LA’s Housing Program Reduced Overall Costs For Homeless Services

MedicalResearch.com Interview with:
“Homeless” by Sonny Abesamis is licensed under CC BY 2.0
Sarah Hunter, PhD
Senior Behavioral Scientist, RAND Corporation
Professor, Pardee RAND Graduate School
Santa Monica, CA 90401-3028

MedicalResearch.com: What is the background for this study?

Response: In 2014, RAND was contracted by Brilliant Corners in collaboration with the Conrad N. Hilton Foundation and Los Angeles County Department of Health Services to conduct an evaluation of the Los Angeles County Department of Health Services’ Housing for Health (HFH) program.  The HFH program began in 2012 with the goal of providing permanent supportive housing for frequent utilizers of county health services who were experiencing homelessness.  Continue reading

Focusing on Physical Activity Can Help Avoid Unnecessary Later Life Social Care Expenses

MedicalResearch.com Interview with:
Dr. Scarlett McNally

Consultant Orthopaedic Surgeo
Eastbourne D.G.H.

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There are vast differences between older people in their abilities and their number of medical conditions. Many people confuse ageing with loss of fitness. Ageing has specific effects (reduction in hearing and skin elasticity for example) but the loss of fitness is not inevitable. Genetics contributes only 20% to diseases. There is abundant evidence that adults who take up physical activity improve their fitness up to the level of someone a decade younger, with improvements in ‘up and go’ times. Physical activity can reduce the severity of most conditions, such as heart disease or the risk of onset or recurrence of many cancers. Inactivity is one of the top four risk factors for most long-term conditions. There is a dose-effect curve. Dementia, disability and frailty can be prevented, reduced or delayed.

The need for social care is based on an individual’s abilities; for example, being unable to get to the toilet in time may increase the need for care from twice daily care givers to needing residential care or live-in care, which increases costs five-fold.

Hospitals contribute to people reducing their mobility, with the ‘deconditioning syndrome’ of bed rest, with 60% of in-patients reducing their mobility.

The total cost of social care in the UK is up to £100 billion, so even modest changes would reduce the cost of social care by several billion pounds a year.

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Couples With Children More Likely To Have Conflicts With In-Laws

MedicalResearch.com Interview with:
Mirkka Danielsbacka PhD, D.Soc.Sci

Senior researcher
University of Turku

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Relations between family generations are widely studied in disciplines such as family sociology and demography. However, relations between in-laws are often neglected in family studies of contemporary societies. Especially conflicts have been surprisingly little investigated. We were especially interested in how parenthood is associated with relations to in-laws in a contemporary Western society.

Using nationally representative survey data from Finland with over 1,200 respondents, we studied conflicts that spouses reported having with their own parents and their in-laws. Overall, Finns more often reported having had any conflict with their own parents than with their in-laws. Compared to childless couples, couples with children were as likely to report conflicts with their own parents. However, couples with children were more likely to report conflicts with their parents-in-law. Our results took into account how frequently family members were in contact with each other and how emotionally close they felt, as well as other sociodemographic factors.

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Genotypes Can Increase or Decrease Young Adult Financial Outcomes, Depending on Parental Income

MedicalResearch.com Interview with:

Emily Rauscher PhD Assistant Professor Department of Sociology University of Kansas

Dr. Rausher

Emily Rauscher PhD
Assistant Professor
Department of Sociology
University of Kansas  

MedicalResearch.com: What is the background for this study?

Response: A lot of previous research has identified genotypes that increase sensitivity to context.  Much of this research, however, looks at particular aspects of health and is not able to address the methodological challenges of investigating gene-environment interactions.  To gain a better sense of the potential outcomes that may be susceptible to gene-environment interactions, I examine financial standing in young adulthood.  Testing this type of interaction is challenging because genotype and social environment are not randomly distributed throughout the population. Given this non-random distribution, unobserved confounders (such as parental behaviors, education, ethnicity, or social capital) could influence both parent and child financial standing.

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Parents Live Longer Than Those Without Children

MedicalResearch.com Interview with:

Dr. Karin Modig, PhD Institute of Environmental Medicine,Epidemiology Karolinska Institute

Dr. Modig

Dr. Karin Modig, PhD
Institute of Environmental Medicine,Epidemiology
Karolinska Institute

MedicalResearch.com: What is the background for this study?

