A Demographic Profile of Obesity in the Adult and Veteran US Populations in 2008

Obesity is increasing in the US population and seems to be disproportionately burdening disadvantaged groups. Veterans using the Veterans Healthcare System (VHS) tend to be more disadvantaged socioeconomically than the general population and in poorer health. It is important to understand how the veteran population differs from or is similar to the general population and whether the VHS is able to mediate obesity risk among veterans. This research assesses the sociodemographic, behavioral, and health risk factors for obesity in the US adult and veteran populations in 2008. We use data from the 2008 Behavioral Risk Factor Surveillance System (BRFSS) to empirically assess predictors of obesity risk. We find that women have lower odds of obesity than men once controls for sociodemographic, behavioral, and health conditions are included in our models. We also observe a veteran obesity disadvantage in the full adult sample when conducting bivariate tests, but no significant association with the odds of obesity in the logistic regression models among veterans and non-veterans. Gender specific models indicate that male veterans have increased odds of obesity compared to non-veterans, but no difference in obesity risks among veterans and non-veterans are noted for women, controlling for all variables. Further, we find no significant differences in the odds of obesity of veterans using VHS for all, some, or none of their health care needs; further no significant gender differences in obesity risk were observed among VHS usages and non-users. Based on the strong, positive association between the number of chronic health conditions and the odds of obesity, we suggest that health policy should focus efforts on weight management counseling for obese patients that have obesity related co-morbidities, and more targeted attention to male veterans would help to address the high level of obesity in this vulnerable population group.     

Weight loss and related behavior changes among lesbians

Overweight and obesity are known risk factors for several modifiable, if not preventable diseases. Growing evidence suggests that lesbians may have higher rates of obesity than other women. This study was designed to describe weight loss and behavior changes related to food choices and exercise habits among lesbians who participated in a predominantly lesbian, mainstream, commercial weight loss program. Behavioral changes were recorded in exercise, quality of food choices, and number of times dining out. Although there were several limitations based on sample size and heterogeneity, the impact of a lesbian-supportive environment for behavior change was upheld.     

Length of residence,social ties,and economic opportunities

This study examines length of residence for movers—that subsection of the population which accounts for the high mobility rates in the United States. The propensity for repeated migration is studied in relation to economic opportunities and previous familial and personal contacts. The results indicate no influence of economic opportunities on duration of residence. This finding is consistent with recent research that indicates economic conditions are not a general stimulus for out-migration, although they are for in-migration. On the other hand, length of residence is found to be longer where previous familial and personal contacts existed. Overall, the results provide additional evidence of the importance of social, as opposed to strictly economic, variables in the migration process.     

Internalized Homophobia,HIV Knowledge,and HIV/AIDS Personal Responsibility Beliefs: Correlates of HIV/AIDS Discrimination among MSM in the Context of Institutionalized Stigma

ABSTRACT

There exists a paucity of research on the psychosocial risk factors of HIV/AIDS among men who have sex with men (MSM) in settings where they are stigmatized or face prosecution. The present study investigates discrimination against people living with HIV (PLHIV), internalized homophobia, HIV/AIDS personal responsibility beliefs and HIV knowledge in a purposive sample of 106 self-identified MSM obtained through a web-based survey disseminated by two voluntary welfare organizations. Results indicate that internalized homophobia is positively associated with discrimination against PLHIV. Internalized homophobia also substantially mediates the effect of HIV/AIDS personal responsibility beliefs on discrimination against PLHIV, highlighting the confounded nature of HIV/AIDS and homosexual stigma in a setting where stigma is deep-rooted and institutionalized. Internalized homophobia may thus serve as a barrier to the effectiveness of HIV prevention efforts among MSM in Singapore.     

From the Editor

This study examined risk factors associated with self-reported health (SRH) in a genetically informative sample of older African American female twins. An interview was conducted with a national sample of 180 African American female twin pairs. Questions included: SRH, demographics, health behaviors, chronic diseases, and functional status. SRH was dichotomized into negative (fair/poor) and positive (good/very good/excellent). Logistic regression for clustered data was used to estimate the odds ratios and 95% confidence intervals. In multivariable analyses, IADL limitations (OR?=?1.5, 95% CI?=?1.7–2.0) and a chronic disease index (OR?=?1.9, 95% CI?=?1.4–2.5) were associated with negative SRH. In multivariate within-twin pair analysis, controlling for genetics/shared familial environment, IADLs (OR?=?1.8, 95% CI?=?1.1–2.7), and increasing numbers of chronic diseases (OR?=?2.0, 95% CI?=?1.3–3.2) remained significantly associated with negative SRH.     

