This paper examines the association between mental health and comorbid obesity and hypertension among US children and adolescents using data from the National Health and Nutritional Examination Survey (NHANES). Questionnaires from NHANES were used to assess mental health during the previous 30 days. Respondents were then categorized into two groups namely "poor mental health" and "good mental health" based on their responses to these survey questions. Three multiple logistic regression models, based on these categories, are estimated to compute the odds ratios and 95% confidence intervals in the association of obesity and hypertension and mental health. As a select example, the results of Model 2 reveal that compared with respondents who are not obese, obese respondents have increased odds (OR = 1.24; P < 0.0001) of poor mental health. Furthermore compared with non-hypertensive respondents, hypertensive respondents have higher odds (OR = 2.96; P < 0.0001) of poor mental health. These findings have important implications for mental health management in younger populations. It brings into focus the maintenance of a healthy body mass index and hypertension control in mitigating poor mental health.
Purpose The purpose of this paper is to assess food security as a risk factor in the development of poor mental health among younger populations in the USA over an eight-year period using a nationally representative cross-sectional sample. Design/methodology/approach Using data from individuals who participated in the National Health and Nutrition Examination Survey between 2005 and 2012, respondents were classified as either having “poor mental health” or “good mental health.” Multivariate logistic regression models based on this dichotomy are employed to estimate the odds ratios in the association of household food security and mental health using three cut-off points that correspond to these models. Findings Respondents from very low food security had higher odds (OR=2.06, p<0.0001; OR=1.98, p<0.0001; OR=1.94, p=0.01) of suffering from poor mental health compared with participants from fully food secure households. These findings indicate the robustness of the results across all three separate regression models. Research limitations/implications Causality cannot be determined from the cross-sectional design. Although potential endogeneity could invalidate the conclusions, these findings inform public policy that food security is a contributory factor in the development of poor mental health at an early age. It suggests that interventions to alleviate food insecurity could improve mental health among younger populations in the USA. Originality/value Several cut-off points are developed to distinguish between “poor” and “good” mental health to assess the robustness of the findings. This approach has the potential to minimize the misclassification of mental health outcomes. Very low food security is a strong predictor of poor mental health regardless of the cut-off point used.
This paper examines the importance of environmental factors (mosquito pools and home foreclosures) in human West Nile virus (WNV) transmission in California and Colorado. The role of environmental factors is investigated by applying an instrumental variable technique to a spatial filtering random-effects negative binomial model to correct for both spatial autocorrelation and endogeneity. The results suggest that mosquito pools and home foreclosures are significant in explaining the prevalence of human WNV. An innovative aspect of this research is that it emphasizes the role of home foreclosures in WNV transmission and in the allocation of resources. Knowledge of the factors associated with WNV prevalence is crucial for abatement of future outbreaks. The results suggest that more resources should be allocated to areas that have a high number of home foreclosures and mosquito pools for surveillance and mitigation of the disease.
Tobacco use is the single largest preventable cause of death in the United States (US). The national goal of reducing the prevalence of adult cigarette smoking to 12% was retained for 20 years due to non-attainment. Meanwhile, varenicline and electronic cigarettes (ECs) became available in the US in 2006 and 2007, respectively, and have been used by many smokers wanting to quit. The purpose of this review is to compare varenicline and ECs in terms of efficacy for smoking cessation after over a decade of widespread use in the US. Data collection for systematic review and qualitative synthesis by a PubMed search using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelinesand the Oxford Quality Scale, respectively, was performed in June 2018 and updated in June 2020. Articles were eligible if published in English as original research in the form of a randomized clinical trial (RCT), a systematic review and meta-analysis, a systematic review, or a cross-sectional study. Eighteen studies were included: nine RCTs, four cross-sectional studies, two meta-analyses, one systematic review, one systematic review and meta-analysis, and one cohort study. No head-to-head RCT compared varenicline to ECs. In four RCTs, varenicline was more effective than placebo for smoking cessation. In two RCTs, ECs were more effective than placebo but a meta-analysis of 20 studies reported a statistically significant decrease in the odds of quitting smoking using ECs as compared to placebo. To conclude, varenicline and ECs have data suggesting efficacy for smoking cessation; however, unlike varenicline, ECs were not effective in all studies.
The results contribute to the discussion on the relationship between depression and cardiovascular disease and will inform future studies that aim to look at longer term outcomes in patients with hypertension.
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