The influence of nativity/birthplace, neighborhood cohesion, and duration lived in the neighborhood on psychological distress.

Introduction: Nativity/birthplace and neighborhood cohesion are potential contributing factors to psychological distress. This study explores the impact of nativity/birthplace and neighborhood cohesion on moderate-severe psychological distress among United States (US) adults, considering the duration lived in a neighborhood. Methods: Using the 2013-2018 National Health Interview Survey data, we conducted a stratified analysis based on years lived in the neighborhood (≤10 years [n = 96,175] and >10 years [n = 68,187]). Bivariate chi-square tests and multivariable logistic regression models were used to assess the statistical differences and associations between moderate-severe psychological distress and nativity/birthplace, and neighborhood cohesion, while adjusting for other covariates. Results: Individuals with 10 years or less of residence reported higher levels of moderate-severe psychological distress than those with more than 10 years (22.3 % vs. 18.1 %). Low or medium neighborhood cohesion, regardless of duration of residence, was associated with significantly higher odds of moderate-severe psychological distress compared to high cohesion. Foreign-born individuals had higher odds of psychological distress after more than 10 years in a neighborhood, although this difference was not statistically significant. However, they had lower odds of psychological distress after 10 years or less in the neighborhood compared to US-born individuals. Similarly, the interaction of foreign-born status and 10 years or less of residence in a neighborhood showed decreased odds of psychological distress. Conclusions: These findings underscore the importance of strong social cohesion in neighborhoods for positive mental well-being. Establishing community initiatives to enhance neighborhood social cohesion is crucial.

Comorbid Conditions Are Associated With Cognitive Impairment in Native Hawaiians and Pacific Islanders.

We examined the association between comorbid conditions and mild cognitive impairment (MCI) in Native Hawaiians and Pacific Islanders (NHPI) (n = 54). Cross-sectional, self-reported questionnaires were utilized to collect demographic, comorbid conditions, and MCI (via the AD8 index) data. Separate logistic regression models were conducted to investigate the relationship between comorbid conditions and MCI, adjusting for other covariates. We found significantly increased odds of MCI in those reporting high blood pressure (OR = 5.27; 95% CI: [1.36, 20.46]; p = 0.016), high cholesterol (OR = 7.30; 95% CI: [1.90, 28.14], p = 0.004), and prediabetes or borderline diabetes (OR = 4.53; 95% CI: [1.27, 16.16], p = 0.02) compared with those not reporting these respective conditions. These data show that hypertension, hypercholesterolemia, and prediabetes are associated with MCI in the NHPI community, suggesting that preventive strategies to reduce chronic conditions may also potentially slow cognitive decline in underrepresented/understudied NHPI.

Cancer worry and its impact on self-reported depressive symptoms among adult males and females in the US: a nationwide sample study.

OBJECTIVE: With cancer the second deadliest disease in the world, worry about cancer can have mental health or psychiatric implications. This study examines the prevalence, differences, and influence of cancer worry (CW), its interaction effect with age, and other confounders on self-reported depressive symptoms (SRDS) among adult males and females in the US. METHODS: We utilized a nationally representative sample data of 2,950 individuals (males = 1,276; females = 1,674) from Cycle 4 of the Health Information National Trends Survey 5 (HINTS 5) 2020. Using frequencies, bivariate chi-square test, and multivariate logistic regression, we examined the prevalence, difference, and association of CW with SRDS, adjusting for confounders. RESULTS: The prevalence rate of SRDS was found to be 32% among females and 23.5% among males. Among individuals with CW, females had a higher prevalence of SRDS compared to males (40.5% vs. 35.1%). However, there was a significant difference in the likelihood of experiencing SRDS between males and females with CW, with males having 84% increased risk compared to females. Across all age groups, the multivariate analysis of the relationship between CW and SRDS revealed that both males and females showed a significantly decreased likelihood of SRDS compared to those aged 18-34 years. However, males aged 35 years or older exhibited an even more pronounced decrease in likelihood compared to females in the same age group. Nonetheless, when examining the interaction of age and CW, we observed a significantly increased likelihood of SRDS across all age groups. Males, in particular, had a higher increased likelihood of SRDS compared to females across all ages, except for those aged 75 years and older. CONCLUSION: The findings of this study highlight the significant influence of CW on individuals' SRDS and the modifying effect of age, particularly among males. These results are important for a better understanding of the risk of CW on mental health, which can be a preventive strategy or control mechanism.