Response: The background to the study was that even though it is established that parents live longer than non-parents the underlying mechanisms are not clear. And it was not known how the association changed with the age of the parents. We hypothesize that if social support is one mechanism – the association between having children and the death risk of parents-non-parents would increase with age of the parents, when health starts to deteriorate and the need of support increases.

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Democrats More Likely To Attribute Obesity to Genetics

MedicalResearch.com Interview with:

Professor Don Haider-Markel Chair, Department of Political Science University of Kansas Lawrence, KS 66045

Prof.  Haider-Markel

Professor Don Haider-Markel
Chair, Department of Political Science
University of Kansas
Lawrence, KS 66045

MedicalResearch.com: What is the background for this study?

Response: We have studied causal attributions for conditions and problems in society for some time. We noticed that public debate over obesity had increased and new policy proposals were being proposed to address what was deemed as a growing public health problem. As the salience of the issue increased so too did partisan views on the topic.

Based on these observations, we wanted to explore individual beliefs about the causes, or attributions for, obesity. Existing research and theory suggested that Republicans following a conservative philosophy would be more likely to attribute obesity to personal choices, such as eating habits and lack of exercise—in short, putting the locus of control on individuals. Meanwhile liberal leaning Democrats, with a known predisposition to suggest conditions or problems are outside of the control of the individual, would be more likely to attribute obesity to either genetic or other biological factors, or the broader context of widely available low-cost high-fat food sources.

Additionally, we know that individuals tend to make attributions that are self-serving. In other words, people tend to make attributions that put themselves in a positive light. Thus, personal weight should factor into obesity attributions. Here we expected that overweight people would be more likely to make attributions that removed personal blame, such as pointing to a genetic cause. People closer to an ideal weight would, on the other hand, be more likely to attribute weight-level to personal choices.

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Food Insecurity Common Among Inner City Stroke Patients

MedicalResearch.com Interview with:

Dr. Lakshmi Warrior MD Assistance Professor, Neurology Cook County Health & Hospitals System Chicago

Dr. Lakshmi Warrior

Dr. Lakshmi Warrior MD
Assistance Professor, Neurology
Cook County Health & Hospitals System
Chicago

MedicalResearch.com: What is the background for this study?

Response: In 2015, 42.2 million Americans lived in food insecure households. Food insecurity is defined as “limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire acceptable foods in socially acceptable ways”. Previous work has demonstrated associations between food insecurity and chronic diseases such as hypertension, diabetes, hyperlipidemia.

Cook County Health and Hospitals System serves a population of largely uninsured and underinsured patients. This pilot study sought determine the prevalence of food insecurity in our population of patients who were recently discharged home from the hospital with the diagnosis of stroke.

MedicalResearch.com: What are the main findings?

Response: We found that food insecurity is a prevalent problem in our patient population with more than 1 in 5 identifying as food insecure. It also appears that food insecure stroke patients had a higher prevalence of diabetes (54% vs 28%)and hypertension (86% vs. 67%) as compared to food secure patients.

MedicalResearch.com: What should readers take away from your report?

Response: Food insecurity is a prevalent issue in our patient population. There should be consideration for food insecurity screening in high-risk populations as food insecurity can complicate the management of diet-related diseases such as hypertension and diabetes. For patients with food insecurity, a multi-disciplinary approach using case and social workers in addition to medical management should be considered.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Further study of this topic is needed. A larger, retrospective review of our stroke patients is currently underway. We are also planning for a prospective study of our inpatient stroke patients to evaluate if these patients are at higher risk for not only vascular risk factors but also re-hospitalization and poor outcomes.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation: Abstract presented at the  AHA/ASA International Stroke Conference February 2017

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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HUD Housing Assistance, But Not Vouchers, Linked To Improvement in Health Measurements

MedicalResearch.com Interview with:

Andrew Fenelon PhD Assistant Professor, Department of Health Services Administration University of Maryland School of Public Health. College Park, MD 20742

Dr. Andrew Fenelon

Andrew Fenelon PhD
Assistant Professor, Department of Health Services Administration
University of Maryland School of Public Health.
College Park, MD 20742

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Despite the relatively large public investment in housing assistance at the federal level, there have been few nationwide analyses of the impacts of these programs on health and well-being. And as policymakers seek solutions to health disparities that incorporate some of the non-medical determinants of health (such as housing quality), our study can make an important contribution to both health and housing policy.