One Size May Not Fit All: How Obesity Among Mexican-Origin Youth Varies by Generation,Gender, and Age

Immigrants’ health (dis)advantages are increasingly recognized as not being uniform, leading to calls for studies investigating whether immigrant health outcomes are dependent on factors that exacerbate health risks. We answer this call, considering an outcome with competing evidence about immigrants’ vulnerability versus risk: childhood obesity. More specifically, we investigate obesity among three generations of Mexican-origin youth relative to one another and to U.S.-born whites. We posit that risk is dependent on the intersection of generational status, gender, and age, which all influence exposure to U.S. society and weight concerns. Analyses of National Health and Nutrition Examination Studies (NHANES) data suggest that accounting for ethnicity and generation alone misses considerable gender and age heterogeneity in childhood obesity among Mexican-origin and white youth. For example, second-generation boys are vulnerable to obesity, but the odds of obesity for first-generation girls are low and on par with those of white girls. Findings also indicate that age moderates ethnic/generational differences in obesity among boys but not among girls. Overall, ethnic/generational patterns of childhood obesity do not conform to a “one size fits all” theory of immigrant health (dis)advantage, leading us to join calls for more research considering how immigrants’ characteristics and contexts differentially shape vulnerability to disease and death.     

Gestational weight gain in obese women by class of obesity and select maternal/newborn outcomes: A systematic review

BackgroundObesity and gestational weight gain impact maternal and fetal risks. Gestational weight gain guidelines are not stratified by severity of obesity.AimConduct a systematic review of original research with sufficient information about gestational weight gain in obese women stratified by obesity class that could be compared to current Institute of Medicine guidelines. Evaluate variance in risk for selected outcomes of pregnancy with differing gestational weight gain in obese women by class of obesity.MethodsA keyword advanced search was conducted of English-language, peer-reviewed journal articles using 3 electronic databases, article reference lists and table of content notifications through January 2015. Data were synthesized to show changes in risk by prevalence.FindingsTen articles met inclusion criteria. Outcomes assessed were large for gestational age, small for gestational age, and cesarean delivery. Results represent nearly 740,000 obese women from four different countries. Findings consistently demonstrated gestational weight gain varies by obesity class and most obese women gain more than recommended by Institute of Medicine guidelines. Obese women are at low risk for small for gestational age and high risk for large for gestational age and risk varies with class of obesity and gestational weight gain. Research suggests the lowest combined risk of selected outcomes with weight gain of 5–9 kg in women with class I obesity, 1 to less than 5 kg for class II obesity and no gestational weight gain for women with class III obesity.ConclusionsGestational weight gain guidelines may need modification for severity of obesity.     

Direct and indirect effects on infant mortality in a high-fertility US population

This article examines the direct and indirect effects of social and demographic measures on infant mortality using data from a church directory of the Old Order Amish of the Lancaster, PA, Settlement. The sample includes all infant deaths and a simple random sample of survivors (total n=2013). The results reveal that the death of the immediately prior sibling directly increases the risk of infant death nearly 30%, net of other factors. Also, the risk of mortality in the first year increases as birth order increases, particularly at the highest orders (8–17 prior sibs). Infants of the youngest mothers (age 13) are nearly 10% more likely to die in the first year of life than are infants of mothers age 24, nearly all of which is indirect via parity, prior sib death and birth interval. Further analysis shows that families adapting more rapidly to external community pressures face a higher risk of infant death than families living in more stable areas. These relationships emerge even in this homogeneous population with a relatively high standard of living and a traditional lifestyle, Implications are that indirect effects should be included in research on teen pregnancy and infant survival, and might be especially important for studies in transitional geographic areas.An earlier version of this paper was presented at the 1993 meetings of Population Association of America, Cincinnati.     

Differential Impacts of Stressors on Sense of Belonging

A number of personal and familial stressors are supposedly stressful. However, their individual impacts on the person’s sense of belonging remain largely uncharted. The study thereby examines the impacts of the stressors in general and in relation to personal and familial background characteristics. Such examination adheres to the perspective of resource theory, which envisions that resources are salutary and relieving the stress of stressors by compensating for resource loss. A survey of 1,200 residents in Taiwan provided data for the examination. Results revealed that work-to-family conflict and family disbanding were two stressors weakening sense of belonging. Furthermore, the former stressor was more stressful to people of higher social class, whereas the latter stressor was more stressful to people with higher family income but lower education. The results imply certain ways to employ resources properly to tackle the stress of stressors.     

