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PurposeTo determine the association between sociodemographic characteristics and blood pressure among a demographically diverse population-based sample of 10-14-year-old US adolescents.MethodsWe conducted cross-sectional analyses of data from the Adolescent Brain Cognitive Development Study (N = 4,466), year two (2018-2020). Logistic and linear regression models were used to determine the association between sociodemographic characteristics (sex, race/ethnicity, sexual orientation, household income, and parental education) with blood pressure among early adolescents.ResultsThe sample was 49.3% female and 46.7% non-White. Overall, 4.1% had blood pressures in the hypertensive range. Male sex was associated with 48% higher odds of hypertensive-range blood pressures than female sex (95% confidence interval [CI], 1.02; 2.14), and Black race was associated with 85% higher odds of hypertensive-range blood pressures compared to White race (95% CI, 1.11; 3.08). Several annual household income categories less than $100,000 were associated with higher odds of hypertensive-range blood pressures compared to an annual household income greater than $200,000. We found effect modification by household income for Black adolescents; Black race (compared to White race) was more strongly associated with higher odds of hypertensive-range blood pressures in households with income greater than $75,000 (odds ratio 3.92; 95% CI, 1.95; 7.88) compared to those with income less than $75,000 (odds ratio 1.53; 95% CI, 0.80; 2.92).DiscussionSociodemographic characteristics are differentially associated with higher blood pressure in early adolescents. Future research could examine potential mediating factors (e.g., physical activity, nutrition, tobacco) linking sociodemographic characteristics and blood pressure to inform targeted interventions.

BackgroundPrevious studies have analyzed the relationship between screen time and cardiometabolic disease risk factors among adolescents, but few have examined the longitudinal effects of screen time on cardiometabolic health into adulthood using nationally representative data.ObjectiveTo determine prospective associations between screen time and later cardiometabolic disease over a 24-year period using a nationally representative adolescent cohort.DesignLongitudinal prospective cohort data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) collected from 1994 to 2018.ParticipantsAdolescents aged 11-18 years old at baseline (1994-1995) followed for 24 years.Main measuresPredictors: screen time (five repeated measures of self-reported television and video watching from adolescence to adulthood).OutcomesFive repeated measures of body mass index (BMI); two repeated measures of waist circumference, hypertension, hyperlipidemia, and diabetes collected at 15- and 24-year follow-up exams.Key resultsFor the 7105 adolescents in the sample (49.7% female, 35.0% non-white), the baseline adolescent average screen time per day was 2.86 ± 0.08 hours per day, which generally declined through 24-year follow-up. Average BMI at baseline was 22.57 ± 0.13 kg/m2, which increased to 30.27 ± 0.18 kg/m2 through follow-up. By 24-year follow-up, 43.4% of participants had obesity, 8.4% had diabetes, 31.8% had hypertension, and 14.9% had hyperlipidemia. In mixed-effects generalized linear models, each additional hour of screen time per day was associated with 0.06 (95% CI 0.04-0.09) within-person increase in BMI. Each additional hour of screen time per day was associated with higher within-person odds of high waist circumference (AOR 1.17, 95% CI 1.09-1.26), obesity (AOR 1.09, 95% CI 1.03-1.15), and diabetes (AOR 1.17, 95% CI 1.07-1.28). Screen time was not significantly associated with hypertension or hyperlipidemia.ConclusionsIn this prospective cohort study, higher screen time in adolescence was associated with higher odds of select indicators of cardiometabolic disease in adulthood.

