Communication Inequalities, Social Determinants, and Intermittent Smoking in the 2003 Health Information National Trends Survey

INTRODUCTION: Intermittent smokers account for a large proportion of all smokers, and this trend is increasing. Social and communication inequalities may account for disparities in intermittent smoking status. METHODS: Data for this study came from 2,641 ever-smokers from a 2003 nationally representative cross-sectional survey. Independent variables of interest included race/ethnicity, sex, household income, education, health media attention, and cancer-related beliefs. The outcome of interest was smoking status categorized as daily smoker, intermittent smoker, or former smoker. Analyses used 2 sets of multivariable logistic regressions to investigate the associations of covariates with intermittent smokers compared with former smokers and with daily smokers. RESULTS: People with high education and high income, Spanish-speaking Hispanics, and women were the most likely to be intermittent rather than daily smokers. Women and Spanish-speaking Hispanics were the most likely to be intermittent rather than former smokers. Attention to health media sources increased the likelihood that a person would be an intermittent smoker instead of a former or daily smoker. Believing that damage from smoking is avoidable and irreversible was associated with lower odds of being an intermittent smoker rather than a former smoker but did not differentiate intermittent smoking from daily smoking. CONCLUSION: The results indicate that tailoring smoking-cessation campaigns toward intermittent smokers from specific demographic groups by using health media may improve the effect of these campaigns and reduce social health disparities

Breakout Session: Increasing Study Recruitment and Retention: Working with Communities to Use Social Media

Overview: Social media and research: What are the options? -- Ethical considerations -- Gateway to Community-Based Participatory Research. Conclusion: Social media has the potential to improve the methods and scope of community research. A number of technical and ethical issues remain unresolved

Race, Ethnicity, Language, Social Class, and Health Communication Inequalities: A Nationally-Representative Cross-Sectional Study

BACKGROUND: While mass media communications can be an important source of health information, there are substantial social disparities in health knowledge that may be related to media use. The purpose of this study is to investigate how the use of cancer-related health communications is patterned by race, ethnicity, language, and social class. METHODOLOGY/PRINCIPAL FINDINGS: In a nationally-representative cross-sectional telephone survey, 5,187 U.S. adults provided information about demographic characteristics, cancer information seeking, and attention to and trust in health information from television, radio, newspaper, magazines, and the Internet. Cancer information seeking was lowest among Spanish-speaking Hispanics (odds ratio: 0.42; 95% confidence interval: 0.28-0.63) compared to non-Hispanic whites. Spanish-speaking Hispanics were more likely than non-Hispanic whites to pay attention to (odds ratio: 3.10; 95% confidence interval: 2.07-4.66) and trust (odds ratio: 2.61; 95% confidence interval: 1.53-4.47) health messages from the radio. Non-Hispanic blacks were more likely than non-Hispanic whites to pay attention to (odds ratio: 2.39; 95% confidence interval: 1.88-3.04) and trust (odds ratio: 2.16; 95% confidence interval: 1.61-2.90) health messages on television. Those who were college graduates tended to pay more attention to health information from newspapers (odds ratio: 1.98; 95% confidence interval: 1.42-2.75), magazines (odds ratio: 1.86; 95% confidence interval: 1.32-2.60), and the Internet (odds ratio: 4.74; 95% confidence interval: 2.70-8.31) and had less trust in cancer-related health information from television (odds ratio: 0.44; 95% confidence interval: 0.32-0.62) and radio (odds ratio: 0.54; 95% confidence interval: 0.34-0.86) compared to those who were not high school graduates. CONCLUSIONS/SIGNIFICANCE: Health media use is patterned by race, ethnicity, language and social class. Providing greater access to and enhancing the quality of health media by taking into account factors associated with social determinants may contribute to addressing social disparities in health

Attitudes of a Multiethnic Group of Immigrants towards Online Social Networking and Physical Activity: Results from Focus Group Discussions

