Xiao-Jun Wen

Prevalence of HIV Risk Behaviors Between Binge Drinkers and Non-Binge Drinkers Aged 18- to 64-Years in US, 2008

Using data from the 2008 Behavioral Risk Factor Surveillance System on 281,303 adults aged 18–64 years in the United States, we examined the relationship between HIV risk behaviors and binge drinking of alcoholic beverages and the frequency of binge drinking among a subgroup of 41,073 respondents who were acknowledged binge drinkers (bingers), based on reported drinking behavior in the year preceding survey. Our findings show that the weighted prevalence of HIV risk behaviors (including injection drug use, exchange of sex for money/drugs, and anal sex without a condom) among binge bingers [7.0%, 95% confidence interval (95% CI): 6.4–7.6%] is twice that among nonbingers (2.9%, 95% CI: 2.7–3.0%). The highest prevalence of HIV risk behaviors is among the bingers aged 18–20 years (14%, 95% CI: 11.2–18.2%). After adjusting for covariates, bingers are 1.77 (95% CI: 1.58–2.00) times more likely than nonbingers to report HIV risk behaviors. Risk increases in bingers with the number of episodes. Compared with bingers reporting 1–2 binge episodes in the month proceeding survey, the adjusted odds of reporting HIV risk behaviors among bingers are 1.27 (1.08–1.49), 1.68 (1.35–2.10), 1.67 (1.08–2.57), and 1.70 (1.34–2.16), respectively for bingers with 3–4, 5–6, 7–8, and ≥9 episodes in the same period. Our results suggest that HIV risk behaviors are strongly linked with binge drinking and its frequency. Effective measures to prevent binge drinking are essential to HIV prevention, especially among youth aged 18–20 years.

Ischemic Heart Disease and Ambient Air Pollution of Particulate Matter 2.5 in 51 Counties in the U.S.

Objective. Ischemic heart disease (IHD) is one of the most common health threats to the adult population of the U.S. and other countries. The objective of this study was to examine the association between exposure to elevated annual average levels of Particulate matter 2.5 (PM2.5) air quality index (AQI) and IHD in the general population. Methods. We combined data from the Behavioral Risk Factor Surveillance System and the U.S Environmental Protection Agency air quality database. We analyzed the data using SUDAAN software to adjust the effects of sampling bias, weights, and design effects. Results. The prevalence of IHD was 9.6% among respondents who were exposed to an annual average level of PM2.5 AQI >60 compared with 5.9% among respondents exposed to an annual average PM2.5 AQI ≤60. The respondents with higher levels of PM2.5 AQI exposure were more likely to have IHD (adjusted odds ratio 5 1.72, 95% confidence interval 1.11, 2.66) than respondents with lower levels of exposure after adjusting for age, gender, race/ethnicity, education, smoking, body mass index, diabetes, hypertension, and hypercholesterolemia. Conclusions. Our study suggested that exposure to relatively higher levels of average annual PM2.5 AQI may increase the likelihood of IHD. In addition to encouraging health-related behavioral changes to reduce IHD, efforts should also focus on implementing appropriate measures to reduce exposure to unhealthy AQI levels.

Prevalence of Diagnosed Cancer According to Duration of Diagnosed Diabetes and Current Insulin Use Among U.S. Adults With Diagnosed Diabetes: Findings from the 2009 Behavioral Risk Factor Surveillance System

OBJECTIVE To estimate the prevalence of diagnosed cancer according to duration of diagnosed diabetes and current insulin use among U.S. adults with diagnosed diabetes. RESEARCH DESIGN AND METHODS We analyzed data from 25,964 adults aged ≥18 years with diagnosed diabetes who participated in the 2009 Behavioral Risk Factor Surveillance System. RESULTS After adjustment for potential confounders, we found that the greater the duration of diagnosed diabetes, the higher the prevalence of diagnosed cancers (P < 0.0001 for linear trend). Among adults with diagnosed type 2 diabetes, the prevalence estimate for cancers of all sites was significantly higher among men (adjusted prevalence ratio 1.6 [95% CI 1.3–1.9]) and women (1.8 [1.5–2.1]) who reported being diagnosed with diabetes ≥15 years ago than among those reporting diabetes diagnosis <15 years ago. The prevalence estimate for cancers of all sites was ~1.3 times higher among type 2 diabetic adults who currently used insulin than among those who did not use insulin among both men (1.3 [1.1–1.6]) and women (1.3 [1.1–1.5]). CONCLUSIONS Our results suggest that there is an increased burden of diagnosed cancer among adults with a longer duration of diagnosed diabetes and among type 2 diabetic adults who currently use insulin.