Urinary Phytoestrogen Levels Are Associated with Female Hormonal Cancers: An Analysis of NHANES Data From 1999 to 2010.

Phytoestrogens are plant-derived compounds that are structurally similar to endogenous estrogens. Studies have shown phytoestrogens to have possible health benefits although they could also act as endocrine disruptors. This is particularly relevant for estrogen-dependent cancers since estrogens increase risk of breast, endometrial, and ovarian cancer. Using data from the National Health and Nutritional Examination Survey (NHANES), we assessed the associations between urinary phytoestrogens (daidzein, equol, o-Desmethylangolensin (O-DMA), genistein, enterodiol, enterolactone) and breast, endometrial, and ovarian cancer using multivariate logistic regression with odds ratios (ORs) and 95% confidence intervals (CIs). Cancer diagnosis and other characteristics were collected via in-person questionnaires. We found women in the highest tertile for daidzein and enterodiol had over twice the odds of having breast cancer (OR = 2.51, 95% CI 1.44-4.36 for daidzein, OR = 2.78, 95% CI 1.44-5.37 for enterodiol). In addition, women in the highest tertiles for daidzein and genistein had three to four times the odds of having endometrial cancer, respectively (OR = 3.09, 95% CI 1.01-9.49 for daidzein, OR = 4.00, 95% CI 1.38-11.59 for genistein). Overall, phytoestrogens were positively associated with breast and endometrial cancer although the associations varied by phytoestrogen type. Additional studies are needed to further inform phytoestrogens' role in disease etiology.Supplemental data for this article is available online at at https://doi.org/10.1080/01635581.2021.2020304.

Marijuana use and high-risk health behaviors among diverse college students post- legalization of recreational marijuana use.

OBJECTIVES: This study examined high-risk health behaviors in marijuana-users among a diverse college population in Southern California, post legalization of marijuana for recreational use. STUDY DESIGN: A cross-sectional research design was employed utilizing existing data via the 2018 National College Health Assessment (NCHA) from a large Minority-Serving Institution (MSI) population [n = 1345 (Hispanic/Latino/a, n = 456; White, n = 353; Asian Pacific Islander (API), n = 288; Multiracial/Biracial, n = 195; Other, n = 53)]. METHODS: Chi square and t-tests assessed differences in descriptive characteristics (age, gender, race/ethnicity and GPA) and high-risk behaviors (alcohol, tobacco and sexual behaviors) among marijuana users and non-users. Logistic regression analyses examined the relationship between race/ethnicity and high-risk behaviors with marijuana use (dependent variable). RESULTS: Among marijuana-users, significant (p = 0.004) differences were observed between race/ethnicity with Whites reporting using most (32.7%), followed by Hispanics (27.6%) and then APIs (17.8%). Marijuana-users compared with non-users consistently reported high-risk alcohol behaviors (p < 0.0001), were more likely to smoke tobacco (p < 0.0001) and engaged in more high-risk sexual behaviors (p < 0.0001). Logistic regression showed after adjusting for demographic characteristics and high-risk behaviors, race/ethnicity was borderline significantly associated with marijuana use, specifically for Whites (OR = 1.53; 95% CI: (-0.01, 0.86), p = 0.06) and the Other race/ethnicity category (OR = 2.32; 95% CI: (0.12, 1.56), p = 0.02) compared with APIs. CONCLUSION: Our findings clearly demonstrate deleterious high-risk behaviors such as alcohol use, tobacco use, and certain sexual behaviors occur more among marijuana-users compared to non-users, post legalization of marijuana for recreational use. Further, race-ethnic differences were observed. Therefore, continued examination of marijuana use trends and high-risk behaviors is critical in monitoring the implications of marijuana policy changes, specifically in diverse populations.

