Healthy Living

Kevin Lewis

September 10, 2009

Some Benefits of Being an Activist: Measuring Activism and Its Role in Psychological Well-Being

Malte Klar & Tim Kasser
Political Psychology, October 2009, Pages 755-777

Do activists lead happier and more fulfilled lives than the average person? Two online surveys using a sample of college students (N = 341) and a national sample of activists matched with a control group (N = 718) demonstrated that several indicators of activism were positively associated with measures of hedonic, eudaimonic, and social well-being. Furthermore, in both studies, activists were more likely to be "flourishing" (Keyes, 2002) than were nonactivists. A third study of college students (N = 296) explored the possible causal role of activism by measuring well-being after subjects either engaged in a brief activist behavior, a brief nonactivist behavior, or no behavior. Although well-being did not differ substantially between these three groups, the subjects who did the brief activist behavior reported significantly higher levels of subjective vitality than did the subjects who engaged in the nonactivist behavior. Potential mediators of the relationship between activism and well-being and the usefulness of these findings are discussed.


Do Alcohol Consumers Exercise More? Findings From a National Survey

Michael French, Ioana Popovici & Johanna Catherine Maclean
American Journal of Health Promotion, September/October 2009, Pages 2-10

This study examines the relationships between alcohol consumption and physical activity in a national sample. Behavioral Risk Factor Surveillance System data from 2005 on 230,856 respondents were analyzed, focusing on the drinking and exercise measures. Results showed a relationship between levels of drinking and physical activity, with greater levels of exercise being associated with higher levels of alcohol consumption.


Social comparisons and health: Can having richer friends and neighbors make you sick?

Genevieve Pham-Kanter
Social Science & Medicine, August 2009, Pages 335-344

Do richer friends and neighbors improve your health through positive material effects, or do they make you feel worse through the negative effect of social comparison and relative deprivation? Using the newly available National Social Life, Health, and Aging Project (NSHAP) data set that reports individuals' income positions within their self-defined social networks, this paper examines whether there is an association between relative position and health in the US. Because this study uses measures of individuals' positions within their self-defined social groups rather than researcher-imputed measures of relative position, I am able to more precisely examine linkages between individual relative position and health. I find a relationship between relative position and health status, and find indirect support for the biological mechanism underlying the relative deprivation model: lower relative position tends to be associated with those health conditions thought to be linked to physiological stress. I also find, however, that only extremes of relative position matter: very low relative position is associated with worse self-rated physical health and mobility, increased overall disease burden, and increased reporting of cardiovascular morbidity; very high relative position is associated with lower probabilities of reporting diabetes, ulcers, and hypertension. I observe few associations between health and either moderately high or moderately low positions. This analysis suggests that the mechanism underlying the relative deprivation model may only have significant effects for those at the very bottom or the very top.


Liquidity, Activity, Mortality

William Evans & Timothy Moore
NBER Working Paper, September 2009

We document a within-month mortality cycle where deaths decline before the 1st day of the month and then spike after the 1st. This cycle is present across a wide variety of causes and demographic groups. A similar cycle exists for a range of activities, suggesting the mortality cycle may be due to short-term variation in levels of activity. We provide evidence that the within-month activity cycle is generated by liquidity. Our results suggest a causal pathway whereby liquidity problems reduce activity, which in turn reduces mortality. These relationships help explain the pro-cyclic nature of mortality.


Vicarious Goal Fulfillment: When the Mere Presence of a Healthy Option Leads to an Ironically Indulgent Decision

Keith Wilcox, Beth Vallen, Lauren Block & Gavan Fitzsimons
Journal of Consumer Research, October 2009, Pages 380-393

This research examines how consumers' food choices differ when healthy items are included in a choice set compared with when they are not available. Results demonstrate that individuals are, ironically, more likely to make indulgent food choices when a healthy item is available compared to when it is not available. The influence of the healthy item on indulgent choice is stronger for those with higher levels of self-control. Support is found for a goal-activation-based explanation for these findings, whereby the mere presence of the healthy food option vicariously fulfills nutrition-related goals and provides consumers with a license to indulge.


Psychological stress and wound healing in humans: A systematic review and meta-analysis

Jessica Walburn, Kavita Vedhara, Matthew Hankins, Lorna Rixon & John Weinman
Journal of Psychosomatic Research, September 2009, Pages 253-271

Objective: The current review aims to synthesize existing knowledge about the relationship between psychological stress and wound healing.

