Long COVID and the higher risk of food insecurity among participants and non-participants of food assistance programs in the United States

Biplab Datta, Serena Phillips

2024-08-01

Background In the aftermath of the COVID-19 public health emergency, it is important to understand the extent of socioeconomic burdens of long COVID, defined as continuation of symptoms after initial infection, including food insecurity. Objective This study aimed to assess the association between long COVID and family food insecurity among low-income individuals (or any of their family members living with them) who were participants and non-participants of public food assistance programs (SNAP, WIC, and NSLP) in the United States. Design The study used an observational cross-sectional design. Participants/setting Data on 7,151 adults (aged 18+ years), with family income of

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Health disparity at the intersection of religion and caste: Evidence from India

Biplab Kumar Datta, Shriya Thakkar

2024-07-26

The provisions and recognition of Schedule Castes (SCs), the constitutional term for the Dalits in India, have been exclusively extended to Hindus, Buddhists, and Sikhs (HBS). Omission of Dalit Muslims and Christians (MC) from the SC category stripped them of the affirmative action benefits tied with the SC status. This study aimed to explore how such differential treatment might play a role in differential health outcomes in Dalit women in India. Methods Drawing data on 177,346 Dalit women, aged 20 to 49 years, from two successive nationally representative surveys, we assessed the differential likelihood of hypertension and diabetes, between MC- and HBS- Dalit women. Accounting for birth cohort-, survey wave-, and state of residence- fixed effects, along with socioeconomic conditions and cardiometabolic risk factors, we obtained adjusted odds of having hypertension and diabetes in MC women. To check the validity of our results, we conducted similar analyses using data on 170,889 Scheduled Tribe (ST) women, another marginalized group, whose ST-status recognition were not tied to religion. Results We found that Dalit MC women were 1.13 (95% CI: 1.03–1.25) and 1.19 (95% CI: 1.05–1.36) times more likely to have hypertension and diabetes, respectively, compared to Dalit HBS women. Conversely, no statistically significant differential likelihood of these conditions was observed between MC and HBS women in the ST sample.

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Religious minority status and risk of hypertension in women: Evidence from Bangladesh

Biplab Kumar Datta, Sanjoy Kumar Chowdhury

2024-06-22

Discrimination based on religion and communal violence against religious minorities have been on the rise worldwide. Despite growing incidences of violence against religious minorities, little is known on the relationship between minority status and population health outcomes in the low-and-middle income countries (LMICs). This study intends fill this gap by assessing the prevalence of hypertension among religious minority women in Bangladesh, a South Asian country with high levels of social hostilities involving religion. Using data from the Bangladesh Demographic and Health Survey (BDHS) 2017-18, we examined whether religious minority women had a differential risk of having hypertension. We estimated logistic regression models to obtain the odds in favor of being hypertensive among women aged 18 to 49 years and compared the odds for religious minority women with that of their non-minority counterparts. We then estimated linear regression models to examine how average systolic- and diastolic- blood pressure measures differ across minority and non-minority women.

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Psychosocial well-being and firearm storage practices: evidence from five US states

Biplab Kumar Datta, Jennifer E. Jaremski, Aaron Johnson

2024-02-08

Objective Gun safety practices can play a pivotal role in preventing suicide and unintentional injuries involving a firearm. This study aimed to assess whether psychosocial well-being, measured by emotional support, feeling of social isolation and life satisfaction, influenced safe storage practices among individuals who had firearms in or around their home. Methods Data are from the firearm safety module of the 2022 Behavioural Risk Factor Surveillance System survey of 11 722 individuals having firearms and living in California, Minnesota, Nevada, New Mexico and Ohio. Respondents were asked to identify how guns were stored in their homes including: (1) not loaded, (2) loaded but locked and (3) loaded and unlocked. Multinomial logistic regression models with controls for sociodemographic correlates assess the relative risks of certain storage measures. Results Relative to the base outcome of not loaded, the adjusted relative risks of having firearms loaded and unlocked among individuals who usually/always felt socially isolated were 1.72 (95% CI: 1.02 to 2.88) times that of individuals who never felt socially isolated. The adjusted risks among individuals who were dissatisfied with their life were 1.82 (95% CI: 1.02 to 3.24) times that of their counterparts who were very satisfied. The adjusted risks were not statistically significant among individuals who rarely/never received needed emotional support compared with individuals who always received support. Conclusion The results suggest a strong relationship between social isolation and life satisfaction and safe storage practices at home. Policies designed to improve psychosocial well-being, therefore, may present an important opportunity for preventing unintentional firearm injuries.

