Associations of Sociodemographic and Neighborhood Vulnerability With Cardiovascular Health in Midlife Women in the United States

Why Do Americans Have Shorter Life Expectancy and Worse Health Than Do People in Other High-Income Countries?

Americans lead shorter and less healthy lives than do people in other high-income countries. We review the evidence and explanations for these variations in longevity and health. Our overview suggests that the US health disadvantage applies to multiple mortality and morbidity outcomes. The American health disadvantage begins at birth and extends across the life course, and it is particularly marked for American women and for regions in the US South and Midwest. Proposed explanations include differences in health care, individual behaviors, socioeconomic inequalities, and the built physical environment. Although these factors may contribute to poorer health in America, a focus on proximal causes fails to adequately account for the ubiquity of the US health disadvantage across the life course. We discuss the role of specific public policies and conclude that while multiple causes are implicated, crucial differences in social policy might underlie an important part of the US health disadvantage.

Credit Access in the United States

We measure differences in US households’ access to credit and explore the mechanisms driving such differences using newly constructed population-level linked credit bureau and Census data. We find large differences in credit scores by race, class, and hometown that emerge in one’s 20s and persist throughout the life cycle. These gaps are primarily driven by differences in delinquencies that emerge in young adulthood. By age 30, 73% of Black individuals, 62% of those from low-income families, and 51% of those from Appalachia and the South have a 90+ day delinquency on their credit report, in contrast to 36% for White individuals, 20% for high-income families, and 31% for those from the upper Midwest. These delinquencies are correlated with income and wealth, but observed income profiles and wealth account for at most 10–35% of the gaps in delinquencies across groups. In contrast, movers-based estimates of hometown effects imply that childhood exposure accounts for around 50% of the differences in delinquencies across hometowns. Counties that promote repayment also promote upward income mobility, but adult income mediates only a small fraction of this relationship: growing up in a place where others are likely to repay improves credit outcomes even for those who do not have higher income in adulthood. We provide suggestive evidence on the mechanisms driving these patterns. JEL Codes: G5, H0.

Homebound: The Long-Term Rise in Time Spent at Home Among U.S. Adults

The changes in daily life induced by the COVID-19 pandemic brought renewed attention to longstanding concerns about social isolation in the United States. Despite the links between the physical setting for individuals' daily lives and their connections with family, friends, and the various institutions of collective life, trends in where American adults spend their time have been largely overlooked as researchers have focused on how and with whom they spend their time. This article analyzes data from the American Time Use Survey over a timeframe spanning nineteen years and argues that the changes in Americans' daily routines induced by the COVID era should be seen as an acceleration of a longer-term trend: the rise of time spent at home. Results show that from 2003 to 2022, average time spent at home among American adults has risen by one hour and 39 minutes in a typical day. Time at home has risen for every subset of the population and for virtually all activities. Preliminary analysis indicates that time at home is associated with lower levels of happiness and less meaning, suggesting the need for enhanced empirical attention to this major shift in the setting of American life.

Homebound: The Long-Term Rise in Time Spent at Home Among U.S. Adults

The changes in daily life induced by the COVID-19 pandemic brought renewed attention to longstanding concerns about social isolation in the United States. Despite the links between the physical setting for individuals' daily lives and their connections with family, friends, and the various institutions of collective life, trends in where American adults spend their time have been largely overlooked as researchers have focused on how and with whom they spend their time. This article analyzes data from the American Time Use Survey over a timeframe spanning nineteen years and argues that the changes in Americans' daily routines induced by the COVID era should be seen as an acceleration of a longer-term trend: the rise of time spent at home. Results show that from 2003 to 2022, average time spent at home among American adults has risen by one hour and 39 minutes in a typical day. Time at home has risen for every subset of the population and for virtually all activities. Preliminary analysis indicates that time at home is associated with lower levels of happiness and less meaning, suggesting the need for enhanced empirical attention to this major shift in the setting of American life.

Menopausal hormone therapy and coronary heart disease: the roller-coaster history

In the USA it is estimated that more than one million women become menopausal each year. Coronary heart disease (CHD) is the leading cause of mortality in menopausal woman globally. The majority of...

Reducing Bias in Observational Studies Using Subclassification on the Propensity Score

The propensity score is the conditional probability of assignment to a particular treatment given a vector of observed covariates. Previous theoretical arguments have shown that subclassification on the propensity score will balance all observed covariates. Subclassification on an estimated propensity score is illustrated, using observational data on treatments for coronary artery disease. Five subclasses defined by the estimated propensity score are constructed that balance 74 covariates, and thereby provide estimates of treatment effects using direct adjustment. These subclasses are applied within subpopulations, and model-based adjustments are then used to provide estimates of treatment effects within these subpopulations. Two appendixes address theoretical issues related to the application: the effectiveness of subclassification on the propensity score in removing bias, and balancing properties of propensity scores with incomplete data.

Most Community Health Centers Provide Prenatal Care, But One-Third Still Lack Services | HPHCI: Department of Population Medicine

Boston, MA—A new national study provides the first comprehensive look at prenatal care services offered by federally qualified health centers (FQHCs), revealing that while these safety-net providers play a critical role in caring for low-income and racially diverse pregnant populations, significant gaps in access remain.

Does Using Social Media Jeopardize Well-Being? The Importance of Separating Within- From Between-Person Effects

Social networking sites (SNS) are frequently criticized as a driving force behind rising depression rates. Yet empirical studies exploring the associations between SNS use and well-being have been predominantly cross-sectional, while the few existing longitudinal studies provided mixed results. We examined prospective associations between SNS use and multiple indicators of well-being in a nationally representative sample of Dutch adults ( N ∼ 10,000), comprising six waves of annual measures of SNS use and well-being. We used an analytic method that estimated prospective effects of SNS use and well-being while also estimating time-invariant between-person associations between these variables. Between individuals, SNS use was associated with lower well-being. However, within individuals, year-to-year changes in SNS use were not prospectively associated with changes in well-being (or vice versa). Overall, our analyses suggest that the conclusions about the causal impact of social media on rising mental health problems in the population might be premature.