Methods: A systematic search strategy was conducted using electronic databases to search for published articles up to the end of October 2007. The reference lists of retrieved articles were inspected for further studies and citation searches were conducted. In addition, a meta-analysis of a subset of studies was conducted to provide a quantitative estimation of the influence of stress on wound healing.

Results: Twenty-two papers met the inclusion criteria of the systematic review and a subsample of 11 was included in a meta-analysis. The studies assessed the impact of stress on the healing of a variety of wound types in different contexts, including acute and chronic clinical wounds, experimentally created punch biopsy and blister wounds, and minor damage to the skin caused by tape stripping. Seventeen studies in the systematic review reported that stress was associated with impaired healing or dysregulation of a biomarker related to wound healing. The relationship between stress and wound healing estimated by the meta-analysis was r=-0.42 (95% CI=-0.51 to -0.32) (P<.01).

Conclusion: Attention now needs to be directed towards investigating potential moderators of the relationship, mediating mechanisms underpinning the association, as well as the demonstration of a causal link by the development of experimental interventions in healthy populations.


The Short-Term Mortality Consequences of Income Receipt

William Evans & Timothy Moore
NBER Working Paper, September 2009

Many studies find that households increase their consumption after the receipt of expected income payments, a result inconsistent with the life-cycle/permanent income hypothesis. Consumption can increase adverse health events, such as traffic accidents, heart attacks and strokes. In this paper, we examine the short-term mortality consequences of income receipt. We find that mortality increases following the arrival of monthly Social Security payments, regular wage payments for military personnel, the 2001 tax rebates, and Alaska Permanent Fund dividend payments. The increase in short-run mortality is large, potentially eliminating some of the protective benefits of additional income.


Smoking prevalence: A comparison of two American surveys

B. Rodu & P. Cole
Public Health, forthcoming

Objectives: To compare smoking prevalence estimates from two nationally representative surveys in the USA.

Study design: Smoking prevalence estimates derived from the National Health Interview Survey (NHIS) and the National Survey on Drug Use and Health (NSDUH) for the period 1998-2005.

Methods: Comparisons according to age (18-34 or 35+ years) and according to smoking frequency (every day or some days).

Results: In 1998, the prevalence of smoking in both surveys was nearly identical at 24%. From 1999 to 2005, a divergence occurred in smoking prevalence found by the NSDUH and the NHIS. By 2005, NHIS prevalence had declined to 20.9% [95% confidence interval (CI) 20.3-21.5], but the NSDUH estimate was 25.4% (95%CI 24.6-26.2), amounting to 9.1 million more smokers. In 1999, prevalence among 18-34 year olds in the NSDUH was only 18% (95%CI 13-22) higher than that in the NHIS, but that difference had doubled by 2005, when smoking prevalence among 18-34 year olds was 36% (95%CI 30-41) higher in the NSDUH than in the NHIS. NSDUH and NHIS prevalence among 35+ year olds were similar in 1999 and 2001, but the difference was 13% (95%CI 9-18) in 2005. Higher smoking prevalence estimates in the NSDUH were largely due to much higher estimates for some-day smoking in that survey, although every-day smoking prevalence among 18-34 year-olds was also higher in the NSDUH than in the NHIS.

Conclusions: These results raise doubt about the recent decline in smoking prevalence described by the NHIS. Further investigation of the NSDUH/NHIS discrepancy may lead to better surveys and to a clearer picture of smoking trends in the USA.


Potential Societal Savings From Reduced Sodium Consumption in the U.S. Adult Population

Kartika Palar & Roland Sturm
American Journal of Health Promotion, September/October 2009, Pages 49-57

Cross-sectional simulation scenarios were developed to estimate the effect of hypertension prevalence, direct medical costs, and quality of life years (QALYs) saved by reductions in sodium consumption. Population-level data on blood pressure, antihypertensive medication use, and sodium intake were from the National Health and Nutrition Examination Survey 1999-2004. These data were then combined with parameters from the literature on sodium effects, disease outcomes, costs, and quality of life to yield model outcomes. Reducing average population sodium intake to the recommended maximum of 2300 mg/d was predicted to reduce hypertension cases by 11 million, save $18 billion in health care costs, and gain 312,000 QALYs, worth $32 billion annually.


