Jenesis Merriman, Christoffer Dharma, Su Hyun Park, Andrea Joiner, Roberta Scheinmann, Kim Watson, Cristina Herrera, John A Schneider, Sahnah Lim, Chau Trinh-Shevrin, Asa Radix, Dustin T Duncan
{"title":"Perceived Access to Gender-Affirming Care, Completion of Gender-Affirming Medical Interventions, and Psychological Distress Among Transgender Women of Color: The TURNNT Cohort Study.","authors":"Jenesis Merriman, Christoffer Dharma, Su Hyun Park, Andrea Joiner, Roberta Scheinmann, Kim Watson, Cristina Herrera, John A Schneider, Sahnah Lim, Chau Trinh-Shevrin, Asa Radix, Dustin T Duncan","doi":"10.1093/aje/kwaf136","DOIUrl":"https://doi.org/10.1093/aje/kwaf136","url":null,"abstract":"<p><p>Transgender women of color (TWOC) are disproportionately impacted by psychological distress. Though gender-affirming care (GAC) has been recommended to alleviate this distress, research examining associations between perceived access to GAC, specific gender-affirming medical interventions (GAMIs), and mental health among TWOC in the United States remains limited. In this study, we examine cross-sectional and longitudinal associations between perceived access to GAC, completion of specific GAMIs, and psychological distress among TWOC, using modified Poisson regression and multilevel linear modeling. Data came from the TURNNT (\"Trying to Understand Relationships, Networks and Neighborhoods Among Transgender Women of Color\") Cohort Study. In multivariable analyses, increased access to GAC was associated with reduced psychological distress risk. All assessed GAMIs suggested protective effects against psychological distress (aRR < 1), with statistical significance found for breast augmentation and facial feminization surgery. On average, those with unmet GAMI needs experienced higher distress risk than those without. Longitudinally, those experiencing reduced access to GAC over 6 months faced the highest distress risk among all trajectory groups (aRR: 1.40, 95% CI: 1.08, 1.82). Our findings support the need for further inquiry in this area and suggest that policies protecting and increasing access to GAC may improve mental health among TWOC.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511404","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":"The importance and challenges of using natural experiments to evaluate the health effects of housing policy. A commentary on Schwartz and Chu's \"Do laws protecting tenants' health work?: Implied warranties of habitability and respiratory health\".","authors":"Rebecca Bentley, Kate Mason","doi":"10.1093/aje/kwaf134","DOIUrl":"https://doi.org/10.1093/aje/kwaf134","url":null,"abstract":"<p><p>Housing policy remains underutilized as a lever for better population health. This commentary discusses the intersection of housing policy and population health, focusing on the use of natural experiments to evaluate the health effects of housing policies. We consider Schwartz and Chu's paper (Am J Epidemiol. XXXX;XXX(XX):XXXX-XXXX)) in which they employ a natural experiment approach to quantifying health impacts of habitability warrants: state-based housing policy aimed at protecting renters in the US. The paper's null findings highlight the complexities of evaluating health effects of housing policies. Findings could be explained by policy failure i.e., habitability warranties place the burden on tenants to act, requiring them to invest resources and potentially risk their tenancy to address suboptimal living conditions. Methodological challenges could also contribute including limited sample sizes, reliance on self-reported data, and potential confounding factors. We argue that failure to optimize housing policies for health outcomes leads to missed opportunities to improve population health using prevention strategies, potential widening existing health inequalities. This review underscores the need for continued research into the health impacts of housing policies, advocating for a shift towards health-centric policy evaluation to better leverage housing as a key social determinant of health.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511405","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}
Tristan V C Paulino, Bwenaua Biiri, Elizabeth Matisoo-Smith, Anna L Gosling
{"title":"A scoping review on cardiometabolic risk factors amongPacific Island populations and implications on future research in the region.","authors":"Tristan V C Paulino, Bwenaua Biiri, Elizabeth Matisoo-Smith, Anna L Gosling","doi":"10.1093/aje/kwaf135","DOIUrl":"https://doi.org/10.1093/aje/kwaf135","url":null,"abstract":"<p><p>Indigenous populations in the Pacific are disproportionately burdened by cardiometabolic diseases compared to other populations, yet understanding of the underlying factors contributing to these health disparities remains limited. A combination of genetic and non genetic risk factors contributes to cardiometabolic disease outcomes, but current reviews involving Pacific Island peoples are limited by geographical and demographic constraints. To address this, we conducted a scoping review that identified risk factors, with an emphasis on genetic factors associated with cardiometabolic diseases among Pacific Island populations (Polynesians, Melanesians, and Micronesians). We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework for scoping reviews utilizing MEDLINE (Ovid) and Web of Science (all databases). From March 2023, we identified population-based studies published in the last decade. A total of 1,887 abstracts were screened, 114 full-text articles were reviewed, and a final 58 articles were included in our review. Within the last decade, genetic studies outnumbered non genetic studies. Obesity, diabetes, and gout were the most prominent conditions researched. Melanesian and Micronesian populations were underrepresented in cardiometabolic disease research compared to Polynesians. The combination of non genetic and genetic research has implications for developing equitable Pacific-centric interventions and treatment in the future.