American Journal of Preventive Medicine最新文献

{"title":"Hormones, Stress, and Heart Disease in Transgender Women with HIV in LITE Plus","authors":"Tonia C. Poteat PhD, PA-C ,&nbsp;Molly Ehrig MB ,&nbsp;Hedyeh Ahmadi PhD ,&nbsp;Mannat Malik MHS ,&nbsp;Sari L. Reisner ScD ,&nbsp;Asa E. Radix MD, PhD ,&nbsp;Jowanna Malone PhD ,&nbsp;Christopher Cannon MPH ,&nbsp;Carl G. Streed Jr. MD, MPH ,&nbsp;Mabel Toribio MD ,&nbsp;Christopher Cortina MS ,&nbsp;Ashleigh Rich PhD ,&nbsp;Kenneth H. Mayer MD ,&nbsp;L. Zachary DuBois PhD ,&nbsp;Robert-Paul Juster PhD ,&nbsp;Andrea L. Wirtz PhD ,&nbsp;Krista M. Perreira PhD","doi":"10.1016/j.amepre.2024.10.001","DOIUrl":"10.1016/j.amepre.2024.10.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Cardiovascular disease (CVD) is a leading cause of death among transgender women and people with HIV. Exogenous estrogen and psychosocial stressors are known risk factors for CVD. Yet, few studies have used biomarkers to examine the role of stress in CVD risk among transgender women with HIV (TWHIV). This analysis examined whether stress moderates relationships between gender-affirming hormone therapy (GAHT) duration and CVD risk among TWHIV.</div></div><div><h3>Methods</h3><div>This cross-sectional analysis of baseline data from an observational cohort of 108 Black and Latina TWHIV in Boston, New York, and Washington, DC, enrolled December 2020 to June 2022, measured sociodemographics, medical diagnoses, medications, smoking history, and perceived stress via interviewer-administered surveys. Physiological stress was measured with 14 biomarkers to calculate allostatic load indices (ALI). Forty participants provided saliva samples used to calculate cortisol awakening response and cortisol daily decline. The 2018 American College of Cardiology Revised Pooled Cohort Equation estimated 10-year CVD risk. Data were analyzed in 2024.</div></div><div><h3>Results</h3><div>GAHT duration was positively associated with CVD risk scores in bivariate regression. In multivariable linear regression models (adjusting for age, income, education), only age and ALI remained significantly associated with CVD risk scores (<em>β</em> 1.13, CI: 1.05, 1.21). No stress measure significantly interacted with GAHT duration to affect CVD risk scores. In visual plots, GAHT duration increased CVD risk scores only for TWHIV experiencing the highest ALI.</div></div><div><h3>Conclusions</h3><div>Stress plays an important role in CVD in TWHIV. More research is needed on non-GAHT factors, which influence CVD health among transgender women.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"68 2","pages":"Pages 245-256"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401872","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":"Factors Associated With Mental Healthcare Utilization Among United States Military Personnel With Posttraumatic Stress Disorder or Depression Symptoms","authors":"Neika Sharifian PhD ,&nbsp;Cynthia A. LeardMann MPH ,&nbsp;Claire A. Kolaja MPH ,&nbsp;Anna Baccetti MPH ,&nbsp;Felicia R. Carey PhD ,&nbsp;Sheila F. Castañeda PhD ,&nbsp;Charles W. Hoge MD ,&nbsp;Rudolph P. Rull PhD ,&nbsp;Millennium Cohort Study Team","doi":"10.1016/j.amepre.2024.10.006","DOIUrl":"10.1016/j.amepre.2024.10.006","url":null,"abstract":"<div><h3>Introduction</h3><div>Although posttraumatic stress disorder (PTSD) and depression are prominent mental health conditions affecting United States service members, only a subset of individuals with these conditions utilize mental healthcare services. Identifying factors associated with mental healthcare utilization may elucidate military subgroups with unmet mental healthcare needs.</div></div><div><h3>Methods</h3><div>Cross-sectional survey data from the 2019–2021 Millennium Cohort Study assessment were used to examine correlates of unmet mental healthcare needs among military personnel who screened positive for PTSD or depression symptoms (<em>n</em>=18,420) using modified Poisson regression models. Data analyses for this study were conducted between 2023 and 2024.</div></div><div><h3>Results</h3><div>Approximately 32%–43% of service members reported receiving any mental health care in the past 12 months. Hispanic and Asian or Pacific Islander personnel and those with certain service characteristics (higher pay grade, recent deployment, experienced discrimination) had a lower likelihood of mental healthcare utilization. Female sex, greater symptom severity, experiencing bullying, and other psychosocial factors were associated with greater likelihood of mental healthcare utilization.