Perceived job insecurity and worker health in the United States

Sarah Burgard, Jennie Brand & James House
Social Science & Medicine, September 2009, Pages 777-785

Economic recessions, the industrial shift from manufacturing toward service industries, and rising global competition have contributed to uncertainty about job security, with potential consequences for workers' health. To address limitations of prior research on the health consequences of perceived job insecurity, we use longitudinal data from two nationally-representative samples of the United States population, and examine episodic and persistent perceived job insecurity over periods of about three years to almost a decade. Results show that persistent perceived job insecurity is a significant and substantively important predictor of poorer self-rated health in the American's Changing Lives (ACL) and Midlife in the United States (MIDUS) samples, and of depressive symptoms among ACL respondents. Job losses or unemployment episodes are associated with perceived job insecurity, but do not account for its association with health. Results are robust to controls for sociodemographic and job characteristics, negative reporting style, and earlier health and health behaviors.


The association between membership in the sandwich generation and health behaviors: A longitudinal study

Laurie Chassin, Jon Macy, Dong-Chul Seo, Clark Presson & Steven Sherman
Journal of Applied Developmental Psychology, forthcoming

The current study examined the association between membership in the sandwich generation, defined as providing care to both children and parents or in-laws, and five health behaviors: checking the food label for health value when buying foods, using a seat belt, choosing foods based on health value, exercising regularly, and cigarette smoking. Participants (N = 4943) were from a longitudinal study of a midwestern community-based sample. Regression analyses tested the unique effect of sandwich generation membership on health behaviors above and beyond demographic factors and prior levels of the same behavior. Compared to other caregivers and noncaregivers, multigenerational caregivers were less likely to check food labels and choose foods based on health values. Multigenerational caregivers were less likely than noncaregivers and those who cared for children only to use seat belts, and they smoked marginally more cigarettes per day than those groups. Multigenerational caregivers were less likely than noncaregivers and those who cared for parents/in-laws only to exercise regularly. Thus, in general, healthy behaviors were diminished for multigenerational caregivers.


Estimating Causal Effects of Early Occupational Choice on Later Health: Evidence Using the PSID

Jason Fletcher & Jody Sindelar
NBER Working Paper, August 2009

In this paper, we provide some of the first empirical evidence of whether early occupational choices are associated with lasting effects on health status, affecting individuals as they age. We take advantage of data on occupational histories available in the Panel Study of Income Dynamics (PSID) to examine this issue. To the PSID data, we merge historical Census data that reflect the labor market conditions when each individual in the PSID made his first occupational choice. These data on labor market conditions (e.g. state-level share of blue collar workers) allow us to instrument for occupational choice in order to alleviate endogeneity bias. We use parental occupation as additional instruments. Since our instruments may have indirect effects on later health, we also control for respondent's pre-labor market health, education and several family and state background characteristics in order to make the instruments more plausibly excludable. We find substantial evidence that a blue collar occupation at labor force entry is associated with decrements to later health status, ceteris paribus. These health effects are larger after controlling for endogeneity and are similar across sets of instruments. We also find differences in the effects of occupation by gender, race, and age.


Is Child Work Injurious to Health?

Aditi Roy
Southern Methodist University Working Paper, June 2009

Estimating the causal impact of child work on the contemporaneous health of a child has proven quite challenging given non-random selection into the labor market and the inability to find strong and valid instruments. Our data, the Indonesian Family Life Survey is no different. Recognizing the lack of a credible instrument, we instead pursue a different strategy based on the methodology of Altonji et al. (JPE, 2005). This method assesses the robustness of the impact of child work estimated under the assumption of random selection (i.e., selection into child work on observable attributes only) to varying degrees of non-random selection (i.e., selection into child labor on unobservable attributes). If the estimated effect is found to be extremely sensitive to selection on unobservables, then one should be wary about inferring an adverse causal effect of child work. In addition, the nature of the selection process is identified using parametric assumptions. The results are striking, suggesting positive selection of children into work when we consider underweight and high weight status as dependent variables. This indicates that there is both healthy worker selection effect as well as unhealthy worker selection effect. There is however negative selection into work for the children belonging to the intermediate weight range. This heterogeneity in the selection process across the distribution has not been previously identified in the literature. Moreover, we also find evidence suggesting a heterogeneous impact of child work on health once we allow for a modest amount of selection on unobservables. Specifically, we find evidence of a negative causal effect of work on healthier children, but evidence of beneficial impact of work on the least healthy children.


