Journal of Epidemiology and Community Health Subject Collection: Press releases

Residential proximity to major roadways and renal function [RESEARCH REPORTS]

Lue, S.-H. — 2013-05-13

BackgroundLiving near major roadways has been associated with increased risk of cardiovascular events, but little is known about its impact on renal function. MethodsWe calculated the estimated glomerular filtration rate (eGFR) for 1103 consecutive Boston-area patients hospitalised with confirmed acute ischaemic stroke between 1999 and 2004. We used linear regression to evaluate the association between eGFR and categories of residential distance to major roadway (0 to [≤]50, >50 to [≤]100, >100 to [≤]200, >200 to [≤]400, >400 to [≤]1000 and >1000 m) adjusting for age, sex, race, smoking, comorbid conditions, treatment with ACE inhibitor and neighbourhood-level socioeconomic characteristics. In a second analysis, we considered the log of distance to major roadway as a continuous variable. ResultsPatients living closer to a major roadway had lower eGFR than patients living farther away (Ptrend=0.01). Comparing patients living 50 m versus 1000 m from a major roadway was associated with a 3.9 ml/min/1.73 m2 lower eGFR (95% CI 1.0 to 6.7; p=0.007): a difference comparable in magnitude to the reduction in eGFR observed for a 4-year increase in age in population-based studies. The magnitude of this association did not differ significantly across categories of age, sex, race, history of hypertension, diabetes or socioeconomic status. ConclusionsLiving near a major roadway is associated with lower eGFR in a cohort of patients presenting with acute ischaemic stroke. If causal, these results imply that exposures associated with living near a major roadway contribute to reduced renal function, an important risk factor for cardiovascular events.

Friends are equally important to men and women, but family matters more for men's well-being [OTHER TOPICS]

Cable, N. — 2013-02-01

BackgroundPeople with larger social networks are known to have better well-being; however, little is known about (1) the association with socio-demographic factors that may predict the size and composition of social networks and (2) whether the association with well-being is independent of pre-existing psychological health or socio-demographic factors. MethodsThe authors used information collected from 3169 men and 3512 women who were born in Great Britain in 1958. First, age on leaving full-time education, partnership and employment status at age 42 were used to predict the size and composition of cohort members' social networks at age 45 using ordered logistic regression. Second, using multiple linear regression, the associations between social network size by composition (relatives and friends) and psychological well-being at age 50 were assessed, adjusting for socio-demographic factors and psychological health at age 42. ResultsNot having a partner and staying in full-time education after age 16 was associated with a smaller kinship network in adults. Having a smaller friendship network at age 45 was associated with poorer psychological well-being among adults at age 50, over and above socio-demographic factors and previous psychological health. Additionally, having a smaller kinship network was associated with poorer psychological well-being among men. ConclusionsHaving a well-integrated friendship network is a source of psychological well-being among middle-aged adults, while kinship networks appear to be more important for men's well-being than for women's. These relationships are independent of education, material status and prior psychological health.

Association of objectively measured physical activity with established and novel cardiovascular biomarkers in elderly subjects: every step counts [SHORT REPORTS]

Klenk, J. — 2013-02-01

ObjectiveTo analyse the relationship between objectively measured daily walking duration and cardiovascular biomarkers of inflammation, cardiac dysfunction and renal impairment. MethodsBetween March 2009 and April 2010, physical activity was assessed in 1253 community-dwelling individuals living in Germany aged [≥]65 years (57% men) over 1 week using a thigh-worn accelerometer. C reactive protein (CRP), white blood cells (WBC), N-terminal pro-brain natriuretic peptide, high-sensitive troponin T (hsTnT), creatinine (Cr) and cystatin C (CysC) were also measured. Least-square means of daily walking duration were calculated for quartiles of each biomarker adjusted for sex, age, pre-existing cardiovascular disease and smoking status. ResultsAfter adjustment for covariates, statistically significant linear associations with walking duration were observed for WBC, hsTnT, Cr and CysC. CRP quartiles 1 and 2 showed no significant difference followed by a significant inverse dose-response relationship. A similar pattern, but less pronounced, was seen for N-terminal pro-brain natriuretic peptide. Mean differences between the first two quartiles of CRP and its fourth quartile were 17 min. Between categories 1 (more beneficial) and 4 of WBC, hsTnT, Cr and CysC the differences were 15, 12, 23 and 20 min, respectively. ConclusionIncreased walking duration is associated with a more favourable profile of cardiovascular biomarkers in elderly subjects.

