Gender and Racial/Ethnic Disparities: Cumulative Screening of Health Risk Indicators in 20-50 Year Olds in the United States

This study explored potential gender and racial/ethnic disparities in overall health risk related to 24 health risk indicators selected across six domains: socioeconomic, health status and health care, lifestyle, nutritional, clinical, and environmental. Using the 2003-2006 National Health and Nutrition Examination Surveys (NHANES), it evaluated cross-sectional data for 5,024 adults in the United States. Logistic regression models were developed to estimate prevalence odds ratios (PORs) adjusted for smoking, health insurance status, and age. Analyses evaluated disparities associated with 24 indicator variables of health risk, comparing females to males and four racial/ethnic groups to non-Hispanic Whites. Non-Hispanic Blacks and Mexican Americans were at greater risk for at least 50% of the 24 health risk indicators, including measures of socioeconomic status, health risk behaviors, poor/fair self-reported health status, multiple nutritional and clinical indicators, and blood lead levels. This demonstrates that cumulative health risk is unevenly distributed across racial/ethnic groups. A similarly high percentage (46%) of the risk factors was observed in females. Females as compared to males were more likely to have lower income, lower blood calcium, poor/fair self-reported health, more poor mental health days/month, higher medication usage and hospitalizations, and higher serum levels of some clinical indicators and blood cadmium. This analysis of cumulative health risk is responsive to calls for broader-based, more integrated assessment of health disparities that can help inform community assessments and public health policy

Combining Social Science and Environmental Health Research for Community Engagement

Social science-environmental health (SS-EH) research takes many structural forms and contributes to a wide variety of topical areas. In this article we discuss the general nature of SS-EH contributions and offer a new typology of SS-EH practice that situates this type of research in a larger transdisciplinary sensibility: (1) environmental health science influenced by social science; (2) social science studies of environmental health; and (3) social science-environmental health collaborations. We describe examples from our own and others’ work and we discuss the central role that research centers, training programs, and conferences play in furthering SS-EH research. We argue that the third form of SS-EH research, SS-EH collaborations, offers the greatest potential for improving public and environmental health, though such collaborations come with important challenges and demand constant reflexivity on the part of researchers

Factors associated with self-reported health: implications for screening level community-based health and environmental studies

Abstract Background Advocates for environmental justice, local, state, and national public health officials, exposure scientists, need broad-based health indices to identify vulnerable communities. Longitudinal studies show that perception of current health status predicts subsequent mortality, suggesting that self-reported health (SRH) may be useful in screening-level community assessments. This paper evaluates whether SRH is an appropriate surrogate indicator of health status by evaluating relationships between SRH and sociodemographic, lifestyle, and health care factors as well as serological indicators of nutrition, health risk, and environmental exposures. Methods Data were combined from the 2003–2006 National Health and Nutrition Examination Surveys for 1372 nonsmoking 20–50 year olds. Ordinal and binary logistic regression was used to estimate odds ratios and 95 % confidence intervals of reporting poorer health based on measures of nutrition, health condition, environmental contaminants, and sociodemographic, health care, and lifestyle factors. Results Poorer SRH was associated with several serological measures of nutrition, health condition, and biomarkers of toluene, cadmium, lead, and mercury exposure. Race/ethnicity, income, education, access to health care, food security, exercise, poor mental and physical health, prescription drug use, and multiple health outcome measures (e.g., diabetes, thyroid problems, asthma) were also associated with poorer SRH. Conclusion Based on the many significant associations between SRH and serological assays of health risk, sociodemographic measures, health care access and utilization, and lifestyle factors, SRH appears to be a useful health indicator with potential relevance for screening level community-based health and environmental studies

Additional file 1: of Factors associated with self-reported health: implications for screening level community-based health and environmental studies

Table S1. Sociodemographic Domain; Table S2. Health Care Domain; Table S3. Health Status Domain; Table S4. Lifestyle Domain; Table S5. Clinical Indicators; Table S6. Environmental Scores/Chemicals). This file details all associations between the domain factors and poorer SRH for both binary (poor/fair versus good/very good/excellent) and ordinal 5-point scoring of SRH (1 = poor, 2 = fair, 3 = good, 4 = very good, and 5 = excellent). (XLSX 45 kb