Health Status and the Allocation of Time

Timothy Halliday & Melinda Podor
University of Hawaii Working Paper, August 2009

In this paper, we quantify the effects of health on time allocation. We estimate that improvements in health status have large and positive effects on time allocated to home and market production and large negative effects on time spent watching TV, sleeping, and consuming other types of leisure. We find that poor health status results in about 300 additional hours allocated to unproductive activities per year. Plausible estimates of the cost of this lost time exceed $10,000. We also find that, for men, better health induces a substitution of market-produced goods for home-produced goods. Particularly, each additional minute spent in home production saves $0.37.


Deterioration of physical performance and cognitive function in rats with short-term high-fat feeding

Andrew Murray, Nicholas Knight, Lowri Cochlin, Sara McAleese, Robert Deacon, Nicholas Rawlins & Kieran Clarke
FASEB Journal (Federation of American Societies for Experimental Biology), forthcoming

Efficiency, defined as the amount of work produced for a given amount of oxygen consumed, is a key determinant of endurance capacity, and can be altered by metabolic substrate supply, in that fatty acid oxidation is less efficient than glucose oxidation. It is unclear, however, whether consumption of a high-fat diet would be detrimental or beneficial for endurance capacity, due to purported glycogen-sparing properties. In addition, a high-fat diet over several months leads to cognitive impairment. Here, we tested the hypothesis that short-term ingestion of a high-fat diet (55% kcal from fat) would impair exercise capacity and cognitive function in rats, compared with a control chow diet (7.5% kcal from fat) via mitochondrial uncoupling and energy deprivation. We found that rats ran 35% less far on a treadmill and showed cognitive impairment in a maze test with 9 d of high-fat feeding, with respiratory uncoupling in skeletal muscle mitochondria, associated with increased uncoupling protein (UCP3) levels. Our results suggest that high-fat feeding, even over short periods of time, alters skeletal muscle UCP3 expression, affecting energy production and physical performance. Optimization of nutrition to maximize the efficiency of mitochondrial ATP production could improve energetics in athletes and patients with metabolic abnormalities.


Milk consumption during adolescence decreases alcohol drinking in adulthood

Jerry Pian, Jose Criado, Brendan Walker & Cindy Ehlers
Pharmacology Biochemistry and Behavior, forthcoming

Early onset of alcohol consumption increases the risk for the development of dependence. Whether adolescent consumption of other highly palatable solutions may also affect alcohol drinking in adulthood is not known. The purpose of this study was to determine the effects of adolescent consumption of four solutions: water, sucrose, sucrose-milk and milk on ethanol drinking in adult rats. Rats had limited access to one of the four solutions from day PND 29 to PND 51 and were subsequently trained to consume ethanol (E) using a sucrose (S) fade-out procedure. Adolescent consumption of sucrose and sucrose-milk solutions increased intake of 2.5% E when it was combined with 10% S but it had no effect on the drinking of 10% E alone. Adolescent consumption of milk and sucrose-milk significantly decreased the intake of 10% E when it was combined with 10% S, and milk significantly reduced 10% E consumption alone and when it was combined with 5% S. Adolescent exposure to the sucrose-milk and sucrose solutions was also found to increase sucrose and sucrose-milk consumption. Our findings suggest adolescent exposure to sucrose increases, whereas, exposure to milk reduces ethanol consumption in adult rats. Our results may provide a new theoretical approach to the early prevention of alcoholism.


The Times They Are a Changin': Marital Status and Health Differentials from 1972 to 2003

Hui Liu & Debra Umberson
Journal of Health and Social Behavior, September 2008, Pages 239-253

Although the meanings and rates of being married, divorced, separated, never-married, and widowed have changed significantly over the past several decades, we know very little about historical trends in the relationship between marital status and health. Our analysis of pooled data from the National Health Interview Survey from 1972 to 2003 shows that the self-rated health of the never-married has improved over the past three decades. Moreover, the gap between the married and the never married has steadily converged over time for men but not for women. In contrast, the self-rated health of the widowed, divorced, and separated worsened over time relative to the married, and the adverse effects of marital dissolution have increased more for women than for men. Our findings highlight the importance of social change in shaping the impact of marital status on self-reported health and challenge long-held assumptions about gender, marital status, and health.


