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Results for “Health determinants”

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At least 19 recordsLinked to original sources
PubMed2026

Association between cumulative social disadvantage, as measured by the social determinants of health score, and epilepsy: a cross-sectional study.

BACKGROUND: Social determinants of health (SDoH) shape access to care, health behaviors, and long-term outcomes, yet their cumulative relationship with epilepsy has not been well quantified. This study examined whether a composite SDoH score was associated with epilepsy in adults. METHODS: This cross-sectional study used data from the National Health and Nutrition Examination Survey 2013-2018. The SDoH score ranged from 0 to 8 and summarized eight unfavorable social conditions. Epilepsy was identified using medication-based ascertainment. Survey-weighted logistic regression models were applied to evaluate the association between SDoH score and epilepsy. Restricted cubic spline, subgroup, sensitivity, and receiver operating characteristic analyses were also performed. RESULTS: A total of 13,119 participants were included, of whom 114 had epilepsy. Participants with epilepsy had a higher mean SDoH score than those without epilepsy (3.41&#xa0;&#xb1;&#xa0;0.24 vs. 2.35&#xa0;&#xb1;&#xa0;0.06, P&#xa0;<&#xa0;0.001). In the fully adjusted model, each 1-point increase in SDoH score was associated with 31% higher odds of epilepsy (OR 1.31, 95% CI 1.16-1.48). Compared with the low-score group (0-2), the adjusted odds ratios were 2.09 (95% CI 1.06-4.15) for scores of 3-5 and 2.67 (95% CI 1.34-5.33) for scores of 6-8. Spline analysis showed a significant overall association without evidence of nonlinearity. Adding SDoH components to demographic variables improved model discrimination (AUC 0.731 vs. 0.589, P for difference <0.001). CONCLUSION: Greater cumulative social disadvantage, as reflected by the SDoH score, was associated with higher odds of epilepsy.

Humans↗
PubMed2026

Social Determinants of Health and Clinical Outcomes in Hypertrophic Cardiomyopathy.

IMPORTANCE: Area-based indicators of social determinants of health (SDOH) are associated with higher risk for acquired heart disease, but their impact on conditions with a strong genetic etiology, such as hypertrophic cardiomyopathy (HCM), is not well understood. OBJECTIVE: To determine the association of area-based SDOH with clinical outcomes in patients with HCM. DESIGN, SETTING, AND PARTICIPANTS: This multicenter, prospective cohort study was conducted among US adult patients with HCM from 5 sites in the Sarcomeric Human Cardiomyopathy Registry (a multicenter prospective registry of patients with HCM) who were followed up for a median (IQR) period of 2.15 (0.15-5.82) years. Data were entered from 2015 to March 2024, and data analysis was completed from March 2024 to June 2025. EXPOSURES: Patients' residential addresses were geocoded at the zip code level and linked to the American Communities Survey to estimate area-based (1) median household income and (2) social deprivation index (SDI), which ranges from 0 to 100, with higher scores indicating a more deprived area. MAIN OUTCOMES AND MEASURES: Multivariate models, adjusting for age at diagnosis, body mass index, hypertension, and sex, were used to estimate the independent association of area-based median household income and SDI with heart failure (HF), ventricular arrhythmias (VA), and an overall composite outcome (VA, HF, atrial fibrillation, stroke, and death). RESULTS: Among 4431 US adult patients with HCM, median (IQR) age at HCM diagnosis was 51.3 (38.9-61.6) years, and 1862 patients (42.0%) were female. Median (IQR) area-based household income was $80&#x202f;000 ($60&#x202f;000-$110&#x202f;000), and median (IQR) SDI was 25 (10-55). Adjusted hazard ratios comparing the lowest income group to the highest income group were 2.07 (95% CI, 1.77-2.42; P&#x2009;<&#x2009;.001) for HF, 1.31 (95% CI, 0.97-1.78; P&#x2009;=&#x2009;.08) for VA, and 1.52 (95% CI, 1.36-1.69; P&#x2009;<&#x2009;.001) for the overall composite outcome. Adjusted hazard ratios comparing the highest SDI (ie, more deprived) group to the lowest SDI group were 1.48 (95% CI, 1.29-1.70; P&#x2009;<&#x2009;.001) for HF, 1.55 (95% CI, 1.15-2.09; P&#x2009;=&#x2009;.004) for VA, and 1.36 (95% CI, 1.22-1.50; P&#x2009;<&#x2009;.001) for the overall composite outcome. CONCLUSIONS AND RELEVANCE: In this multicenter cohort study, residing in an area with lower median household income or worse SDI were each independently associated with adverse clinical outcomes in patients with HCM. These findings suggest that despite the genetically determined nature of HCM, place of residence is associated with patient outcomes.

Humans↗
PubMed2026

Metabolome-driven rhizosphere microbiome assembly determining the health of medicinal herb (Angelica sinensis) against root rot.