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511402","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":"Correction to: Omics feature selection with the extended SIS R package: identification of a body mass index epigenetic multimarker in the Strong Heart Study.","authors":"","doi":"10.1093/aje/kwaf121","DOIUrl":"https://doi.org/10.1093/aje/kwaf121","url":null,"abstract":"","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144300988","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":"More research needed on measures of transgender self-identification.","authors":"Ayden I Scheim","doi":"10.1093/aje/kwaf103","DOIUrl":"https://doi.org/10.1093/aje/kwaf103","url":null,"abstract":"","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144300989","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}
Orchee L Syed, Frank J Infurna, Yesenia Cruz-Carrillo, Nutifafa E Y Dey, Markus Wettstein, Kevin J Grimm, Margie E Lachman, Denis Gerstorf
{"title":"Pain During Midlife: A Cross-National Analysis of Cohort Differences in Reports of Pain in the United States, Europe, South Korea, and Mexico.","authors":"Orchee L Syed, Frank J Infurna, Yesenia Cruz-Carrillo, Nutifafa E Y Dey, Markus Wettstein, Kevin J Grimm, Margie E Lachman, Denis Gerstorf","doi":"10.1093/aje/kwaf130","DOIUrl":"https://doi.org/10.1093/aje/kwaf130","url":null,"abstract":"<p><p>Middle-aged Americans today are reporting poorer mental, cognitive, and physical health compared to previous cohorts, but this trend has not been consistently observed in other nations. It is an open question whether pain shows similar cohort differences amongst U.S. middle-aged adults compared to other nations. We used harmonized data on pain from nationally representative longitudinal panel surveys from the U.S., 13 European nations (England, Continental, Mediterranean, and Nordic regions), South Korea, and Mexico to directly quantify cohort similarities and differences in midlife pain. Results from multilevel models demonstrated that midlife pain is higher amongst later-born cohorts in the U.S. than among earlier-born cohorts. The increased odds for later-born cohorts emerged in the early years of midlife when people are in their early 50s. A similar pattern of increased odds of reporting pain for later-born cohorts was observed in England and Mexico. In contrast, a decreased odds of reporting pain for later-born cohorts was observed in Continental, Mediterranean, and Nordic Europe as well as South Korea. Results for pain severity revealed a highly similar pattern. Our discussion focuses on potential explanations, including population-level discrepancies in use and quality of healthcare services and how pain is conceptualized across nations.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144300990","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}
Yueying Hu, Michael R Elliott, Helen C S Meier, Liang Chen, Monica E Walters, Ketlyne Sol, Laura B Zahodne
{"title":"The Impact of Census-Tract Level Mortgage Discrimination on Cognitive Function: Accounting for Measurement Instability in Small-Area Data via Joint Modeling.","authors":"Yueying Hu, Michael R Elliott, Helen C S Meier, Liang Chen, Monica E Walters, Ketlyne Sol, Laura B Zahodne","doi":"10.1093/aje/kwaf131","DOIUrl":"https://doi.org/10.1093/aje/kwaf131","url":null,"abstract":"<p><p>Racial disparities in cognitive health reflect entrenched structural inequalities. This study investigates the association between census-tract level mortgage discrimination, operationalized as the Mortgage Density Index Ratio (MDIR), and cognitive outcomes among racially diverse older adults. Using data from the Michigan Cognitive Aging Project (MCAP), a cohort of 644 participants was analyzed across six cognitive measures. Hypersegregation, driven in part by historical redlining and contemporary racial discrimination in housing and lending, introduces instability in ratio indices like MDIR. To address this, we employed a joint modeling approach that simultaneously estimates cognitive outcomes and latent mortgage rates for Black and White households. This method identified a significant association between MDIR and processing speed only among Non-Hispanic Black participants, with a one-unit MDIR increase corresponding to a 0.48 SD improvement in processing speed (95% CI: 0.05-0.93) while controlling for individual demographics. Contrarily, traditional regression methods failed to detect such effects. Simulations further demonstrated the superiority of joint modeling in managing measurement instability, showing notably lower bias and greater robustness in small- to moderate-sized census tracts. These findings underscore the importance of advanced statistical methods in quantifying structural racism and highlight the disproportionate effects of mortgage discrimination on cognitive outcomes among Black adults.