Background
Psychological distress and self-rated health status may create additional complexities in patients already diagnosed with breast cancer. This study aims to assess the association of self-report-based assessment of psychological distress and self-rated health on survival times among women with breast cancer diagnoses.
Methods
Seventeen-year data from the Integrated Public Use Microdata Series—National Health Interview Survey (IPUMS-NHIS) were pooled and analyzed. Women who were aged 30 to 64 years old, with breast cancer diagnosis were selected (n = 2,819). The outcome variable was time to death. The independent variables were self-reported assessment of psychological distress and self-rated health. Psychological distress was defined using the Kessler-6 scale while self-rated health was measured on a 3-point Likert scale: Poor, Fair, and Good-to-Excellent (referred to as good for brevity). We computed unadjusted and adjusted hazard ratios (HR) using Cox-Proportional Hazard regression models with sociodemographic characteristics and measures of health care access used as potential confounders. Significance was set at alpha = 0.05.
Results
Women with breast cancer assessed as having psychological distress had 46% (Adjusted HR: 1.46; 95% CI: 1.02–2.09) increased risks of mortality. Also, women who rated their health as poor or fair had a significantly elevated mortality risk (Poor Health: Adjusted HR: 3.05; 95% CI: 2.61–4.69; Fair Health: Adjusted HR: 1.83; 95% CI: 1.43–2.35) as compared to women with good health status.
Conclusions
Self-reported psychological distress and fair and poor self-rated health are associated with reduced survival times among women with breast cancer diagnoses.
Background Nearly half of all pregnancies in the U.S. are unintended. Unintended pregnancy refers to a mistimed or unwanted pregnancy. Unwanted and mistimed pregnancies are often distinguished from each other because of the negative social connotations and poorer health outcomes associated with unwanted pregnancies. However, mistimed pregnancies also pose significant economic, societal, and health burdens that necessitate enhanced risk factor identification and prevention efforts. Purpose Religion and religious practices are important to consider as potential risk factors for mistimed pregnancy as over 70% of Americans identify as religious. However, little research exists on the potential religious factors-mistimed pregnancy association. The purpose of this study was to evaluate this association among women using contraception in the U.S. Methods This analysis used National Survey of Family Growth data. Women (n = 2841) self-reported measures of religion, religiosity and pregnancy timing. Logistic regression was used to obtain odds ratios (ORs) and 95% confidence intervals. Results After adjustment, women who reported currently being Catholic, Protestant, or another religion had statistically significant increased odds of mistimed pregnancy compared to women with no current religious affiliation (Catholic OR = 2.31, Protestant OR = 1.41, Other OR = 2.58). Women who reported that religion was very important or somewhat important had statistically significant increased odds of mistimed pregnancy (Very Important OR = 1.82, Somewhat Important OR = 1.60). More frequent service attendance was associated with statistically significant decreased odds of mistimed pregnancy. Specifically, women who reported attending services 2–3 times a month or 1 or more times per week had nearly half the odds of mistimed pregnancy compared to women who never attended services (OR = 0.54 and OR = 0.51). Conclusions and Implications This study provides insight into the interrelationship of religion as a sociocultural risk factor for mistimed pregnancy and found that while religiously active women had increased odds of mistimed pregnancy, frequency of service attendance was a protective factor against mistimed pregnancy. Given that approximately half of pregnancies in the U.S. are unintended, additional studies are needed to further understand cultural mechanisms that may be important risk factors of unintended pregnancy, and to confirm this study's findings.
Background The prevalence of large-scale natural and biological disasters has increased in recent years and can have detrimental impacts on health. Some populations are more susceptible to these impacts, including medically vulnerable populations. The purpose of this study was to evaluate the association between medically vulnerable populations and perceived emergency preparedness status. Methods This study used 2010 and 2012 Behavioral Risk Factor Surveillance System data (n = 33,852). Participants were classified into four exposure groups related to medical vulnerability for each of three chronic diseases. The outcome was based on responses to a question that asked how prepared the individual's household was to handle a large-scale disaster or emergency. Logistic regression was used to assess the medical vulnerability-preparedness association. Results In adjusted analyses, individuals who were considered medically vulnerable had approximately 40% decreased odds of feeling prepared (OR range 0.61-0.64) compared to individuals without chronic diseases and disabilities. Conclusions Public health professionals should direct their efforts toward medically vulnerable individuals and their preparedness statuses. This study further solidifies the need for community partnerships between medical, emergency, and public health professionals to help individuals prepare for future emergencies.
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