</div></div><div><h3>Conclusions</h3><div>One third of service members with PTSD or depression symptoms reported any mental healthcare use, highlighting the need to identify factors that may impede or delay treatment. Racial and ethnic disparities in treatment utilization persist, as do differences in utilization by military characteristics. Further research and initiatives are necessary to identify potential service-specific or cultural barriers and provide equitable quality and access to needed mental health services within the Military Health System.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"68 2","pages":"Pages 289-299"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479932","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":"Nonfatal Firearm Injury and Subsequent Emergency Department Utilization Among Nonelderly Adults","authors":"Theodoros Giannouchos PhD, MSc, MPharm ,&nbsp;Hye-Chung Kum PhD, MS, MSW ,&nbsp;Hannah Rochford PhD, MPH","doi":"10.1016/j.amepre.2024.10.005","DOIUrl":"10.1016/j.amepre.2024.10.005","url":null,"abstract":"<div><h3>Introduction</h3><div>The mortality, long-term morbidity, and exacerbated healthcare needs due to firearm injury in the U.S. are significant and growing. However, the relationship between exposure to a nonfatal firearm injury and long-term emergency department (ED) utilization is poorly understood. This study estimates the association between exposure to a nonfatal firearm injury and ED utilization in the subsequent year.</div></div><div><h3>Methods</h3><div>Using all-payer ED data among nonelderly adults in Georgia and New York, all ED visits for nonfatal firearm injuries from 2017 to 2018 were identified. Sociodemographic, clinical, and contextual characteristics between nonfatal firearm injury ED patients and the broader population of ED users were compared. ED utilization in the year following a nonfatal firearm injury relative to ED use in the year before and compared with ED use by a propensity score matched control group was examined using Poisson and negative binomial multivariable regressions. Analyses were performed in 2024.</div></div><div><h3>Results</h3><div>Nonfatal firearm injury ED patients were disproportionately male, younger, non-Hispanic Black, uninsured, and residents of areas with low median income and high firearm ownership. Compared to a matched control group, multivariable analyses indicated that nonfatal firearm injury ED patients had significantly higher risks of having hospital admissions through the ED (aRR: 1.42), all-cause injury-related ED visits (aRR: 1.47), nonfirearm injury-related ED visits (aRR: 1.26), and additional nonfatal firearm injury-related ED visits (aRR: 325.45) in the subsequent year (<em>p</em>&lt;0.001 for all). About one in every eight ED users with a firearm-related injury at index also sought ED care for another nonfatal firearm injury within 1 year.</div></div><div><h3>Conclusions</h3><div>Nonfatal firearm-related injuries contribute to preventable harm, health inequity, and increased ED utilization.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"68 2","pages":"Pages 281-288"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479934","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 Physical Activity Paradox in Low Muscle Mass in Middle-Aged and Older Adults","authors":"Bokun Kim PhD ,&nbsp;Yosuke Osuka PhD ,&nbsp;Yoshiro Okubo PhD ,&nbsp;Xiaoguang Zhao PhD ,&nbsp;Gwon-min Kim PhD ,&nbsp;Sechang Oh PhD","doi":"10.1016/j.amepre.2024.10.015","DOIUrl":"10.1016/j.amepre.2024.10.015","url":null,"abstract":"<div><h3>Introduction</h3><div>Physical activity is widely accepted as a therapeutic approach to age-related muscle mass loss. However, it is unclear whether all physical activity domains benefit muscle mass maintenance. This study investigated the association between low muscle mass and domain-specific physical activity, including leisure-time and occupational moderate-to-vigorous physical activity (MVPA).</div></div><div><h3>Methods</h3><div>This study included 27,357 middle-aged and older individuals (≥40 years) whose data were collected from 2014 to 2022 and analyzed in 2024. Low muscle mass was defined as a muscle mass index 2 SDs below the sex-specific average of 9,426 young individuals (aged 20–39 years). Leisure-time and occupational MVPA were assessed using the Global Physical Activity Questionnaire and categorized as 0 min/wk, 1–149 min/wk, and ≥150 min/wk. Logistic regression analysis focused on all participants, and additional analyses stratified by sex, age, sedentary time, and transfer time were performed.</div></div><div><h3>Results</h3><div>For leisure-time MVPA, participants with 1–149 min/wk and ≥150 min/wk had significantly lower odds of low muscle mass compared to those with no MVPA, with ORs of 0.795 (95% CI=0.691, 0.914) and 0.740 (95% CI=0.649, 0.843), respectively (<em>p</em>&lt;0.01 for both). No significant association was found between occupational MVPA and low muscle mass. These findings were consistent across different strata of sex, age, sedentary time, and transfer time.