http://www.biomedcentral.com/bmcpublichealth/ The editor's pick of recent articles published by BMC Public Health 2012-03-23T00:00:00Z Background: An increasing proportion of the population lives in one-person households. The authors examined whether living alone predicts the use of antidepressant medication and whether socioeconomic, psychosocial, or behavioral factors explain this association. Methods: The participants were a nationally representative sample of working-age Finns from the Health 2000 Study, totaling 1695 men and 1776 women with a mean age of 44.6 years. In the baseline survey in 2000, living arrangements (living alone vs. not) and potential explanatory factors, including psychosocial factors (social support, work climate, hostility), sociodemographic factors (occupational grade, education, income, unemployment, urbanicity, rental living, housing conditions), and health behaviors (smoking, alcohol use, physical activity, obesity), were measured. Antidepressant medication use was followed up from 2000 to 2008 through linkage to national prescription registers. Results: Participants living alone had a 1.81-fold (CI = 1.46-2.23) higher purchase rate of antidepressants during the follow-up period than those who did not live alone. Adjustment for sociodemographic factors attenuated this association by 21% (adjusted OR = 1.64, CI = 1.32-2.05). The corresponding attenuation was 12% after adjustment for psychosocial factors (adjusted OR = 1.71, CI = 1.38-2.11) and 9% after adjustment for health behaviors (adjusted OR = 1.74, CI = 1.41-2.14). Gender-stratified analyses showed that in women the greatest attenuation was related to sociodemographic factors and in men to psychosocial factors. Conclusions: These data suggest that people living alone may be at increased risk of developing mental health problems. The public health value is in recognizing that people who live alone are more likely to have material and psychosocial problems that may contribute to excess mental health problems in this population group. http://www.biomedcentral.com/1471-2458/12/236 Laura Pulkki-Råback Mika Kivimäki Kirsi Ahola Kaisla Joutsenniemi Marko Elovainio Helena Rossi Sampsa Puttonen Seppo Koskinen Erkki Isometsä Jouko Lönnqvist Marianna Virtanen BMC Public Health 2012, 12:236 2012-03-23T00:00:00Z 10.1186/1471-2458-12-236 Living alone associated with antidepressant use People living alone have a higher risk of initiating antidepressant use compared to those not living alone, with lack of social support, poor job climate, and a hostile personality contributing greatest to antidepressant use of these individuals. /content/figures/1471-2458-12-236-toc.gif BMC Public Health 1471-2458 12 236 2012-03-23T00:00:00Z XML Background: Alcohol is a substantial risk factor for mortality according to the recent 2010 World Health Assembly strategy to reduce the harmful use of alcohol which outlined the need to characterize and monitor this burden. Accordingly, using new methodology we estimated 1) the number of deaths caused and prevented by alcohol consumption, and 2) the potential years of life lost (PYLLs) attributable to alcohol consumption in Canada in 2005. Methods: Mortality attributable to alcohol consumption was estimated by calculating Alcohol-Attributable Fractions (AAFs) (defined as the proportion of mortality that would be eliminated if the exposure was eliminated) using data from various sources. Indicators for alcohol consumption were obtained from the Canadian Alcohol and Drug Use Monitoring Survey 2008 and corrected for adult per capita recorded and unrecorded alcohol consumption. Risk relations were taken from the Comparative Risk Assessment within the current Global Burden of Disease (GBD) study. Due to concerns about the reliability of information specifying causes of death for people aged 65 or older, our analysis was limited to individuals aged 0 to 64 years. Calculation of the 95% confidence intervals (CIs) for the AAFs was performed using Monte Carlo random sampling. Information on mortality was obtained from Statistics Canada. A sensitivity analysis was performed comparing the mortality results obtained using our study methods to results obtained using previous methodologies. Results: In 2005, 3,970 (95% CI: 810 to 7,170) deaths (4,390 caused and 420 prevented) and 134,555 (95% CI: 36,690 to 236,376) PYLLs were attributable to alcohol consumption for individuals aged 0 to 64 years. These figures