Current Tobacco Use Trends and Harm Perceptions Among High School Students by Asthma Status and Sex, 2012-2018.

BACKGROUND: Tobacco use is known to worsen asthma management. No studies have investigated how trends in youth tobacco use and related harm perceptions vary by asthma status and sex. This study examined these trends among Florida high school students during 2012-2018. METHODS: Data from the 2012, 2014, 2016, and 2018 Florida Youth Tobacco Survey were analyzed. Public high school students (grades 9-12) with known asthma status were included along with their current tobacco product use, tobacco product harm perceptions, and demographics. Weighted multivariable logistic regression was used to assess trends in tobacco product use and harm perceptions and test differences by asthma status and sex. RESULTS: From 2012 to 2018, high school students with asthma had the slowest decline in cigarette and cigar use prevalence (asthma status-time interaction p = .01) compared to those with no asthma. Cigarette and cigar smoking were perceived as less harmful over time, except among females with asthma who smoked cigarettes (p < .05). CONCLUSIONS: Those with asthma showed a slower decline and were more likely to smoke cigarettes. Results indicate that further public health efforts are needed to address tobacco use among high school students with asthma.

Cumulative Inequality at the End of Life?: Racial Disparities in Impairment in the Time Before Death.

OBJECTIVES: Drawing from cumulative inequality (CI) theory, the current study examined racial disparities in impairment as individuals approached death to determine whether proposed mechanisms hypothesized to fuel or diminish racial disparities at late ages were at work at the end of individualized life spans. METHOD: Black-white disparities were analyzed among decedents using latent growth curves based on the data from the North Carolina Established Populations for Epidemiologic Studies of the Elderly (EPESE) (N = 1,926). RESULTS: Consistent with previous literature, racial inequalities in functional disparities diminish at late ages. However, significant black-white disparities emerge as older adults approach death, exponentially increasing within the 2 years immediately preceding death. Further, these disparities are not fully mediated by socioeconomic status. DISCUSSION: The results confirm that CI in health outcomes is observable in late life among individual life spans, suggesting the years surrounding death may be a particularly vulnerable period for health inequality. Future research should examine how advantaged statuses translate to increased access to health-related resources that aid in maintaining greater functional independence until the last stage of life.

Tobacco Product Use Among Youths With and Without Lifetime Asthma - Florida, 2016.

The increasing availability of diverse tobacco products has led to complex tobacco product use patterns among youths (1). Use by youths of products containing nicotine in any form is unsafe (2); among young persons with asthma, use of combustible tobacco products, particularly cigarettes, is associated with worsening symptoms, poor asthma control, and an increased need for medical management (3,4). Studies suggest that youths with asthma adopt health risk behaviors, including tobacco product use, at rates similar to or higher than those of youths without asthma (3-7); however, these studies are often limited to a partial list of tobacco product types among high school students. To assess current use (≥1 days during the past 30 days) of one or more of five tobacco product types (cigarettes, electronic cigarettes [defined as e-cigarettes, e-cigars, vape pipes, vaping pens, e-hookah, and hookah pens], hookah, smokeless tobacco, or cigars) among Florida middle school (grades 6-8) and high school (grades 9-12) students with or without a previous medical diagnosis of asthma, the Florida Department of Health analyzed data from the 2016 Florida Youth Tobacco Survey (FYTS). In 2016, 11.1% of middle school and 27.9% of high school students with asthma, and 7.9% of middle school and 24.2% of high school students without asthma, reported any current tobacco product use. Current use of each tobacco product type was considerably higher among students with asthma than among those without asthma. E-cigarettes were the most commonly used tobacco product type reported by middle and high school students with asthma (7.9% and 19.6%, respectively) and without asthma (5.8% and 17.2%, respectively). Statewide tobacco prevention strategies could help reduce all forms of tobacco product use among youths, particularly among those with asthma.

Social support, stress, and maternal postpartum depression: A comparison of supportive relationships.

A large body of literature documents the link between social support, stress, and women's mental health during pregnancy and the postpartum period; however, uncertainty remains as to whether a direct effect or stress mediating pathway best describes the relationship between these factors. Moreover, specific dimensions of social support that may be influential (family type, sources of support) have largely been neglected. Using data from the Fragile Families and Child Well-being Study (N=4150), we examine the pathway between social support, stress exposure, and postpartum depression in greater detail. Findings reveal that social support is a significant, protective factor for postpartum depression, and the variety of support providers in a woman's social network is important, especially in the context of family type. Findings also reveal the importance of considering social support and stress exposure as part of a larger causal pathway to postpartum mental health.

The relationship between parents' poor emotional health status and childhood mood and anxiety disorder in Florida children, national survey of children's health, 2011-2012.

The purpose of this study was to examine how parents' emotional health relates to childhood mood and anxiety disorder among Florida children in the 2011-2012 National Survey of Children's Health. Analyses were restricted to 1,241 Florida children 6-17 years of age. Childhood mood and anxiety disorder was defined as a parent-reported diagnosis of current depression or anxiety. Parents' emotional health status was a composite measure of the lowest reported emotional health of any parent in the household. To assess the association between parents' emotional health and childhood mood and anxiety disorder, bivariate and multivariate logistic regression analyses were performed. Nearly 5 % of Florida children had a mood or anxiety disorder in 2011-2012. Children living with a parent in poor emotional health were significantly more likely to have a mood or anxiety disorder compared to children living with a parent in good emotional health (OR 5.01; 95 % CI 1.89, 13.29). After adjusting for covariates, this association remained substantial and significant (aOR 4.33; 95 % CI 1.49, 12.57). Findings presented here are consistent with national findings and emphasize the strong link between parents' emotional health status and childhood mood and anxiety disorders. To address the mental health of children in the state of Florida, Florida public health initiatives should consider family processes and child level characteristics.