American journal of epidemiology最新文献

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Trends in depression in the European population aged 50 years and older by geographic region.
IF 5 2区 医学
American journal of epidemiology Pub Date : 2025-02-10 DOI: 10.1093/aje/kwaf027
Rodrigo Núñez-Cortés, Joaquín Calatayud, Lars Louis Andersen, Jorge Hugo Villafañe, Luis Suso-Martí, Rubén López-Bueno
{"title":"Trends in depression in the European population aged 50 years and older by geographic region.","authors":"Rodrigo Núñez-Cortés, Joaquín Calatayud, Lars Louis Andersen, Jorge Hugo Villafañe, Luis Suso-Martí, Rubén López-Bueno","doi":"10.1093/aje/kwaf027","DOIUrl":"https://doi.org/10.1093/aje/kwaf027","url":null,"abstract":"<p><p>This study assesses the prevalence and trends of depression in the European population aged 50 years and older between 2004 and 2022 in different geographical regions. We retrieved and pooled data from waves 1,2,4,5,6,7,8, and 9 of the Survey of Health, Ageing and Retirement in Europe (SHARE) conducted between 2004 and 2022. The 12-item EURO-D scale was used as a continuous marker of depression risk. Twenty-eight countries were classified into five geographical regions (Eastern, Western, Southern and Northern Europe, and Israel) as defined by the United Nations. A total of 375 693 observations corresponding to 146 888 participants (weighted mean age 65.8 years [SE=0.2], 54.2% women) were included in the study. In 2022, the overall prevalence of self-reported depression in Europe was 28.3% (95% CI: 27.0-29.7). From 2004 to 2022, the prevalence of self-reported depression in Europe decreased significantly by 5.9% (95% CI= -8.1 to -3.8). In particular, in Southern Europe, the prevalence of depression decreased significantly by 8.8% (95% CI= -12.3 to -5.2). No significant differences were observed in the other geographic regions. These findings highlight the need to develop depression screening and prevention strategies focused on countries with higher prevalence and identified associated factors.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389862","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}
引用次数: 0
Effects of US state paid family leave policies on perinatal and postpartum health: A quasi-experimental analysis.
IF 5 2区 医学
American journal of epidemiology Pub Date : 2025-02-07 DOI: 10.1093/aje/kwaf010
Whitney M Wells, Justin S White, Daniel F Collin, Guangyi Wang, Sepideh Modrek, Rita Hamad
{"title":"Effects of US state paid family leave policies on perinatal and postpartum health: A quasi-experimental analysis.","authors":"Whitney M Wells, Justin S White, Daniel F Collin, Guangyi Wang, Sepideh Modrek, Rita Hamad","doi":"10.1093/aje/kwaf010","DOIUrl":"https://doi.org/10.1093/aje/kwaf010","url":null,"abstract":"<p><p>The US is the only high-income country without a national paid family leave (PFL) policy, although several states have implemented policies recently. This study evaluated whether PFL policies in six states improved maternal and infant health. We used difference-in-differences, a quasi-experimental approach, to estimate the impact of state-level policy implementation. We leveraged recently developed methods designed to account for staggered policy implementation and treatment effect heterogeneity. Data were drawn from the Pregnancy Risk Assessment Monitoring System 2004-2021 waves. Primary outcomes included breastfeeding, maternal postpartum depressive symptoms, and attendance at a postpartum check-up; secondary outcomes included birth outcomes. Multivariable regressions were adjusted for possible confounders. PFL policies led to increased breastfeeding duration (0.53 weeks; 95% CI: 0.06 to 0.99) and decreased depressive symptoms (-0.93 percentage points; 95% CI: -1.84 to -0.01). Policies were also associated with worsening of some birth outcomes, possibly reflecting selection in utero, data limitations, or true negative effects. Estimates were largely robust to alternative specifications, with subgroup differences by race/ethnicity and income. This study adds important evidence on the health effects of state-level PFL policies at a critical point when many states are considering or enacting policies, and during ongoing conversations about national PFL policy implementation.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370229","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}
引用次数: 0
Note on targeted learning with an undersmoothed Lasso propensity score model for large-scale covariate adjustment in health care database studies.