We use an innovative data linkage program which links individuals in a federal household health survey and administrative housing records from the U.S. Department of Housing and Urban Development (HUD). We examine the health impacts of three HUD housing programs: public housing, housing choice vouchers, and multifamily housing. We find that public housing and multifamily housing lead to an improvement in self-reported health status, and public housing leads to a reduction in serious psychological distress. We do not find health impacts associated with housing choice vouchers.

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Combination of Restrictions and Incentives May Lead To Better Food Choices By SNAP Beneficiaries

MedicalResearch.com Interview with:

Lisa Harnack, DrPH, RD | Professor and Director Nutrition Coordinating Center Division of Epidemiology and Community Health School of Public Health, University of Minnesota Minneapolis, MN 55454-1087

Dr. Lisa Harnack

Lisa Harnack, DrPH, RD | Professor and Director
Nutrition Coordinating Center
Division of Epidemiology and Community Health
School of Public Health, University of Minnesota
Minneapolis, MN 55454-1087

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There is interest in considering ways to reshape SNAP so that it better meets meet its objective to help families buy the food they need for good health. Prohibiting the purchase of foods such as soft drinks with SNAP benefits is one of the proposed program changes. Offering an incentive for the purchase of fruits and vegetables is another program change that is being discussed.

Little is known about the effects of prohibitions and restrictions on food purchasing and consumption. Consequently, we carried out an experimental trial to evaluate effects.

In our study we found that a food benefit program that includes both prohibitions on the purchase of less nutritious foods and incentives for purchasing nutritious foods may lead to a number of favorable changes in diet.

To elaborate, we found those enrolled in a food benefit program that prohibited the purchase of sugar sweetened beverages, sweet bakes goods, and candies with food program benefits and provided a 30% financial incentive for fruit and vegetable purchases had a number of favorable dietary changes that were significantly different from changes among those enrolled in a food benefit program that had neither prohibitions or incentives. These favorable changes included reduced consumption of calories, sugar sweetened beverages, sweet baked goods, and candies; and increased consumption of fruit. The overall nutritional quality of the diet also improved.

Fewer nutritional improvements were observed among those enrolled in food benefit programs that included prohibitions or incentives only.

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Socio-Economic Factors Influence Genetic Tendency Toward Obesity

MedicalResearch.com Interview with:

Professor Timothy Frayling PhD Professor of Human Genetics University of Exeter Medical School Exeter, UK

Prof. Timothy Frayling

Professor Timothy Frayling PhD
Professor of Human Genetics
University of Exeter Medical School
Exeter, UK

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We know that genes and environmental factors influence our Body mass index. We know less about if and how they interact.

We wanted to answer the question of whether or not aspects of the environment and our lifestyles accentuate any genetic predisposition to obesity. The question is important as it may highlight aspects of the environment that cause some people to be particularly susceptible to gaining weight. Previous, separate, studies have suggested that specific aspects of the environment are to blame. These included sugary drinks, fried food and TV watching.

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Can Bartenders Have ‘Normal’ Home and Family Lives?

MedicalResearch.com Interview with:
Emily H. Starr, M.A.

Doctoral Candidate
City, Culture, & Community
Tulane University, New Orleans

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This study examines the relationship between work, partnering, and parenthood through the perspectives of bartenders working in the New Orleans metro area. Bartenders frame work, intimate relationships, and family as interlocking matrices and view their lack of legitimate work (or their lack of a normative 9-5 job with security, benefits, and a salary) as a prohibitive or complicating factor in their ability to assume the roles of partner and parent.

Some of the fastest growing segments of the U.S. labor market are low-wage and low-skill jobs meaning that young people will increasingly grapple with hegemonic “white picket fence” ideologies that prescribe certain family forms and occupational/labor relationships as ideal. Moreover, the matrices of performative adulthood are gendered with women and men framing their work as incompatible with family life for different reasons. Women more often experience sexual harassment/objectification, feel their skills and abilities are called into question, and perceive that women bartenders are marginalized as “certain types of women.” These perceptions lend themselves towards women bartenders framing barwork as incompatible or undesirable with mothering.

Men express anxiety about their long-term earning potential and combating the stigma of low-status work through the professionalization of the craft cocktail and spirits industry. Thus, men are more concerned about their role as breadwinner rather than viewing bartending and fatherhood roles as mutually-exclusive. These findings suggest that bartenders draw upon dominant ideologies of normative adulthood and invoke traditional gender roles to frame their perspectives about bartending and family life.

Importantly, the contours and realities of their working lives are the prohibitive factor in bartenders’ perspectives about the possibility for participating in long-term intimate relationships and parenthood.

