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Current Epidemiology Reports

Alexis D Vick, Heather H Burris
PURPOSE OF REVIEW: African Americans disproportionately suffer from leading causes of morbidity and mortality including cardiovascular disease (CVD), cancer, and preterm birth. Disparities can arise from multiple social and environmental exposures, but how the human body responds to these exposures to result in pathophysiologic states is incompletely understood. RECENT FINDINGS: Epigenetic mechanisms, particularly DNA methylation, can be altered in response to exposures such as air pollution, psychosocial stress, and smoking...
March 2017: Current Epidemiology Reports
Joanna Maselko
PURPOSE OF THE REVIEW: The vast majority of research on the social determinants of mental health has been generated from high-income country (HIC) populations, even as the greatest health disparities, and greatest disease burden, is observed in lower- and middle-income countries (LMICs). The goal of this review is to examine the evidence base on how key social epidemiology constructs relate to mental health in LMIC contexts. A special focus is on points of departure from the HIC knowledge base, gaps in overall understanding, and opportunities for social epidemiology to make a significant contribution...
2017: Current Epidemiology Reports
K S Joseph, Neda Razaz, Giulia M Muraca, Sarka Lisonkova
PURPOSE OF REVIEW: Several prestigious agencies routinely rank countries based on crude perinatal and infant mortality rates, while more recently, international neonatal networks have begun comparing neonatal mortality and morbidity rates among very preterm and very low-birth-weight infants. We discuss the methodologic challenges that compromise such comparisons and potential remedies. RECENT FINDINGS: Crude perinatal mortality rates are biased by international variations in birth registration, especially at the borderline of viability...
2017: Current Epidemiology Reports
Chirag J Patel
PURPOSE OF REVIEW: Mixtures, or combinations and interactions between multiple environmental exposures, are hypothesized to be causally linked with disease and health-related phenotypes. Established and emerging molecular measurement technologies to assay the exposome, the comprehensive battery of exposures encountered from birth to death, promise a new way of identifying mixtures in disease in the epidemiological setting. In this opinion, we describe the analytic complexity and challenges in identifying mixtures associated with phenotype and disease...
2017: Current Epidemiology Reports
Tyler M Sharp, Kay M Tomashek, Jennifer S Read, Harold S Margolis, Stephen H Waterman
PURPOSE OF REVIEW: By all measures, the morbidity and mortality due to dengue are continuing to worsen worldwide. Although both early and recent studies have demonstrated regional differences in how dengue affects local populations, these findings were to varying extents related to disparate surveillance approaches. RECENT FINDINGS: Recent studies have broadened the recognized spectrum of disease resulting from DENV infection, particularly in adults, and have also demonstrated new mechanisms of DENV spread both within and between populations...
2017: Current Epidemiology Reports
M Elizabeth Halloran, Michael G Hudgens
One hundred years ago Sir Ronald Ross published his treatise on a general Theory of Happenings. Dependent happenings are those in which the frequency depends on the number already affected. When there is dependency of events, interventions can have different types of effects. Interventions such as vaccination can have direct protective effects for the person receiving the treatment, as well as indirect/spillover effects for others in the population. Causal inference is a framework for carefully defining the causal effect of a treatment, exposure, or policy, and then determining conditions under which such effects can be estimated from the observed data...
December 2016: Current Epidemiology Reports
Kevin D Shield, D Maxwell Parkin, David C Whiteman, Jürgen Rehm, Vivian Viallon, Claire Marant Micallef, Paolo Vineis, Lesley Rushton, Freddie Bray, Isabelle Soerjomataram
The proportions of new cancer cases and deaths that are caused by exposure to risk factors and that could be prevented are key statistics for public health policy and planning. This paper summarizes the methodologies for estimating, challenges in the analysis of, and utility of, population attributable and preventable fractions for cancers caused by major risk factors such as tobacco smoking, dietary factors, high body fat, physical inactivity, alcohol consumption, infectious agents, occupational exposure, air pollution, sun exposure, and insufficient breastfeeding...