Health-Related Quality of Life, Quality-Adjusted Life Years, and Quality-Adjusted Life Expectancy in New York City from 1995 to 2006

Erica Lubetkin & Haomiao Jia
Journal of Urban Health, July 2009, Pages 551-561

We applied our previously developed estimation equation to predict EQ-5D index scores from the Centers for Disease Control and Prevention's Healthy Days measures for the New York City (NYC) adult population from 1995 to 2006 and compared these trends over time with the US general population. Such scores enabled us to examine the burden of disease attributable to smoking and overweight/obesity at both the local and national levels. We employed the estimation equation to the 1993-2007 Behavioral Risk Factor Surveillance System (BRFSS) data to obtain EQ-5D index scores for all survey respondents based on their age, self-rated health status, and overall number of unhealthy days. With the combination of mortality data, we calculated trends of quality-adjusted life years (QALYs), life expectancy (LE), and quality-adjusted life expectancy (QALE) as well as the percent of QALYs and QALE lost contributed by smoking and overweight/obesity. Mean EQ-5D index scores for NYC adults decreased from 0.874 to 0.852 but, more recently, have increased to 0.869. The LE of an 18-year-old living in NYC increased 4.7 years and QALE increased 2.6 years. The contribution of smoking to the proportion of QALYs lost decreased from 6.7% to 3.5%, while the contribution of overweight/obesity to the proportion of QALYs lost increased from 4.5% to 16.9%. The proportion of QALEs lost due to smoking decreased from 5.5% to 4.5%, while the proportion of QALEs lost due to overweight/obesity increased from 3.5% to 11.8%. Because the Healthy Days measures have been included in the BRFSS since 1993, translating Healthy Days Measures to a preference-based measure is a useful method for longitudinal tracking of population health at the local, state, and national level.


Association of Enjoyable Leisure Activities With Psychological and Physical Well-Being

Sarah Pressman, Karen Matthews, Sheldon Cohen, Lynn Martire, Michael Scheier, Andrew Baum & Richard Schulz
Psychosomatic Medicine, forthcoming

Objective: To examine whether engaging in multiple enjoyable activities was associated with better psychological and physiological functioning. Few studies have examined the health benefits of the enjoyable activities that individuals participate in voluntarily in their free time.

Method: Participants from four different studies (n = 1399 total, 74% female, age = 19-89 years) completed a self-report measure (Pittsburgh Enjoyable Activities Test (PEAT)) assessing their participation in ten different types of leisure activities as well as measures assessing positive and negative psychosocial states. Resting blood pressure, cortisol (over 2 days), body mass index, waist circumference, and perceived physiological functioning were assessed.

Results: Higher PEAT scores were associated with lower blood pressure, total cortisol, waist circumference, and body mass index, and perceptions of better physical function. These associations withstood controlling for demographic measures. The PEAT was correlated with higher levels of positive psychosocial states and lower levels of depression and negative affect.

Conclusion: Enjoyable leisure activities, taken in the aggregate, are associated with psychosocial and physical measures relevant for health and well-being. Future studies should determine the extent that these behaviors in the aggregate are useful predictors of disease and other health outcomes.


Smoking to stay thin or giving up to save face? Young men and women talk about appearance concerns and smoking

Sarah Grogan, Gary Fry, Brendan Gough & Mark Conner
British Journal of Health Psychology, February 2009, Page 175-186

Objective: This study was designed to investigate how young men and women smokers and non-smokers talk about the impact of smoking on appearance, with the aim of using these accounts to inform anti-smoking campaigns targeted at young people.

Design: Volunteer smokers and non-smokers took part in 24 focus groups.

Method: Eighty-seven men and women aged 17-24 were asked to talk about impacts of smoking on appearance.

Results: A thematic analysis of transcripts suggested that weight gain after quitting was only a significant concern for the younger (17-year-old) women. Non-smokers of both genders expressed concern about yellowing of skin and teeth if they started smoking, and women non-smokers were concerned about skin ageing. Smokers believed that smoking made them look `cool', mature, and sophisticated and would quit only if skin ageing and other negative effects on appearance became visible.

Conclusions: Appearance concerns are relevant to the decision whether to start and quit smoking, and are linked to gender and age. Results are discussed in relation to implications for the development of age- and gender-relevant anti-smoking interventions.

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