THE HEALTH OF YOUNG ADULTS WITH DISABILITIES IN THE UNITED STATES: THE COLLECTIVE ROLES OF RISK FACTORS IN SOCIAL ECOLOGIC FRAMEWORK

Background: Over the last few decades, the prevalence of young adults with disabilities (YAD) has steadily risen as a result of advances in medicine, clinical treatment, and biomedical technologythat enhanced their survival into adulthood. Despite investments in services, family supports, and insurance, they experience poor health status and barriers to successful transition into adulthood. Objectives: We investigated the collective roles of multi-faceted factors at intrapersonal, interpersonal and community levels within the social ecological framework on health related outcome including self-rated health (SRH) of YAD. The three specific aims are: 1) to examine sociodemographic differences and health insurance coverage in adolescence; 2) to investigate the role of social skills in relationships with family and peers developed in adolescence; and 3) to collectively explore the association of sociodemographic characteristics, social skills, and community participation in adolescence on SRH. Methods: Using longitudinal data (N=5,020) from the National Longitudinal Transition Study (NLTS2), we conducted multivariate logistic regression analyses to understand the association between insurance status as well as social skills in adolescence and YAD’s health related outcomes. Structural equation modeling (SEM) assessed the confluence of multi-faceted factors from the social ecological model that link to health in early adulthood. Results: Compared with YAD who had private insurance, YAD who had public health insurance in adolescence are at higher odds of experiencing poorer health related outcomes in self-rated health [adjusted odds ratio (aOR=2.89, 95% confidence interval (CI): 1.16, 7.23), problems with health (aOR=2.60, 95%CI: 1.26, 5.35), and missing social activities due to health problems (aOR=2.86, 95%CI: 1.39, 5.85). At the interpersonal level, overall social skills developed through relationship with family and peers in adolescence do not appear to have association with health related outcomes in early adulthood. Finally, at the community level, community participation in adolescence does not have an association with SRH in early adulthood. Conclusions: Having public health insurance coverage does not equate to good health. YAD need additional supports to achieve positive health outcomes. The findings in social skills and community participation suggest other potential factors may be at play for health related outcomes for YAD and the need for further investigation.

Feasibility of An Online Survey Examining the Physical Activity Patterns Among South Asian Adults Residing In the United States

Background: Physical inactivity is a major risk factor for cardiovascular disease and diabetes among South Asians (SAs) - Bangladeshi, Bhutanese, Indian, Maldivian, Nepali, Pakistani, and Sri Lankan. Methods: An online survey was used to determine the feasibility of examining physical activity (PA) levels of SAs living in the US. The Social Ecological Model was the theoretical basis for identifying individual-level, social environmental, and physical environmental factors that impact PA. Results: Ethnicity, intention, self-efficacy, and perceived health benefits of PA were significantly associated with being physically active. Facilitators to PA included achieving improved health; while barriers were lack of time to exercise, unfamiliarity with PA, and nonexistent gender-specific PA facilities. Conclusions: This study showed that online surveys can be a promising tool for data collection among SAs. Health promotion programs should include education on the benefits of PA, and provide culturally sensitive facilities that support PA, especially for SA women.

Bioenergetic and ecological consequences of diet variability in Atlantic croaker Micropogonias undulatus

Atlantic croaker Micropogonias undulatus is a commercially and ecologically important bottom-associated fish that occurs in marine and estuarine systems from Cape Cod, MA to Mexico. I documented the temporal and spatial variability in the diet of Atlantic croaker in Chesapeake Bay and found that in the summer fish, particularly bay anchovies Anchoa mitchilli, make up at least 20% of the diet of croaker by weight. The use of a pelagic food source seems unusual for a bottom-associated fish such as croaker, but appears to be a crepuscular feeding habit that has not been previously detected. Thus, I investigated the bioenergetic consequences of secondary piscivory to the distribution of croaker, to the condition of individuals within the population and to the ecosystem. Generalized additive models revealed that the biomass of anchovy explained some of the variability in croaker occurrence and abundance in Chesapeake Bay. However, physical factors, specifically temperature, salinity, and seasonal dynamics were stronger determinants of croaker distribution than potential prey availability. To better understand the bioenergetic consequences of diet variability at the individual level, I tested the hypothesis that croaker feeding on anchovies would be in better condition than those feeding on polychaetes using a variety of condition measures that operate on multiple time scales, including RNA:DNA, Fulton's condition factor (K), relative weight (Wr), energy density, hepatosomatic index (HSI), and gonadosomatic index (GSI). Of these condition measures, several morphometric measures were significantly positively correlated with each other and with the percentage (by weight) of anchovy in croaker diets, suggesting that the type of prey eaten is important in improving the overall condition of individual croaker. To estimate the bioenergetic consequences of diet variability on growth and consumption in croaker, I developed and validated a bioenergetic model for Atlantic croaker in the laboratory. The application of this model suggested that croaker could be an important competitor with weakfish and striped bass for food resources during the spring and summer when population abundances of these three fishes are high in Chesapeake Bay. Even though anchovies made up a relatively small portion of croaker diet and only at certain times of the year, croaker consumed more anchovy at the population level than striped bass in all simulated years and nearly as much anchovy as weakfish. This indicates that weak trophic interactions between species are important in understanding ecosystem processes and should be considered in ecosystem-based management.