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Higher Minimum Wage Associated With Fewer Small Babies and Neonatal Deaths

MedicalResearch.com Interview with:

Kelli A. Komro, MPH, PhD, Professor Director of Graduate Studies Behavioral Sciences and Health Education Jointly Appointed, Epidemiology Rollins School of Public Health Emory University Atlanta, GA 30322

Dr. Kelli Komro

Kelli A. Komro, MPH, PhD, Professor
Director of Graduate Studies
Behavioral Sciences and Health Education
Jointly Appointed, Epidemiology
Rollins School of Public Health
Emory University
Atlanta, GA 30322

MedicalResearch.com: What is the background for this study? 

Dr. Komro: Epidemiologists have done a thorough job describing the income-health gradient, which shows a clear association between income and health. That is, as income increases, exposure to health risks and premature mortality decreases. Each step down on the income ladder decreases one’s health for many reasons related to material resources, physical environment exposures and social circumstances.

The income to health association begins at birth, and more than one in four women giving birth in the U.S. are below the poverty level, putting nearly 1 million babies at risk each year. Low-income mothers are more likely to give birth prematurely, to have low birth weight babies, and to suffer the death of their infant during the post-neonatal period (28 to 364 days old).

Given the importance of the income-health gradient, we set out to test the health effects of policies that are designed to increase economic security among low-income families. Our main question is: Do policies designed to reduce poverty and improve family economic security also improve health?

One relevant policy is minimum wage laws. A federal minimum wage was first enacted in 1938. The real value (in 2015 dollars) of the federal minimum wage reached a high of $10.85 in 1968. The current federal rate is $7.25. Many cities and states have passed minimum wage laws that are higher than the federal rate, and currently there is a range of minimum wage increases under active public and policymaker discussion.

Given that some states pass minimum wage standards and others do not, and that laws within states change over time, we took advantage of all the changes that have occurred to design a natural experiment. Our natural experiment examined the effects of state minimum wage laws on infant health.

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Study Addresses Why Blacks Are At Higher Risk of Cognitive Impairment in Later Life

MedicalResearch.com Interview with:

Zhenmei Zhang, Ph.D. Associate Professor Department of Sociology Michigan State University East Lansing, MI48824

Dr. Zhenmei Zhang

Zhenmei Zhang, Ph.D.
Associate Professor
Department of Sociology
Michigan State University
East Lansing, MI48824

MedicalResearch.com: What is the background for this study?

Dr. Zhang: Blacks are especially hard hit by cognitive impairment and dementia. Recent estimates of dementia prevalence and incidence were substantially higher for blacks than whites. Reducing racial/ethnic disparities in dementia has been identified as a national priority by the National Alzheimer’s Project Act, which was signed into law by President Obama in 2011. So I really want to contribute to the ongoing discussion of the origins and pathways through which racial disparities in cognitive impairment is produced. If we have a better understanding of the factors contributing to racial disparities in cognitive impairment in later life, more effective interventions can be conducted to reduce the racial disparities.
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Street Children Report Poverty, Family Conflict, and Abuse as Reasons For Their Homelessness

MedicalResearch.com Interview with:

Paula Braitstein, PhD Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada Department of Medicine, College of Health Sciences, School of Medicine, Moi University, Eldoret, Kenya 7Department of Epidemiology, Fairbanks School of Public Health, Indiana University, Indianapolis Regenstrief Institute Inc, Indianapolis, Indiana

Dr. Paula Braitstein

Paula Braitstein, PhD
Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
Department of Medicine, College of Health Sciences, School of Medicine, Moi University, Eldoret, Kenya Department of Epidemiology, Fairbanks School of Public Health, Indiana University, Indianapolis
Regenstrief Institute Inc, Indianapolis, Indiana

MedicalResearch.com: What is the background for this study?

Dr. Braitstein: There are vast numbers of children and youth in the world who find themselves in street circumstances. Yet, there is an absence of consensus among academics, policymakers, stakeholders, and international organizations regarding the causes of child and youth street-involvement around the world. Without data concerning these reasons, policies are developed or implemented to mitigate street-involvement without taking these causes into account. Often, the prevailing paradigm assumes that children and youth on the street are juvenile delinquents and the government response is often characterized by social exclusion, criminalization, and oppression by police and civic authorities. Therefore we wanted to find out what reasons do children and youth self-report for their street-involvement globally.

MedicalResearch.com: What are the main findings? 

