Zohn Rosen

The general social survey-national death index: an innovative new dataset for the social sciences

BackgroundSocial epidemiology seeks in part to understand how social factors--ideas, beliefs, attitudes, actions, and social connections--influence health. However, national health datasets have not kept up with the evolving needs of this cutting-edge area in public health. Sociological datasets that do contain such information, in turn, provide limited health information.FindingsOur team has prospectively linked three decades of General Social Survey data to mortality information through 2008 via the National Death Index. In this paper, we describe the sample, the core elements of the dataset, and analytical considerations.ConclusionsThe General Social Survey-National Death Index (GSS-NDI), to be released publicly in October 2011, will help shape the future of social epidemiology and other frontier areas of public health research.

Validation of photoplethysmography as a method to detect heart rate during rest and exercise.

Abstract Despite their enhanced marketplace visibility, validity of wearable photoplethysmographic heart rate monitoring is scarce. Forty-seven healthy participants performed seven, 6-min exercise bouts and completed a valid skin type scale. Participants wore an Omron HR500U (OHR) and a Mio Alpha (MA), two commercial wearable photoplethysmographic heart rate monitors. Data were compared to a Polar RS800CX (PRS). Means and error were calculated between devices using minutes 2–5. Compared to PRS, MA data was significantly different in walking, biking (2.41 ± 3.99 bpm and 3.26 ± 11.38 bpm, p < 0.05) and weight lifting (23.30 ± 31.94 bpm, p < 0.01). OHR differed from PRS in walking (4.95 ± 7.53 bpm, p < 0.05) and weight lifting (4.67 ± 8.95 bpm, p < 0.05). MA during elliptical, stair climbing and biking conditions demonstrated a strong correlation between jogging speed and error (r = 0.55, p < 0.0001), and showed differences in participants with less photosensitive skin.

The Impact of Socioeconomic Status on the Neural Substrates Associated with Pleasure

Low socio-economic status (SES) is associated with increased morbidity and premature mortality. Because tonic adversity relates to a diminished ability to experience pleasure, we hypothesized that subjects living in poverty would show diminished neural responsivity to positive stimuli in regions associated with positive experience and reward. Visual images were presented to twenty-two subjects in the context of a EPI-BOLD fMRI paradigm. Significant differences in neural responses between SES groups to poverty vs. neutral images were assessed, examining group, condition, and interaction effects. The data suggest that persons living in low-SES have neural experiences consistent with diminished interest in things generally enjoyed and point toward a possible explanation for the relationship between socioeconomic inequalities and mood disorders, such as depression, by SES.

Mobile Exercise Apps and Increased Leisure Time Exercise Activity: A Moderated Mediation Analysis of the Role of Self-Efficacy and Barriers

Background There are currently over 1000 exercise apps for mobile devices on the market. These apps employ a range of features, from tracking exercise activity to providing motivational messages. However, virtually nothing is known about whether exercise apps improve exercise levels and health outcomes and, if so, the mechanisms of these effects. Objective Our aim was to examine whether the use of exercise apps is associated with increased levels of exercise and improved health outcomes. We also develop a framework within which to understand how exercise apps may affect health and test multiple models of possible mechanisms of action and boundary conditions of these relationships. Within this framework, app use may increase physical activity by influencing variables such as self-efficacy and may help to overcome exercise barriers, leading to improved health outcomes such as lower body mass index (BMI). Methods In this study, 726 participants with one of three backgrounds were surveyed about their use of exercise apps and health: (1) those who never used exercise apps, (2) those who used exercise apps but discontinued use, and (3) those who are currently using exercise apps. Participants were asked about their long-term levels of exercise and about their levels of exercise during the previous week with the International Physical Activity Questionnaire (IPAQ). Results Nearly three-quarters of current app users reported being more active compared to under half of non-users and past users. The IPAQ showed that current users had higher total leisure time metabolic equivalent of task (MET) expenditures (1169 METs), including walking and vigorous exercise, compared to those who stopped using their apps (612 METs) or who never used apps (577 METs). Importantly, physical activity levels in domains other than leisure time activity were similar across the groups. The results also showed that current users had lower BMI (25.16) than past users (26.8) and non-users (26.9) and that this association was mediated by exercise levels and self-efficacy. That relationship was also moderated by perceived barriers to exercise. Multiple serial mediation models were tested, which revealed that the association between app use and BMI is mediated by increased self-efficacy and increased exercise. Conclusions Exercise app users are more likely to exercise during their leisure time, compared to those who do not use exercise apps, essentially fulfilling the role that many of these apps were designed to accomplish. Data also suggest that one way that exercise apps may increase exercise levels and health outcomes such as BMI is by making it easier for users to overcome barriers to exercise, leading to increased self-efficacy. We discuss ways of improving the effectiveness of apps by incorporating theory-driven approaches. We conclude that exercise apps can be viewed as intervention delivery systems consisting of features that help users overcome specific barriers.

