Depression, smoking, and ego-centric social network characteristics in Ohio Appalachian women.

Abstract

Depression is a serious, costly, and debilitating disorder that is understudied in rural women. Studies show that depression is associated with low social integration and support, but few studies investigate the relationship between depression and social network characteristics. This study examined the associations among women from three Ohio Appalachian counties enrolled in a health study, which aimed to collect information for a future social network smoking cessation intervention. An address-based sampling method was used to randomly select and recruit 404 women. A cross-sectional survey and interview were used to collect information about demographic, psychosocial, behavioral factors, and ego-centric social network characteristics, which are variables derived from an individual (ego) and her first degree contacts (alters). The CES-D scale assessed depressive symptoms. A multivariable logistic regression analysis described the association between these factors and participants with depression (defined as CES-D≥16). Higher network density, or greater number of relationships among alters divided by the total amount of alters, reduced the risk for depression (OR = 0.84, 95% confidence interval [CI] 0.73–0.95). Additionally, women with a high percentage of smoking alters were at greater risk for depression (OR = 1.19, 95% CI 1.02–1.39). Other factors associated with risk for depression included perceived stress score (OR = 1.34, 95% CI 1.24–1.45), loneliness score (OR = 1.37, 95% CI 1.05–1.80), and days with poor physical health (OR = 1.06, 95% CI 1.02–1.11). Findings suggest that psychosocial factors and social networks should be considered when addressing depression in clinical practice.

The impact of smoking cessation attempts on stress levels

“…Cigarette smoking is a well-characterized underlying cause of cardiovascular and respiratory diseases, neoplasias, and depression [1–3]. Cessation of smoking is therefore recommended and is associated with many advantages.…”

Place, Power, and Premature Mortality: A Rapid Scoping Review on the Health of Women in Appalachia

“…Overall, articles focused on cancer disparities (49.4%) with a particular focus on cervical cancer (27.2%). 26 -46 Many of the remaining articles focused on cancer-related risk factors, such as Human Papillomavirus (HPV; 16.0%), 41,47 -54 smoking (16.0%), 55 -64 or prenatal or gynecologic care (23.5%). 60 -62,64 -80 See Figure 2 for a summary of the reviewed health topics divided by decade of publication; these topics are not mutually exclusive, as 1 article could discuss multiple health topics.…”

“…60 -62,64 -80 See Figure 2 for a summary of the reviewed health topics divided by decade of publication; these topics are not mutually exclusive, as 1 article could discuss multiple health topics. Only 10 articles (12.3%) focused on other chronic diseases including cardiovascular disease and diabetes, 3,12,78,81 -85 while increasing numbers of more recent studies focus on mental health (8.6%), 63,70,76,86,87 substance use (7.4%), 80,88 -91 and intimate partner violence (6.2%). 74,77,92…”

“…In rural areas, some studies suggested that the desire to avoid having an acquaintance involved in health-related decision-making increases body discomfort and worry of stigma, supporting the elevated need for privacy. 102,105 Additionally, authors referenced the role of health literacy, 89 one’s medical history (eg, pregnancy outcomes, 65,73,74,79 substance use, 80,89,91 mental health, 63,77,87,106 chronic disease 83 -85 ), and identifying oneself as Appalachian 31 as important determinants of health behaviors and outcomes. Authors also referenced the role of an individual’s financial and employment status, 74 which can affect access to insurance, 35 transportation, 3 and childcare.…”

“…108 Additionally, researchers noted the lack of specialized services for women, including those affecting oral 76,109 or mental health. 63,77,87,106 Beyond access-related challenges, authors noted quality of care available to women as an important consideration. 39,63,78,102 Broadly, authors noted policies and industries affecting availability of economic opportunities and community assets that relate to population health.…”