Health Behaviors Flashcards
Factor, Kawachi, & Williams. (2011). Understanding high-risk behavior among non-dominant minorities: A social resistance framework.
Gist: Non-dominant minority groups exhibit higher rates of involvement in high-risk behaviors than non-dominant minority groups. Develops integrated theoretical framework to incorporate structural inequalities but also role of individual agency. The social resistance framework suggests that power relations in society encourage members of non-dominant minority groups to actively engage in everyday resistance practices that include various unhealthy behaviors.
Fenelon & Preston. (2012). Estimating smoking-attributable mortality in the United States.
Gist: Tobacco use is the largest single cause of premature death in the developed world. Use two methods of estimating number of deaths attributable to smoking mortality by using lung cancer as an indicator of damage.
Ford, Bergmann, Boeing, Li, & Capewell. (2012). Healthy lifestyle behaviors and all-cause mortality among adults in the United States.
Gist: Examined links between 3 healthy lifestyle behaviors (not smoking, healthy diet, adequate physical activity) and all-cause mortality. Each reduces risk of early death. Compared to people with no healthy behaviors, risk decreased progressively as number of healthy behaviors increased.
Fuller. (2011). Moderate alcohol consumption and the risk of mortality.
Gist: Although previous research suggests that the relationship between moderate alcohol consumption and lower mortality risk is due to misclassification errors, the current study suggests that moderate alcohol consumption is related to lower all-cause mortality and lower congestive heart disease mortality.
Himes. (2011). Relationships among health behaviors, health, and mortality.
Gist: Summarizes health and mortality risks for tobacco use, nutrition and diet, alcohol consumption, physical activity, and obesity.
Ho & Elo. (2013). The contribution of smoking to black-white differences in U.S. mortality.
Gist: Examined the contribution of smoking-attributable deaths to mortality trends among blacks or to black-white mortality differences at older ages over time. Smoking contributed to the black-white gap in life expectancy age age 50 for males, but not for females. Blacks in U.S. suffer disproportionately from smoking-related diseases (except COPD), slightly more likely to be ever-smokers, and have lower smoking cessation rates compared to whites. Longer smoking durations & lower smoking cessation rates among blacks than whites may explain blacks’ higher mortality from lung cancer & other smoking-related diseases. Blacks also tend to have different smoking patterns: smoke fewer cigarettes but inhale more deeply, more likely to smoke menthols & cigarettes w/higher tar yields, achieve higher next indexes of smoke exposure, & may be at risk of greater dependence on & exposure to smoke toxins. The contribution of smoking to the B-W male expectancy gap at age 50 peaked in 1984 (48% of gap) & was reduced by 2005 (23% of gap). For females, smoking only contributed to a minor portion of gap at age 50. Black excess mortality risk was reduced by 20% when baseline smoking status was included in model, but risk reduction greater after adding sociodemographic characteristics (62%).
Krueger, Saint Onge, & Chang. (2011). Race/ethnic differences in adult mortality: The role of perceived stress and health behaviors.
Gist: Examined the role of perceived stress & health behaviors in shaping differential mortality among whites, blacks, & Hispanics.
Aim 1: First aim examined whether unhealthy behaviors & perceived stress mediate racial/ethnic disparities in mortality. The black disadvantage in mortality (relative to whites) closed after adjusting for SES but re-emerged after adjusting for the lower smoking levels among blacks. Hispanics have slightly lower mortality rates than whites after adjusting for SES but the advantage increases after adjusting for the greater physical inactivity among Hispanics & closes after adjusting for lower smoking levels. Perceived stress, sleep duration, & alcohol consumption did not mediate racial/ethnic disparities in mortality.
Aim 2: Tested competing hypotheses about racial/ethnic differences in relationships among unhealthy behaviors, perceived stress, & mortality.
1) Social vulnerability hypothesis: unhealthy behaviors & high stress levels will be more harmful for racial/ethnic minorities; smoking is more harmful for blacks than for whites.
2) Blaxter hypothesis: unhealthy behaviors & high stress levels will be less harmful for disadvantaged groups; compared to whites, current smoking has a weaker relationship with mortality for Hispanics & low/high levels of alcohol consumption, high levels of physical inactivity, & short/long sleep hours have weaker relationships with mortality for blacks.