PurposeThe aim of the study was to determine the association between food insecurity, sexual risk behaviors, sexually transmitted infections (STIs), and substance use in a nationally representative sample of U.S. young adults.MethodsCross-sectional nationally representative data of U.S. young adults aged 24-32 years from Wave IV (2008) of the National Longitudinal Study of Adolescent to Adult Health were analyzed. Multiple logistic and linear regression analyses were conducted with food insecurity as the independent variable and self-reported STIs, sexual risk behaviors, and substance use as the dependent variables, adjusting for covariates and stratifying by sex.ResultsOf the 14,786 young adults in the sample, 14% of young women and 9% of young men were food insecure. Food-insecure young women had greater odds of any STI, HIV, chlamydia, exchanging sex for money, and multiple concurrent sex partners in the past 12 months compared to young women reporting food security, adjusting for covariates. Food insecurity was associated with higher odds of any STI, chlamydia, and exchanging sex for money among young men who identify as gay or bisexual, but not in the general population of young men. Food insecurity was associated with greater odds of marijuana use, methamphetamine use, and nonmedical use of prescription opioids, sedatives, and stimulants in both young men and women.ConclusionsFood insecurity is associated with risk behaviors and self-reported STIs, including HIV, in young adulthood. Health care providers should screen for food insecurity in young adults and provide referrals when appropriate.

PurposeThe aim of the study was to determine the association between food insecurity, mental health, and sleep outcomes among young adults. Young adulthood represents an important developmental period when educational and economic transitions may increase the risk for food insecurity; however, little is known about associations between food insecurity and health outcomes in this period.MethodsCross-sectional nationally representative data of U.S. young adults aged 24-32 years from Wave IV (2008) of the National Longitudinal Study of Adolescent to Adult Health were analyzed in 2018. Multiple logistic regression analysis was conducted with food insecurity as the independent variable and self-reported mental health (depression, anxiety, and suicidality) and sleep (trouble falling and staying asleep) outcomes as the dependent variables.ResultsOf the 14,786 young adults in the sample, 11% were food insecure. Food-insecure young adults had greater odds of mental health problems including a depression diagnosis (1.67, 95% confidence interval [CI] 1.39-2.01), anxiety or panic disorder diagnosis (1.47, 95% CI 1.16-1.87), and suicidal ideation in the past 12 months (2.76, 95% CI 2.14-3.55). Food insecurity was also associated with poorer sleep outcomes including trouble falling (adjusted odds ratio 1.78, 95% CI 1.52-2.08) and staying (adjusted odds ratio 1.67, 95% CI 1.42-1.97) asleep.ConclusionsFood insecurity is associated with poorer mental and sleep health in young adulthood. Health care providers should screen for food insecurity in young adults and provide referrals when appropriate. Future research should test interventions to simultaneously combat food insecurity and mental health problems in young adulthood.

BackgroundFood insecurity, or the limited or uncertain access to food resulting from inadequate financial resources, is associated with a higher prevalence of chronic disease in adulthood. Little is known about these relationships specifically in young adulthood, an important time for the development of chronic disease.ObjectiveTo determine the association between food insecurity and chronic disease including diabetes, hypertension, obesity, and obstructive airway disease in a nationally representative sample of US young adults.DesignCross-sectional nationally representative data collected from Wave IV (2008) of the National Longitudinal Study of Adolescent to Adult Health was analyzed using multiple logistic regression models.ParticipantsUS young adults ages 24-32 years old MAIN MEASURES: Food insecurity and general health; self-reported diabetes, hypertension, hyperlipidemia, "very overweight," and obstructive airway disease; measured obesity derived from body mass index; and inadequate disease control (hemoglobin A1c ≥ 7.0%, blood pressure ≥ 140/90 mmHg) among those with reported diabetes and hypertension.Key resultsOf the 14,786 young adults in the sample, 11% were food insecure. Food-insecure young adults had greater odds of self-reported poor health (2.63, 95% confidence interval (CI) 1.63-4.24), diabetes (1.67, 95% CI 1.18-2.37), hypertension (1.40, 95% CI 1.14-1.72), being "very overweight" (1.30, 95% CI 1.08-1.57), and obstructive airway disease (1.48, 95% CI 1.22-1.80) in adjusted models compared with young adults who were food secure. Food insecurity was not associated with inadequate disease control among those with diabetes or hypertension.ConclusionsFood insecurity is associated with several self-reported chronic diseases and obesity in young adulthood. Health care providers should screen for food insecurity in young adults and provide referrals when appropriate. Future research should evaluate the impact of early interventions to combat food insecurity on the prevention of downstream health effects in later adulthood.