September 2016: Current Epidemiology Reports
Tamarra M James-Todd, Yu-Han Chiu, Ami R Zota
Disparities in women's reproductive health outcomes across the life course have been well-documented. Endocrine disrupting chemicals may be one factor driving disparities, as studies suggest exposure to certain environmental endocrine disrupting chemicals, such as certain phthalates, bisphenol A, parabens and polybrominated diphenyl ethers are higher in non-whites. Yet, a limited amount of research has focused on these chemical exposures as a potential mediator of racial/ethnic differences in women's reproductive health outcomes, such as pubertal development, fibroids, infertility, and pregnancy complications...
June 2016: Current Epidemiology Reports
David S Fink, Katherine M Keyes, Magdalena Cerdá
Population distributions of health emerge from the complex interplay of health-related factors at multiple levels, from the biological to the societal level. Individuals are aggregated within social networks, affected by their locations, and influenced differently across time. From aggregations of individuals, group properties can emerge, including some exposures that are ubiquitous within populations but variant across populations. By combining a focus on social determinants of health with a conceptual framework for understanding how genetics, biology, behavior, psychology, society, and environment interact, a systems science approach can inform our understanding of the underlying causes of the unequal distribution of health across generations and populations, and can help us identify promising approaches to reduce such inequalities...
March 2016: Current Epidemiology Reports
David H Rehkopf, M Maria Glymour, Theresa L Osypuk
The assumption that exposures as measured in observational settings have clear and specific definitions underpins epidemiologic research and allows us to use observational data to predict outcomes in interventions. This leap between exposures as measured and exposures as intervened upon is typically supported by the consistency assumption. The consistency assumption has received extensive attention in risk factor epidemiology but relatively little emphasis in social epidemiology. However, violations of the consistency assumption may be especially important to consider when understanding how social and economic exposures influence health...
March 2016: Current Epidemiology Reports
Claire Margerison-Zilko, Sidra Goldman-Mellor, April Falconi, Janelle Downing
The severity, sudden onset, and multipronged nature of the Great Recession (2007-2009) provided a unique opportunity to examine the health impacts of macroeconomic downturn. We comprehensively review empirical literature examining the relationship between the Recession and mental and physical health outcomes in developed nations. Overall, studies reported detrimental impacts of the Recession on health, particularly mental health. Macro- and individual-level employment- and housing-related sequelae of the Recession were associated with declining fertility and self-rated health, and increasing morbidity, psychological distress, and suicide, although traffic fatalities and population-level alcohol consumption declined...
March 2016: Current Epidemiology Reports
Janne Boone-Heinonen, Lynne Messer, Kate Andrade, Erin Takemoto
In this review, we considered how disparities in obesity emerge between birth, when socially disadvantaged infants tend to be small, and later in childhood, when socially disadvantaged groups have high risk of obesity. We reviewed epidemiologic evidence of socioeconomic and racial/ethnic differences in growth from infancy to pre-adolescence. Minority race/ethnicity and lower socioeconomic status was associated with rapid weight gain in infancy but not in older age groups, and social differences in linear growth and relative weight were unclear...
March 1, 2016: Current Epidemiology Reports
Catherine E Oldenburg, Ellen Moscoe, Till Bärnighausen
Regression discontinuity analyses can generate estimates of the causal effects of an exposure when a continuously measured variable is used to assign the exposure to individuals based on a threshold rule. Individuals just above the threshold are expected to be similar in their distribution of measured and unmeasured baseline covariates to individuals just below the threshold, resulting in exchangeability. At the threshold exchangeability is guaranteed if there is random variation in the continuous assignment variable, e...
