Cigarette Smoking and All-Cause and Cause-Specific Adult Mortality in the United States

This study illuminates the association between cigarette smoking and adult mortality in the contemporary United States. Recent studies have estimated smoking-attributable mortality using indirect approaches or with sample data that are not nationally representative and that lack key confounders. We use the 1990–2011 National Health Interview Survey Linked Mortality Files to estimate relative risks of all-cause and cause-specific mortality for current and former smokers compared with never smokers. We examine causes of death established as attributable to smoking as well as additional causes that appear to be linked to smoking but have not yet been declared by the U.S. Surgeon General to be caused by smoking. Mortality risk is substantially elevated among smokers for established causes and moderately elevated for additional causes. We also decompose the mortality disadvantage among smokers by cause of death and estimate the number of smoking-attributable deaths for the U.S. adult population ages 35+, net of sociodemographic and behavioral confounders. The elevated risks translate to 481,887 excess deaths per year among current and former smokers compared with never smokers, 14 % to 15 % of which are due to the additional causes. The additional causes of death contribute to the health burden of smoking and should be considered in future studies of smoking-attributable mortality. This study demonstrates that smoking-attributable mortality must remain a top population health priority in the United States and makes several contributions to further underscore the human costs of this tragedy that has ravaged American society for more than a century.     

Using the Shapley Decomposition to Disentangle the Impact of Circumstances and Efforts on Health Inequality

Following previous work on inequality in health opportunity, this paper attempts to determine the contribution of circumstances, efforts and lifestyle, and demographic variables to the overall inequality in health in Luxembourg. Health is measured via the answers given to a question on self-assessed health and is considered as an ordinal variable. The educational level of each parent, the financial situation of the family during childhood, the area of birth of the individual, and of his/her parents, and the year of immigration are considered as circumstances. Effort and lifestyle variables are proxied by information on the educational level of the individual, whether he/she smoked and whether he/she had a physical activity on a regular basis. Sex and age are considered as demographic variables. To solve the issue of correlation between circumstances and effort and lifestyle the estimation is implemented in two stages. In the first stage, each effort and lifestyle variable is regressed in a separate equation against the vector of circumstances and demographic variables and, in a second stage, the individual health status is regressed against the vector of circumstances and demographic variables along with the estimated residuals of the effort equations described previously. The respective impacts of the three categories of explanatory variables (circumstances, effort and lifestyle and demographic variables) on health inequality are derived via a Shapley decomposition of the likelihood ratio of the health ordered logit regression. It appears that differences in circumstances and effort and lifestyle explain each around a quarter of this likelihood ratio.     

Do anti-bullying laws work? New evidence on school safety and youth violence

This study is the first to comprehensively examine the effect of state anti-bullying laws (ABLs) on school safety and youth violence. Using existing data from the Youth Risk Behavior Surveys and the Uniform Crime Reports, and newly-collected data on school shootings, we find little evidence that the typical state ABL is effective in improving school safety and student well-being. However, this null finding masks substantial policy heterogeneity. State mandates that require school districts to implement strong, comprehensive anti-bullying policies are associated with a 7 to 13 % reduction in school violence and an 8 to 12 % reduction in bullying. In addition, our results show that strong anti-bullying policy mandates are associated with a reduction in minor teen school shooting deaths and violent crime arrests, suggesting potentially important spillover effects.     

Latent Class Analysis of Gambling Activities in a Sample of Young Swiss Men: Association with Gambling Problems,Substance Use Outcomes,Personality Traits and Coping Strategies

