Educational Benefits and Cognitive Health Life Expectancies: Racial/Ethnic, Nativity, and Gender Disparities

Background and Objectives: To examine racial/ethnic, nativity, and gender differences in the benefits of educational attainment on cognitive life expectancies among older adults in the United States. Design and Methods: We used data from the Health and Retirement Study (1998-2014) to estimate Sullivan-based life tables of cognitively healthy, cognitively impaired/no dementia (CIND), and dementia life expectancies by gender for older White, Black, U.S.-born and foreign-born Hispanic adults with less than high school, high school, and some college or more. Results: White respondents lived a greater percentage of their remaining lives cognitive healthy than their minority Black or Hispanic counterparts, regardless of level of education. Among respondents with some college or more, versus less than high school, Black and U.S.-born Hispanic women exhibited the greatest increase (both 37 percentage points higher) in the proportion of total life expectancy spent cognitively healthy; whereas White women had the smallest increase (17 percentage points higher). For men, the difference between respondents with some college or more, versus less than high school, was greatest for Black men (35 percentage points higher) and was lowest for U.S.-born Hispanic men (21 percentage points higher). Discussion and Implications: Our results provide evidence that the benefits of education on cognitive life expectancies are largest for Black men and women, and U.S.-born Hispanic women. The combination of extended longevity and rising prevalence of Alzheimer’s disease point to the need for understanding why certain individuals spend an extended period of their lives with poor cognitive health

Greater social cohesion is associated with lower body mass index among African American adults

Obesity remains a public health issue, especially for Blacks (or African Americans). Obesity is thought to reflect a complex interaction of socioenvironmental, biological, and cognitive factors. Yet, insufficient attention has been given to psychosocial factors like social cohesion within the African American community. Using multivariable linear regression, we examined the association between social cohesion, measured by the Social Cohesion and Trust scale, and body mass index (BMI) with cross-sectional data (n = 1467) from a cohort study (2008–2009). Greater social cohesion was associated with lower BMI (b = -0.88; 95% CI: −1.45, −0.32) in an unadjusted model. The association was strengthened after further adjusting for relevant covariates (i.e., individual-level sociodemographic factors, health behaviors, and depressive symptoms) (b = -1.26; 95% CI: −1.94, −0.58). Future research should examine potential mechanisms underlying the association between social cohesion and BMI with longitudinal data. In the meantime, obesity prevention and intervention measures should consider promoting social ties and bonds to lower BMI in African American communities

Health-Related Regional and Neighborhood Correlates of Sexual Minority Concentration: A Systematic Review

<div><p>Background</p><p>A growing literature explores spatial patterns of regional and neighborhood correlates of sexual minority (e.g., lesbian, gay, bisexual) concentration. Such patterns have implications for health and wellbeing if there are differences in health-promoting or health-hindering resources in neighborhoods or regions. We conducted a systematic review to assess sexual minority concentration in relation to area unit characteristics.</p><p>Methods</p><p>We included only records published after 1973 and made no exclusions by geography or language. We searched 11 databases (Academic Search Complete, CINAHL, Embase, GeoBase, GeoRef, LGBT Life, PsycINFO, PubMed/MEDLINE, Scopus, Sociological Abstracts, Web of Science) on November 19–21, 2016. We searched reference lists of included records. We used the following inclusion criteria: (1) Record is a quantitative study (that is, it uses statistics to describe or associate two or more variables); (2) Record is about (a) migration or internal migration of, (b) area unit selection by, or (c) concentration of sexual minority people (defined by identity, behavior, or attraction); (3) Criterion 2 is linked to the characteristics of regions or neighborhoods (at any spatial scale).</p><p>Results</p><p>Dual independent coding resulted in 51 records meeting inclusion criteria from the original pool of 5,591. From these records, we identified the 647 reported results linking sexual minority concentration with area unit characteristics. Of these, 132 were unadjusted relationships between sexual minority concentration and four theory-informed domains of neighborhood influence on health. We identified greater concentration of sexual minorities in regions with more resources and in more urban regions. A limited but troubling literature at the neighborhood level suggested potentially higher concentrations of sexual minorities in neighborhoods with fewer resources.</p><p>Conclusions</p><p>There are substantial gaps in the literature. We discuss the implications of our findings and gaps in relation to key theories of sexual minority health.</p><p>Registration</p><p>The review was not registered with PROSPERO because it was not eligible for registration at the time of the research project’s initiation due to the outcome of interest.</p></div

