Longitudinal associations between allostatic load, pet ownership, and socioeconomic position among U.S. adults aged 50.

It is hypothesized that pets provide benefits to human health by buffering the deleterious effects of stress, but varying exposure to chronic stress via social position is rarely considered in these conceptual and empirical models. Allostatic load is an index of biological and physical measures that represents cumulative wear and tear on the body via chronic stress exposure. In this study, we use the 2006-2016 waves of the Health and Retirement Study, a nationally representative, longitudinal panel survey of adults aged 50+ in the United States, to test whether and to what extent pet ownership has an impact on allostatic load, and whether pet ownership moderates the effects of socioeconomic position on allostatic load. Linear mixed effects regression models revealed that pet owners had significantly lower allostatic load scores than those who do not own pets; however, after adjusting for socioeconomic position (i.e., wealth, education, race, ethnicity, gender, marital status), the effect of pet ownership was no longer significant. We estimated a series of models stratified by sociodemographic groups to test moderation effects. Among those who had a high school education, pet owners had lower allostatic load scores, whereas among those who had attended some college, pet owners had higher scores. Among those who were aged 80+, pet owners had higher scores than those who did not own pets. These findings suggest that the magnitude of the effect of pet ownership on allostatic load may not be sufficient to counteract experiences of high chronic stress as experienced by lower-status groups. Supporting the human-animal bond may contribute to improving older adult population health if paired with efforts to address the underlying causes of population health disparities.

Child and Pet Care-Planning During COVID-19: Considerations for the Evolving Family Unit.

OBJECTIVE: Using a mixed-methods design, we aimed to understand household dynamics and choices in hypothetical planning for child and pet care if an individual is faced with hospitalization for COVID-19. BACKGROUND: As the COVID-19 public health crisis persists, children and pets are vulnerable to caregiver hospitalization. METHODS: Bivariate associations from a large-scale survey explore hypothetical options for dependent care-planning. An open-ended question regarding pet-child interactions is coded applying a grounded theory framework. RESULTS: Caregivers expect to rely on family and friends to care for children, especially young children, and pets if hospitalized. The presence of pets in the home has been predominately positive for children during the pandemic, suggesting benefits of alternative care options that keep children and pets together. CONCLUSIONS: Relying on one's social network to care for dependents if caregivers become ill from COVID-19 could place loved ones at risk for contracting the virus, which could present obstacles to arranging care plans, especially inclusive of pets and children. IMPLICATIONS: The changing information regarding COVID-19 warrants that families establish concrete care plans for dependent children and pets. The spread of COVID-19 to the most vulnerable, such as grandparents and other family who may be expected to care for dependents, could create additional public health concerns.

Attachment to Pets Moderates Transitions in Latent Patterns of Mental Health Following the Onset of the COVID-19 Pandemic: Results of a Survey of U.S. Adults.

This cross-sectional study examined whether, and to what extent, attachment to pets was associated with changes in latent patterns of adults' perceived mental health symptoms during the COVID-19 pandemic (n = 1942). We used latent transition analysis to determine the stability of subgroup membership pre- and post-COVID and the effect of attachment to pets on transition probabilities. Mental health before COVID-19 was measured retrospectively. Five subgroups were identified: low symptoms, mild symptoms, moderate symptoms, high symptoms, and severe symptoms. Among individuals in the moderate and high symptoms subgroups, those who reported high attachment to pets generally had greater odds of transitioning to a less severe symptom profile (OR = 2.12) over time than those with low attachment to pets (OR = 1.39). However, those who had a severe symptom profile and high attachment to pets had lower odds of transitioning to a less severe symptom profile (OR = 0.30) and higher odds of maintaining a severe symptom profile (OR = 3.33) than those with low attachment to pets. These findings suggest that the protective and risk effects of attachment to pets differ based on individuals' psychological symptom patterns across multiple indicators. We discuss the implications of these findings for research, policy, and practice.

The Impact of Pets on Everyday Life for Older Adults During the COVID-19 Pandemic.