BACKGROUND: The rhizosphere-associated microbiota plays a crucial role in plant responses to disease stress. Plant secondary metabolites are recognized as crucial mediators in the assembly of rhizosphere microbial communities, particularly by enhancing the colonization of beneficial microorganisms. Despite this recognized importance, a deeper understanding of how such metabolome-driven microbiome assembly specifically determines plant resistance against soil-borne diseases is still lacking. RESULTS: Here, we focused on the widely planted medicinal plant Angelica sinensis and demonstrated that root rot-diseased rhizosphere soils (DRS) exhibited a higher relative abundance of Fusarium and a lower relative abundance of Streptomyces compared to healthy rhizosphere soils (HRS). Shotgun metagenomic sequencing revealed that metabolism-associated genes, particularly those related to steroid degradation, are significantly enriched in HRS samples. Subsequent genome and functional gene analysis of Streptomyces revealed that the steroid degradation-related genes are associated with rhizosphere colonization in hosts. Rhizosphere Streptomyces S15 directly antagonized Fusarium and enhanced the root resistance of A. sinensis. Comparative metabolomics showed that A. sinensis plants from HRS secreted more lipid and lipid-like molecules than those from DRS, especially sterol lipids and long-chain fatty acids, which promoted the growth of Streptomyces S15 isolates. Transcriptome analysis validated that the lipid hormones are essential for sporulation, biofilm formation, and streptomycin biosynthesis of S15 strain. Finally, exogenous application of synbiotics (lipid prebiotics and S15) to A. sinensis resulted in the enrichment of S15-homologous Streptomyces amplicon sequence variant (ASV), further establishing beneficial bacterial communities in Fusarium-stressed rhizospheres. CONCLUSIONS: Our study proposes that A. sinensis recruits steroid-metabolizing Streptomyces species by exuding key lipid compounds (i.e., methyl jasmonate and brassinolide) to combat Fusarium root rot. This study provides novel insights into using functional synbiotics as a promising strategy for manipulating plant-microbiome interactions to promote sustainable agriculture. Video Abstract.

Rhizosphere↗
PubMed1978

The supply of optometric manpower.

Approaches to determining health manpower requirements are reviewed. The paper identifies a source of error in determining the present supply of optometric manpower which will ultimately influence any policy or program intended to either correct or adjust future health manpower supplies. The study also demonstrates a need to refine the data on health manpower supplies with particular reference to the characteristics and practices of the optometrist.

Adult↗
PubMed1977

Community education for cardiovascular health.

To determine whether community health education can reduce the risk of cardiovascular disease, a field experiment was conducted in three northern California towns. In two of these communities there were extensive mass-media campaigns over a 2-year period, and in one of these, face-to-face counselling was also provided for a small subset of high-risk people. The third community served as a control. People from each community were interviewed and examined before the campaigns began and one and two years afterwards to assess knowledge and behaviour related to cardiovascular disease (e.g., diet and smoking) and also to measure physiological indicators of risk (e.g., blood-pressure, relative weight, and plasma-cholesterol). In the control community the risk of cardiovascular disease increased over the two years but in the treatment communities there was a substantial and sustained decrease in risk. In the community in which there was some face-to-face counselling the initial improvement was greater and health education was more successful in reducing cigarette smoking, but at the end of the second year the decrease in risk was similar in both treatment communities. These results strongly suggest that mass-media education campaigns directed at entire communities may be very effective in reducing the risk of cardiovascular disease.

Adult↗
PubMed1979

Health beliefs of hypertensive patients in a family medicine residency program.

This paper presents the results of a survey of the hypertensive patient population in a university family medicine practice to determine health beliefs, patient perceptions of the severity of their condition, stated levels of compliance to drug regimens, frequency of drug side effects, and frequency of physician discussions of drug side effects and diet. Health beliefs were then associated with diastolic hypertension and increase in medication dosage over a four-month period. Results of the survey sharpen the focus of patient education efforts by the family physician on specific attitudes, beliefs, and treatment issues which are most appropriate for the hypertensive patient. The physician may improve his/her management of hypertensive patients by: (1) anticipating prevalent myths and misconceptions which patients have concerning hypertension; (2) alleviating patient anxiety by stressing that control of blood pressure decreases the likelihood of complications; (3) effectively communicating to each patient the current status of his/her condition at each visit; and (4) initiating discussion of side effects through direct questioning for those effects most frequently seen.

Adult↗
PubMed1978

A causal model of health services for diabetic patients.

A causal model of health services which includes patient and provider variables, perceived access to care, utilization of services, continuity of care, technical quality of the care process, technical quality of the care outcome, and patient satisfaction is applied to a group of diabetic patients enrolled in the Seattle Prepaid Health Care Project. The enrollees received comprehensive health services at zero out-of-pocket cost from either a prepaid group practice plan or an independent practice plan. Surveys were periodically conducted to determine health status, satisfaction, and demographic characteristics of the enrollees; utilization of services was monitored throughout the experiment. The causal model is operationalized through the use of path analysis. Significant relationships (p less than or equal to .10) were established between satisfaction and perceived access to care, family size, sex, and professional qualifications of the provider; between outcome of care and health status, female education, and physician performance; between physician performance and professional qualifications; between continuity of care and health status and female education; between utilization and perceived access, specialty of provider, and provider system; and between access to care and provider system. The policy implications of the results are discussed.

Consumer Behavior↗
PubMed1978

Epidemiologic investigations of styrene-butadiene rubber production and reinforced plastics production.

The United States National Institute for Occupational Safety and Health (NIOSH) began an epidemiologic study of workers employed in the styrene-butadiene rubber (SBR) industry during 1976. This study was prompted by reports of relatively high numbers of leukemia deaths occurring within SBR production work populations. Simultaneous with the initiation of this investigation, the University of North Carolina released a report associating an excess risk of death due to hematopoietic and lymphatic malignancies among workers producing several synthetic rubbers, including SBR. This report presents NIOSH's preliminary mortality observations and a discussion of progress made on the analyses of contaminants found in two SBR production facilities. Currently, NIOSH is determining the feasibility of doing an epidemiologic study in the reinforced plastics industry. Interest in this study developed as part of an effort to determine health hazards associated with occupational exposure to styrene. Most of the technology for the reinforced plastics industry developed in the 1950s, and therefore this process represents a relatively new industry. This report also includes information on environmental conditions observed in the reinforced plastics industry and enumerates some of the complicating characteristics of this industry which increase the complexity of this study.

Bone Marrow Diseases↗