Neighbourhood Influences on Population Health: Time to Unpack the Black Box

[No abstract available]This work was financed by national funds through FCT—Fundação para a Ciência e a Tecnologia, I.P., under the project “HUG: The health impacts of inner-city gentrification, displacement and housing insecurity: a quasi-experimental multi-cohort study (PTDC/GES-OUT/1662/2020)” and the projects UIDB/04750/2020 and LA/P/0064/2020. AR was supported by National Funds through FCT, under the “Stimulus of Scientific Employment—Individual Support” programme within the contract CEECIND/02386/2018. PG is supported by Instituto de Salud Carlos III, Subdirección General de Evaluación y Fomento de la Investigación, Government of Spain (PI18/00782) and by the Young Projects program funded by Comunidad de Madrid and UAH under the project GentriHealth (CM/JIN/2021-028). EM is supported by The Health Foundation’s Social and Economic Value of Health programme (R-000002350)

Improving longitudinal research in geospatial health: An agenda

All aspects of public health research require longitudinal analyses to fully capture the dynamics of outcomes and risk factors such as ageing, human mobility, non-communicable diseases (NCDs), climate change, and endemic, emerging, and re-emerging infectious diseases. Studies in geospatial health are often limited to spatial and temporal cross sections. This generates uncertainty in the exposures and behavior of study populations. We discuss a research agenda, including key challenges and opportunities of working with longitudinal geospatial health data. Examples include accounting for residential and human mobility, recruiting new birth cohorts, geoimputation, international and interdisciplinary collaborations, spatial lifecourse studies, and qualitative and mixed-methods approaches

Nine years of comparative effectiveness research education and training: initiative supported by the PhRMA Foundation

The term comparative effectiveness research (CER) took center stage with passage of the American Recovery and Reinvestment Act (2009). The companion US$1.1 billion in funding prompted the launch of initiatives to train the scientific workforce capable of conducting and using CER. Passage of the Patient Protection and Affordable Care Act (2010) focused these initiatives on patients, coining the term ‘patient-centered outcomes research’ (PCOR). Educational and training initiatives were soon launched. This report describes the initiative of the Pharmaceutical Research and Manufacturers Association of America (PhRMA) Foundation. Through provision of grant funding to six academic Centers of Excellence, to spearheading and sponsoring three national conferences, the PhRMA Foundation has made significant contributions to creation of the scientific workforce that conducts and uses CER/PCOR

Local area unemployment, individual health and workforce exit: ONS Longitudinal Study

This work was jointly funded by the Economic and Social Research Center (ESRC) and the United Kingdom’s Medical Research Council, under the Lifelong Health and Wellbeing Cross-Council Programme initiative [ES/L002892/1]. CeLSIUS is supported by the ESRC Census of Population Programme (Award Ref: ES/ K000365/1)

What about the Rest of Them? Fatal Injuries Related to Production Agriculture Not Captured by the Bureau of Labor Statistics (BLS) Census of Fatal Occupational Injuries (CFOI)

Surveillance of injuries in production agriculture is necessary to inform stakeholders about workplace hazards and risks in order to improve and advance injury prevention policies and practices for this dangerous industry. The most comprehensive fatal injury surveillance effort currently in the United States is the Bureau of Labor Statistics (BLS) Census of Fatal Occupational Injuries (CFOI), which covers occupational fatalities in all U.S. industries, including production agriculture. However, this surveillance does not include many categories of fatalities that occur during agricultural work or on production agriculture worksites. To better capture the human cost of production agriculture, the authors of this paper call for the collection of additional data with a broader scope that supplements, not replaces, the current CFOI. This paper describes challenges in surveillance, highlights key procedural gaps, and offers recommendations for advancing national surveillance of fatal traumatic injuries associated with production agriculture

Life Course Socioeconomic Position: associations with cardiac structure and function at age 60-64 years in the 1946 British Birth Cohort