Global QUALITY OF LIFE (QOL), health and ability are primarily determined by our consciousness. Research findings from Denmark 1991–2004

Objective: To explain the global quality of life (QOL) from 2000 indicators representing all aspects of life. Design and setting: Two cross sectional population studies, one prospective cohort study and one retrospective cohort study. Participants: (1) Representative sample of 2500 Danes (18–88 years), (2) 7222 members of the Copenhagen Perinatal Birth Cohort 1959–1961 (31–33 years), (3) 9.006 mothers and their 8820 children born in Copenhagen 1959–1961, (4) 746 Danes (55–66 years). Main outcome measures: Global QOL measured by SEQOL (self evaluation of QOL) containing eight global QOL measures: Well-being, life-satisfaction, happiness, fulfilment of needs, experience of temporal and spatial domains, expression of lifes potentials and objective factors. Results: 2000 associations; strongest between QOL and health, ability, the personal philosophy of life, the relationships to oneself, the partner and friends; weakest between QOL and 1000 early life factors, 1000 life events and 100 objective factors like income. Conclusions: Quality of life is associated with personal health and attitude towards life, rather than objective factors, life style, or life events. We conclude that QOL can be developed independently and thus be used as medicine.     

"Safety" in gay men's personal ads, 1985-1996

A content analysis was conducted of a sample of gay men's personal ads over the period 1985-1996. Ads (591) were analysed, comparing those which contained references to "safety" and those which did not. Approximately 10% of ads included such a reference and this proportion did not change over time. "Safety" was not associated with the personal characteristics of advertisers or their desired partners but was more commonly mentioned by older men. There were strong associations between oral sex, anal sex and mentioning safety. However, the differential risks of HIV transmission associated with oral sex and anal sex were not reflected in the extent of reference to safety, suggesting uncertainty about the risks of HIV transmission associated with oral sex.     

Comparing Observed and Unobserved Components of Childhood: Evidence From Finnish Register Data on Midlife Mortality From Siblings and Their Parents

In this study, we argue that the long arm of childhood that determines adult mortality should be thought of as comprising an observed part and its unobserved counterpart, reflecting the observed socioeconomic position of individuals and their parents and unobserved factors shared within a family. Our estimates of the observed and unobserved parts of the long arm of childhood are based on family-level variance in a survival analytic regression model, using siblings nested within families as the units of analysis. The study uses a sample of Finnish siblings born between 1936 and 1950 obtained from Finnish census data. Individuals are followed from ages 35 to 72. To explain familial influence on mortality, we use demographic background factors, the socioeconomic position of the parents, and the individuals’ own socioeconomic position at age 35 as predictors of all-cause and cause-specific mortality. The observed part—demographic and socioeconomic factors, including region; number of siblings; native language; parents’ education and occupation; and individuals’ income, occupation, tenancy status, and education—accounts for between 10 % and 25 % of the total familial influence on mortality. The larger part of the influence of the family on mortality is not explained by observed individual and parental socioeconomic position or demographic background and thus remains an unobserved component of the arm of childhood. This component highlights the need to investigate the influence of childhood circumstances on adult mortality in a comprehensive framework, including demographic, social, behavioral, and genetic information from the family of origin.     

社会网络视角下中国农村成年男性初婚风险的影响因素分析

在婚姻挤压背景下,男性拥有较多的社会网络资源是否意味着他们有更多结识异性和获得应急性经济支持的机会,从而增加了其初婚的概率?利用2008年西安交通大学人口与发展研究所在安徽X县调查的数据,从社会网络角度出发,采用事件史分析方法分析影响18~50岁农村男性初婚风险水平的因素。分析结果表明,当前农村男性的初婚年龄主要集中在22~27岁之间,27岁以上仍未结婚的男性,其成婚的概率急剧下降,成为婚姻市场的弱势群体;男性自身的特征和资源拥有状况,包括婚前社会网络、个人经济和非经济特征、家庭和社区因素,往往决定着个人的初婚风险水平,一般来说,男性自身特征和资源拥有状况越差,结婚的可能性越小。     

The effect of inbreeding on early childhood mortality: Twelve generations of an amish settlement

An unresolved issue in research on child survival is the extent to which familial mortality risk in infancy is due to biological influences net of sociodemographic and economic factors. We examine the effect of consanguinity on early childhood mortality in an Old Order Amish settlement by using the inbreeding coefficient, an explicit measure of the degree of relatedness in one's ancestry. Inbreeding has a net positive effect on neonatal and postneonatal deaths. We find social, demographic, and population-based sociocultural explanations for this effect among the Amish population which is known to experience certain genetically transmitted defects associated with mortality.     