The study aimed to identify different patterns of gambling activities (PGAs) and to investigate how PGAs differed in gambling problems, substance use outcomes, personality traits and coping strategies. A representative sample of 4989 young Swiss males completed a questionnaire assessing seven distinct gambling activities, gambling problems, substance use outcomes, personality traits and coping strategies. PGAs were identified using latent class analysis (LCA). Differences between PGAs in gambling and substance use outcomes, personality traits and coping strategies were tested. LCA identified six different PGAs. With regard to gambling and substance use outcomes, the three most problematic PGAs were extensive gamblers, followed by private gamblers, and electronic lottery and casino gamblers, respectively. By contrast, the three least detrimental PGAs were rare or non-gamblers, lottery only gamblers and casino gamblers. With regard to personality traits, compared with rare or non-gamblers, private and casino gamblers reported higher levels of sensation seeking. Electronic lottery and casino gamblers, private gamblers and extensive gamblers had higher levels of aggression-hostility. Extensive and casino gamblers reported higher levels of sociability, whereas casino gamblers reported lower levels of anxiety–neuroticism. Extensive gamblers used more maladaptive and less adaptive coping strategies than other groups. Results suggest that gambling is not a homogeneous activity since different types of gamblers exist according to the PGA they are engaged in. Extensive gamblers, electronic and casino gamblers and private gamblers may have the most problematic PGAs. Personality traits and coping skills may predispose individuals to PGAs associated with more or less negative outcomes.     

Religion and the Representative Anecdote: Replacement and Revenge in AMC’s The Walking Dead

The current study examines how the horror-based AMC television series The Walking Dead portrays religion in terms of a reframing of the role, if any, of faith in a higher power, and the portrayal of the faithful. The religious-themed discourse of this highly successful story about survivors of a zombie apocalypse as presented through dialogic and visual imagery serves as the text analyzed here; specifically, related episodes set in churches at two separate points in the series that combine to offer a metaphor of “structure” used to disassemble and reconstruct the role of religion. These episodes interlace religious themes to develop an overarching message that forms a representative anecdote of replacement in which the notion of “faith” becomes redefined.     

Government Capital,Intimate and Community Social Capital,and Food Security Status in Older Adults with Different Income Levels

Whether government‐based forms of food assistance such as the Supplemental Nutrition Assistance Program (SNAP), communal efforts including food pantries, aid from friends and family, or alternative means such as gardening are the appropriate means to reduce the prevalence of household food insecurity is a continuous source of policy contention. To inform this debate, we examine the relative importance of these forms of food assistance and acquisition to a sample of U.S. older adults from the 2010 Brazos Valley Health Assessment of central Texas households that have been stratified by income eligibility for SNAP, low‐income SNAP ineligibility, and above low income status. To identify how membership in these socioeconomic groups constrains household capacity to acquire sufficient food to maintain an adequate and healthy diet, we explore the varied associations of assets received from government; communal and intimate social networks; and alternative food sources such as gardening, hunting, and fishing with household food security across socioeconomic status, while examining the importance of place of residence on the use of capital assets. SNAP participation was the only specific capital asset associated with all levels of food insecurity for both SNAP‐eligible and ineligible low‐income groups, thus emphasizing the continued importance of food assistance among poverty‐level older adults.     

Benefits and costs associated with mutual-help community-based recovery homes: The Oxford House model

We used data from a randomized controlled study of Oxford House (OH), a self-run, self-supporting recovery home, to conduct a cost-benefit analysis of the program. Following substance abuse treatment, individuals that were assigned to an OH condition (n = 68) were compared to individuals assigned to a usual care condition (n = 61). Economic cost measures were derived from length of stay at an Oxford House residence, and derived from self-reported measures of inpatient and outpatient treatment utilization. Economic benefit measures were derived from self-reported information on monthly income, days participating in illegal activities, binary responses of alcohol and drug use, and incarceration. Results suggest that OH compared quite favorably to usual care: the net benefit of an OH stay was estimated to be roughly $29,000 per person on average. Bootstrapped standard errors suggested that the net benefit was statistically significant. Costs were incrementally higher under OH, but the benefits in terms of reduced illegal activity, incarceration and substance use substantially outweighed the costs. The positive net benefit for Oxford House is primarily driven by a large difference in illegal activity between OH and usual care participants. Using sensitivity analyses, under more conservative assumptions we still arrived at a net benefit favorable to OH of $17,830 per person.