Purpose: The social and behavioral health of older adults is of particular concern during the COVID-19 pandemic. It is estimated that at least 50% of older adults in the U.S. have pets; while pets may be a source of support, they could also pose unique challenges during an already trying time. We aimed to investigate how pets impacted the everyday lives of older adults in the early stages of the COVID-19 pandemic. Methods: A large survey of U.S. pet owners (n = 2,068) was administered to assess the impact of relationships with pets during COVID-19 on human health and well-being. We conducted bivariate analyses to compare levels of social support, loneliness, pet attachment, and family income for a subset of older adults (ages 65 and older) with a younger comparison group (ages 18-64). Using thematic and content analysis, we analyzed two open-ended prompts from age 65+ respondents (n = 122): (1) the pros and cons of living with pets during the pandemic, and (2) advice for those living with pets in future pandemics. Results: Older adults, on average, reported lower levels of social support and less loneliness than respondents below age 65. There were no significant differences in strength of attachment to pets nor income between the younger and older respondents. For the open-ended prompt regarding pros and cons, we coded three emerging themes and related sub-themes: (1) pros (company; more time together; life purpose or meaning; love; support; stress relief; routine; distraction; exercise), (2) cons (general worry; potential for illness; limited participation; veterinary care access; obtaining supplies; difficulty meeting pet needs; financial concerns), and (3) no difference. Advice shared was coded into 13 themes/sub-themes: pets' health and welfare; make plans; veterinary information; treat pets like family; don't abandon pets; human health and well-being; stay calm; enjoy pets; keep routine; be careful of transmission; seek community resources; keep supplies stocked; and finances. Conclusions: Pets may fulfill some social and emotional needs for older adults during this particularly isolating event; equally important to consider are the challenges that may be precipitated by and/or exacerbated by this public health emergency.

How pets factor into healthcare decisions for COVID-19: A One Health perspective.

There is evidence that prioritizing pets' welfare can impact the health and well-being of their owners, especially when pet owners have a strong bond with their pet. This carries public health implications, particularly in a global public health emergency such as COVID-19. The study objective was to understand pet owners' consideration of their pets' welfare when making personal healthcare decisions specific to COVID-19. A large sample (n = 1356) of adult pet owners in the U.S. completed an online survey in April and May of 2020, coinciding with the onset of social distancing measures to prevent the spread of COVID-19. Respondents were asked if they would delay or avoid testing or treatment for COVID-19 due to concern for their pets' welfare, and a follow-up question asked them to elaborate. Multinomial logistic regression models showed that attachment to pets and socioeconomic resources were important factors in pet owners' hypothetical decisions regarding testing and treatment for COVID-19. Qualitative analysis of responses to the follow-up question revealed explanations across three themes: (1) the need to find pet accommodation prior to seeking healthcare; (2) pet-related concerns; and, (3) human-related concerns. Pet owners often cited concern for their pets' welfare as a factor contributing to their decision making; participants' lack of a concrete plan for pet care was most commonly cited as the reason for their delay in seeking healthcare. Results from this study indicate that pet owners experience unique obstacles to accessing healthcare related to COVID-19, which has implications for future public health emergencies. Increased disease spread and prevalence of poor health outcomes could result if pet owners delay or avoid testing or treatment. Communities can benefit from a One Health/One Welfare approach to collaboration between human and animal health and service providers to reduce COVID-19 spread and secure the well-being of people and their pets.

The Concerns, Difficulties, and Stressors of Caring for Pets during COVID-19: Results from a Large Survey of U.S. Pet Owners.