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144300991","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":"Longitudinal Pattern of Multimorbidity in Older Adult Population: Latent Transition Analysis in 34 Countries.","authors":"Ridho Al Izzati, Eduwin Pakpahan","doi":"10.1093/aje/kwaf129","DOIUrl":"https://doi.org/10.1093/aje/kwaf129","url":null,"abstract":"<p><p>Multimorbidity has become a global public health concern, yet cross-national comparisons remain limited, especially in longitudinal settings. This study investigates the longitudinal patterns and transitions of multimorbidity status of people over age 50 in 34 countries. Utilizing comparable health indicators across countries, we examine chronic health conditions (hypertension and diabetes), cognitive function, physical ability, and self-report of general health. Using latent transition analysis, we identify a pattern of multimorbidity and classify it into three classes: mild, moderate, and severe multimorbidity. Mild multimorbidity is characterized by a lower prevalence of three morbidities out of five, while severe multimorbidity is characterized by a higher prevalence across all health conditions. Moderate multimorbidity falls between these two extremes. Our findings reveal substantial variation in these classes across countries, with diabetes and hypertension emerging as the predominant condition among older adults with severe and moderate multimorbidity, respectively. Over time, both severe and moderate multimorbidity tend to increase, with similar transition probabilities from mild to more severe categories across countries. Covariate analysis indicates that men and low-educated individuals are more likely to experience severe multimorbidity. These results underscore the importance of understanding multimorbidity patterns and dynamics for effective public health planning and healthcare services.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144289374","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}
Eri Eguchi, Anna Prizment, Shuo Wang, Sanaz Sedaghat, Mako Nagayoshi, Susan A Everson-Rose, Kevin J Sullivan, Ganga Bey, Anna Kucharska-Newton, Weihua Guan, Pamela L Lutsey
{"title":"Associations of social network size and perceived level of social support with age acceleration estimated by a proteomic aging clock: The Atherosclerosis Risk in Communities Study.","authors":"Eri Eguchi, Anna Prizment, Shuo Wang, Sanaz Sedaghat, Mako Nagayoshi, Susan A Everson-Rose, Kevin J Sullivan, Ganga Bey, Anna Kucharska-Newton, Weihua Guan, Pamela L Lutsey","doi":"10.1093/aje/kwaf125","DOIUrl":"https://doi.org/10.1093/aje/kwaf125","url":null,"abstract":"<p><strong>Background: </strong>We examined the associations of social network size and social support with biological age acceleration using a protein-based aging clock.</p><p><strong>Methods: </strong>A total of 11,719 participants (mean age 57.1±5.7 years; 55.6% female) of the Atherosclerosis Risk in Communities (ARIC) study Visit 2 (1990-1992) were included. Biological age was calculated using a proteomic aging clock (PAC), and age acceleration was defined as the residuals after regressing the PAC on chronological age. The associations of self-reported social network size and level of support with standardized mean age acceleration were examined using multivariable linear regression.</p><p><strong>Results: </strong>Size of social networks and level of support were inversely associated with age acceleration. The age accelerations of small, medium, and large social networks were 0.24, 0.08, and -0.05 (p for trend = 0.003), while for low, moderate and high levels of support the age accelerations were 0.33, 0.19, and -0.06 (p for trend < 0.0001), respectively. Associations were modestly attenuated after adjusting for social and lifestyle factors.</p><p><strong>Discussion: </strong>Findings of the benefit of social networks and support to biological aging processes provide evidence of potential physiological underpinnings of social interactions on health outcomes.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144289370","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":"Heterogeneous associations of retirement with health and behaviors: A longitudinal study in 35 countries.","authors":"Koryu Sato, Haruko Noguchi","doi":"10.1093/aje/kwaf126","DOIUrl":"https://doi.org/10.1093/aje/kwaf126","url":null,"abstract":"<p><p>Many developed countries are raising their state pension age, thereby delaying retirement. However, existing evidence on the impact of retirement on health yields inconsistent results. This study aims to explore heterogeneous associations of retirement with health and behaviors using harmonized datasets of the Health and Retirement Study and its sister surveys in 35 countries. The data comprises 396,904 observations from 106,927 individuals aged 50-70 years. On average, participants were followed up for 6.7 years, and 50.5% of them consisted of men. This study employed the state pension age of each country as an instrument for retirement and performed fixed-effects instrumental variable regression. Among women, retirement was associated with a 0.100 SD increase in cognitive function and a 3.8%-point increase in physical independence. In both genders, retirement was associated with increased self-rated health, with women indicating a larger point estimate than men. Additionally, retirement was associated with a 4.3%-point decrease in physical inactivity and a 1.9%-point decrease in smoking among women, while no such associations were observed among men. Heterogeneity was not found across countries, educational levels, and pre-retirement job characteristics. Gender differences in post-retirement health behaviors may contribute to heterogeneous associations between retirement and health.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144289371","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}