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Prevalence of intellectual disability among adults born in the 1980s and 1990s in the United States

Teal Benevides, Biplab Datta, Jen Jerneski, M. McKee

2024-01-16

Background Prevalence of intellectual disability (ID) is currently estimated through parent report on surveys of children. It is difficult to estimate the number of adults living with ID in the United States because no comprehensive survey or surveillance allows for identification. The purpose of this study was to estimate the prevalence and number of adults with ID born between 1980 and 1999 using multiple years of the National Health Interview Survey (NHIS) and Census data. Methods We concatenated the NHIS from 1997–2016 that evaluated parental response about whether a child aged 3–17 years had an ID. Using weighted survey analyses, we estimated the prevalence of ID among individuals across four birth cohorts—(1) 1980–1984, (2) 1985–1989, (3) 1990–1994, and (4) 1995–1999. The number of adults with ID was then extrapolated by applying these prevalence rates to Census population estimates (as of 1 July 2021) of respective birth cohorts. Results Weighted prevalence of ID varied by birth cohort, sex, race and ethnicity, and US Census Bureau regions. The overall prevalence rate was 1.066 [95% confidence interval (CI): 0.831–1.302] for adults born between 1980 and 1984, 0.772 (CI: 0.654–0.891) for adults born between 1985 and 1989, 0.774 (0.675–0.874) for adults born between 1990 and 1994, and 1.069 (CI: 0.898–1.240) for adults born between 1995 and 1999. Overall, we estimate that 818 564 adults with ID who were approximately 21–41 years were living in the United States as of 2021.

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COVID-19 and health care related financial toxicity in the United States: Evidence from the 2022 National Health Interview Survey

Biplab Datta, Steven S. Coughlin, Ishtaque Fazlul, Ajay Padey

2023-11-10

The COVID-19 pandemic has taken its toll on the health and wellbeing of individuals from almost all walks of life. Illness due to SARS-CoV-2 has brought numerous hardships to individuals and families including job loss, financial hardship, reductions in income, diminished social connections, and decreased access to healthcare. Several studies explored these issues primarily in the context of psychological resilience and mental health outcomes. Few studies examined barriers in access and utilization of health care during the pandemic, and these were conducted on special populations such as survivors of different types of cancer. Evidence on the relationship between COVID-19 and health care related financial toxicity in the general population has been limited.

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Perceived Social Support and Cardiovascular Risk Among Nonelderly Adults in the United States

Biplab Datta, Steven S. Coughlin, Aneesha Gummadi, Daniel Mehrabain, Benjamin Ansa

2023-12-15

Hypertension, diabetes mellitus, dyslipidemia, and obesity are major risk factors of cardiovascular diseases. A recent study projected a marked surge in these cardiometabolic conditions in the United States by the year 2060, posing a challenge for cardiovascular disease management in the coming years. This study aimed to explore and quantify the relation of a key psychosocial factor, social support, with the cardiovascular risk factors among nonelderly US adults (aged 18 to 64 years). Using data on 19,827 adults from the 2021 National Health Interview Survey, we assessed whether lower level of social support was associated with higher likelihood of having cardiovascular risks. We found that for subjects who “rarely/never” received social support, the adjusted odds of having hypertension, high cholesterol, and diabetes were 1.42 (95% confidence interval [CI] 1.20 to 1.67), 1.39 (95% CI 1.18 to 1.65), and 1.53 (95% CI 1.22 to 1.91) times those of subjects “always” receiving support, respectively. Further, compared with the base outcome of no CV risk, the adjusted relative risks of having 3+ cardiovascular risks for subjects “rarely/never” receiving support were 1.91 (95% CI 1.49 to 2.46) times that of those “always” receiving support. These results were robust across socioeconomic status condition sub-groups manifested by educational attainment and income. In conclusion, our findings suggest that social support may be considered as a critical part of the comprehensive efforts to mitigate the future burden of cardiovascular diseases in the United States.