Background and Purpose: Sedentary behavior contributes to the risk of obesity and cardiovascular disease. Increasing physical activity is particularly important for new immigrants to the U.S., since the risk of obesity and cardiovascular disease increases with acculturation to U.S. society. This study examined facilitators and barriers of using social media to provide information on physical activity, perceptions of the benefits of physical activity, and barriers to physical activity in low English proficiency immigrants in a New England city. Methods: Three focus groups were conducted to collect information from 25 adults in a New England city (Mean= 47.7+13.2 year, 68% female, 64% Asian). Results: Participants reported using social media to connect with family and friends, rather than to make new social connections. Barriers to social media use included access and privacy concerns. While the participants believed physical activity was necessary for health, they identified a number of barriers to exercise, including lack of access to exercise facilities, financial issues, and information on safe and effective ways to exercise. Conclusion: Using social media may be a convenient way to provide information about physical activity to low English proficiency immigrants, but researchers need to address the barriers to utilizing social media and engaging in physical activity

Mobile Pantry of Lowell Survey

The Mobile Pantry (MP) program of the Merrimack Valley Food Bank in Lowell, Massachusetts provides supplementary food to ensure that their clients have a sufficient amount of appropriate foods for a nutritious diet. The purpose of this project was to assess the effectiveness of MP services and explore opportunities for providing more healthful foods. The project was a descriptive cross-sectional study surveying MP clients, who are homebound, low-income elderly and/or disabled individuals residing in Greater Lowell. The survey took place between October 10 and November 16, 2011. Participation was anonymous and voluntary. The primary client from each of 77 households out of 309 responded to the questionnaire. Most of the respondents were white, female, and over age 65. Most respondents agreed strongly that with MP’s aid they ate more fruits, vegetables, and healthy foods; ate a balanced diet; were more physically and socially active; and generally felt healthier. Most respondents also stated that they would skip more meals and spend less on other necessities if they did not have help from MP. The program may be essential for the health, nutritional well-being, and food security of the low-income elderly and/or disabled in the Greater Lowell community. The results of this study may be utilized to improve MP services and food variety

Healthy Homes Asthma Survey

Asthma is a serious health concern among older adults in Massachusetts, the age group with the highest number of deaths due to asthma. The objective of this research is to investigate the prevalence of asthma and respiratory illness as well as the presence of environmental respiratory irritants in public senior housing. A total of 57 survey participants were recruited from social events for senior citizens sponsored by the Lowell Housing Authority. A paper survey was used to collect data regarding respiratory health and the presence of respiratory irritants in the homes. The study found that a large portion of the study participants has one or more respiratory ailments, and the majority of the participants have respiratory irritants present in their homes. Seniors living in public housing may benefit from residential respiratory health interventions

Movies and TV Influence Tobacco Use in India: Findings from a National Survey

Background: Exposure to mass media may impact the use of tobacco, a major source of illness and death in India. The objective is to test the association of self-reported tobacco smoking and chewing with frequency of use of four types of mass media: newspapers, radio, television, and movies. Methodology/Principal Findings: We analyzed data from a sex-stratified nationally-representative cross-sectional survey of 123,768 women and 74,068 men in India. All models controlled for wealth, education, caste, occupation, urbanicity, religion, marital status, and age. In fully-adjusted models, monthly cinema attendance is associated with increased smoking among women (relative risk [RR]: 1·55; 95% confidence interval [CI]: 1·04–2·31) and men (RR: 1·17; 95% CI: 1·12–1·23) and increased tobacco chewing among men (RR: 1·15; 95% CI: 1·11–1·20). Daily television and radio use is associated with higher likelihood of tobacco chewing among men and women, while daily newspaper use is related to lower likelihood of tobacco chewing among women. Conclusion/Significance: In India, exposure to visual mass media may contribute to increased tobacco consumption in men and women, while newspaper use may suppress the use of tobacco chewing in women. Future studies should investigate the role that different types of media content and media play in influencing other health behaviors

Patterning in Birthweight in India: Analysis of Maternal Recall and Health Card Data

