from the Korea Longitudinal Study of Aging. Propensity Score Matching was utilized to match the characteristics between urban and rural participants. Using Trajectory analysis, SIT was classified from 2006 to 2012, and the association with all-cause mortality was investigated through Cox-proportional hazard model from 2013 to 2022.</div></div><div><h3>Results</h3><div>Five SIT types were identified in both urban and rural areas. In urban areas, Ascending (Hazard Ratio [HR]: 1.89, p: 0.033), Mild (HR: 1.86, p: 0.013), and Severe SIT (HR: 2.58, p: 0.000) were significantly associated with all-cause mortality, whereas Descending SIT was not. In rural areas, Ascending (HR: 1.42, p: 0.035), Moderate (HR: 1.59, p: 0.005), and Severe SIT (HR: 1.67, p: 0.005) had higher HR Compared to Non-SIT. A stratified analysis showed a strong association in urban areas for males and those aged ≤ 64, and in rural areas for females and those aged ≥ 65.</div></div><div><h3>Conclusion</h3><div>Based on the differences in SIT between urban and rural areas, future policies should develop specific indicators for managing SI and create tailored regional policies to reduce mortality.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"106 ","pages":"Pages 55-66"},"PeriodicalIF":3.3,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143913023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}