Survival expectations of the obese: Is excess mortality reflected in perceptions?

OBJECTIVE: This study compared self-reported subjective life expectancy (i.e., probability of living to age 75) for normal-weight, overweight, and obese weight groups to examine whether individuals are internalizing information about the health risks due to excessive weight. RESEARCH METHODS AND PROCEDURES: Using data from the Health and Retirement Study, a total of 9035 individuals 51 to 61 years old were analyzed by BMI category. The primary outcome measure was individuals' reports about their own expectations of survival to age 75. Absolute and relative risks of survival were compared with published estimates of survival to age 75. RESULTS: Consistently, higher levels of BMI were associated with lower self-estimated survival probabilities. Differences relative to normal weight ranged from 4.9% (p < 0.01) for male nonsmokers to 8.8% (p < 0.001) for female nonsmokers. However, these differences were substantially less than those obtained from published survival curve estimates, suggesting that obese individuals tended to underestimate mortality risks. DISCUSSION: Individuals appeared to underestimate the mortality risks of excessive weight; thus, knowledge campaigns about the risks of obesity should remain a top priority.

Qualitative analysis of the interdisciplinary interaction between data analysis specialists and novice clinical researchers.

BACKGROUND: The inherent complexity of statistical methods and clinical phenomena compel researchers with diverse domains of expertise to work in interdisciplinary teams, where none of them have a complete knowledge in their counterpart's field. As a result, knowledge exchange may often be characterized by miscommunication leading to misinterpretation, ultimately resulting in errors in research and even clinical practice. Though communication has a central role in interdisciplinary collaboration and since miscommunication can have a negative impact on research processes, to the best of our knowledge, no study has yet explored how data analysis specialists and clinical researchers communicate over time. METHODS/PRINCIPAL FINDINGS: We conducted qualitative analysis of encounters between clinical researchers and data analysis specialists (epidemiologist, clinical epidemiologist, and data mining specialist). These encounters were recorded and systematically analyzed using a grounded theory methodology for extraction of emerging themes, followed by data triangulation and analysis of negative cases for validation. A policy analysis was then performed using a system dynamics methodology looking for potential interventions to improve this process. Four major emerging themes were found. Definitions using lay language were frequently employed as a way to bridge the language gap between the specialties. Thought experiments presented a series of "what if" situations that helped clarify how the method or information from the other field would behave, if exposed to alternative situations, ultimately aiding in explaining their main objective. Metaphors and analogies were used to translate concepts across fields, from the unfamiliar to the familiar. Prolepsis was used to anticipate study outcomes, thus helping specialists understand the current context based on an understanding of their final goal. CONCLUSION/SIGNIFICANCE: The communication between clinical researchers and data analysis specialists presents multiple challenges that can lead to errors.

The impact of the developmental timing of trauma exposure on PTSD symptoms and psychosocial functioning among older adults.

The present study examined the impact of the developmental timing of trauma exposure on posttraumatic stress disorder (PTSD) symptoms and psychosocial functioning in a large sample of community-dwelling older adults (N = 1,995). Specifically, we investigated whether the negative consequences of exposure to traumatic events were greater for traumas experienced during childhood, adolescence, young adulthood, midlife, or older adulthood. Each of these developmental periods is characterized by age-related changes in cognitive and social processes that may influence psychological adjustment following trauma exposure. Results revealed that older adults who experienced their currently most distressing traumatic event during childhood exhibited more severe symptoms of PTSD and lower subjective happiness compared with older adults who experienced their most distressing trauma after the transition to adulthood. Similar findings emerged for measures of social support and coping ability. The differential effects of childhood compared with later life traumas were not fully explained by differences in cumulative trauma exposure or by differences in the objective and subjective characteristics of the events. Our findings demonstrate the enduring nature of traumatic events encountered early in the life course and underscore the importance of examining the developmental context of trauma exposure in investigations of the long-term consequences of traumatic experiences.

Poverty and Place in the Context of the American South

In the United States, poverty has been historically higher and disproportionately concentrated in the American South. Despite this fact, much of the conventional poverty literature in the United States has focused on urban poverty in cities, particularly in the Northeast and Midwest. Relatively less American poverty research has focused on the enduring economic distress in the South, which Wimberley (2008:899) calls “a neglected regional crisis of historic and contemporary urgency.” Accordingly, this dissertation contributes to the inequality literature by focusing much needed attention on poverty in the South.

Each empirical chapter focuses on a different aspect of poverty in the South. Chapter 2 examines why poverty is higher in the South relative to the Non-South. Chapter 3 focuses on poverty predictors within the South and whether there are differences in the sub-regions of the Deep South and Peripheral South. These two chapters compare the roles of family demography, economic structure, racial/ethnic composition and heterogeneity, and power resources in shaping poverty. Chapter 4 examines whether poverty in the South has been shaped by historical racial regimes.

The Luxembourg Income Study (LIS) United States datasets (2000, 2004, 2007, 2010, and 2013) (derived from the U.S. Census Current Population Survey (CPS) Annual Social and Economic Supplement) provide all the individual-level data for this study. The LIS sample of 745,135 individuals is nested in rich economic, political, and racial state-level data compiled from multiple sources (e.g. U.S. Census Bureau, U.S. Department of Agriculture, University of Kentucky Center for Poverty Research, etc.). Analyses involve a combination of techniques including linear probability regression models to predict poverty and binary decomposition of poverty differences.

Chapter 2 results suggest that power resources, followed by economic structure, are most important in explaining the higher poverty in the South. This underscores the salience of political and economic contexts in shaping poverty across place. Chapter 3 results indicate that individual-level economic factors are the largest predictors of poverty within the South, and even more so in the Deep South. Moreover, divergent results between the South, Deep South, and Peripheral South illustrate how the impact of poverty predictors can vary in different contexts. Chapter 4 results show significant bivariate associations between historical race regimes and poverty among Southern states, although regression models fail to yield significant effects. Conversely, historical race regimes do have a small, but significant effect in explaining the Black-White poverty gap. Results also suggest that employment and education are key to understanding poverty among Blacks and the Black-White poverty gap. Collectively, these chapters underscore why place is so important for understanding poverty and inequality. They also illustrate the salience of micro and macro characteristics of place for helping create, maintain, and reproduce systems of inequality across place.