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.     

Conducive Characteristics or Anti-Racist Context? Decomposing the Reasons for Veterans’ High Likelihood of Interracial Marriage

Over the twentieth and twenty-first centuries, veterans have been more likely to enter into race/ethnic intermarriages than non-veterans. Theories of race/ethnic intermarriage variously point to how minority race/ethnicity, race/ethnically diverse social settings, progressive racial attitudes, and high socioeconomic status increase individuals’ likelihood of intermarrying. Veterans’ unique racial and socioeconomic characteristics may contribute to their greater likelihood of intermarrying relative to non-veterans: larger percentages of veterans than non-veterans are members of racial and ethnic minority groups, while military service increases individual service members’ long-term economic and educational prospects. At the same time, veterans share in common their exposure to the unique military environment, which may increase their likelihood of intermarriage by diversifying their social circles, and subjecting their attitudes and behavior to group norms that are more explicitly egalitarian than those of society at large. The present study considers these two possible explanations for veterans’ greater likelihood of intermarriage. We use data on seven cohorts of men over six decades in the Current Population Survey, representing a total of 1,456,742 observations, to decompose the difference in likelihood of racial intermarriage between veterans and non-veterans among married men aged 18–65. We find that across cohorts and decades, veterans’ greater likelihood of intermarrying is not fully explained by their race/ethnic and socioeconomic composition. We argue that veterans’ greater likelihood of intermarrying may therefore be driven by their exposure to the military environment.     

Estimating Recent Local Impacts of Sea-Level Rise on Current Real-Estate Losses: A Housing Market Case Study in Miami-Dade,Florida

Sea-Level Rise (SLR) Projections from the National Oceanic and Atmospheric Administration (NOAA) and the U.S. Army Corp of Engineers (USACE) indicate increasing, and imminent, risk to coastal communities from tidal flooding and hurricane storm surge. Building on recent research related to the potential demographic impacts of such changes (Hauer et al. 2016, in Nat Clim Chang 3:802–806, 2017; Neumann et al. 2015; Curtis and Schneider in Popul Environ 33:28–54, 2011), localized flooding projections in the Miami Beach area (Wdowinski et al. in Ocean Coast Manag 126:1–8, 2016) and projected economic losses associated with this rise in projected SLR (Fu et al. Ocean Coast Manag 133:11–17, 2016); this research investigates the accrued current cost, in terms of real-estate dollars lost, due to recurrent tidal flooding and projected increases of flooding in Miami-Dade County. Most directly related to this line of research, Keenan et al. (2018) have recently produced results indicating that Climate Gentrification is taking place in Miami, FL with higher elevations in flood prone areas appreciating at a higher rate. In that vein of thinking, we seek to answer a question posed by such research: What is the actual accrued loss to sea-level rise over the recent past? To answer this question, we replicate well-documented estimation methods by combining publicly available sea-level rise projections, tide gauge trends, and property lot elevation data to identify areas regularly at risk of flooding. Combining recent patterns of flooding inundation with future forecasts, we find that properties projected to be inundated with tidal flooding in 2032 have lost $3.08 each year on each square foot of living area, and properties near roads that will be inundated with tidal flooding in 2032 have lost $3.71 each year on each square foot of living area. These effects total over $465 million in lost real-estate market value between 2005 and 2016 in the Miami-Dade area.     

Providers’ perspectives of barriers experienced in maternal health care among Marshallese women

Problem

Pacific Islanders are disproportionately burdened by poorer maternal health outcomes with higher rates of pre-term births, low birth weight babies, infant mortality, and inadequate or no prenatal care.

Best practices for online Canadian prenatal health promotion: A public health approach

Background

Prenatal health promotion provides information regarding pregnancy risks, protective behaviours and clinical and community resources. Typically, women obtain prenatal health information from health care providers, prenatal classes, peers/family, media and increasingly, Internet sites and mobile apps. Barriers to prenatal health promotion and related services include language, rural/remote location, citizenship and disability. Online public health platforms represent the capacity to reach underserved women and can be customised to address the needs of a heterogeneous population of pregnant women.

The Methuselah Effect: The Pernicious Impact of Unreported Deaths on Old-Age Mortality Estimates

We examine inferences about old-age mortality that arise when researchers use survey data matched to death records. We show that even small rates of failure to match respondents can lead to substantial bias in the measurement of mortality rates at older ages. This type of measurement error is consequential for three strands in the demographic literature: (1) the deceleration in mortality rates at old ages; (2) the black-white mortality crossover; and (3) the relatively low rate of old-age mortality among Hispanics, often called the “Hispanic paradox.” Using the National Longitudinal Survey of Older Men matched to death records in both the U.S. Vital Statistics system and the Social Security Death Index, we demonstrate that even small rates of missing mortality matching plausibly lead to an appearance of mortality deceleration when none exists and can generate a spurious black-white mortality crossover. We confirm these findings using data from the National Health Interview Survey matched to the U.S. Vital Statistics system, a data set known as the “gold standard” (Cowper et al. 2002) for estimating age-specific mortality. Moreover, with these data, we show that the Hispanic paradox is also plausibly explained by a similar undercount.     

The Life Course,Cohort Dynamics,and International Differences in Aging Trajectories

In recent years, population health research has focused on understanding the determinants of later-life health. Two strands of that work have focused on (1) international comparisons of later-life health and (2) assessing the early-life origins of disease and disability and the importance of life course processes. However, the less frequently examined intersection of these approaches remains an important frontier. The present study contributes to the integration of these approaches. We use the Health and Retirement Study family of data sets and a cohort dynamic approach to compare functional health trajectories across 12 high-income countries and to examine the role of life course processes and cohort dynamics in contributing to variation in those trajectories. We find substantial international variation in functional health trajectories and an important role of cohort dynamics in generating that variation, with younger cohorts often less healthy at comparable ages than the older cohorts they are replacing. We further find evidence of heterogeneous effects of life course processes on health trajectories. The results have important implications for future trends in morbidity and mortality as well as public policy.     

Positive Identity Experiences of Young Bisexual and Other Nonmonosexual People: A Qualitative Inquiry

The majority of LGBTQ psychological research focuses on dysfunction. The exclusion of strengths-based perspectives in LGBTQ psychology limits the understanding of LGBTQ mental health. In this article we report experiences that young bisexual and other nonmonosexual people perceive as affirming of their sexual identity. A 28-day, daily diary study was used to investigate whether bisexual-identified participants encountered positive experiences related to their sexual identity, and which type of experiences they perceived to be positive. Using a constructivist grounded theory approach, participants’ experiences were organized according to a social ecological model. Experiences were reported at the intrapersonal, interpersonal, and institutional levels, but most positive sexual identity experiences occurred at the interpersonal level. Implications for positive health outcome research and the integration of positive psychology with LGBTQ psychology are discussed, as well as study limitations.     

“I Had to Go to the Streets to Get Love”: Pathways From Parental Rejection to HIV Risk Among Young Gay and Bisexual Men

Young, gay, and bisexual men (YGBM) are at increased risk of family rejection, which is related to HIV infection. What remains unknown is how family rejection leads to HIV risk. In this exploratory study, qualitative interviews were conducted with 21 HIV-positive YGBM aged 18 to 24. Most participants reported family rejection, which decreased instrumental and emotional support and resulted in participants using riskier ways to support themselves, such as engaging in survival sex. Conceptualizing the findings using a family systems framework, we present a tentative conceptual model to describe the potential relationships between family rejection and HIV risk for YGBM.