Effects of total fat intake on body fatness in adults

Background: The ideal proportion of energy from fat in our food and its relation to body weight is not clear. In order to prevent overweight and obesity in the general population, we need to understand the relationship between the proportion of energy from fat and resulting weight and body fatness in the general population. Objectives: To assess the effects of proportion of energy intake from fat on measures of body fatness (including body weight, waist circumference, percentage body fat and body mass index) in people not aiming to lose weight, using all appropriate randomised controlled trials (RCTs) of at least six months duration. Search methods: We searched CENTRAL, MEDLINE, Embase, Clinicaltrials.gov and the WHO International Clinical Trials Registry Platform (ICTRP) to October 2019. We did not limit the search by language. Selection criteria: Trials fulfilled the following criteria: 1) randomised intervention trial, 2) included adults aged at least 18 years, 3) randomised to a lower fat versus higher fat diet, without the intention to reduce weight in any participants, 4) not multifactorial and 5) assessed a measure of weight or body fatness after at least six months. We duplicated inclusion decisions and resolved disagreement by discussion or referral to a third party. Data collection and analysis: We extracted data on the population, intervention, control and outcome measures in duplicate. We extracted measures of body fatness (body weight, BMI, percentage body fat and waist circumference) independently in duplicate at all available time points. We performed random-effects meta-analyses, meta-regression, subgrouping, sensitivity, funnel plot analyses and GRADE assessment. Main results: We included 37 RCTs (57,079 participants). There is consistent high-quality evidence from RCTs that reducing total fat intake results in small reductions in body fatness; this was seen in almost all included studies and was highly resistant to sensitivity analyses (GRADE high-consistency evidence, not downgraded). The effect of eating less fat (compared with higher fat intake) is a mean body weight reduction of 1.4 kg (95% confidence interval (CI) -1.7 to -1.1 kg, in 53,875 participants from 26 RCTs, I2 = 75%). The heterogeneity was explained in subgrouping and meta-regression. These suggested that greater weight loss results from greater fat reductions in people with lower fat intake at baseline, and people with higher body mass index (BMI) at baseline. The size of the effect on weight does not alter over time and is mirrored by reductions in BMI (MD -0.5 kg/m2, 95% CI -0.6 to -0.3, 46,539 participants in 14 trials, I2 = 21%), waist circumference (MD -0.5 cm, 95% CI -0.7 to -0.2, 16,620 participants in 3 trials; I2 = 21%), and percentage body fat (MD -0.3% body fat, 95% CI -0.6 to 0.00, P = 0.05, in 2350 participants in 2 trials; I2 = 0%). There was no suggestion of harms associated with low fat diets that might mitigate any benefits on body fatness. The reduction in body weight was reflected in small reductions in LDL (-0.13 mmol/L, 95% CI -0.21 to -0.05), and total cholesterol (-0.23 mmol/L, 95% CI -0.32 to -0.14), with little or no effect on HDL cholesterol (-0.02 mmol/L, 95% CI -0.03 to 0.00), triglycerides (0.01 mmol/L, 95% CI -0.05 to 0.07), systolic (-0.75 mmHg, 95% CI -1.42 to -0.07) or diastolic blood pressure(-0.52 mmHg, 95% CI -0.95 to -0.09), all GRADE high-consistency evidence or quality of life (0.04, 95% CI 0.01 to 0.07, on a scale of 0 to 10, GRADE low-consistency evidence). Authors' conclusions: Trials where participants were randomised to a lower fat intake versus a higher fat intake, but with no intention to reduce weight, showed a consistent, stable but small effect of low fat intake on body fatness: slightly lower weight, BMI, waist circumference and percentage body fat compared with higher fat arms. Greater fat reduction, lower baseline fat intake and higher baseline BMI were all associated with greater reductions in weight. There was no evidence of harm to serum lipids, blood pressure or quality of life, but rather of small benefits or no effect