represent 7.7% (95% CI: 1.6% to 13.9%) of all deaths and 8.0% (95% CI: 2.2% to 14.1%) of all PYLLs for individuals aged 0 to 64 years. The sensitivity analysis showed that the number of deaths as measured by this new methodology is greater than that if mortality was estimated using previous methodologies. Conclusions: The mortality burden attributable to alcohol consumption for Canada is large, unnecessary, and could be substantially reduced in a short period of time if effective public health policies were implemented. A monitoring system on alcohol consumption is imperative and would greatly assist in planning and evaluating future Canadian public health policies related to alcohol consumption. http://www.biomedcentral.com/1471-2458/12/91 Kevin D Shield Benjamin Taylor Tara Kehoe Jayadeep Patra Jürgen Rehm BMC Public Health 2012, 12:91 2012-01-31T00:00:00Z 10.1186/1471-2458-12-91 Alcohol use mortality burden large in Canada The mortality burden attributable to alcohol consumption for Canada is substantial, with alcohol-attributable deaths from motor vehicle accidents being among the largest contributors, suggesting monitoring the burden is needed to formulate policies for reducing alcohol's effects. /content/figures/1471-2458-12-91-toc.gif BMC Public Health 1471-2458 12 91 2012-01-31T00:00:00Z XML Background: Marital distress and depression frequently co-occur, and partnership quality is associated with depressive symptoms and mental disorders in both men and women. One aim of this study was to investigate the contribution of a set of risk factors for emotional distress among men and women in couples, with a special focus on satisfaction with partner relationship. The most important aim was to investigate the extent to which high relationship satisfaction in couples acts as a buffer against stressful events. Methods: Pregnant women and their husbands (n = 62,956 couples) enrolled in the Norwegian Mother and Child Cohort Study completed a questionnaire with questions about emotional distress, relationship satisfaction, and other risk factors. Twelve potential risk factors were included in the analyses, including relationship satisfaction, demographic characteristics, and somatic diseases in men and women. Associations between the predictor variables and emotional distress were estimated by multiple linear regression analysis. Cross-spousal effects, in which data reported by one of the spouses predicted emotional distress in the other, were also investigated. Possible interaction effects between certain risk factors and self-reported and partner's relationship satisfaction were tested and further explored with regression analyses in subsamples stratified by relationship satisfaction scores. Results: The unique effects of relationship satisfaction were of similar sizes for both men and women: substantial for self-reported (β = -0.23 and β = -0.28, respectively) and weak for partner-reported satisfaction (β = -0.04 and β = -0.02, respectively). Other relatively strong risk factors were somatic disease, first-time motherhood, and unemployment. Self-reported as well as partner-reported relationship satisfaction appeared to strongly buffer the effects of a number of stressors. Conclusions: Partner relationship dissatisfaction is strongly associated with emotional distress in men and women. Good partner relationship, both as perceived by the individual him(her)self and by the spouse, quite strongly moderates adverse effects of various types of emotional strain. http://www.biomedcentral.com/1471-2458/12/66 Gun-Mette B Røsand Kari Slinning Malin Eberhard-Gran Espen Røysamb Kristian Tambs BMC Public Health 2012, 12:66 2012-01-22T00:00:00Z 10.1186/1471-2458-12-66 Partnership quality moderates emotional stress High relationship satisfaction in pregnant women and their partners substantially moderates the adverse effects of various emotional stressors, including first-time pregnancy, somatic disease, and unemployment, suggesting that partnership quality may buffer emotional strain. /content/figures/1471-2458-12-66-toc.gif BMC Public Health 1471-2458 12 66 2012-01-22T00:00:00Z XML Background: The authors examined factors associated with nutritional resilience/vulnerability among preschoolers in the Gaza Strip in 2007, where political violence and deprivation are widespread. Methods: This cross-sectional study was carried out in 2007 using random sampling of kindergartens in order to select 350 preschoolers. Binary