National data on birthweight from birth certificates or medical records are not available in India. The third Indian National Family Health Survey included data on birthweight of children obtained from health cards and maternal recall. This study aims to describe the population that these data represent and compares the birthweight obtained from health cards with maternal recall data in terms of its socioeconomic patterning and as a risk factor for childhood growth failure.The analytic sample consisted of children aged 0 to 59 months with birthweight data obtained from health cards (n = 3227) and maternal recall (n = 16,787). The difference between the card sample and the maternal recall sample in the distribution across household wealth, parental education, caste, religion, gender, and urban residence was compared using multilevel models. We also assessed the ability of birthweight to predict growth failure in infancy and childhood in the two groups. The survey contains birthweight data from a majority of household wealth categories (>5% in every category for recall), both genders, all age groups, all caste groups, all religion groups, and urban and rural dwellers. However, children from the lowest quintile of household wealth were under-represented (4.73% in card and 8.62% in recall samples). Comparison of data across health cards and maternal recall revealed similar social patterning of low birthweight and ability of birthweight to predict growth failure later in life. Children were less likely to be born with low birthweight if they had mothers with over 12 years of education compared to 1-5 years of education with relative risk (RR) of 0.79 (95% confidence interval [CI]: 0.52, 1.2) in the card sample and 0.70 (95% CI: 0.59, 0.84) in the recall sample. A 100 gram difference in a child's birthweight was associated with a decreased likelihood of underweight in both the card (RR: 0.95; 95% CI: 0.94, 0.96) and recall (RR: 0.96; 95% CI: 0.96, 0.97) samples.Our results suggest that in the absence of other sources, the data on birthweight in the third Indian National Family Health Survey is valuable for epidemiologic research

Oral and Systemic Effects of Xylitol Consumption

Recent results of randomized trials testing the efficacy of xylitol in caries prevention have been conflicting. This narrative review reveals the sources of discrepancy. The following databases were searched for the terms xylitol or artificial sweeteners restricted to the English language: PubMed, Web of Science, Evidenced-Based Medicine, Scopus, and the Cochrane database. In a separate search, the terms dental caries or cariogenicity or glucosyltransferase or low glycemic or low insulinemic or dysbiosis or gut microbiome were used and then combined. In section I, findings regarding the role of xylitol in dental caries prevention, the appropriateness of research methods, and the causes for potential biases are summarized. In section II, the systemic effects of xylitol on gut microbiota as well as low-glycemic/insulinogenic systemic effects are evaluated and summarized. The substitution of a carbonyl group with an alcohol radical in xylitol hinders its absorption and slowly releases sugar into the bloodstream. This quality of xylitol is beneficial for diabetic patients to maintain a constant glucose level. Although this quality of xylitol has been proven in in vitro and animal studies, it has yet to be proven in humans. Paradoxically, recent animal studies reported hyperglycemia and intestinal dysbiosis with artificial sweetener consumption. Upon careful inspection of evidence, it was revealed that these reports may be due to misinterpretation of original references or flaws in study methodology. Any systemic benefits of xylitol intake must be weighed in consideration with the well-established adverse gastrointestinal consequences. The contribution of xylitol to gut dysbiosis that may affect systemic immunity warrants further research.Peer reviewe

Geography of underweight and overweight among women in India: A multilevel analysis of 3204 neighborhoods in 26 states

We investigated the geographic distribution and the relationship with neighborhood wealth of underweight and overweight in India. Using multilevel modeling techniques, we calculated state-specific smoothed shrunken state residuals of overweight and underweight, neighborhood and state variation of nutritional status, and the relationships between neighborhood wealth and nutritional status of 76,681 women living in 3204 neighborhoods in 26 Indian states. We found a substantial variation in overweight and underweight at the neighborhood and state levels, net of what could be attributed to individual-level factors. Neighborhood wealth was associated with increased levels of overweight and decreased levels of underweight, and was found to modify the relationship between personal living standard and nutritional status. These findings suggest that interventions to address the double burden of undernutrition and overnutrition in India must take into account state and neighborhood characteristics in order to be successful.