2016: Current Epidemiology Reports
Mariana C Stern, Laura Fejerman, Rina Das, V Wendy Setiawan, Marcia R Cruz-Correa, Eliseo J Perez-Stable, Jane C Figueiredo
Latinos have lower rates for most common cancer sites and higher rates of some less common cancers (gallbladder, liver, gastric, and cervical) than other ethnic/racial groups. Latinos are a highly heterogeneous population with diverse national origins, unique genetic admixture patterns, and wide spectrum of socio-demographic characteristics. Across the major cancers (breast, colorectal, prostate, lung, and liver) US-born Latinos have higher incidence and worse survival than foreign-born, and those with low-socioeconomic status have the lowest incidence...
2016: Current Epidemiology Reports
Pennan M Barry, Alexander W Kay, Jennifer M Flood, James Watt
This review of tuberculosis epidemiology is intended to provide a historical perspective on the public health approach to tuberculosis (TB) control in California. This historical context offers a lens through which to view current epidemiologic trends and insight into how new therapeutic tools can be applied. Since 1993, the year detailed case reporting was instituted, California has had a decrease in recent TB transmission as evidenced by a reduction in pediatric cases and an increased percentage of cases attributable to progression of latent infection to TB disease in the foreign-born population...
2016: Current Epidemiology Reports
Jennifer L Lund, David B Richardson, Til Stürmer
Better understanding of biases related to selective prescribing of, and adherence to, preventive treatments has led to improvements in the design and analysis of pharmacoepidemiologic studies. One influential development has been the "active comparator, new user" study design, which seeks to emulate the design of a head-to-head randomized controlled trial. In this review, we first discuss biases that may affect pharmacoepidemiologic studies and describe their direction and magnitude in a variety of settings...
December 2015: Current Epidemiology Reports
Brion S Maher
Genes account for a significant proportion of the risk for most common diseases. The genome-wide association scan (GWAS) era of genetic epidemiology has generated a massive amount of data, revolutionized our thinking on the genetic architecture of common diseases and positioned the field to realistically consider risk prediction for common polygenic diseases, such as non-familial cancers, and autoimmune, cardiovascular and psychiatric diseases. Polygenic scoring is an approach that shows promise for understanding the polygenic contribution to common human diseases...
December 2015: Current Epidemiology Reports
Anders Huitfeldt, Mette Kalager, James M Robins, Geir Hoff, Miguel A Hernán
Clinical guidelines that rely on observational data due to the absence of data from randomized trials benefit when the observational data or its analysis emulates trial data or its analysis. In this paper, we review a methodology for emulating trials that compare the effects of different timing strategies, that is, strategies that vary the frequency of delivery of a medical intervention or procedure. We review trial emulation for comparing (i) single applications of the procedure at different times, (ii) fixed schedules of application, and (iii) schedules adapted to the evolving clinical characteristics of the patients...
September 1, 2015: Current Epidemiology Reports
Chanelle J Howe, Lauren E Cain, Joseph W Hogan
Estimating causal effects is a frequent goal of epidemiologic studies. Traditionally, there have been three established systematic threats to consistent estimation of causal effects. These three threats are bias due to confounders, selection, and measurement error. Confounding, selection, and measurement bias have typically been characterized as distinct types of biases. However, each of these biases can also be characterized as missing data problems that can be addressed with missing data solutions. Here we describe how the aforementioned systematic threats arise from missing data as well as review methods and their related assumptions for reducing each bias type...
September 1, 2015: Current Epidemiology Reports
Lesli E Skolarus, James F Burke
Due to the aging of the baby boomer generation, the number of stroke survivors is expected to increase from 7 million to over 10 million in 2030. Stroke survivorship will be particularly important for African Americans who have a higher incidence of strokes compared to non-Hispanics whites and greater post stroke disability. Current evidence suggests that the most prominent racial differences in post-stroke disability emerge in the post-stroke period. Further work, with a focus on modifiable factors, is needed to understand which factors in the post-stroke period lead to racial differences in post-stroke disability...
September 2015: Current Epidemiology Reports
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