Dr. Braitstein: We systematically reviewed the literature and compiled data from 49 studies representing 24 countries globally. Street-connected children and youth most frequently reported poverty, family conflict, and abuse as their reasons for street-involvement. They infrequently identified delinquent behaviours for their circumstances. There were no significant differences between males and females reported reasons, with the exception of females in developed regions who were more likely to report abuse.
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Strong Men Given Higher Status By Others In Hopes of Group Gain

MedicalResearch.com Interview with:

Aaron W. Lukaszewski, Ph.D. Assistant Professor Department of Psychology

Dr. Aaron Lukaszewski

Aaron W. Lukaszewski, Ph.D.
Assistant Professor
Department of Psychology
Oklahoma State University

Medical Research: What is the background for this study? What are the main findings?

Dr. Lukaszewski: A large body of evidence from multiple social science fields indicates that physically formidable men tend to attain positions of leadership and prestige within cooperative groups (e.g., communities, businesses, nations). The most common explanation for this phenomenon is that strong men ascend hierarchies by aggressively intimidating their rivals and fellow group members into submission — much like chickens use physical contests to establish “pecking orders” that define rank.

The current research advances a different explanation for why formidable men attain high status. Specifically, we propose that members of cooperative groups willingly confer high status upon physically strong men, because they are perceived as possessing specific leadership capacities. To test this, we had people view photographs of men and women whose physical strength had been previously measured, and evaluate them along specific dimensions. As predicted, stronger men (but not women) were seen as deserving higher status, and this was explained by the fact that such men were seen as being better leaders (as defined by their apparent ability to enforce group policies and represent the group to outsiders). Moreover, physically strong men who were seen as being likely to aggressively intimidate others were projected to acquire less status than their apparently gentler counterparts.

Taken together, the findings support the idea that strong men are given higher status by others because they are perceived as being likely to use their strength to benefit the group by cost-effectively providing valuable leadership services.

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Social Barriers Limit Benefits of Exercise in Heart Failure Patients

Lauren Cooper, MD Fellow in Cardiovascular Diseases Duke University Medical Center Duke Clinical Research Institute

Dr. Cooper

MedicalResearch.com Interview with:
Lauren Cooper, MD
Fellow in Cardiovascular Diseases
Duke University Medical Center
Duke Clinical Research Institute

Medical Research: What is the background for this study?

Dr. Cooper: The HF-ACTION study, published in 2009, showed that exercise training is associated with reduced risk of death or hospitalization, and is a safe and effective therapy for patients with heart failure and reduced ejection fraction. Subsequently, Medicare began to cover cardiac rehabilitation for patients with heart failure. However, many patients referred to an exercise training program are not fully adherent to the program. Our study looked at psychosocial reasons that may impact participation in an exercise program.

Medical Research: What are the main findings?

Dr. Cooper: We found that patients with higher levels of social support and fewer barriers to exercise exercised more than patients with lower levels of social support and more barriers to exercise. And patients who exercised less had a higher risk of cardiovascular death or heart failure hospitalization compared to patients who exercised more.

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Teenagers: What are the Psychosocial Problems if Parent has Cancer?

Dr. Elisabeth Jeppesen MPH, PhD-fellow National Resource Center for Late Effects after Cancer Treatment, Department of Oncology, Oslo University, Hospital, The Norwegian Radiumhospitalet, OslMedicalResearch.com Interview with:
Dr. Elisabeth Jeppesen MPH, PhD-fellow
National Resource Center for Late Effects after Cancer Treatment, Department of Oncology, Oslo University, Hospital, The Norwegian Radiumhospitalet, Oslo, Norway
mobil +47 951 05271 
Wisit: Ullernchaussen 70 (Radiumhospitalet)
www.oslo-universitetssykehus.no


MedicalResearch.com: What is the background of this study?

Answer: Each year a considerable number of parents with children younger than 18 years of age are affected by cancer in a parent. Cancer in one of the parents might represent a potentially traumatic event and thereby may be a risk factor for psychosocial problems in the offspring. So far, teenagers’ psychosocial responses to parental cancer have only been studied to a limited extent in controlled trials. Using a trauma theory perspective many studies have shown significant direct associations between parental cancer and psychosocial problems in teenagers. However, the literature also indicates that most children and teenagers have normal stress reactions to such events. In order to identify the need for eventual prevention and intervention among teenagers exposed to such a stressor, we need more empirical knowledge of their psychosocial situation.

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