While there are state and national estimates of serious psychological distress (SPD), these are not useful for targeting local mental health interventions or for addressing the needs of sub-populations at increased risk for SPD. This cross-sectional study uses data from the population-based 2010 Health of Houston Survey (n = 5,116) to examine (1) the prevalence of SPD and its determinants in Houston area and (2) predictors of the utilization of mental health services among people with SPD. The prevalence of SPD among the Houston area adult population was 7 %, more than twice the national average. Correlates of SPD included: being female, under 65, lacking emotional support, smoking, having poor health status and financial distress. The odds of utilizing health services by those with SPD were affected by financial distress, insurance, employment and perceived need for services, among other factors. Interventions should be tailored to mitigate risk factors for SPD and to improve access to mental health services in the SPD sub-population.
This study used the 2010 Health of Houston Survey to examine the physical activity of Asian American adults living in Houston, Texas. Multivariate regression models were conducted to examine the number of moderate leisure physical activity days in the past week and likelihood of having sufficient levels of physical activity. The results showed that Asians were among the least physically active of the major racial/ethnic groups. Most notably, Asians were less likely than whites to have sufficient levels of physical activity and had similarly lower expected numbers of physical activity minutes and days. Within the Asian American population, Vietnamese adults had more physical activity minutes and days than their Chinese counterparts—after controlling for other sociodemographic and health factors. Age- and gender-adjusted rates suggested a significant gender disparity among the Vietnamese and South Asian adults (less so for the Chinese adults), but this varied across different age groups. Several factors emerged as significant predictors of physical activity for Asian Americans, including age, immigration status, speaking a non-English language at home, marital status, and neighborhood incivilities. Findings highlight the need for targeted, culturally appropriate interventions to promote physical activity in Asian American communities.
- William A. Calo, Sally W. Vernon, David R. Lairson, Stephen H. Linder. 2016 Area-level Socioeconomic Inequalities in the Use of Mammography Screening: A Multilevel Analysis of the Health of Houston Survey Women's Health Issues. 26(2):201-207
An emerging literature reports that women who reside in socioeconomically deprived communities are less likely to adhere to mammography screening. This study explored associations between area-level socioeconomic measures and mammography screening among a racially and ethnically diverse sample of women in Texas. Methods: We conducted a cross-sectional, multilevel study linking individual-level data from the 2010 Health of Houston Survey and contextual data from the U.S. Census. Women ages 40 to 74 years (n ¼ 1,541) were included in the analyses. We examined tract-level poverty, unemployment, education, Hispanic and Black composition, female-headed householder families, and crowding as contextual measures. Using multilevel logistic regression modeling, we compared most disadvantaged tracts (quartiles 2–4) to the most advantaged tract (quartile 1). Results: Overall, 64% of the sample was adherent to mammography screening. Screening rates were lower (p < .05) among Hispanics, those foreign born, women aged 40 to 49 years, and those with low educational attainment, unemployed, and without health insurance coverage. Women living in areas with high levels of poverty (quartile 2 vs. 1: odds ratio [OR], 0.50; 95% CI, 0.30–0.85), Hispanic composition (quartile 3 vs. 1: OR, 0.54; 95% CI, 0.32–0.90), and crowding (quartile 4 vs. 1: OR, 0.53; 95% CI, 0.29–0.96) were less likely to have up-to-date mammography screening, net of individual-level factors. Conclusion: Our findings highlight the importance of examining area-level socioeconomic inequalities in mammography screening. The study represents an advance on previous research because we examined multiple area measures, controlled for key individual-level covariates, used data aggregated at the tract level, and accounted for the nested structure of the data.
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