Can social factors explain sex differences in insomnia? Findings from a national survey in Taiwan.

Study Objective: To examine sociological explanations for the higher level of insomnia in women, including social roles and socioeconomic status (SES).

Design: Cross sectional survey research

Setting: Taiwanese 2001 "social trend survey"

Participants: A nationally representative sample of 39,588 citizens aged 15 years or older living in Taiwan.

Main Results: On average, women scored 1.

The relative influence of individual and contextual socio-economic status on consumption of fruit and soft drinks among adolescents in Europe.

Background: The number of studies among children and adolescents that focus on socio-economic differences in food habits is limited. Moreover, most are done in only one country and often include a non-representative sample. The present study examines whether socio-economic differences in the consumption of fruit and soft drinks can be found among young adolescents in a wide range of European countries.

Poverty, child undernutrition and morbidity: new evidence from India.

Undernutrition continues to be a primary cause of ill-health and premature mortality among children in developing countries. This paper examines how the prevalence of undernutrition in children is measured and argues that the standard indices of stunting, wasting and underweight may each be underestimating the scale of the problem. This has important implications for policy-makers, planners and organizations seeking to meet international development targets.

Impaired wound contraction and delayed myofibroblast differentiation in restraint-stressed mice.

Previous research has shown that psychological stress delays wound closure by >25%. Gene expression of pro-inflammatory cytokines and the maturation of the epithelium were also impaired by stress (Mercado et al.).

Racial residential segregation and geographic heterogeneity in black/white disparity in poor self-rated health in the US: a multilevel statistical analysis.

Existing evidence demonstrating a relationship between racial residential segregation and health has been based on aggregate analysis. Using a multilevel analytical framework, we assess the extent of geographic variation in black/white disparities in self-rated health across US metropolitan areas, and whether racial residential segregation accounts for such variation. We estimated multilevel regression models of poor self-rated health among 51,316 non-Hispanic white and non-Hispanic black adults nested within 207 metropolitan areas to assess the multilevel relationship between segregation and racial disparities in health.

Painting a truer picture of US socioeconomic and racial/ethnic health inequalities: the Public Health Disparities Geocoding Project.

Objectives: We describe a method to facilitate routine monitoring of socioeconomic health disparities in the United States.

Methods: We analyzed geocoded public health surveillance data including events from birth to death (c. 1990) linked to 1990 census tract (CT) poverty data for Massachusetts and Rhode Island.

Racial disparities in context: a multilevel analysis of neighborhood variations in poverty and excess mortality among black populations in Massachusetts.

Objectives: We analyzed neighborhood heterogeneity in associations among mortality, race/ethnicity, and area poverty.

Methods: We performed a multilevel statistical analysis of Massachusetts all-cause mortality data for the period 1989 through 1991 (n=142836 deaths), modeled as 79813 cells (deaths and denominators cross-tabulated by age, gender, and race/ethnicity) at level 1 nested within 5532 block groups at level 2 within 1307 census tracts (CTs) at level 3. We also characterized CTs by percentage of the population living below poverty level.

Socioeconomic disadvantage, parenting responsibility, and women's smoking in the United States.

Objectives: We carried out analyses of smoking in relation to poverty and child care responsibility among women aged 18-54 years residing in the United States.

Methods: With data from the Behavioral Risk Factor Surveillance System, we assessed the interaction effects of poverty and living with young children on maternal smoking behavior among 61,700 women aged 18-54 years in 4 different racial/ethnic groups.

Results: For non-White racial/ethnic groups, the prevalence of smoking among women with small children in the household was lower than that among women without small children.

Women's status and depressive symptoms: a multilevel analysis.

The effects of state-level women's status and autonomy on individual-level women's depressive symptoms were examined. We conducted a multi-level analysis of the 1991 longitudinal follow up of the 1988 National Maternal Infant Health Survey (NMIHS), with 7789 women nested within the fifty American states. State-level women's status was assessed by four composite indices measuring women's political participation, economic autonomy, employment & earnings, and reproductive rights.

A multilevel analysis of women's status and self-rated health in the United States.

Objectives: We investigated associations between various dimensions of women's status and self-rated health. We hypothesized that women living in states with lower levels of women's status would be at greater risk of reporting poor health than women living in states with higher levels of women's status, even when controlling for individual and state characteristics.

Methods: We used individual self-rated health and sociodemographic characteristics for 87 848 female respondents to the Behavioral Risk Factor Surveillance System (BRFSS) 2000.

Induction of vascular smooth muscle alpha-actin gene transcription in transforming growth factor beta1-activated myofibroblasts mediated by dynamic interplay between the Pur repressor proteins and Sp1/Smad coactivators.

The mouse vascular smooth muscle alpha-actin (SMA) gene enhancer is activated in fibroblasts by transforming growth factor beta1 (TGFbeta1), a potent mediator of myofibroblast differentiation and wound healing. The SMA enhancer contains tandem sites for the Sp1 transcriptional activator protein and Puralpha and beta repressor proteins. We have examined dynamic interplay between these divergent proteins to identify checkpoints for possible control of myofibroblast differentiation during chronic inflammatory disease.

Patterns and distribution of tobacco consumption in India: cross sectional multilevel evidence from the 1998-9 national family health survey.