The association between fitness and obesity in diverse multi-ethnic college students.

OBJECTIVE: We examined differences and associations between physical fitness and behavioral factors with obesity in a multi-ethnic student population. Participants: Study population included non-Hispanic whites (NHW, n = 1,454); Hispanics (n = 1,436) and Asians (n = 1,016) at a metropolitan university from Fall 2006 to Fall 2013. Methods: Analyses of Variance and regression analyses, utilizing cross-sectional data, measured the association between fitness, and behavior with obesity. Results: BMI differences (p < .05) were observed between NHW (23.17 ± 3.67), Hispanics (24.32 ± 3.67), and Asians (22.92 ± 4.12). Fitness parameters, relative VO2 max, % body fat, and total fitness score were significantly (p < .0001) associated with obesity. Stress was strongly significantly associated with obesity in Hispanics (p < .001) and somewhat in NHW. Conclusions: Obesity disparities persist in college. Physical fitness and stress management interventions should be targeted towards Hispanic and NHW college students, which may curb current and/or adult-onset obesity.

Logistic LASSO Regression for Dietary Intakes and Breast Cancer.

A multitude of dietary factors from dietary fat to macro and micronutrients intakes have been associated with breast cancer, yet data are still equivocal. Therefore, utilizing data from the large, multi-year, cross-sectional National Health and Nutrition Examination Survey (NHANES), we applied a novel, modern statistical shrinkage technique, logistic least absolute shrinkage and selection operator (LASSO) regression, to examine the association between dietary intakes in women, ≥50 years, with self-reported breast cancer (n = 286) compared with women without self-reported breast cancer (1144) from the 1999-2010 NHANES cycle. Logistic LASSO regression was used to examine the relationship between twenty-nine variables, including dietary variables from food, as well as well-established/known breast cancer risk factors, and to subsequently identify the most relevant variables associated with self-reported breast cancer. We observed that as the penalty factor (λ) increased in the logistic LASSO regression, well-established breast cancer risk factors, including age (ß = 0.83) and parity (ß = -0.05) remained in the model. For dietary macro and micronutrient intakes, only vitamin B12 (ß = 0.07) was positively associated with self-reported breast cancer. Caffeine (ß = -0.01) and alcohol (ß = 0.03) use also continued to remain in the model. These data suggest that a diet high in vitamin B12, as well as alcohol use may be associated with self-reported breast cancer. Nonetheless, additional prospective studies should apply more recent statistical techniques to dietary data and cancer outcomes to replicate and confirm the present findings.

Physical Activity, Nutrition, and Obesity among Pacific Islander Youth and Young Adults in Southern California: An Exploratory Study.

This exploratory study aimed to assess obesity, physical activity, and nutrition among Pacific Islander youth and young adults in Southern California. A total of 129 Tongan, Samoan, and Marshallese participated in the study, including relatively similar proportions of males and females and age groups. We calculated Body Mass Index (BMI), dietary intake by a food frequency questionnaire (FFQ), and 7-day physical activity levels with accelerometers. Overall, 84% of Tongan, 76% of Samoan, and 24% of Marshallese participants were overweight or obese, with mean BMI of 31.2 and 34.3 kg/m2 (for Tongan males and females), 32.3 and 33.4 kg/m2 (Samoan males and females), and 25.3 and 22.1 kg/m2 (Marshallese males and females). We found moderate- and vigorous-intensity physical activity (MVPA) fell below current guidelines at 38 min/day, with over 87% engaging in light-intensity PA and large sedentary times. Daily percent of energy from saturated fat, fiber/1,000 kcal and dairy intake were higher in Tongans compared to Samoans and Marshallese. Despite promising outcomes from this study, high prevalence of overweight, low physical activity levels, and high caloric intake put Pacific Islander youth and young adults at risk for a variety of health concerns and future efforts should focus on further research as well as community-wide prevention and amelioration efforts.