Although it is recognized that risks of cardiovascular diseases associated with heart failure develop over the life course, no studies have reported whether life course socioeconomic inequalities exist for heart failure risk. The Medical Research Council’s National Survey of Health and Development was used to investigate associations between occupational socioeconomic position during childhood, early adulthood and middle age and measures of cardiac structure [left ventricular (LV) mass index and relative wall thickness (RWT)] and function [systolic: ejection fraction (EF) and midwall fractional shortening (mFS); diastolic: left atrial (LA) volume, E/A ratio and E/e’ ratio)]. Different life course models were compared with a saturated model to ascertain the nature of the relationship between socioeconomic position across the life course and each cardiac marker. Findings showed that models where socioeconomic position accumulated over multiple time points in life provided the best fit for 3 of the 7 cardiac markers: childhood and early adulthood periods for the E/A ratio and E/e’ ratio, and all three life periods for LV mass index. These associations were attenuated by adjustment for adiposity, but were little affected by adjustment for other established or novel cardio-metabolic risk factors. There was no evidence of a relationship between socioeconomic position at any time point and RWT, EF, mFS or LA volume index. In conclusion, socioeconomic position across multiple points of the lifecourse, particularly earlier in life, is an important determinant of some measures of LV structure and function. BMI may be an important mediator of these associations

Novel coronary heart disease risk factors at 60e64 years and life course socioeconomic position: The 1946 British birth cohort

a b s t r a c t Social disadvantage across the life course is associated with a greater risk of coronary heart disease (CHD) and with established CHD risk factors, but less is known about whether novel CHD risk factors show the same patterns. The Medical Research Council National Survey of Health and Development was used to investigate associations between occupational socioeconomic position during childhood, early adulthood and middle age and markers of inflammation (C-reactive protein, interleukin-6), endothelial function (Eselectin, tissue-plasminogen activator), adipocyte function (leptin, adiponectin) and pancreatic beta cell function (proinsulin) measured at 60e64 years. Life course models representing sensitive periods, accumulation of risk and social mobility were compared with a saturated model to ascertain the nature of the relationship between social class across the life course and each of these novel CHD risk factors. For interleukin-6 and leptin, low childhood socioeconomic position alone was associated with high risk factor levels at 60e64 years, while for C-reactive protein and proinsulin, cumulative effects of low socioeconomic position in both childhood and early adulthood were associated with higher (adverse) risk factor levels at 60e64 years. No associations were observed between socioeconomic position at any life period with either endothelial marker or adiponectin. Associations for C-reactive protein, interleukin-6, leptin and proinsulin were reduced considerably by adjustment for body mass index and, to a lesser extent, cigarette smoking. In conclusion, socioeconomic position in early life is an important determinant of several novel CHD risk factors. Body mass index may be an important mediator of these relationships

The Lived Clinical Experiences of Expatriate Athletic Trainers

Context: The international practice setting is gaining popularity for athletic trainers (ATs). Little has been investigated about the clinical experiences and challenges this setting presents. The purpose of this study was to create a baseline of understanding surrounding AT’s lived clinical experiences within the international practice setting. Methods: We used a consensual qualitative design and recruited credentialed ATs who are practicing the athletic training skillset outside the US. The Board of Certification supplied email addresses for recruitment (Sample: 23 total; 11 females, 12 males; 34 ± 7 years old. Representation was from fifteen different countries. Participants completed an electronic informed consent and demographic survey (Qualtrics® Inc., Provo, UT). Based on previous literature and in consultation with an international sports medicine expert, both interview and survey tools were developed, validated, and piloted. Semi-structured interviews were conducted and transcribed by the lead investigator using teleconferencing software (Zoom, San Jose, CA). Three researchers coded transcripts using a consensual codebook to confirm domains, codes, and data saturation. Member checking, peer reviewing, and multiple researchers were used to triangulate data and enhance trustworthiness. Results: Three domains emerged during analysis: (1) Professional and Cultural Adaptations, (2) Healthcare Landscape, and (3) Personal Pathways and Motivators. Participants voiced struggles with self-efficacy, as well as detailed incongruities of their clinical roles and others’ understanding of their skill set as ATs. Clinicians detailed the versatility of ATs’ skillset filling clinical gaps within their country’s healthcare landscape. Institutional and intraprofessional relationships were expanded on and emphasized personal connections. Participants voiced challenges surrounding resources and adapting to their country’s legal systems. Interprofessional practice and collaboration, as well as cultural competence, was discussed as imperative to practice. A wide range of work settings within countries were regularly found. Conclusions: International ATs expressed a variety of ways that the AT skillset fits a unique international need. Both interprofessional relationships and intraprofessional practice were crucial; relationships were enhanced through communication skills, empathy, and cultural competence. While native clinicians had a consistent lack of knowledge of the AT skill, clinical advocacy and a strong desire to grow the international practice setting was salient to practitioners