Do Obese Adults Have a Higher Risk of Asthma Attack When Exposed to Indoor Mold? A Study Based on the 2005 Behavioral Risk Factor Surveillance System

Objective. Some studies show an association between asthma and obesity, but it is unknown whether exposure to mold will increase the risk of asthma attacks among obese people. This study examined whether obese adults have a higher risk of asthma attacks than non-obese adults when exposed to indoor mold. Methods. We used data from the 2005 Behavioral Risk Factor Surveillance System to conduct a cross-sectional analysis among 9,668 respondents who reported exposure to indoor mold. Results. With exposure to indoor mold, weighted prevalence of asthma attacks among obese respondents was 11.4% (95% confidence interval [CI] 6.0, 20.6], which was 2.3 times as high as among the exposed non-obese respondents (5.0%, 95% CI 2.8, 8.8). This ratio was almost the same as the ratio of 2.0:1 between the obese respondents (5.7%, 95% CI 4.6, 7.2) and the non-obese respondents (2.8%, 95% CI 2.3, 3.9) when neither group had exposure to mold. The odds ratio of asthma attack among obese people was 3.10 (95% CI 1.10, 8.67) for those with exposure to mold and 2.21 (95% CI 1.54, 3.17) for those without exposure to mold after adjusting for age, sex, race/ethnicity, and smoking status. Conclusion. Our study suggests that obese adults who have been exposed to indoor mold may not necessarily have a higher risk of asthma attack than obese adults who have not been exposed, even though obesity and exposure to indoor mold are both major risk factors for asthma attack. Medical professionals should not only incorporate weight-control or weight-reduction measures as the components of asthma treatment plans, but also advise asthma patients to avoid exposure to indoor mold.

Age adjustment of diabetes prevalence: use of 2010 U.S. Census data.

There is a growing interest in using the 2010 US Census data for age adjustment after the Census data are officially released. This report discusses the rationale, procedures, demonstrations, and caveats of age adjustment using the 2010 US Census data.

Long-Term Exposure to Ozone and Life Expectancy in the United States, 2002 to 2008.

AbstractLong-term exposure to ground-level ozone is associated with increased risk of morbidity and mortality. The association remains uncertain between long-term exposure to ozone and life expectancy.We assessed the associations between seasonal mean daily 8-hour maximum (8-hr max) ozone concentrations measured during the ozone monitoring seasons and life expectancy at birth in 3109 counties of the conterminous U.S. during 2002 to 2008. We used latent class growth analysis to identify latent classes of counties that had distinct mean levels and rates of change in ozone concentrations over the 7-year period and used linear regression analysis to determine differences in life expectancy by ozone levels.We identified 3 classes of counties with distinct seasonal mean daily 8-hr max ozone concentrations and rates of change. When compared with the counties with the lowest ozone concentrations, the counties with the highest ozone concentrations had 1.7- and 1.4-year lower mean life expectancy in males and females (both P < 0.0001), respectively. The associations remained statistically significant after controlling for potential confounding effects of seasonal mean PM2.5 concentrations and other selected environmental, demographic, socio-economic, and health-related factors (both P < 0.0001). A 5 ppb higher ozone concentration was associated with 0.25 year lower life expectancy in males (95% CI: −0.30 to −0.19) and 0.21 year in females (95% CI: −0.25 to −0.17).We identified 3 classes of counties with distinct mean levels and rates of change in ozone concentrations. Our findings suggest that long-term exposure to a higher ozone concentration may be associated with a lower life expectancy.

Age adjustment of diabetes prevalence: Use of 2010 US Census data 根据年龄调整的糖尿病患病率：使用美国2010年人口普查数据

There is a growing interest in using the 2010 US Census data for age adjustment after the Census data are officially released. This report discusses the rationale, procedures, demonstrations, and caveats of age adjustment using the 2010 US Census data.

Age adjustment of diabetes prevalence: Use of 2010 US Census data 根据年龄调整的糖尿病患病率：使用美国2010年人口普查数据: Age adjustment using 2010 US Census data

There is a growing interest in using the 2010 US Census data for age adjustment after the Census data are officially released. This report discusses the rationale, procedures, demonstrations, and caveats of age adjustment using the 2010 US Census data.