Family meals can help children reach their 5 A Day: a cross-sectional survey of children's dietary intake from London primary schools [RESEARCH REPORTS]

Christian, M. S. — 2012-12-19

BackgroundThis study aims to explore how the home food environment and parental attitudes and values affect children's fruit and vegetable (F&V) intake. MethodsThe sample consists of 2383 children with a mean age of 8.3 years (95% CI 8.2 to 8.3) attending 52 primary schools in London. These children are taking part in two randomised controlled trials to evaluate a school gardening programme. Diet was assessed using a validated 24-h food tick list, the Child And Diet Evaluation Tool (CADET). ResultsThe CADET tool found that children consumed on average 293 g F&V (95% CI 287 to 303) per day. Clustered (by school) multilevel regression models with total F&V as the primary outcome were conducted to explore how the home environment affects children's F&V intake. Children of families who reported always' eating a family meal together at a table had 125 g (95% CI 92 to 157; p=<0.001) more F&V than families who never ate a meal together. Daily consumption of F&V by parents was associated with higher F&V (88 g, 95% CI 37 to 138) intake in children compared with rarely/never consumption of F&V by parents. Cutting up fruit and vegetables for children was associated with higher consumption. Families who reported always cutting up F&V for their children had 44 g (95% CI 18 to 71) more F&V than families who never cut up F&V. ConclusionsThis study identified that cutting up F&V and family consumption of F&V facilitates children's intake. Eating a family meal together regularly could increase children's F&V intake and help them achieve the recommended intake. Trial registrationISRCTN11396528.

Childlessness, parental mortality and psychiatric illness: a natural experiment based on in vitro fertility treatment and adoption [SHORT REPORTS]

Agerbo, E. — 2012-12-05

BackgroundChildlessness increases the risk of premature mortality and psychiatric illness. These results might, however, be confounded by factors that affect both the chance of parenthood as well as the risk of premature death and psychiatric illness. MethodsUsing population-based health and social registers, we conducted a follow-up study of 21 276 childless couples in in vitro fertility treatment. ResultsThe crude death rate ratio in women who become mothers to a biological child is 0.25 (95% CI 0.16 to 0.39). In other words, childless women experience a fourfold higher rate of death, that is, 4.02 (2.56 to 6.31). The analogous death rate in fathers is approximately halved: 0.51 (0.39 to 0.68) and 0.55 (0.32 to 0.96) associated with having a biological child and an adopted child, respectively. With substance use disorders being the exception, none of the crude rates of psychiatric illness in parents of a biological child were statistically distinguishable from the rates in the childless. These findings were slightly confounded by age, calendar year, income, education, somatic comorbidity and marital breakup. ConclusionsMindful that association is not causation, our results suggest that the mortality rates are higher in the childless. Rates of psychiatric illness do not appear to vary with childlessness, but the rate of psychiatric illness in parents who adopt is decreased.