Arsenic exposure at birth, socioeconomic status, and epigenetic aging among adults in northern Chile

Background Arsenic exposure remains a major global health concern, and early-life exposure has been linked to cancer, cardiovascular disease, and diabetes. Epigenetic biomarkers of aging may capture long-term effects of arsenic, yet whether exposure during sensitive developmental windows leaves detectable epigenetic signatures decades later remains unclear. Socioeconomic status (SES) may modify these relationships, yet its role as a modifier has not been examined. Methods We leveraged a natural experiment in northern Chile, where municipal drinking-water arsenic concentrations were extremely high from 1958 to 1972. Decades later, leukocyte DNA methylation was measured among 358 adults (mean age = 65.7 years) using the Illumina EPIC v2 array. Arsenic concentration at birth (0-860 μg/L) was assigned from historical water records. Current exposure was measured in urine (2-646 μg/g creatinine). We evaluated associations of birth and current arsenic exposure with epigenome-wide methylation and epigenetic aging, incorporating multiplicative interaction and stratification by SES. Results No CpGs were linked to birth arsenic exposure, whereas nine CpGs passed the Bonferroni threshold for current urinary arsenic (pBonferroni

Arsenic exposure at birth, socioeconomic status, and epigenetic aging among adults in northern Chile

Background Arsenic exposure remains a major global health concern, and early-life exposure has been linked to cancer, cardiovascular disease, and diabetes. Epigenetic biomarkers of aging may capture long-term effects of arsenic, yet whether exposure during sensitive developmental windows leaves detectable epigenetic signatures decades later remains unclear. Socioeconomic status (SES) may modify these relationships, yet its role as a modifier has not been examined. Methods We leveraged a natural experiment in northern Chile, where municipal drinking-water arsenic concentrations were extremely high from 1958 to 1972. Decades later, leukocyte DNA methylation was measured among 358 adults (mean age = 65.7 years) using the Illumina EPIC v2 array. Arsenic concentration at birth (0-860 μg/L) was assigned from historical water records. Current exposure was measured in urine (2-646 μg/g creatinine). We evaluated associations of birth and current arsenic exposure with epigenome-wide methylation and epigenetic aging, incorporating multiplicative interaction and stratification by SES. Results No CpGs were linked to birth arsenic exposure, whereas nine CpGs passed the Bonferroni threshold for current urinary arsenic (pBonferroni

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Reporting from the frontiers of health and medicine

Smartphone interactions and mental well-being in young adults: A longitudinal study based on objective high-resolution smartphone data

Aims: To investigate the effects of objectively measured smartphone interactions on indicators of mental well-being among men and women in a population of young adults. Methods: A total of 816 young adults (mean±SD age 21.6±2.6 years; 77% men) from the Copenhagen Network Study were followed with objective recordings of smartphone interactions from calls, texts and social media. Participants self-reported on loneliness, depressive symptoms and disturbed sleep at baseline and in a four-month (interquartile range 75–163 days) follow-up survey. Multiple linear regression was used to analyse the association between smartphone interactions and mental well-being separately for men and women. Results: A higher number of smartphone interactions was associated with lower levels of loneliness at baseline and the same pattern appeared for depressive symptoms, although this was less pronounced. A high level of smartphone interaction was associated with lower levels of disturbed sleep for men, but not for women. In follow-up analyses, a high versus low level of smartphone interaction was associated with an increase in loneliness and depressive symptoms over time for women, but not for men. Conclusions: Smartphone interactions are related to better mental well-being, which may be attributed to the beneficial effects of an underlying social network. Over time, accommodating a large network via smartphone communication might, however, have negative effects on mental well-being for women.

Digital inequality in communication during a time of physical distancing: The case of COVID-19

In times of physical distancing, such as during the COVID-19 pandemic, people are likely to turn to digital communication to replace in-person interactions. Yet, persisting digital inequality suggests that not everyone will be equally able or disposed to increasing digital communication during a public health crisis. Using survey data from a national sample of U.S. participants (N = 2,925) that we collected during the early months of the pandemic, we analyzed how sociodemographics, living arrangements, and Internet experiences and skills relate to increases and decreases in various digital communication methods. We find that people privileged in their socioeconomic status, their Internet skills and online experiences are more likely to increase and less likely to decrease digital communication during the pandemic. The findings illustrate how digital inequalities can put already disadvantaged groups at greater risk of diminished social contact during a public health crisis. We discuss the theoretical implications of our findings for digital inequality research, the practical implications for inclusive crisis responses, and directions for future research.

Methylphenidate and Short-Term Cardiovascular Risk

This cohort study examines the risks of cardiovascular disease after 6 months of methylphenidate treatment in individuals with attention-deficit/hyperactivity disorder.

It’s Stanford time, baby: 8-hour time-restricted press releases linked to a 91% higher risk of hype

You and the blog readers might find this interesting: https://newsroom.heart.org/news/8-hour-time-restricted-eating-linked-to-a-91-higher-risk-of-cardiovascular-death.

Menopausal Hormone Therapy and Health Outcomes During the Intervention and Extended Poststopping Phases of the Women’s Health Initiative Randomized Trials

Manson and coauthors provide an update and overview of health outcomes during the intervention and poststopping phases of the Women’s Health Initiative (WHI) hormone therapy trials. In an accompanying Editorial, Nabel discusses how the WHI is a victory for women and their health.