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Early Marriage in Adolescence and Risk of High Blood Pressure and High Blood Glucose in Adulthood: Evidence from India

2022 Adolescence, the transition phase to adulthood, is a critical period for physical and psychological development. Disruptions during this period, such as getting married, could result in various adverse short- and long-term health outcomes. This study aimed to assess the differential risk of two common chronic conditions—high blood pressure and high blood glucose—in adult women (20–49 years) who were married during different stages of adolescence (10–19 years) compared to women who were married in their youth (20–24 years). Using the most recent nationally representative data from India, we separately assessed the odds in favor of having the two chronic conditions for women who were married during early (10–14 years), middle (15–17 years), and late (18–19 years) adolescence. We found that an earlier age at marriage during adolescence was associated with a higher risk of chronic conditions later in life. Women who were married during early adolescence were respectively 1.29 and 1.23 times more likely (p < 0.001) to have high blood pressure and high blood glucose compared to women who were married in their youth. These findings highlight the importance of preventing underage marriage among adolescent females to address the risk of downstream chronic health consequences as adults.

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The risk of hypertension among child brides and adolescent mothers at age 20 s, 30 s, and 40 s: Evidence from India

2022 Hypertension in reproductive age women, particularly in low-and-middle income countries (LMICs) is an area that is less explored. This study assesses the risk of hypertension in relation to two critical women’s health issues in the LMICs – child marriage and adolescent childbearing. The health consequences of these issues have been primarily studied in the context of reproductive health. There is a dearth of evidence on the long-term health outcomes associated with these early life events. The current study, by linking child marriage and adolescent motherhood with hypertension in young adult and early middle-aged women, is commensurate with the body of literature that examines the link between potentially early adversity and later life risk of chronic health outcomes. Using the most recent data on 582,358 women aged 20 to 49 years from India, this study examined whether child brides and adolescent mothers at age 20 s, 30 s, and 40 s had a higher risk of having hypertension compared to women who were not married before age 18 years or did not give birth by age 19 years in respective age groups. Estimating multivariable logistic regressions, we found that child brides and adolescent mothers were about 1.2 times more likely to have hypertension later in life. The elevated risk of hypertension among child brides and adolescent mothers were evident at every age group. These results were robust after controlling for various sociodemographic, anthropometric, and behavioral characteristics as well as across urban and rural, and poor and non-poor subgroups.

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Stolen childhood taking a toll at young adulthood: The higher risk of high blood pressure and high blood glucose comorbidity among child brides

2022 Despite notable progress being made in preventing child marriage, a significant proportion of women worldwide are still married before reaching adulthood. Though many aspects of child marriage have been widely studied, little is known on the later life health outcomes of child brides, let alone the critical need for healthcare during adulthood. This paper examines whether child brides at a young adult age bear a greater risk of high blood pressure (HBP) and high blood glucose (HBG) comorbidity than those who were married as adults. Using nationally representative data from India, we categorized married young adult (aged 20-34 years) women in four categories: neither HBP nor HBG, HBP only, HBG only, and both HBP and HBG. We estimated multinomial logistic regressions to obtain unadjusted and adjusted relative risk ratios in favor of these mutually exclusive outcomes for the child marriage indicator. Around 0.5% of the women in our sample had high blood pressure and high blood glucose comorbidity. While the prevalence of comorbidity was 0.4% among women who were married as adults, comorbidity was 40% higher (p < 0.000) among women who were married as children. The relative risk of the comorbidity among child brides was 1.4 (95%CI: 1.2–1.7) times that of their peers who were not married as children. The findings, thus, suggest that child brides at young adult age are at greater risk of having high blood pressure and high blood glucose comorbidity. Concerted public health efforts, therefore, are necessary to improve their long-term health and wellbeing.