IF 5 2区 医学
American journal of epidemiology Pub Date : 2025-02-07 DOI: 10.1093/aje/kwaf024
Richard Wyss, Mark van der Laan, Susan Gruber, Xu Shi, Hana Lee, Sarah K Dutcher, Jennifer C Nelson, Sengwee Toh, Massimiliano Russo, Shirley V Wang, Rishi J Desai, Kueiyu Joshua Lin
{"title":"Note on targeted learning with an undersmoothed Lasso propensity score model for large-scale covariate adjustment in health care database studies.","authors":"Richard Wyss, Mark van der Laan, Susan Gruber, Xu Shi, Hana Lee, Sarah K Dutcher, Jennifer C Nelson, Sengwee Toh, Massimiliano Russo, Shirley V Wang, Rishi J Desai, Kueiyu Joshua Lin","doi":"10.1093/aje/kwaf024","DOIUrl":"https://doi.org/10.1093/aje/kwaf024","url":null,"abstract":"","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555619","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}
引用次数: 0
Fast-food and convenience outlets near schools in California: a comparison of private and public schools.
IF 5 2区 医学
American journal of epidemiology Pub Date : 2025-02-06 DOI: 10.1093/aje/kwaf025
Md Karimuzzaman, Sydney Miller, Emma V Sanchez-Vaznaugh, Brisa N Sánchez
{"title":"Fast-food and convenience outlets near schools in California: a comparison of private and public schools.","authors":"Md Karimuzzaman, Sydney Miller, Emma V Sanchez-Vaznaugh, Brisa N Sánchez","doi":"10.1093/aje/kwaf025","DOIUrl":"10.1093/aje/kwaf025","url":null,"abstract":"<p><p>Food environments near schools (FENS) influence children's dietary habits and contribute to obesity. Socioeconomic characteristics of schools and school neighborhoods play a role in determining FENS. We compare the availability of fast-food restaurants (FFR) and convenience stores (CS) across schools' socioeconomic characteristics: whether the school is public vs. private, and the school neighborhood's median household income. We obtained the number of FFR and CS within a 0.75-mile network buffer from schools' locations and the names of the outlets. Negative binomial regression models, stratified by urbanicity, were used to estimate the association between the number of outlets near schools and schools' socioeconomic characteristics. We explored brand names and types of outlets. Private schools' neighborhoods had more FFR and CS than public schools across all income and urbanization levels. Private and public schools in low-income urban neighborhoods had more outlets compared to those in higher-income urban areas. While the names of FFR and CS near both school types were broadly similar, private schools had more non-chain outlets. Programs and policies to promote healthy eating and reduce obesity and diet-related diseases should target food environments near both private and public schools, especially those located in urban areas and low-income communities.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363203","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}
引用次数: 0
Employment quality and suicide, drug poisoning, and alcohol-attributable mortality.