Nativity and older women's health: constructed reliance in the health and retirement study

Gender and nativity are known risk factors for physical and economic dependency. Immigrant women are particularly disadvantaged because of their greater lack of social and economic resources. In this study, we investigate how women immigrants coordinate and utilize various support systems as they approach retirement age, as well as how choices and constraints affect their physical wellbeing. Experiences throughout the life course play a role in the maintenance of health, but the pre-retirement years are particularly crucial to the establishment of patterns of reliance to be used in later life. We examine the effects of economic resources, social support, and family ties (as well as several exogenous variables) on women's physical health using data from the Health and Retirement Survey. For the women in this study, demographic characteristics, such as Hispanic ethnicity and low education are strong risk factors for poor health. Findings also indicate that reliance patterns across resource domains do not differ significantly by nativity and that both economic and familial resource access significantly lessens the risk of poor health for both native and foreign born women.     

Prevalence of and risk factors associated with cesarean section in Lebanon — A retrospective study based on a sample of 29,270 women

Background

During the last decades, there has been an alarming and dramatic increase in the number of cesarean births in both developed and undeveloped countries. This increase has not been clinically justified but, nevertheless, has raised an important number of issues.

Risk factors of severity of abuse against older women in the home setting: A multinational European study

ABSTRACT

This article examines the ecological risk factors of abuse against older women. Data from 2,880 older women were randomly collected in five European countries (Austria, Belgium, Finland, Lithuania, and Portugal) using a standardized questionnaire. Results indicate that overall 30.1 % older women had at least one experience of abuse in the past year. The findings demonstrate that a single emphasis on personal risk factors (e.g., health, coping) is important but too simple: Abuse is multifaceted and is embedded in environmental (e.g., loneliness, household income) as well as macrocultural contexts (e.g., old age dependency ratio).     

Through gendered lens:explaining Chinese caregivers' task performance and care reward

The Chinese cultural norm of xiao, or filial piety, has long been held responsible for the practice of familial caregiving for older parents. Yet few explore the gendered nature of such a cultural practice in the current changing economic dynamics. Using data collected in 1997-1999 from 110 Chinese caregivers who were caring for physically dependent elder parents, this researcher explores the influence of changing economic conditions and Chinese cultural values in caregiver task performance and reward. Findings suggest that Chinese caregiving is highly gendered: Women are more likely to be unemployed and provide more personal care than men; sons are not more likely than daughters to provide financial assistance for parents. Chinese cultural values are playing an important role sanctioning caregiver task performance. Caregivers who believed in patrilocal norms provided more financial assistance; caregivers who reported higher social pressure provided more personal care. While the caregivers' report of social pressure is positively related to the caregivers' performance in personal care tasks, it is negatively related to caregiver reward. The author further explores the gendered implications for the changing economy and culture in China.     

Age,gender and daily life: An analysis of social involvements

Variety of role involvements based on the allocation of time is an alternative indicator of multiple roles. The measure of variety developed by Altergott (1982) is analyzed for a sample of U.S. adults, aged 18–88. The multivariate analysis of the structural and personal factors that account for the level of variety is presented. Age is negatively associated with variety. Women have lower levels of variety than men. While the amount of variety in men's daily life is influenced by family, health and preference, the amount of variety in women's daily life is affected by work and education. Opportunity structures and individual propensities affect levels of variety. The conclusions support the development of the behavioral measurement of multiple roles. Variety of role involvement in daily life provides a sensitive indicator that varies with age, gender and personal resources.     

Personal and Planetary Well-being: Mindfulness Meditation,Pro-environmental Behavior and Personal Quality of Life in a Survey from the Social Justice and Ecological Sustainability Movement

Employing data from a mailed survey of a sample of ecologically and spiritually aware respondents (N = 829), the study tests the hypothesized relationship between ecologically sustainable behavior (ESB) and subjective well-being (SWB). The proposed link between ESB and SWB is the spiritual practice of mindfulness meditation (MM). In multiple regression equations ESB and MM independently explain statistically significant amounts of variance in SWB, indicating, for at least the study’s sample, that there can be a relationship between personal and planetary well-being. The inter-relationships among SWB, ESB and MM suggest that for specific segments of the general population (e.g., the spiritually inclined) there may not necessarily be an insurmountable conflict between an environmentally responsible lifestyle and personal quality of life. The research reported here also points to the potential for meditative/mindful experiences to play a prominent role in the explanation of variance in SWB, a direction in QoL studies recently highlighted by several researchers (Layard 2005, pp. 189–192; Nettle 2005, pp. 153–160; Haidt 2006).