Impact of Caregiving During Emerging Adulthood on Frequent Mental Distress, Smoking, and Drinking Behaviors: United States, 2015–2017

Objectives. To examine associations between caregiving mental or behavioral health outcomes among emerging US adults, defined as persons aged 18 to 25 years. Methods. The study sample included emerging adult respondents to the 2015–2017 Behavioral Risk Factor Surveillance System’s caregiving module. Exposures were caregiver (n = 3087), expectant caregiver (n = 2303), and noncaregiver (n = 12 216) status. Expectant caregivers were defined as persons not currently providing care but anticipating doing so within the next 2 years. Outcomes included frequent mental distress (FMD), drinking (binge or heavy), and current smoking (cigarette or e-cigarette use). We used robust Poisson regression to calculate adjusted prevalence ratios (APRs) and corresponding 95% confidence intervals (CIs). We adjusted all models for income. Results. Caregivers had a similar prevalence of FMD when compared with both expectant caregivers (APR = 1.67; 95% CI = 1.28, 2.17) and noncaregivers (APR = 1.50; 95% CI = 1.23, 1.82). Caregivers had a higher prevalence of current cigarette smoking compared with noncaregivers (APR = 1.44; 95% CI = 1.21, 1.71). Conclusions. Among emerging adults, providing care is associated with poorer mental health. Point estimates looking at FMD were higher when we compared caregivers with expectant caregivers, suggesting a difference in exchangeability between comparison groups. Public Health Implications. This study highlights the importance of including emerging adults in caregiving research.

Prevalence of Frequent Mental Distress Among Illinois Adults With Chronic Conditions: Estimates From the Behavioral Risk Factor Surveillance System, 2011 to 2017

Purpose: The objective of this study was to examine frequent mental distress (FMD) by demographics, chronic conditions, and health risk factors among Illinois adults. Design: Descriptive analyses included χ2 and pairwise t tests to examine how FMD status differed by selected characteristics and Cox proportional hazards regression analysis to examine the association between FMD and chronic conditions and risk factors. Setting: Illinois Behavioral Risk Factor Surveillance System, 2011 to 2017 (n = 37 312). Participants: Adults who self-report FMD (n = 3455) were included. Measures: Prevalence of high blood pressure, coronary heart disease, chronic obstructive pulmonary disease, arthritis, asthma, high blood cholesterol, cancer, kidney disease, stroke, diabetes, weight status, physical activity status, smoking status, and drinking status. Results: A significantly higher FMD prevalence was found among females (11.7%; 95% confidence interval [CI]: 11.1-12.4), non-Hispanic blacks (13.4, 95% CI: 11.9-15.0), adults with less than a high school degree (14.4%; 95% CI: 12.6-16.3), adults with an annual income of less than $15 000 (21.4%; 95% CI: 19.4-23.5), and adults with a disability (23.3%, 95% CI: 21.9-24.7). Adjusted prevalence of FMD was significantly higher among adults for 8 of 10 chronic conditions and 4 of 5 health risk factors studied. Conclusions: Social stigmas related to depression and anxiety may lead to the underreporting of FMD. Chronic disease management programs in Illinois should consider integrating mental health services.

Patterns of Diet, Physical Activity, Sitting and Sleep Are Associated with Socio-Demographic, Behavioural, and Health-Risk Indicators in Adults

Our understanding of how multiple health-behaviours co-occur is in its infancy. This study aimed to: (1) identify patterns of physical activity, diet, sitting, and sleep; and (2) examine the association between sociodemographic and health-risk indicators. Pooled data from annual cross-sectional telephone surveys of Australian adults (2015–2017, n = 3374, 51.4% women) were used. Participants self-reported physical activity, diet, sitting-time, sleep/rest insufficiency, sociodemographic characteristics, smoking, alcohol use, height and weight to calculate body mass index (BMI), and mental distress frequency. Latent class analysis identified health-behaviour classes. Latent class regression determined the associations between health-behaviour patterns, sociodemographic, and health-risk indicators. Three latent classes were identified. Relative to a ‘moderate lifestyle’ pattern (men: 43.2%, women: 38.1%), a ‘poor lifestyle’ pattern (men: 19.9%, women: 30.5%) was associated with increased odds of a younger age, smoking, BMI ≥ 30.0 kg/m2, frequent mental distress (men and women), non-partnered status (men only), a lower Socioeconomic Index for Areas centile, primary/secondary education only, and BMI = 25.0–29.9 kg/m2 (women only). An ‘active poor sleeper’ pattern (men: 37.0%, women: 31.4%) was associated with increased odds of a younger age (men and women), working and frequent mental distress (women only), relative to a ‘moderate lifestyle’ pattern. Better understanding of how health-behaviour patterns influence future health status is needed. Targeted interventions jointly addressing these behaviours are a public health priority.

Posttraumatic Stress Disorder and Mental Distress Following the 2004 and 2005 Florida Hurricanes

ObjectiveCommunity characteristics, such as perceived collective efficacy, a measure of community strength, can affect mental health outcomes following disasters. We examined the association of perceived collective efficacy with posttraumatic stress disorder (PTSD) and frequent mental distress (14 or more mentally unhealthy days in the past month) following exposure to the 2004 and 2005 hurricane seasons.MethodsParticipants were 1486 Florida Department of Health workers who completed anonymous questionnaires that were distributed electronically 9 months after the 2005 hurricane season. Participant ages ranged from 20 to 79 years (mean, 48; SD, 10.7), and the majority were female (79%), white (75%), and currently married (64%). Fifty percent had a BA/BS degree or higher.ResultsIn 2 separate logistic regression models, each adjusted for individual sociodemographics, community socioeconomic characteristics, individual injury/damage, and community storm damage, lower perceived collective efficacy was significantly associated with a greater likelihood of having PTSD (OR, 0.93; 95% CI, 0.90-0.96), and lower collective efficacy was significantly associated with frequent mental distress (OR, 0.94; 95% CI, 0.92-0.96).ConclusionsPrograms enhancing community collective efficacy may be a significant part of prevention practices and possibly lead to a reduction in the rate of PTSD and persistent distress postdisaster. (Disaster Med Public Health Preparedness. 2019;13:44–52).