The Association between Types of Soda Consumption and Overall Diet Quality: Evidence from National Health and Nutrition Examination Survey (NHANES).

BACKGROUND AND PURPOSE: Daily soda consumption may lead to high energy intake and poor diet quality. Although diet sodas contain no calories, they lack healthful nutrients. The study examined different types of soda consumption [regular (sugar-sweetened) sodas, diet sodas, and non-sodas] associated with overall diet quality. METHODS: Cross sectional, 24-hour dietary recall data from the National Health and Nutrition Examination Survey (NHANES) from 2005-2012 were utilized for the study. Majority of the participants (n = 4,427) were female (57%), adults aged 19-55 years (51%), and non-Hispanic whites (67%). Nutritional Quality Index (NQI) was calculated as an indicator of diet quality. Multiple linear regression models were used to estimate the significant association between types of soda consumption and NQI stratified by body mass index. RESULTS: Regular soda drinkers had lower NQI than diet soda drinkers, but only for overweight (ß =-9.72; p=0.031) and obese (ß =-7.06; p<0.002) individuals. Non-soda drinkers had higher NQI compared to diet soda drinkers in normal weight (ß =12.38; p=0.006) and obese (ß =6.19; p<0.000) individuals. CONCLUSION: Nutrition intervention programs, therefore, should target overweight and obese soda drinkers, emphasizing reduction in soda consumption, which may improve nutrient density in their diets and subsequently impact long-term health outcomes.

Racial and Ethnic Disparities in Access to Care during the Early Years of Affordable Care Act Implementation in California.

BACKGROUND AND PURPOSE: Following the Affordable Care Act (ACA) health insurance expansions, this study asks: did racial/ethnic group disparities in access to care remain? And specifically, did Latinos experience worse access to care after the ACA expansions compared to other racial/ethnic groups? METHODS: Dataset: 2015 California Health Interview Survey (n=21,034; N=29,083,000). Participants: Adults, ages 18 and older, in California. Analyses: Bivariate chi-square tests and logistic multivariate regressions, including stratification by insurance. RESULTS: Bivariate tests showed associations between racial/ethnic group and access to care. Latinos had lowest rates of having a usual source of care among uninsured (49.5%) and job-based coverage (85.2%). One-fifth of uninsured non-Latino whites (21%) report foregoing needed care. In the multivariate models, non-Latino whites had significantly higher odds of having a usual source of care (OR=1.32; p<0.05), but also of foregoing needed care (OR=1.43; p<0.05), than Latinos. Asian Americans had significantly lower odds of visiting a doctor in the past year (OR=0.65; p<0.05) than Latino adults. CONCLUSION: Following the ACA, disparities among racial/ethnic groups have become more complex. While Latino adults still have lower rates of having a usual source of care, Asian American adults have low rates of visiting a doctor, and non-Latino whites have high rates of foregoing needed care. Further research into the causes of difficulties in accessing care is needed, as health insurance expansions did not create health equity in solving access to care problems.

Can Multimedia Tools Promote Big Data Learning and Knowledge in a Diverse Undergraduate Student Population?

BACKGROUND AND PURPOSE: Multimedia tools are an integral part of teaching and learning in today's technology-driven world. The present study explored the role of a newly-developed video introducing the emerging field of big data to a diverse undergraduate student population. Particularly, we investigated whether introduction of a multimedia tool would influence students' self-perceived knowledge related to various big data concepts and future interest in pursuing the field, and what factors influence these. METHODS: Students (n = 331) completed a survey on-line after viewing the video, consisting of Likert-type and quantitative questions about students' learning experience, future interest in big data, and background. The dataset was analyzed via ANOVA and multiple linear regression methods. RESULTS: Gender, major, and intended degree were significantly associated with students' learning experience and future interest in big data. Moreover, students who had no prior exposure to big data reported a better learning experience, although they also reported less likelihood to pursue it in the future. CONCLUSION: Multimedia tools may serve as an effective learning tool in introducing and creating interest in a diverse group of students related to introductory big data science concepts. Both similarities and differences were observed regarding such behaviors among different student sub-groups.