BackgroundBlood pressure (BP) and cholesterol are major modifiable risk factors for cardiovascular disease (CVD), but effects of exposures during young adulthood on later life CVD risk have not been well quantified.ObjectiveThe authors sought to evaluate the independent associations between young adult exposures to risk factors and later life CVD risk, accounting for later life exposures.MethodsThe authors pooled data from 6 U.S. cohorts with observations spanning the life course from young adulthood to later life, and imputed risk factor trajectories for low-density lipoprotein (LDL) and high-density lipoprotein cholesterols, systolic and diastolic BP starting from age 18 years for every participant. Time-weighted average exposures to each risk factor during young (age 18 to 39 years) and later adulthood (age ≥40 years) were calculated and linked to subsequent risks of coronary heart disease (CHD), heart failure (HF), or stroke.ResultsA total of 36,030 participants were included. During a median follow-up of 17 years, there were 4,570 CHD, 5,119 HF, and 2,862 stroke events. When young and later adult risk factors were considered jointly in the model, young adult LDL ≥100 mg/dl (compared with

A 19-year-old woman on immunomodulatory therapy presents to her provider for a routine physical. She is diagnosed with chlamydia trachomatis during screening for sexually transmitted infections (STIs) and returns to the clinic for directly observed treatment with azithromycin. She later calls the practice to express dismay that her parents questioned her about her sexual activity after they received an explanation of benefits for services rendered.

Physician burnout and empathy erosion are common during training and clinical practice. Museums can effectively partner with health professional schools and hospitals to address these challenges through reflective practice and a focus on physician wellness. We describe a partnership between the Brigham and Women's Hospital Department of Medicine and the Boston Museum of Fine Arts created to meet these needs. Since 2010, internal medicine residents have spent an evening of reflection and community-building at the museum as part of their Humanistic Curriculum. Residents participate in a visual thinking exercise, metaphor-making with contemporary art, group drawing, a discussion of death and dying, and a brief meditation. Residents report that the program has led them to renew commitments to family and friends, to spend time in daily reflection, and to connect more with patients. In this article we report perspectives from physician and museum stakeholders highlighting the value of this unique collaboration.

Background: Previous studies have analyzed the relationship between screen time and cardiometabolic disease risk factors among adolescents, but few have examined the longitudinal effects of screen time on cardiometabolic health into adulthood using nationally representative data. Objective: To determine prospective associations between screen time and later cardiometabolic disease over a 24-year period using a nationally representative adolescent cohort. Design: Longitudinal prospective cohort data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) collected from 1994 to 2018. Participants: Adolescents aged 11–18 years old at baseline (1994–1995) followed for 24 years. Main Measures: Predictors: screen time (five repeated measures of self-reported television and video watching from adolescence to adulthood). Outcomes: Five repeated measures of body mass index (BMI); two repeated measures of waist circumference, hypertension, hyperlipidemia, and diabetes collected at 15- and 24-year follow-up exams. Key Results: For the 7105 adolescents in the sample (49.7% female, 35.0% non-white), the baseline adolescent average screen time per day was 2.86 ± 0.08 hours per day, which generally declined through 24-year follow-up. Average BMI at baseline was 22.57 ± 0.13 kg/m2, which increased to 30.27 ± 0.18 kg/m2 through follow-up. By 24-year follow-up, 43.4% of participants had obesity, 8.4% had diabetes, 31.8% had hypertension, and 14.9% had hyperlipidemia. In mixed-effects generalized linear models, each additional hour of screen time per day was associated with 0.06 (95% CI 0.04–0.09) within-person increase in BMI. Each additional hour of screen time per day was associated with higher within-person odds of high waist circumference (AOR 1.17, 95% CI 1.09–1.26), obesity (AOR 1.09, 95% CI 1.03–1.15), and diabetes (AOR 1.17, 95% CI 1.07–1.28). Screen time was not significantly associated with hypertension or hyperlipidemia. Conclusions: In this prospective cohort study, higher screen time in adolescence was associated with higher odds of select indicators of cardiometabolic disease in adulthood. [ABSTRACT FROM AUTHOR]