</div></div><div><h3>Conclusions</h3><div>Leisure-time MVPA is inversely associated with low muscle mass, whereas occupational MVPA shows no association, highlighting the importance of dynamic movements of sufficient intensity and recuperation time in maintaining muscle mass.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"68 2","pages":"Pages 348-356"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548765","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":"Appalachian Primary Care Patients’ Quit Readiness and Tobacco Treatment Receipt","authors":"Jessica L. Burris PhD ,&nbsp;Abigayle R. Feather BS ,&nbsp;Asal Pilehvari PhD ,&nbsp;Sarah Cooper MPH ,&nbsp;Amie M. Ashcraft PhD, MPH ,&nbsp;Roger Anderson PhD ,&nbsp;Amy Ferketich PhD","doi":"10.1016/j.amepre.2024.09.017","DOIUrl":"10.1016/j.amepre.2024.09.017","url":null,"abstract":"<div><h3>Introduction</h3><div>Healthcare providers should facilitate smoking cessation, and primary care is an ideal setting for delivering this evidence-based care. This study's objective was to describe readiness to quit smoking combustible cigarettes among adult Appalachian primary care patients and determine their providers’ implementation of an established tobacco treatment model.</div></div><div><h3>Methods</h3><div>As part of a randomized clinical trial, 298 providers in 10 health systems across 4 states received tobacco treatment training. Periodically between January 2022 and June 2023, anonymous surveys were distributed to patients after primary care visits. The survey included questions about demographics, visit type, smoking status, readiness to quit, and provider behavior related to tobacco treatment implementation. In 2023, descriptive statistics, bivariate tests and logistic regression models were conducted.</div></div><div><h3>Results</h3><div>Among 1,242 survey respondents, 34.1% reported current smoking. Among those who reported current smoking, 13.9% expressed readiness to quit within the next 30 days and 15.3% reported readiness in 1–6 months while 36.7% indicated “never” wanting to quit. Nearly all providers asked respondents about smoking status (96.9%) and advised them to quit (89.8%); fewer providers engaged in cessation assistance by discussing behavioral counseling, discussing medication options, and/or prescribing medication (25.1%–64.6% across behaviors). Provider behavior was most consistently associated with patient age and visit type.</div></div><div><h3>Conclusions</h3><div>Nearly one third of Appalachian patients who smoke reported readiness to quit within 6 months and nearly all received advice to quit from their provider. Patients would benefit from more intensive tobacco treatment delivery in primary care settings, with a focus on assisting with quit attempts.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"68 2","pages":"Pages 396-401"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331831","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":"Disparities in Tobacco Smoking and Risk of Cardiovascular Disease in People With Low Socioeconomic Status or Serious Psychological Distress: A Simulation Analysis","authors":"Boram Lee PhD ,&nbsp;Linzy V. Rosen BA ,&nbsp;Nora M. Mulroy BA ,&nbsp;Yiqi Qian MPH ,&nbsp;Fatma M. Shebl MD, PhD ,&nbsp;Jessica E. Becker MD, MPH ,&nbsp;Emily P. Hyle MD, MSc ,&nbsp;Douglas E. Levy PhD ,&nbsp;Krishna P. Reddy MD, MS","doi":"10.1016/j.amepre.2024.10.008","DOIUrl":"10.1016/j.amepre.2024.10.008","url":null,"abstract":"<div><h3>Introduction</h3><div>High tobacco smoking prevalence in people with low SES or serious psychological distress in the U.S. may increase cardiovascular disease risk among these marginalized subpopulations. The authors estimate how smoking disparities contribute to cardiovascular disease disparities.</div></div><div><h3>Methods</h3><div>Using the Simulation of Tobacco and Nicotine Outcomes and Policy model, a validated microsimulation model of tobacco use and clinical outcomes, the authors used 2004–2019 data from the National Health Interview Survey to first compare 20-year cumulative cardiovascular disease incidence for people aged 40 years by sex, smoking status, and marginalized subpopulation membership. Second, the authors simulated the marginalized subpopulations with representative age, sex, and smoking status distributions to estimate 20-year cumulative cardiovascular disease incidence under status quo and counterfactual scenarios. In the counterfactual scenario, smoking prevalence and trends in the low SES and serious psychological distress subpopulations match those in the higher SES and non-SPD subpopulations, respectively.