Association between Caffeine Consumption and Depression in NHANES 2009-2010.

BACKGROUND AND PURPOSE: Caffeine is ubiquitous in foods, supplements, and medications and has been hypothesized to be associated with several health-related outcomes, including mental health disorders such as anxiety. We explored a possible relationship between caffeine consumption and depression using data from the National Health and Nutrition Examination Survey (NHANES). METHODS: Data from 1,342 adult NHANES participants were included. Statistical software for complex survey sample designs was used to perform two multivariable logistic regressions with a binary indicator of depression as the dependent variable: one using dietary caffeine consumption and one using the caffeine metabolite AAMU as the independent variable. Both analyses were adjusted for gender, race/ethnicity, smoking status, and use of anti-depressants. RESULTS: We observed a descriptive, albeit non-significant (p = 0.12), pattern of increasing odds of depression with increasing levels of the AAMU caffeine metabolite. CONCLUSION: Our finding of a possible association between caffeine metabolite level and depression is compelling because it is independent of self-reported caffeine consumption. Prospective studies are warranted to further explore the temporal relationship.

The Association between Total Folate Intakes and Depression amongst Three Racial/Ethnic Groups.

BACKGROUND AND PURPOSE: Low dietary folate intake has been associated with depression outcomes, but few studies have been reported on the association in diverse populations. Using data from the National Health and Nutrition Examination Survey (NHANES), we examined the relationship between depression and folate intake from diet and supplementation in non-Hispanic whites, Hispanics and African Americans. METHODS: 3,687 adult respondents from the 2009-2010 NHANES cycle were included. Statistical methods for analyzing data from complex survey sample designs were used to assess differences by race/ethnicity in demographic, behavioral, dietary and depression variables and to assess the relationship between depression and folate, adjusting for confounding variables using multivariable logistic regression. RESULTS: We observed significant (p < 0.01) differences by race/ethnicity for all demographic, behavioral, dietary and depression variables, except for physical activity. The relationship between dietary folate and depression significantly differed by race/ethnicity (p = 0.03), with an inverse and significant association in Hispanics only (OR= 0.25; 95% CI= 0.09 - 0.70.; p for trend = 0.02). CONCLUSION: These data suggest that a diet high in folate, such as from dark green leafy vegetables, may be associated with a reduced odds for depression, and specifically, Hispanics may benefit from nutrition education to potentially reduce depression in the population.

Enhancing Diversity in Biomedical Data Science.

The gap in educational attainment separating underrepresented minorities from Whites and Asians remains wide. Such a gap has significant impact on workforce diversity and inclusion among cross-cutting Biomedical Data Science (BDS) research, which presents great opportunities as well as major challenges for addressing health disparities. This article provides a brief description of the newly established National Institutes of Health Big Data to Knowledge (BD2K) diversity initiatives at four universities: California State University, Monterey Bay; Fisk University; University of Puerto Rico, Río Piedras Campus; and California State University, Fullerton. We emphasize three main barriers to BDS careers (ie, preparation, exposure, and access to resources) experienced among those pioneer programs and recommendations for possible solutions (ie, early and proactive mentoring, enriched research experience, and data science curriculum development). The diversity disparities in BDS demonstrate the need for educators, researchers, and funding agencies to support evidence-based practices that will lead to the diversification of the BDS workforce.

Sex differences in the association of cutaneous melanoma incidence rates and geographic ultraviolet light exposure.