IF 5 2区 医学
American journal of epidemiology Pub Date : 2025-02-06 DOI: 10.1093/aje/kwaf018
Alessandra T Andreacchi, Anne E Fuller, Peter M Smith, Alexandra Blair, Anne Harris, Nancy Carnide, Roman Pabayo, Brendan T Smith, Arjumand Siddiqi, Faraz Vahid Shahidi
{"title":"Employment quality and suicide, drug poisoning, and alcohol-attributable mortality.","authors":"Alessandra T Andreacchi, Anne E Fuller, Peter M Smith, Alexandra Blair, Anne Harris, Nancy Carnide, Roman Pabayo, Brendan T Smith, Arjumand Siddiqi, Faraz Vahid Shahidi","doi":"10.1093/aje/kwaf018","DOIUrl":"https://doi.org/10.1093/aje/kwaf018","url":null,"abstract":"<p><p>Suicide, drug poisoning, and alcohol-attributable mortality (SDAM) - often labelled 'deaths of despair' - are increasing among working-aged individuals in many high-income countries. We examined the association between employment quality and SDAM in Canada. Census records from the 2006 Canadian Census Health and Environment Cohort (n=2,805,550) were linked to mortality data from 2006-2019. Latent class analysis identified five employment quality types: standard (secure and rewarding), portfolio (rewarding but demanding), marginal (limited hours and earnings), intermittent (sporadic and unstable), and precarious (insecure and unrewarding). Poisson regression models estimated sex/gender-stratified associations between employment quality type and suicide, drug poisoning, and alcohol-attributable deaths separately. We observed a consistent mortality gradient across employment quality groups, with lower-quality employment - and precarious employment in particular - associated with increased rates of SDAM relative to higher-quality (i.e., standard) employment. For example, precarious employment was associated with a more than threefold rate of drug poisoning deaths among women (RR: 3.58, 95% CI: 3.21-4.00) and a more than twofold rate of alcohol-attributable death among men (RR: 2.22, 95% CI: 2.07-2.38). Employment quality is an important determinant of SDAM, with varying associations by sex/gender. Improvements in employment conditions may help to reduce the burden of premature mortality attributable to suicide and substance use.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363198","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}
引用次数: 0
Racialized experience, biomarkers of lead exposure, and later-life cognition: a mediation analysis. 种族化经历、铅暴露生物标志物与晚年认知:中介分析。
IF 5 2区 医学
American journal of epidemiology Pub Date : 2025-02-05 DOI: 10.1093/aje/kwae194
Tara E Jenson, Kelly M Bakulski, Linda Wesp, Keith Dookeran, Ira Driscoll, Amy E Kalkbrenner
{"title":"Racialized experience, biomarkers of lead exposure, and later-life cognition: a mediation analysis.","authors":"Tara E Jenson, Kelly M Bakulski, Linda Wesp, Keith Dookeran, Ira Driscoll, Amy E Kalkbrenner","doi":"10.1093/aje/kwae194","DOIUrl":"10.1093/aje/kwae194","url":null,"abstract":"<p><p>We evaluated the role of the neurotoxicant lead (Pb) in mediating racial disparities in later-life cognition in 1085 non-Hispanic Black and 2839 non-Hispanic white participants in the National Health and Nutrition and Examination Survey (NHANES, 1999-2002, 2011-2014) 60+ years of age. We operationalized Black race as a marker for the experience of racialization and exposure to systemic racism. We estimated patella bone Pb via predictive models using blood Pb and demographics. Concurrent cognition (processing speed, sustained attention, working memory) was measured by the Digit Symbol Substitution Test (DSST) and a global measure combining 4 cognitive tests. To obtain the portion mediated, we used regression coefficients (race on Pb * Pb on cognitive score)/(race on cognitive score), adjusting for age, NHANES cycle, and sample weights. Other confounder adjustment (education, poverty income ratio, smoking) was limited to the mediator-outcome (ie, Pb-cognition) pathway because these factors do not lie upstream of race and so cannot confound associations with race. Lead was estimated to mediate 0.6% of the association between race and global cognition, and 4% of the DSST. Our results suggest that later-life cognitive health disparities may be impacted by avoidable lead exposure driven by environmental injustice, noting that a large proportion of the pathway of systemic racism harming cognition remains. This article is part of a Special Collection on Mental Health.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"420-431"},"PeriodicalIF":5.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141726733","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}
引用次数: 0
Depicting deterministic variables within directed acyclic graphs: an aid for identifying and interpreting causal effects involving derived variables and compositional data. 在有向无环图(DAG)中描述确定性变量:用于识别和解释涉及派生变量和组合数据的因果效应的辅助工具。
IF 5 2区 医学