</div></div><div><h3>Results</h3><div>The model-projected impact of smoking on 20-year cumulative cardiovascular disease incidence is considerably larger than the impact of low SES or serious psychological distress; for example, among males aged 40 years, cumulative cardiovascular disease incidence is 28.3% for low SES people who currently smoke, 13.0% for low SES people who never smoke, and 26.2% for higher SES people who currently smoke. In the second analysis, in the status quo scenario, model-projected 20-year cumulative cardiovascular disease incidence is 19.3% for low SES and 22.1% for serious psychological distress; in the counterfactual scenario, it is 18.1% for low SES and 19.6% for serious psychological distress.</div></div><div><h3>Conclusions</h3><div>Interventions focused on reducing smoking disparities could substantially reduce cardiovascular disease in marginalized subpopulations.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"68 2","pages":"Pages 402-407"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479931","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":"Content Is King but Ignored in the Debate on Screentime and Adolescent Health","authors":"Jon-Patrick Allem PhD","doi":"10.1016/j.amepre.2024.10.010","DOIUrl":"10.1016/j.amepre.2024.10.010","url":null,"abstract":"","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"68 2","pages":"Pages 415-417"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512406","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":"Gun Ownership for Safety/Protection and Unsecured Firearm Storage Practices: Suicide Risk and Prevention Among U.S. Army Servicemembers","authors":"Catherine L. Dempsey PhD, MPH ,&nbsp;David M. Benedek MD ,&nbsp;Patricia T. Spangler PhD ,&nbsp;James C. West MD ,&nbsp;Robert M. Bossarte PhD ,&nbsp;Matthew K. Nock PhD ,&nbsp;Kelly L. Zuromski PhD ,&nbsp;Matthew W. Georg MPH ,&nbsp;Jingning Ao MPH ,&nbsp;Katy Haller MSPH ,&nbsp;Deborah M. Probe MA ,&nbsp;Robert J. Ursano MD","doi":"10.1016/j.amepre.2024.10.011","DOIUrl":"10.1016/j.amepre.2024.10.011","url":null,"abstract":"<div><h3>Introduction</h3><div>Year 2021 had the highest number firearm suicide deaths in U.S. history, with veterans representing 62.4% of firearm suicide deaths. The study objective is to understand motivations for firearm ownership, storage practices, history of mental health disorders and suicide risk in servicemembers, as reported by family members.</div></div><div><h3>Methods</h3><div>Data were obtained from a case-control psychological autopsy study of 135 suicide decedents in the U.S. Army compared to a probability sample of 255 living controls, who are also service members weighted to be representative of the Army. Next-of-kin and Army supervisor informants participated in structured interviews and assessed reasons for firearm ownership, and storage practices. The military medical record provided lifetime mental health history of suicide decedents. A subsample of 123 personal firearm owners (<em>n</em>=31 cases and <em>n</em>=92 living controls) addressed the study objectives. Multivariable logistic regression analyses were constructed to examine predictors of unsecured firearm storage practices.</div></div><div><h3>Results</h3><div>Family members reported safety/protection as the main reason for suicide decedents’ firearm ownership, which was significantly associated with unsecured firearm storage practices (OR=3.8, 95% CI, 1.65, 8.75, <em>x</em>²=9.88, <em>p</em>=0.0017). Ownership for safety/protection and lifetime history of Generalized Anxiety Disorder (GAD) from the military medical record (OR=3.65, 95% CI, 1.48–9.02, <em>x</em>²=7.89 <em>p</em>=0.0050) predicted unsecured storage.</div></div><div><h3>Conclusions</h3><div>Ownership for safety/protection and the presence of clinically significant anxiety predicted unsecured firearm storage practices. Future research examining motivations for gun ownership for safety/protection, anxiety, and unsecured storage practices may help target interventions to prevent suicide.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"68 2","pages":"Pages 311-319"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512407","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":"Trends in Availability and Nutritional Profile of Meat-Based Versus Meat-Free Menu Items in 75 Large Chain Restaurants in the United States, 2013–2021","authors":"Anna C. Tucker ,&nbsp;Megan P. Mueller ,&nbsp;Lindsey Smith Taillie ,&nbsp;Jason P. Block ,&nbsp;Cindy W. Leung ,&nbsp;Julia A. Wolfson","doi":"10.1016/j.amepre.2024.10.013","DOIUrl":"10.1016/j.amepre.2024.10.013","url":null,"abstract":"<div><h3>Introduction</h3><div>Chain restaurants are ubiquitous in the U.S. While restaurants are increasingly promoting health- and climate-conscious menu options, few studies have examined whether restaurants are increasing availability of menu items with lower climate impact and whether these offerings are healthier. This study examines trends in the availability and nutritional profile of food items featuring different meat sources on menus at 75 large chain restaurants in the U.S. from 2013 to 2021.