Objective: To investigate the demographic, socioeconomic, and geographical distribution of tobacco consumption in India.

Design: Multilevel cross sectional analysis of the 1998-9 Indian national family health survey of 301 984 individuals in 92 447 households in 3215 villages in 440 districts in 26 states.

Setting: Indian states.

The association between state income inequality and worse health is not confounded by race.

Background: The relationship between income inequality and health across US states has been challenged recently on grounds that this relationship may be confounded by the effect of racial composition, measured as the proportion of the state's population who are black.

Methods: Using multilevel statistical models, we examined the association between state income inequality and poor self-rated health. The analysis was based on the pooled 1995 and 1997 Current Population Surveys, comprising 201 221 adults nested within 50 US states.

Income inequality and health: multilevel analysis of Chilean communities.

Study Objective: The evidence supporting the effect of income inequality on health has been largely observed in societies far more egalitarian than the US. This study examines the cross sectional multilevel associations between income inequality and self rated poor health in Chile; a society more unequal than the US.

Design: A multilevel statistical framework of 98 344 people nested within 61 978 households nested within 285 communities nested within 13 regions.

Race/ethnicity, gender, and monitoring socioeconomic gradients in health: a comparison of area-based socioeconomic measures--the public health disparities geocoding project.

Use of multilevel frameworks and area-based socioeconomic measures (ABSMs) for public health monitoring can potentially overcome the absence of socioeconomic data in most US public health surveillance systems. To assess whether ABSMs can meaningfully be used for diverse race/ethnicity-gender groups, we geocoded and linked public health surveillance data from Massachusetts and Rhode Island to 1990 block group, tract, and zip code ABSMs. Outcomes comprised death, birth, cancer incidence, tuberculosis, sexually transmitted infections, childhood lead poisoning, and nonfatal weapons-related injuries.

Monitoring socioeconomic inequalities in sexually transmitted infections, tuberculosis, and violence: geocoding and choice of area-based socioeconomic measures--the public health disparities geocoding project (US).

Objectives: To determine which area-based socioeconomic measures, at which level of geography, are suitable for monitoring socioeconomic inequalities in sexually transmitted infections (STIs), tuberculosis (TB), and violence in the United States.

Methods: Cross-sectional analysis of public health surveillance data, geocoded and linked to area-based socioeconomic measures generated from 1990 census tract, block group, and ZIP Code data. We included all incident cases among residents of either Massachusetts (MA; 1990 population = 6016425) or Rhode Island (RI; 1990 population = 1003464) for: STIs (MA: 1994-1998, n = 26535 chlamydia, 7464 gonorrhea, 2619 syphilis; RI: 1994-1996, n = 4473 chlamydia, 1256 gonorrhea, 305 syphilis); TB (MA: 1993-1998, n = 1793; RI: 1985-1994, n = 576), and non-fatal weapons related injuries (MA: 1995-1997, n = 6628).

Neighborhood differences in social capital: a compositional artifact or a contextual construct?

Assessment of social capital at the neighborhood level is often based on aggregating individual perceptions of trust and reciprocity. Individual perceptions, meanwhile, are influenced through a range of individual attributes. This paper examines the socioeconomic and demographic attributes that systematically correlate with individual perception of social capital and determines the extent to which such attributes account for neighborhood differences in social capital.

Oxygen sensing by primary cardiac fibroblasts: a key role of p21(Waf1/Cip1/Sdi1).

In mammalian organs under normoxic conditions, O2 concentration ranges from 12% to <0.5%, with O2 approximately 14% in arterial blood and <10% in the myocardium. During mild hypoxia, myocardial O2 drops to approximately 1% to 3% or lower.

Choosing area based socioeconomic measures to monitor social inequalities in low birth weight and childhood lead poisoning: The Public Health Disparities Geocoding Project (US).

Study Objectives: : To determine which area based socioeconomic measures can meaningfully be used, at which level of geography, to monitor socioeconomic inequalities in childhood health in the US.

Design: Cross sectional analysis of birth certificate and childhood lead poisoning registry data, geocoded and linked to diverse area based socioeconomic measures that were generated at three geographical levels: census tract, block group, and ZIP code.

Setting: Two US states: Massachusetts (1990 population=6,016,425) and Rhode Island (1990 population=1,003,464).

Future directions in residential segregation and health research: a multilevel approach.

The authors examine the research evidence on the effect of residential segregation on health, identify research gaps, and propose new research directions. Four recommendations are made on the basis of a review of the sociological and social epidemiology literature on residential segregation: (1) develop multilevel research designs to examine the effects of individual, neighborhood, and metropolitan-area factors on health outcomes; (2) continue examining the health effects of residential segregation among African Americans but also initiate studies examining segregation among Hispanics and Asians; (3) consider racial/ethnic segregation along with income segregation and other metropolitan area factors such as poverty concentration and metropolitan governance fragmentation; and (4) develop better conceptual frameworks of the pathways that may link various segregation dimensions to specific health outcomes.

Social trust and self-rated health in US communities: a multilevel analysis.

This study assessed the contextual and individual effects of social trust on health. Methods consisted of a multilevel regression analysis of self-rated poor health among 21,456 individuals nested within 40 US communities included in the 2000 Social Capital Community Benchmark Survey. Controlling for demographic covariates, a strong income and education gradient was observed for self-rated health.