American journal of epidemiology Pub Date : 2025-02-05 DOI: 10.1093/aje/kwae153
Laurie Berrie, Kellyn F Arnold, Georgia D Tomova, Mark S Gilthorpe, Peter W G Tennant
{"title":"Depicting deterministic variables within directed acyclic graphs: an aid for identifying and interpreting causal effects involving derived variables and compositional data.","authors":"Laurie Berrie, Kellyn F Arnold, Georgia D Tomova, Mark S Gilthorpe, Peter W G Tennant","doi":"10.1093/aje/kwae153","DOIUrl":"10.1093/aje/kwae153","url":null,"abstract":"<p><p>Deterministic variables are variables that are functionally determined by one or more parent variables. They commonly arise when a variable has been functionally created from one or more parent variables, as with derived variables, and in compositional data, where the \"whole\" variable is determined from its \"parts.\" This article introduces how deterministic variables may be depicted within directed acyclic graphs (DAGs) to help with identifying and interpreting causal effects involving derived variables and/or compositional data. We propose a 2-step approach in which all variables are initially considered, and a choice is made as to whether to focus on the deterministic variable or its determining parents. Depicting deterministic variables within DAGs brings several benefits. It is easier to identify and avoid misinterpreting tautological associations, that is, self-fulfilling associations between deterministic variables and their parents, or between sibling variables with shared parents. In compositional data, it is easier to understand the consequences of conditioning on the \"whole\" variable and to correctly identify total and relative causal effects. For derived variables, it encourages greater consideration of the target estimand and greater scrutiny of the consistency and exchangeability assumptions. DAGs with deterministic variables are a useful aid for planning and interpreting analyses involving derived variables and/or compositional data.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"469-479"},"PeriodicalIF":5.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11815499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141449375","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}
引用次数: 0
The health implications of cumulative exposure to contextual (dis)advantage: methodological and substantive advances from a unique data linkage. 累积暴露于环境(不利)优势对健康的影响:从独特的数据关联中获得的方法论和实质性进展。
IF 5 2区 医学
American journal of epidemiology Pub Date : 2025-02-05 DOI: 10.1093/aje/kwae183
Wei Xu, Christina Kamis, Megan Agnew, Amy Schultz, Sarah Salas, Kristen Malecki, Michal Engelman
{"title":"The health implications of cumulative exposure to contextual (dis)advantage: methodological and substantive advances from a unique data linkage.","authors":"Wei Xu, Christina Kamis, Megan Agnew, Amy Schultz, Sarah Salas, Kristen Malecki, Michal Engelman","doi":"10.1093/aje/kwae183","DOIUrl":"10.1093/aje/kwae183","url":null,"abstract":"<p><p>Deleterious neighborhood conditions are associated with poor health, yet the health impact of cumulative lifetime exposure to neighborhood disadvantage is understudied. Using up to 5 decades of residential histories for 4177 adult participants in the Survey of the Health of Wisconsin (SHOW) and spatiotemporally linked neighborhood conditions, we developed 4 operational approaches to characterizing cumulative neighborhood (dis)advantage over the life course. We estimated their associations with self-reported general health and compared them with estimates using neighborhood (dis)advantage at the time of study enrollment. When cumulative exposures were assessed with the most granular temporal scale (approach 4), neighborhood transportation constraints (odds ratio [OR] = 1.21; 95% CI, 1.08-1.36), residential turnover (OR = 1.20; 95% CI, 1.07-1.34), education deficit (OR = 1.17; 95% CI, 1.04-1.32), racial segregation (OR = 1.20; 95% CI, 1.04-1.38), and median household income (OR = 0.85; 95% CI, 0.75-0.97) were significantly associated with risk of fair or poor health. For composite neighborhood disadvantage, cumulative exposures had a stronger association (OR = 1.05; 95% CI, 1.02-1.08) than the cross-sectional exposure (OR = 1.03; 95% CI, 1.01-1.06). Single-point-in-time neighborhood measures underestimate the relationship between neighborhood and health, underscoring the importance of a life-course approach to cumulative exposure measurement.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"480-489"},"PeriodicalIF":5.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11815491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141553982","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}
引用次数: 0
Prospective transitions in hemoglobin A1c following gestational diabetes using multistate Markov models. 利用多态马尔可夫模型对妊娠糖尿病后血红蛋白 A1c 的前瞻性变化进行分析。