Pets may be a positive presence for their owners during the Coronavirus Disease 2019 (COVID-19) pandemic. However, it is pertinent to identify the hardships associated with pet ownership. We conducted a large-scale survey of U.S. pet owners (n = 2254) in spring and summer 2020 to assess the ways that relationships with pets impacted life during COVID-19. We used thematic analysis to analyze 3671 open-ended responses to three prompts. Reported concerns fell into three major categories: (1) pet-focused (meeting needs of pets; procuring supplies; accessing veterinary care; new and emerging behavioral issues; fate of the pet if owner becomes ill; general safety and well-being), (2) human-focused (issues with working from home; well-being and mental health; balancing responsibilities), and (3) household-focused (disease spread; economic issues). Quantitative analyses showed that the owner's strength of attachment to their pet, economic resources, and relationship status were associated with the types of concerns expressed. Results from this study indicate that pet owners experienced unique hardships related to changes in everyday life from the COVID-19 pandemic. These hardships should be considered alongside the potential benefits found in other studies in order to manage pet owner expectations, prevent pet relinquishment, and more fully understand multifaceted human-companion animal relationships.

Ain't nobody got time for dad? Racial-ethnic disproportionalities in child welfare casework practice with nonresident fathers.

BACKGROUND: Given fathers' potential role in bringing about desired child welfare case outcomes, researchers have begun to identify factors that impact agency efforts to identify and involve fathers. Racial-ethnic inequality and bias are not among factors studied, despite longstanding evidence that racial-ethnic minority children make up a disproportionate share of the child welfare population. OBJECTIVE: We set out to identify racial-ethnic patterns in initial casework activity with nonresident fathers and explore whether select factors explain racial-ethnic differentials. PARTICIPANTS AND SETTING: Caseworkers of 1,754 children in foster care in four U.S. states were surveyed. METHODS: Bivariate and multivariate logistic regression models were used to identify factors associated with whether agencies identified, located, and contacted nonresident fathers. RESULTS: Agencies were less likely to identify nonresident fathers of Black, Latinx, and Multiracial children, relative to those of White children. Among fathers whom agencies identified, Black and Latinx fathers were less likely to be located. Among fathers whom agencies located, Black and Latinx fathers were less likely to be contacted. Whereas greater rates of international mobility among Latinx fathers explained agencies' disproportionately low rates of contact, no other factor explained racial-ethnic differentials. CONCLUSION: We find evidence of historical racial-ethnic disproportionalities across the three initial stages of casework practice with nonresident fathers in U.S. child welfare systems. Though more recent data are needed, this research suggests that racial-ethnic minority foster children are more likely than White foster children to be denied the benefits of agency-father contact, whether due to societal or systemic racial inequalities.

A longitudinal analysis of sociodemographic and health correlates of sexual health among HIV-infected men in the USA.

BACKGROUND: Sexual health among HIV-infected men primarily has been examined in cross-sectional designs. Few have used longitudinal data to measure sexual health change or factors associated with change. Moreover, studies of HIV-infected men disproportionately focus on sexual risk behaviours. The present paper examines temporal changes in sexual health based on measures of sexual activity, erectile function, sex drive, and sex life satisfaction. METHODS: Data from a prospective cohort study of HIV-infected men (n = 197) in the USA were used. Sexual health measures were based on self-reported sexual activity, erectile function, sex drive, and sex life satisfaction at 12- and 24-month follow-ups. Transition matrices described 1-year sexual health changes. Logistic regression models determined sociodemographic and health-related factors associated with change. RESULTS: Men reported considerable change in sexual health during the year-long observation interval. Among men who experienced change, younger age, cohabitation, and higher CD4 counts were associated with greater sexual activity over time. Men with more depression symptoms had lower erectile function over time, and higher education and higher income were protective against temporal declines in sex drive and satisfaction. Less disease comorbidity was associated with 1-year improvements in sex life satisfaction. CONCLUSIONS: Some men in our sample experienced sexual health change, but stability was common for most. Temporal changes in sexual health varied according to age, cohabitation, education, income, and physical and mental health covariates. The present paper highlights the benefits of longitudinal investigations and multidimensional definitions of sexual health.

Patterns of informal care among Puerto Rican, African American, and white stroke survivors.