Association of serum 25-hydroxyvitamin D3 and D2 with academic performance in childhood: findings from a prospective birth cohort [RESEARCH REPORTS]

Tolppanen, A.-M. — 2012-12-01

BackgroundHigher total serum 25-hydroxyvitamin D (25(OH)D) concentrations have been associated with better cognitive function mainly in cross-sectional studies in adults. It is unknown if the associations of different forms of 25(OH)D (25(OH)D3 and 25(OH)D2) are similar. MethodsProspective cohort study (n=3171) with serum 25(OH)D3 and 25(OH)D2 concentrations measured at mean age of 9.8 years and academic performance at age 13-14 years (total scores in English, mathematics and science) and 15-16 years (performance in General Certificates of Education examinations). ResultsSerum 25(OH)D3 concentrations were not associated with any educational outcomes. Higher 25(OH)D2 concentrations were associated with worse performance in English at age 13-14 years (adjusted SD change per doubling in 25(OH)D2 (95% CI) -0.05 (-0.08 to -0.01)) and with worse academic performance at age 15-16 years (adjusted OR for obtaining [≥]5 A*-C grades (95% CI) 0.91 (0.82 to 1.00)). ConclusionThe null findings with 25(OH)D3 are in line with two previous cross-sectional studies in children. It is possible that the positive association of 25(OH)D with cognitive function seen in adults does not emerge until later in life or that the results from previous cross-sectional adult studies are due to reverse causality. The unexpected inverse association of 25(OH)D2 with academic performance requires replication in further studies. Taken together, our findings do not support suggestions that children should have controlled exposure to sunlight, or vitamin D supplements, in order to increase academic performance.

Prospective associations between meth/amphetamine (speed) and MDMA (ecstasy) use and depressive symptoms in secondary school students [CHILD AND ADOLESCENT HEALTH]

Briere, F. N. — 2012-11-01

BackgroundResearch has raised significant concern regarding the affective consequences of synthetic drug use. However, little evidence from well-controlled longitudinal studies exists on these consequences. The aim of this study was to determine whether use of meth/amphetamine (speed) and {+/-}3,4-methylenedioxymethamphetamine (MDMA, ecstasy) is independently predictive of subsequent depressive symptoms in adolescents. MethodsA sample of 3880 adolescents from secondary schools in disadvantaged areas of Quebec, Canada, were followed over time (2003-2008). Logistic regression was used to test the association between meth/amphetamine and MDMA use in grade 10 (ages 15-16 years) and elevated depressive symptoms on an abridged Center for Epidemiologic Studies-Depression scale in grade 11, controlling for pre-existing individual and contextual characteristics. ResultsAfter adjustment, both MDMA use (OR 1.7, 95% CI 1.1 to 2.6) and meth/amphetamine use (OR 1.6, 95% CI 1.1 to 2.3) in grade 10 significantly increased the odds of elevated depressive symptoms in grade 11. These relationships did not vary by gender or pre-existing depressive symptoms. Increased risk was particularly observed in concurrent usage (OR 1.9, 95% CI 1.2 to 2.9). ConclusionsAdolescent use of meth/amphetamine and MDMA (particularly concurrent use) is independently associated with subsequent depressive symptoms. Further enquiry must determine whether these associations reflect drug-induced neurotoxicity and whether adolescence is a period of increased vulnerability to the hazards of synthetic drug exposure.

School dropout: a major public health challenge: a 10-year prospective study on medical and non-medical social insurance benefits in young adulthood, the Young-HUNT 1 Study (Norway) [CHILD AND ADOLESCENT HEALTH]