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Inequities in routine preventive care utilization among persons with overweight/obesity in the United States: An analysis of nativity, racial and ethnic identity, and socioeconomic status

Biplab Kumar Datta, Stephen S. Coughlin, Ben Majeed

2023-03-13

Extant literature documented various health disparities among immigrants and racial and ethnically marginalized individuals in the United States. However, health disparities in the intersection of nativity and race are generally less visited. This cross-sectional study assessed utilization of routine preventive care among adults with overweight/obesity at the junction of their nativity, racial/ethnic identity, and socioeconomic status (i.e., income and education). Pooling data on 120,184 adults with overweight/obesity from the 2013–2018 waves of the National Health Interview Survey (NHIS), we estimated modified Poisson regressions with robust standard errors to obtain adjusted prevalence rates of preventive care visit, receiving flu shot, and having blood pressure, cholesterol and blood glucose screened. We found that immigrant adults with overweight/obesity had lower rates of utilization of all five preventive care services. However, these patterns varied by racial and ethnic sub-populations. While White immigrants had comparable rates of cholesterol and blood glucose screening, they had 2.7%, 2.9%, and 14.5% lower rates of preventive care visit, blood pressure screening, and getting a flu shot respectively, compared to native-born Whites. These patterns were similar for Asian immigrants as well. Black immigrants, on the other hand, had comparable rates of getting a flu shot and blood glucose screening, and had 5.2%, 4.9%, and 4.9% lower rates of preventive care visit, blood pressure screening, and cholesterol screening respectively. Lastly, the rates of utilization among Hispanic immigrants were significantly lower (ranging from 9.2% to 20%) than those of their native-born counterparts for all five preventive care services. These rates further varied by education, income, and length of stay in the US, within the racial and ethnic sub-groups. Our findings thus suggest a complex relationship between nativity and racial/ethnic identity in relation to preventive care utilization among adults with overweight/obesity.

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The role of child marriage and marital disruptions on hypertension in women - A nationally representative study from India

Ashwini Tiwari, Biplab Kumar Datta, Mohammad Rifat Haider, Murshed Jahan

2023-04-17

Child marriage is associated with negative health trajectories among women in low- and middle-income countries (LMICs). Marital disruptions in LMICs are also associated with adverse socioeconomic and health outcomes in women. Yet, little is known about the compounded health effects of experiencing both child marriage and marital disruptions. Using nationally representative data from India among women aged 18–49 years, we examined the effects of marital age (i.e., marriage before or after 18 years) and martial disruptions (i.e., widowed/divorced/separated) on the odds of having hypertension. Findings suggest that together, marital disruptions and child marriage increase the risk of hypertension. Specifically, women married as children and who experienced marital disruptions were 1.2 (95% CI: 1.2–1.3) times more likely to have hypertension compared to women who married as adults and currently in marriage. Additionally, among women married as children, those who experienced martial disruptions had a higher risk (AOR = 1.1, 95% CI: 1.0–1.2) of hypertension compared to their currently married peers. These results suggest public health strategies must consider contextual effects of being widowed/divorced/separated among women who were married as children. Simultaneously, prevention initiatives should be strengthened to reduce the incidence of child marriage in LMICs and associated downstream health consequences.