BACKGROUND: Cutaneous melanoma (CM) incidence rates continue to increase, and the reasons are unknown. Previously, we reported a unique age-specific sex difference in melanoma that suggested additional causes other than solar ultraviolet (UV) radiation. OBJECTIVE: This study attempted to understand whether and how UV radiation differentially impacts the CM incidence in men and women. METHODS: CM data and daily UV index (UVI) from 31 cancer registries were collected for association analysis. A second dataset from 42 US states was used for validation. RESULTS: There was no association between log-transformed female CM rates and levels of UVI, but there was a significant association between male rates and UVI and a significant association between overall rates and UVI. The 5-year age-specific rate-UVI association levels (represented by Pearson's coefficient ρ) increased with age in men, but age-specific ρ levels remained low and unchanged in women. The significant rate-UVI association in men and nonassociation in women was validated in a population of white residents of the United States. LIMITATIONS: Confounders, including temperature and latitude, are difficult to separate from UVI. CONCLUSIONS: Ambient UVI appears to be associated with melanoma incidence in males but not in females.

The association between circulating total folate and folate vitamers with overall survival after postmenopausal breast cancer diagnosis.

We studied the relationship between plasma total folate and folate vitamer concentrations [5-methyltetrahydrofolic acid, pteroylglutamic acid (folic acid) and tetrahydrofolic acid] with overall survival after breast cancer diagnosis. A secondary aim was to assess the relationship between folic acid supplement use with circulating total folate and folate vitamer concentrations. Participants were postmenopausal women diagnosed with breast cancer (n = 498) with an average follow-up of 6.7 yr. Plasma total folate and folate vitamers were measured by isotope-dilution LC-MS/MS in samples collected at or postdiagnosis. Cox proportional multivariate hazards models (controlled for stage, age at diagnosis, body mass index, parity, hormone replacement therapy use, treatment, alcohol use, folic acid use, and energy intake), were used to assess overall survival after breast cancer diagnosis. We found that the relative risk of dying for women with plasma total folate concentrations in the highest quartile was 59% lower (hazard ratio: 0.41, 95% confidence interval: 0.19-0.90) compared with the lowest quartile. Data on supplement use showed that women taking folic acid supplements had significantly higher circulating total folate and folate vitamer concentrations (P < 0.0001), suggesting that increased folate consumption through diet and/or supplementation may improve prognosis after breast cancer diagnosis.

Dietary intakes, obesity and health behaviors in Native Hawaiians residing in Southern California.

OBJECTIVES: Accessing dietary intakes, body mass index (BMI) and health behaviors in Native Hawaiians residing in Southern California. DESIGN: Cross-sectional, community based participatory research. PARTICIPANTS: Native Hawaiian (N = 55); Mean age 59 (± 15). MAIN OUTCOME MEASURES: Diet, body mass index (BMI), and diet/exercise health behaviors. Collected diet via 24-hr dietary recalls, health behaviors through questionnaires and BMI via measurement/self-report. ANALYSIS: Frequencies/means and multiple linear regression were used to assess diet, BMI, and health behaviors. RESULTS: Nearly 90% of the participants were either overweight or obese. Less than 20% met the vegetable, fruit, fiber, and whole grain recommendations. Most were a little or somewhat sure (relative to almost always sure) about their ability "to stick with an exercise program when attending a cultural gathering", and "when visiting Hawai'i". CONCLUSIONS AND IMPLICATIONS: These results suggest that developing a culturally-based education program to reduce obesity and improve diet is critical for Native Hawaiians residing in Southern California.

Health behaviors of native Hawaiian and Pacific Islander adults in California.

Smoking, diet and physical activity are associated with chronic diseases, but representative prevalence data on these behaviors for Native Hawaiian and Pacific Islander (NHPI) adults are scarce. Data from the 2005 California Health Interview Survey were analyzed for self-identified NHPI and non-Hispanic white (NHW) adults. Ethnic and NHPI gender differences were examined for socio-demographic variables, obesity and health behaviors. Compared to NHW, NHPI displayed higher prevalence of obesity (p<0.001), smoking (p<0.05) and consumption of unhealthy foods and beverages (p<0.05). NHPI males were more likely than females to smoke (p<0.001). NHPI adults appear to be at higher risk for chronic disease than NHW due to obesity, smoking and intake of unhealthy foods and beverages. Culturally-specific health promotion interventions are needed to reduce risks among the underrepresented NHPI population.