IF 5 2区 医学
American journal of epidemiology Pub Date : 2025-02-05 DOI: 10.1093/aje/kwae219
Katharine J McCarthy, Shelley H Liu, Joseph Kennedy, Hiu Tai Chan, Victoria L Mayer, Luciana Vieira, Kimberly B Glazer, Gretchen Van Wye, Teresa Janevic
{"title":"Prospective transitions in hemoglobin A1c following gestational diabetes using multistate Markov models.","authors":"Katharine J McCarthy, Shelley H Liu, Joseph Kennedy, Hiu Tai Chan, Victoria L Mayer, Luciana Vieira, Kimberly B Glazer, Gretchen Van Wye, Teresa Janevic","doi":"10.1093/aje/kwae219","DOIUrl":"10.1093/aje/kwae219","url":null,"abstract":"<p><p>We characterized the state-to-state transitions in postpartum hemoglobin A1c levels after gestational diabetes, including remaining in a state of normoglycemia or transitions between prediabetes or diabetes states of varying severity. We used data from the APPLE Cohort, a postpartum population-based cohort of individuals with gestational diabetes between 2009 and 2011, and linked A1c data with up to 9 years of follow-up (n = 34 171). We examined maternal sociodemographic and perinatal characteristics as predictors of transitions in A1c progression using Markov multistate models. In the first year postpartum following gestational diabetes, 45.1% of people had no diabetes, 43.1% had prediabetes, 4.6% had controlled diabetes, and 7.2% had uncontrolled diabetes. Roughly two-thirds of individuals remained in the same state in the next year. Black individuals were more likely to transition from prediabetes to uncontrolled diabetes (adjusted hazard ratio [aHR] = 2.32; 95% CI, 1.21-4.47) than White persons. Perinatal risk factors were associated with disease progression and a lower likelihood of improvement. For example, hypertensive disorders of pregnancy were associated with a stronger transition (aHR = 2.06; 95% CI, 1.39-3.05) from prediabetes to uncontrolled diabetes. We illustrate factors associated with adverse transitions in incremental A1c stages and describe patient profiles that may warrant enhanced postpartum monitoring.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"397-406"},"PeriodicalIF":5.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141625708","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}
引用次数: 0
Association between neighborhood walkability and physical activity in a community-based twin sample. 以社区为基础的双胞胎样本中邻里步行与身体活动的关系。
IF 5 2区 医学
American journal of epidemiology Pub Date : 2025-02-05 DOI: 10.1093/aje/kwae170
Glen E Duncan, Philip M Hurvitz, Bethany D Williams, Ally R Avery, Matthew J D Pilgrim, Siny Tsang, Ofer Amram, Stephen J Mooney, Andrew G Rundle
{"title":"Association between neighborhood walkability and physical activity in a community-based twin sample.","authors":"Glen E Duncan, Philip M Hurvitz, Bethany D Williams, Ally R Avery, Matthew J D Pilgrim, Siny Tsang, Ofer Amram, Stephen J Mooney, Andrew G Rundle","doi":"10.1093/aje/kwae170","DOIUrl":"10.1093/aje/kwae170","url":null,"abstract":"<p><p>We investigated associations between neighborhood walkability and physical activity using twins (5477 monozygotic and same-sex dizygotic pairs) as \"quasi-experimental\" controls of genetic and shared environment (familial) factors that would otherwise confound exposure-outcome associations. Walkability comprised intersection density, population density, and destination accessibility. Outcomes included self-reported weekly minutes of neighborhood walking and moderate-to-vigorous physical activity (MVPA) and days per week using transit services (eg, bus, commuter rail). There was a positive association between walkability and walking, which remained significant after controlling for familial and demographic factors: a 1% increase in walkability was associated with a 0.42% increase in neighborhood walking. There was a positive association between walkability and MVPA, which was not significant after considering familial and demographic factors. In twins with at least 1 day of transit use, a 1-unit increase in log (walkability) was associated with a 6.7% increase in transit use days; this was not significant after considering familial and demographic factors. However, higher walkability reduced the probability of no transit use by 32%, considering familial and demographic factors. Using a twin design to improve causal inference, walkability was associated with walking, whereas walkability and both MVPA and absolute transit use were confounded by familial and demographic factors. This article is part of a Special Collection on Environmental Epidemiology.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"340-348"},"PeriodicalIF":5.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817049","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}
引用次数: 0
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