logistic regression was used to compare resilient (adequate nutrition) and vulnerable (stunted) groups with those with moderate nutrition. Results: Approximately 37% of the subjects demonstrated nutritional resilience and 15% were vulnerable. Factors associated with nutritional resilience were child younger age, normal birth weight, actively hand- or spoon-feeding when the child was below two years, and residential stability in the past two years. The only factor associated with nutritional vulnerability was lower total score on the mother's General Health Questionnaire, which we interpret as a marker of maternal mental health. Conclusions: Children with low-birth weight and older children had worse nutritional resiliency outcomes. Further, poorer outcomes for children were associated with lower maternal mental health status, as well as increased family residential instability. Our results add to the large literature on the pervasive effects of violence and instability on children and underscore the need for resources for early intervention and for the urgent resolution of the Palestinian and other armed conflicts. http://www.biomedcentral.com/1471-2458/12/27 Salwa G Massad FJ Nieto Mari Palta Maureen Smith Roseanne Clark Abdel-Aziz Thabet BMC Public Health 2012, 12:27 2012-01-11T00:00:00Z 10.1186/1471-2458-12-27 Children's nutritional status in the Gaza Strip Poor outcomes in preschoolers in the Gaza Strip who demonstrate nutritional resilience and vulnerability are associated with lower maternal mental health status and increased family residential instability, both factors attributed to pervasive political violence and deprivation. /content/figures/1471-2458-12-27-toc.gif BMC Public Health 1471-2458 12 27 2012-01-11T00:00:00Z XML Background: Existing studies are divided as to whether social inequalities in health widen or converge as people age. In part this is due to reliance on cross-sectional data, but also among longitudinal studies to differences in the measurement of both socioeconomic status (SES) and health and in the treatment of survival effects. The aim of this paper is to examine social inequalities in health as people age using longitudinal data from the West of Scotland Twenty-07 Study to investigate the effect of selective mortality, the timing of the SES measure and cohort on the inequality patterns. Methods: The Twenty-07 Study has followed three cohorts, born around 1932, 1952 and 1972, from 1987/8 to 2007/8; 4,510 respondents were interviewed at baseline and, at the most recent follow-up, 2,604 were interviewed and 674 had died. Hierarchical repeated-measures models were estimated for self-assessed health status, with and without mortality, with baseline or time-varying social class, sex and cohort. Results: Social inequalities in health emerge around the age of 30 after which they widen until the early 60s and then begin to narrow, converging around the age of 75. This pattern is a result of those in manual classes reporting poor health at younger ages, with the gap narrowing as the health of those in non-manual classes declines at older ages. However, employing a more proximal measure of SES reduces inequalities in middle age so that convergence of inequalities is not apparent in old age. Including death in the health outcome steepens the health trajectories at older ages, especially for manual classes, eliminating the convergence in health inequalities, suggesting that healthy survival effects are important. Cohort effects do not appear to affect the pattern of inequalities in health as people age in this study. Conclusions: There is a general belief that social inequalities in health appear to narrow at older ages; however, taking account of selective mortality and employing more proximal measures of SES removes this convergence, suggesting inequalities in health continue into old age. http://www.biomedcentral.com/1471-2458/11/947 Michaela Benzeval Michael J Green Alastair H Leyland BMC Public Health 2011, 11:947 2011-12-22T00:00:00Z 10.1186/1471-2458-11-947 Social health inequalities persist into old age Although general belief is that social inequalities in health narrow at older ages, taking selective mortality into account employing a more proximal measure of socioeconomic status removes this convergence, suggesting inequalities in health continue into old age. /content/figures/1471-2458-11-947-toc.gif BMC Public Health 1471-2458 11 947 2011-12-22T00:00:00Z XML