BACKGROUND: There has been an increase in the number of non-institutionalized stroke survivors over the past few decades leading to larger numbers of family caregivers. Less is known about the patterns of informal caregiving within racially and ethnically diverse families even though there is greater post-stroke morbidity and mortality for these groups. RESEARCH AIMS: The purpose of our research is to examine the informal caregiving networks of white, African American, and Puerto Rican caregivers. METHODOLOGY: We examine data collected from 118 stroke survivors and caregivers to explore the dynamics of caregiving. Data are drawn from a diverse group of whites, African Americans, and Puerto Ricans living on the US Mainland and Puerto Rico at three different time points over the course of 12 months. ANALYSIS: We examine the size, stability, change, and family dynamics of informal caregiving networks. FINDINGS AND IMPLICATIONS: We find that whites, African Americans, and Puerto Ricans each have differing caregiving structures highlighted by expansion and contraction across time, size of network, and relationship to the stroke survivor. Greater cultural awareness among health professionals can lead to improved coordination of information or formal care services. These findings may also be used as a baseline for understanding the caregiving patterns of other Spanish-speaking Caribbean nations.

Definitions and patterns of CAM use by the lay public.

INTRODUCTION: CAM is a socially constructed concept, and the literature on CAM definitions and patterns of use illustrates problems centering on the conceptualization and operationalization of "CAM." This renders it hard for researchers to truly understand CAM use patterns by the public. We use pilot data to explore lay conceptions of "CAM," and methodological approaches to capturing CAM usage. METHODS: Our pilot data come from surveys and journals of undergraduates, yielding direct and indirect measures of levels and patterns of CAM use. RESULTS AND CONCLUSIONS: The free listing method is a way to methodologically get around cultural bias and other problems conceptualizing CAM. Our pilot data suggest the public may have trouble conceptualizing CAM, and that survey construction does affect the richness of data on CAM use. Asking respondents direct measures of CAM modalities through surveys yielded the richest data.

Acculturation and orofacial pain among Hispanic adults.

UNLABELLED: This study examined the associations between acculturation and orofacial pain and healthcare among Hispanic adults. Understanding the effects of acculturation on Hispanic oral health may improve understanding of oral health disparities in the United States. Data were collected from 911 Hispanic adults reporting tooth pain and painful oral sores who were part of a larger study of South Florida residents conducted using random-digit dialing methodology. The survey was conducted in Spanish or English by bilingual interviewers per the choice of each respondent. Greater use of the Spanish language was associated with disparities in healthcare visits for orofacial pain, not having a usual dentist, having greater pain, increased difficulty eating and sleeping, and more depression. Respondents' and their parents' nativity (families that had been in the United States longer) and those identifying more closely to Hispanic culture were also predictive of several of the outcomes. Gender, financial status, and age, independent of acculturation, were also associated with orofacial pain, accessing health care, and pain-related loss of functioning among Hispanics. The data support the hypothesis that Hispanics with less acculturation are less able to access needed oral health care. This study highlights the need for outreach programs targeting recent Hispanic immigrants focusing on oral health care. PERSPECTIVE: This study found that lower levels of acculturation, particularly less frequent use of English, were associated with greater oral pain and depression for Hispanics adults. This emphasizes the need to provide Hispanic patients with information in Spanish and the importance of having bilingual materials and staff in dental clinics.

Ethnic variation in health and the determinants of health among Latinos.

The purpose of this research is to document and explain ethnic variation in health among Latino adults in the United States. Results of analyses of data pooled from the 1997-2001 National Health Interview surveys reveal that health patterns are clearly different among Latino ethnic groups. Mexicans have health advantages, whereas Puerto Ricans experience health disparities. Cubans and Dominicans reveal a mix of health disparities and advantages, depending on the health outcome. The effects of social determinants of health are also contingent upon ethnicity. For example, worse health is associated with higher levels of socioeconomic status (SES) and acculturation among Mexicans, but with lower levels of SES and acculturation among Latinos whose origins are from Caribbean islands. We conclude that racial/ethnic comparative health research should avoid pan-ethnic groupings, and explicitly acknowledge ethnic group distinctiveness.