Overall, promoting 7-8 h of sleep & increase physical activity would improve health of all groups while widening black-white disparities in mortality. Reducing smoking would improve survival in all groups but would narrow Hispanic advantage in mortality compared to whites. Efforts to improve survival should encourage healthier behaviors, but policies that aim to close disparities might be most effective if they target broad structural disadvantages.
Lantz, Golberstein, House, & Morenoff. (2010). Socioeconomic and behavioral risk factors for mortality in a national 19-year prospective study of U.S. adults.
Gist: Few population-based longitudinal studies simultaneously investigate the impact of a variety of social factors on mortality. Low educational attainment was not associated with mortality when income & health risk behaviors were included in the model. The association of low income w/mortality remained after controlling for major behavioral risks. Compared to the “normal” weight category, neither overweight nor obesity were associated with mortality risk. For adults age 55+, the risk of mortality was actually reduced for those who were overweight or obese, controlling for other health risk behaviors & health status. Having a low level of physical activity was a risk factor for mortality. For studies not controlling for level of physical activity, they may be overestimating the mortality risks associated with obesity.
Pampel, Krueger, & Denney. (2010). Socioeconomic disparities in health behaviors.
Gist: Review of relationships between SES & unhealthy behaviors but with focus on multiple explanations for links. Link & Phelan suggest that even if the differences in health behaviors across socioeconomic strata disappeared, the relationship btw SES health would show little change. On the other hand, health behaviors account for about 1/4 of SES disparities in health. Consider 9 broad mechanisms that underlie relationship between SES & health behaviors:
1) In stress paradigm, disadvantaged social position is a source of disparity & drain on capacity to cope. Smoking, overeating, & inactivity represent forms of pleasure & relaxation to regulate mood. Two limitations: (a) Low-SES individuals may experience more stressors, but also report lower levels of perceived stress than high-SES counterparts; (b) assumption that stress precedes rather than follows unhealthy behavior, but evidence on smoking & physical activity less clear.
2) For low-SES groups, fewer benefits of health behaviors on longevity. Economic view that low-SES groups have less reason to invest in future longevity & more reason to focus on current decision-making because of lower lifetime earnings & wealth. Blaxter’s hypothesis: Indulging in enjoyable but unhealthy behaviors may make sense given a shorter life expectancy & limited payoff from healthier behavior (but recent evidence contradicts this hypothesis).
3) Latent traits determine both SES & health behavior.
4) High-SES groups may use adoption of healthy behaviors & lifestyles to set themselves apart from other SES groups. Think history of smoking as an innovative behavior (diffusion).
5) Lack of knowledge and access to information about health risks. Knowledge about smoking doesn’t differ by SES, but knowledge about risks of obesity is less widespread & differs by SES.
6) Differences in efficacy, problem-solving skills, ability to process information, & locus of control needed to overcome obstacles to good health.
7) Adopting health behavior doesn’t require money, but income & ability to pay for aids for healthy behavior (e.g., smoking cessation aids, fitness club, etc.) does.
8) Communities shape opportunities to adopt & maintain healthy behaviors. Low-income neighborhoods have higher share of fast-food restaurants, liquor stores, etc.
9) Networks of health-oriented family members, relatives, friends, & neighbors support healthy behavior, sanction unhealthy behavior, & exchange information on ways to change. Persons living in economically depressed areas & neighborhoods w/high rates of obesity are more likely to be obese, regardless of individual characteristics. Suggests a type of “social contagion”.
Overall: SES can affect incentives or motivations for healthy behaviors; SES can affect means to reach health goals.
Preston, Stokes, Mehta, & Cao. (2014). Projecting the effect of changes in smoking and obesity on future life expectancy in the United States.
Gist: Estimated effects of declining smoking and increasing obesity on mortality in U.S. between 2010-2040. Both are expected to have large effects on U.S. mortality. For males, reductions in smoking have larger effects than the rise in obesity (will see a gain in male life expectancy). For females, the two sets of effects will mostly offset each other.