Black youth empowerment project

Much of the research on Black K-12 students’ experiences in U.S. schools has focused primarily on Black American youth. Yet, Black immigrants (African, Caribbean, and Afro-Latinx) and their children make up 20% of the Black U.S. population, growing from 816,000 in 1980, to over 4.2 million as of 2016. Little attention has been given to how these demographic shifts complicate traditional definitions of race, ethnicity, and academic achievement in U.S. schools. Given the current U.S. racial climate, the #BlackLivesMatter movement, and the pervasiveness of racial discrimination in school, it is crucial to understand how Black youth of the African Diaspora are using their Blackness to navigate racism and thrive academically. Specifically, we explore two race-related resilience concepts (John Henryism and the model minority myth) that shape short and long term academic success (e.g., grades, graduation rates). Understanding the varying roles of these resilience strategies may explain why some Black students succeed academically despite the everyday racial discrimination they face

Educational Benefits and Cognitive Health Life Expectancies: Racial/Ethnic, Nativity, and Gender Disparities

Background and Objectives: To examine racial/ethnic, nativity, and gender differences in the benefits of educational attainment on cognitive life expectancies among older adults in the United States. Design and Methods: We used data from the Health and Retirement Study (1998-2014) to estimate Sullivan-based life tables of cognitively healthy, cognitively impaired/no dementia (CIND), and dementia life expectancies by gender for older White, Black, U.S.-born and foreign-born Hispanic adults with less than high school, high school, and some college or more. Results: White respondents lived a greater percentage of their remaining lives cognitive healthy than their minority Black or Hispanic counterparts, regardless of level of education. Among respondents with some college or more, versus less than high school, Black and U.S.-born Hispanic women exhibited the greatest increase (both 37 percentage points higher) in the proportion of total life expectancy spent cognitively healthy; whereas White women had the smallest increase (17 percentage points higher). For men, the difference between respondents with some college or more, versus less than high school, was greatest for Black men (35 percentage points higher) and was lowest for U.S.-born Hispanic men (21 percentage points higher). Discussion and Implications: Our results provide evidence that the benefits of education on cognitive life expectancies are largest for Black men and women, and U.S.-born Hispanic women. The combination of extended longevity and rising prevalence of Alzheimer’s disease point to the need for understanding why certain individuals spend an extended period of their lives with poor cognitive health

Partnerships, Processes, and Outcomes: A Health Equity-Focused Scoping Meta-Review of Community-Engaged Scholarship

In recent decades, there has been remarkable growth in scholarship examining the usefulness of community-engaged research (CEnR) and community-based participatory research (CBPR) for eliminating health inequities.This article seeks to synthesize the extant literature of systematic reviews, scoping reviews, and other related reviews regarding the context, processes, and research designs and interventions underlying CEnR that optimize its effectiveness. Through a scoping review, we have utilized an empirically derived framework of CBPR to map this literature and identify key findings and priorities for future research. Our study found 100 reviews of CEnR that largely support the CBPR conceptual framework

Harvest plot (count) of unadjusted relationship between sexual minority concentration and (a) regional area unit characteristics and (b) neighborhood area unit characteristics, by gender, n = 132 results from n = 36 records.

<p>Harvest plot (count) of unadjusted relationship between sexual minority concentration and (a) regional area unit characteristics and (b) neighborhood area unit characteristics, by gender, n = 132 results from n = 36 records.</p

Inclusion flow diagram, Nov. 19–21, 2016.

<p>Inclusion flow diagram, Nov. 19–21, 2016.</p