</div></div><div><h3>Methods</h3><div>Longitudinal data on menu items from 75 large U.S. chain restaurants from 2013 to 2021 were obtained from MenuStat.org, an online database of menu items from the largest-grossing restaurant chains in the U.S. Annual counts and proportions of food items featuring different meat sources were calculated overall, by food category, and by restaurant type. Differences in predicted mean calories between meat-based items and meat-free items were calculated (overall, by restaurant type, by year) using linear regression models with clustered standard errors.</div></div><div><h3>Results</h3><div>Availability and calorie content of meat-based versus meat-free items were generally stable over time. Availability of chicken-containing items increased and there was an absolute reduction in the availability of beef-containing menu items (<em>p</em>-trends&lt;0.001). Total calories and calories from protein, unsaturated fat, and saturated fat were lower among meat-free items versus meat-based items. However, calories from sugar were higher for meat-free items.</div></div><div><h3>Conclusions</h3><div>While meat-free items had fewer calories and some aspects of nutritional profile were more favorable, the availability of meat-free menu items has not increased in large chain restaurants, suggesting limited improvement on reducing climate impact.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"68 2","pages":"Pages 327-335"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512408","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":"Loneliness, Discrimination, Stress, and Type 2 Diabetes Risk in Young Adults","authors":"Caleb Harrison BS ,&nbsp;Maya I. Ragavan MD, MPH, MS ,&nbsp;Margaret F. Zupa MD, MS ,&nbsp;Xu Qin PhD ,&nbsp;Vicki S. Helgeson PhD ,&nbsp;Mary Ellen Vajravelu MD, MSHP","doi":"10.1016/j.amepre.2024.09.019","DOIUrl":"10.1016/j.amepre.2024.09.019","url":null,"abstract":"<div><h3>Introduction</h3><div>The aim of this study was to determine the associations between type 2 diabetes or prediabetes and loneliness and related social experiences in young adults, a population at increasingly high risk of type 2 diabetes.</div></div><div><h3>Methods</h3><div>This was a cross-sectional analysis using data from adults aged 18–35 years enrolled in the All of Us Research Program. Exposures included loneliness, social support, discrimination, neighborhood social cohesion, and stress, measured by standardized surveys. The main outcome was type 2 diabetes or prediabetes by self-report or linked health record. Logistic regression determined the odds of type 2 diabetes/prediabetes for each survey measure, adjusting for age, sex, race or ethnicity, income, and family history. Latent class analysis evaluated clustering of social experiences. Data were collected from 2018 to 2022 and analyzed in May 2023–June 2024.</div></div><div><h3>Results</h3><div>The cohort included 14,217 young adults (aged 28.2 ± 4.4 years, 73.1% [<em>n</em>=10,391] women, 64.1% [<em>n</em>=9,111] White, 10.6% [<em>n</em>=1,506] Hispanic, 5.7% [<em>n</em>=806] Black, and 9.1% [<em>n</em>=1,299] multiracial). Overall, 5.5% (<em>n</em>=777) had either prediabetes or type 2 diabetes. The 2 highest loneliness quartiles were associated with increased odds of prediabetes/type 2 diabetes (Q3: OR=1.42 [95% CI=1.15, 1.76] and Q4: OR=1.78 [95% CI=1.45, 2.19]). Greater stress and discrimination and lower social support and neighborhood social cohesion were also associated with increased odds of prediabetes/type 2 diabetes. Latent class analysis revealed 3 distinct phenotypes, with elevated odds of prediabetes/type 2 diabetes in the 2 with the most adverse social profiles (OR=2.32 [95% CI=1.89, 2.84] and OR=1.28 [95% CI=1.04, 1.58]).</div></div><div><h3>Conclusions</h3><div>Loneliness and related experiences are strongly associated with type 2 diabetes and prediabetes in young adults. Whether these factors could be leveraged to reduce type 2 diabetes risk should be investigated.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"68 2","pages":"Pages 217-226"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373477","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}