Health behavior profiles of U.S. adults

Research focusing on individual behaviors ignores complex unmeasured group level patterns which, if acted upon as lifestyle interventions, provide a more cost efficient and effective route to changing health outcomes. This was the focus of a recent NIA-funded study which examined how different health behavior patterns relate to mortality.

Data from the 2004–2009 National Health Interview Survey was analyzed using latent class analysis to identify seven typologies of health behavior based on sleep, physical activity, smoking status, alcohol use, preventive dental or eye care, and receiving a flu vaccine. Results revealed 44% of the population fell into a typology comprised of concordant healthy behaviors, 30% in a discordant typology of healthy and unhealthy behaviors, and 26% in a concordant unhealthy typology. However, within typologies difference in mortality exists. For example, individuals in the healthy typology who have low vigorous physical activity have a 39% higher mortality risk than individuals in similar classes that obtain greater amounts of vigorous activity.

Results suggest individual behaviors do not occur in isolation, instead grouping together to create distinct lifestyles that are embedded in social circumstances. These findings reinforce the need for interventions focusing on individuals within a behavioral typology.

Citation:
Saint Onge JM, Krueger PM. 2017. Health lifestyle behaviors among U.S. adults. SSM Popul Health 3:89-98.

Affect, self-management behavior and glucose control in Latinos with Type 2 diabetes

Glucose control is essential for people with diabetes, and while medicinal and lifestyle effects are well established, less is known about the influence of psychosocial characteristics on glucose control. A new NIMHD-funded study examines this relationship by considering the influence of affect and self-care behaviors on glucose variability and control in Latinos with type 2 diabetes.

The study included 50 participants who were part of the Community Health Workers Assisting Latinos Manage Stress and Diabetes study. A continuous glucose monitor, measuring interstitial glucose every 10 seconds, was worn by participants for 7 days. In addition, interactive voice response was used to query participants twice a day about their affect and self-management behaviors.

Higher levels and variability of negative affect were associated with significantly higher glucose levels and greater percentage of hyperglycemic values whereas participants with greater variability in positive affect had a higher proportion of hypoglycemic values. Increased self-care behavior was also found to be significantly associated with subsequently lower glucose levels and hyperglycemia but also a greater percentage of hypoglycemic values.

These data help to establish the connection between mood state and consequent glycemic control, confirming previous findings that this connection may be mediated through self-care behaviors.

Citation:
Wagner J, Armeli S, Tennen H, Bermudez-Millan A, Wolpert H, Perez-Escamilla R. 2017. Mean levels and variability in affect, diabetes self-care behaviors, and continuously monitored glucose: A daily study of Latinos with type 2 diabetes. Psychosom Med 79:798-805.

Does smoking and obesity-related mortality risk vary internationally?

Does engaging in same health behavior in a different social context produce significantly different results? This was the focus of a recent NIA-funded study which examined whether the risk of mortality from smoking and obesity differs between the U.S. and Finland.

The study pooled nationally representative demographic, behavioral, and mortality data collected in the U.S. and Finland between 1971 and 2014. These two countries were chosen because they have higher than average GPD but differ in their health care delivery systems, amount of poverty, and levels of income inequality.

Results indicate cigarette smoking–related mortality risk increased from 1971 to 2014 in females from both countries, however, this increase did not extend to men. In addition, the mortality risk from smoking was 55% higher in U.S. women compared to Finnish women. For women and men in both countries, the mortality risk from obesity were similar.

The results of this study shed new light on the unmeasured moderating and mediating factors which predict health. As such, these factors should be accounted for across populations when possible.

Citation:
Mehta N, Elo I, Stenholm S, Aromaa A, Heliövaara M, Koskinen S. 2017. International Differences in the Risk of Death from Smoking and Obesity: The Case of the United States and Finland. SSM Popul Health 3:141-52.