De Ridder, K. A. A. — 2012-11-01

BackgroundSchool and work participation in adolescence and young adulthood are important for future health and socioeconomic status. The authors studied the association between self-rated health in adolescents, high school dropout and long-term receipt of medical and non-medical social insurance benefits in young adulthood. MethodsSelf-rated health in adolescence was assessed in 8795 adolescents participating in the Norwegian Young-HUNT Study (1995-1997). Linkages to the National Education Database and the National Insurance Administration allowed identification of school dropout and receipt of long-term medical and non-medical benefits during a 10-year follow-up (1998-2007). The data were explored by descriptive statistics and by multinomial logistic regression. ResultsA total of 17% was registered as being high school dropouts at age 24. The predicted 5-year risk of receiving benefits between ages 24-28 was 21% (95% CI 20% to 23%). High school dropouts had a 5-year risk of receiving benefits of 44% (95% CI 41 to 48) compared with 16% (95% CI 15 to 17) in those who completed high school (adjusted for self-rated health, parental education and sex). There was a 27% school dropout rate in adolescents who reported poor health compared with 16% in those who reported good health. The predicted 5-year risk of receiving any long-term social insurance benefits in adolescents who reported poor health was 33% (95% CI 30 to 37) compared with 20% (95% CI 19 to 21) in those who reported good health. ConclusionThe strong association between poor self-rated health in adolescence, high school dropout and reduced work integration needs attention and suggests preventive measures on an individual as well as on a societal level.

Interpersonal trauma exposure and cognitive development in children to age 8 years: a longitudinal study [CHILD AND ADOLESCENT HEALTH]

Bosquet Enlow, M. — 2012-11-01

BackgroundChildhood trauma exposure has been associated with deficits in cognitive functioning. The influence of timing of exposure on the magnitude and persistence of deficits is not well understood. The impact of exposure in early development has been especially under-investigated. This study examined the impact of interpersonal trauma exposure (IPT) in the first years of life on childhood cognitive functioning. MethodsChildren (N=206) participating in a longitudinal birth cohort study were assessed prospectively for exposure to IPT (physical or emotional abuse or neglect, sexual abuse, witnessing maternal partner violence) between birth and 64 months. Child intelligent quotient (IQ) scores were assessed at 24, 64 and 96 months of age. Race/ethnicity, gender, socioeconomic status, maternal IQ, birth complications, birth weight and cognitive stimulation in the home were also assessed. ResultsIPT was significantly associated with decreased cognitive scores at all time points, even after controlling for socio-demographic factors, maternal IQ, birth complications, birth weight and cognitive stimulation in the home. IPT in the first 2 years appeared to be especially detrimental. On average, compared with children not exposed to IPT in the first 2 years, exposed children scored one-half SD lower across cognitive assessments. ConclusionIPT in early life may have adverse effects on cognitive development. IPT during the first 2 years may have particular impact, with effects persisting at least into later childhood.

The association between lung function and fatal stroke in a community followed for 4 decades [GENERAL PAPERS]

Gulsvik, A. K. — 2012-11-01

BackgroundPrevious studies, all of <20 years of follow-up, have suggested an association between lung function and the risk of fatal stroke. This study investigates the stability of this association in a cohort followed for 4 decades. MethodsThe Bergen Clinical Blood Pressure Survey was conducted in Norway in 1964-1971. The risk of fatal stroke associated with forced expiratory volume after one second (FEV1) was estimated with Cox proportional hazards regression, making progressive adjustment for potential confounders. ResultsOf 5617 (84%) participants with recorded baseline FEV1, 462 died from stroke over 152 786 subsequent person-years of follow-up according to mortality statistics of 2005; mean (SD) follow-up was 27 (12) years. An association between baseline FEV1 (L) and fatal stroke was observed; HR=1.38 (95% CI 1.11 to 1.71) and HR=1.62 (95% CI 1.22 to 2.15) for men and women, respectively (adjusted for age and height). The findings were not explained by smoking, hypertension, diabetes, atherosclerosis, socioeconomic status, obstructive lung disease, physical inactivity, cholesterol or body mass index and persisted in subgroups of never-smokers, subgroups without respiratory symptoms and survivors of the first 20 years of follow-up. For male survivors with a valid FEV1 at follow-up (1988-1990) (n=953), baseline FEV1 (L) indicated a possible strong and independent association to the risk of fatal stroke after adjustments for individual changes in FEV1 (ml/year) (HR 1.95 (95% CI 0.98 to 3.86)). ConclusionThere is a consistent, independent and long-lasting association between lung function and fatal stroke, probably irrespective of changes during adult life.