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Role of perceived social support in COVID-19 vaccine uptake among U.S. adults

Biplab Kumar Datta, Jennifer Jaremski, Benjamin Ansa, Lorraine Odhiambo, K.M. Monirul Islam, J Aaron Johnson

2023-04-27

Background Vaccine uptake concerns in the Unites States were at the forefront of public health discussions during the COVID-19 pandemic. By the end of 2022, approximately 80% of the U.S. population was vaccinated against the virus. This study examined the relationship between perceived social support and COVID-19 vaccine uptake among U.S. adults. Methods Using nationally representative cross-sectional data on 21,107 adults from the 2021 National Health Interview Survey, we assessed the COVID-19 vaccination rates across individuals with strong, some, and weak levels of social support. Multivariable logistic regression models were estimated to obtain the odds of being vaccinated in adults with different levels of perceived social support for the full sample and sub-samples of age groups. Results We found that compared to adults with perceived strong social support, adults with weak social support were 21.1% less likely to be vaccinated against COVID-19. Apart from the age 18-24 years group, the lower likelihood of being vaccinated for adults with weak social support was evident in age 24-49 years (AOR=0.66, 95% CI: 0.52-0.85), age 50-64 years (AOR=0.67, 95% CI: 0.50-0.90), and age 65+ years (AOR=0.56, 95% CI: 0.41-0.75) groups. Conclusions These findings are consistent with a broader literature indicating that social support increases the likelihood of healthy behaviors and decreases risky behaviors. Interventions designed to improve the perception of social support, particularly among those at high risk of mortality from COVID-19 may be a promising tactic for increasing COVID-19 vaccine uptake.

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Relationship between social support, life satisfaction, and smoking status among US adults with cardiovascular risks

Biplab Kumar Datta, Steven S. Coughlin, Jiheyne

2023-09-28

Social support and life satisfaction are important determinants of health behaviors and health outcomes. Cigarette smoking, a health risk behavior that increases the risk of cardiovascular diseases, is deemed to have association with perceived social support and life satisfaction. This study assessed this relationship among US adults with one or more cardiovascular (CV) risks, namely, hypertension, high cholesterol, diabetes, and obesity. Using nationally representative data from the 2021 National Health Interview Survey on 17,557 adults with at least one CV risk, we examined whether individuals with low life-satisfaction and weak social-support were more likely to smoke compared to those with high life-satisfaction and strong social support. At different levels of social support (strong and weak), the odds of smoking were higher among individuals with low level of life satisfaction. Likewise, at different levels of life satisfaction (high, medium, and low), smoking prevalence was the highest among individuals with weak social support. Estimates of the multivariable logistic regressions, with controls for various demographic and socioeconomic correlates, suggested that the adjusted odds of current smoking for individuals with low life-satisfaction and weak social-support were 3.07 (95% CI: 2.34, 4.03) times that of individuals with high life-satisfaction and strong social support. This association was robust across all four CV risk factors, and across different sociodemographic (i.e., sex, age, race and ethnicity) and socioeconomic (i.e., income, urban/rural residence) sub-groups.

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Health disparity at the intersection of religion and caste: Evidence from India

Biplab Kumar Datta, Shriya Thakkar

2023-12-01

Objective The provisions and recognition of Schedule Castes (SCs), the constitutional term for the Dalits in India, have been exclusively extended to Hindus, Buddhists, and Sikhs (HBS). Omission of Dalit Muslims and Christians (MC) from the SC category stripped them of the affirmative action benefits tied with the SC status. This study aimed to explore how such differential treatment might play a role in differential health outcomes in Dalit women in India. Methods Drawing data on 177,346 Dalit women, aged 20 to 49 years, from two successive nationally representative surveys, we assessed the differential likelihood of hypertension and diabetes, between MC- and HBS- Dalit women. Accounting for birth cohort-, survey wave-, and state of residence- fixed effects, along with socioeconomic conditions and cardiometabolic risk factors, we obtained adjusted odds of having hypertension and diabetes in MC women. To check the validity of our results, we conducted similar analyses using data on 170,889 Scheduled Tribe (ST) women, another marginalized group, whose ST-status recognition were not tied to religion. Results We found that Dalit MC women were 1.13 (95% CI: 1.03–1.25) and 1.19 (95% CI: 1.05–1.36) times more likely to have hypertension and diabetes, respectively, compared to Dalit HBS women. Conversely, no statistically significant differential likelihood of these conditions was observed between MC and HBS women in the ST sample. Conclusion Our investigation thus, indicated a potential link at the crossroads of religion and caste that may contribute to the health disparities among marginalized women in India.

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