Gender Differences in Material, Psychological, and Social Domains of the Income Gradient in Mortality: Implications for Policy

We set out to examine the material, psychological, and sociological pathways mediating the income gradient in health and mortality. We used the 2008 General Social Survey-National Death Index dataset (N = 26,870), which contains three decades of social survey data in the US linked to thirty years of mortality follow-up. We grouped a large number of variables into 3 domains: material, psychological, and sociological using factor analysis. We then employed discrete-time hazard models to examine the extent to which these three domains mediated the income-mortality association among men and women. Overall, the gradient was weaker for females than for males. While psychological and material factors explained mortality hazards among females, hazards among males were explained only by social capital. Poor health significantly predicted both income and mortality, particularly among females, suggesting a strong role for reverse causation. We also find that many traditional associations between income and mortality are absent in this dataset, such as perceived social status.

Exploring Prospective Predictors of Completed Suicides

BACKGROUND This study was based on over 30,000 respondents who completed General Social Surveys between 1978 and 2002. AIMS We approached these respondents prospectively, comparing and contrasting the responses of those who subsequently died by suicide (N = 141) with those who died from all other causes (N = 9,115). METHOD We employed chi-square and logistic regression analyses of important demographic confounders to test for statistically significant differences between suicide decedents and all other decedents. RESULTS Suicide decedents died on average 2 years sooner than all other decedents. When covariates of age and gender were applied, suicide decedents exhibited greater acceptance of suicide for dealing with various adverse life circumstances, were more likely to have been the gun owners in their households, lived in regions where gun ownership was more commonplace, and held less strong religious beliefs and less of a belief of an afterlife. CONCLUSION The observed affinity between attitudes of suicide acceptability and completed suicide suggests a potential for creating a meaningful assessment tool to identify those positioned at the extreme end of the suicide risk continuum.

Impact of Welfare Reform on Mortality: An Evaluation of the Connecticut Jobs First Program, A Randomized Controlled Trial

OBJECTIVES We examined whether Jobs First, a multicenter randomized trial of a welfare reform program conducted in Connecticut, demonstrated increases in employment, income, and health insurance relative to traditional welfare (Aid to Families with Dependent Children). We also investigated if higher earnings and employment improved mortality of the participants. METHODS We revisited the Jobs First randomized trial, successfully linking 4612 participant identifiers to 15 years of prospective mortality follow-up data through 2010, producing 240 deaths. The analysis was powered to detect a 20% change in mortality hazards. RESULTS Significant employment and income benefits were realized among Jobs First recipients relative to traditional welfare recipients, particularly for the most disadvantaged groups. However, although none of these reached statistical significance, all participants in Jobs First (overall, across centers, and all subgroups) experienced higher mortality hazards than traditional welfare recipients. CONCLUSIONS Increases in income and employment produced by Jobs First relative to traditional welfare improved socioeconomic status but did not improve survival.

Cost Effectiveness of the Earned Income Tax Credit as a Health Policy Investment

INTRODUCTION Lower-income Americans are suffering from declines in income, health, and longevity over time. Income and employment policies have been proposed as a potential non-medical solution to this problem. METHODS An interrupted time series analysis of state-level incremental supplements to the Earned Income Tax Credit (EITC) program was performed using data from 1993 to 2010 Behavioral Risk Factor Surveillance System surveys and state-level life expectancy. The cost effectiveness of state EITC supplements was estimated using a microsimulation model, which was run in 2015. RESULTS Supplemental EITC programs increased health-related quality of life and longevity among the poor. The program costs about

Vision zero: a toolkit for road safety in the modern era

7,786/quality-adjusted life-year gained (95% CI=

Investigating correlates of suicide among male youth: questioning the close affinity between suicide attempts and deaths

4,100,