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Biomedical subjects

Stephen L Buka

Publications and source records attributed to Stephen L Buka.

28 records · Page 2Linked to original sources

Intergenerational transmission of tobacco use and dependence: a transdisciplinary perspective.

Numerous questions remain regarding the intergenerational transmission of tobacco use and dependence, and some of these questions are best approached from a transdisciplinary perspective. For example, considering both genetic and environmental influences on cigarette smoking promises to be a fruitful venue for future investigations. In this paper, we consider the evidence regarding intergenerational influences on the transmission of tobacco use and nicotine dependence in both humans and animal models; our focus will be on genetic influences, in utero exposure to nicotine, and some postnatal influences. Research gaps that exist between scientific disciplines are highlighted, and some directions for future research are suggested.

Adult↗

Diverging associations of maternal age with low birthweight for black and white mothers.

BACKGROUND: In the US, the risk of low birthweight appears to increase more quickly with maternal age for black women than it does for white women. Our aim was to investigate correlates and causes of the racial/ethnic divergence in low birthweight by maternal age. METHODS: We analysed birth certificate data from 96 887 singleton births to black and white mothers in Chicago from 1994 to 1996 to determine if the association between maternal age and low birthweight differed by maternal ethnicity, marital status, and socioeconomic disadvantage. The association of maternal age with risk of low birthweight was examined, considering especially the interactions of maternal age with maternal race/ethnicity, marital status, education, and neighbourhood poverty. RESULTS: In unadjusted data, the risk of low birthweight rose steeply with maternal age for black, but not white, mothers. Adjustment for the main effects of maternal education, marital status, adequacy of prenatal care, cigarette smoking, and neighbourhood poverty accounted for some of the age-related excess risk of black mothers. Further adjustment for interactions of maternal age with these risk factors eliminated the ethnic divergence in age slopes. The fully adjusted analysis indicated that the risk of low birthweight rises more quickly with maternal age for disadvantaged women, regardless of race/ethnicity. CONCLUSION: This analysis suggests that hardships act cumulatively to threaten reproductive health. The particularly steep increase in risk of low birthweight with increasing maternal age for black women is explained by the high prevalence of disadvantage in this population.

Adolescent↗

Elevated risk of tobacco dependence among offspring of mothers who smoked during pregnancy: a 30-year prospective study.

OBJECTIVE: The authors' goal was to investigate whether maternal smoking during pregnancy is associated with an increased risk of nicotine dependence among adult offspring. METHOD: Prospective data from two samples of offspring in the National Collaborative Perinatal Project, a long-term prospective investigation from pregnancy through adulthood, were combined (N=1,248). Maternal smoking during pregnancy was assessed during each prenatal visit. Offspring smoking behavior and lifetime risk of nicotine dependence were obtained by structured interview with the Diagnostic Interview Schedule; the mean age of the offspring at the time of interview was 29 years. RESULTS: Offspring whose mothers reported smoking a pack or more of cigarettes during their pregnancy were significantly more likely to meet DSM criteria for lifetime tobacco dependence than offspring of mothers who reported that they never smoked during pregnancy. The odds of progressing from smoking to nicotine dependence were almost twice as great for offspring whose mothers smoked heavily during pregnancy. These significant differences remained after adjustments for participants' gender and age and maternal socioeconomic status and age at pregnancy. Results were comparable for men and women. The findings were specific for tobacco dependence; odds of marijuana dependence were not significantly elevated among the offspring of tobacco smokers. CONCLUSIONS: Offspring of mothers who smoked a pack or more of cigarettes during pregnancy are at elevated risk of developing nicotine dependence but not marijuana dependence as adults. Maternal smoking during pregnancy is a risk factor for subsequent nicotine dependence among offspring.

Adolescent↗

Family disruption in childhood and risk of adult depression.

OBJECTIVE: The authors examined the risk that family disruption and low socioeconomic status in early childhood confer on the onset of major depression in adulthood. METHOD: Participants were 1,104 offspring of mothers enrolled during pregnancy in the Providence, R.I., site of the National Collaborative Perinatal Project. Measures of childhood family disruption and socioeconomic status were obtained before birth and at age 7. Structured diagnostic interviews were used to assess respondents' lifetime history of major depressive episode between the ages of 18 and 39. Survival analysis was used to identify childhood risks for depression onset. RESULTS: Parental divorce in early childhood was associated with a higher lifetime risk of depression among subjects whose mothers did not remarry as well as among subjects whose mothers remarried. These effects were more pronounced when accompanied by high levels of parental conflict. Independent of the respondents' adult socioeconomic status, low socioeconomic status in childhood predicted an elevated risk of depression. CONCLUSIONS: Family disruption and low socioeconomic status in early childhood increase the long-term risk for major depression. Reducing childhood disadvantages may be one avenue for prevention of depression. Identification of modifiable pathways linking aspects of the early childhood environment to adult mental health is needed to mitigate the long-term consequences of childhood disadvantage.

Adolescent↗

A multilevel study of neighborhoods and parent-to-child physical aggression: results from the project on human development in Chicago neighborhoods.

The majority of children in the United States experience parent-to-child physical aggression (PCPA), a disciplinary strategy out of favor with many experts. Several decades of research have documented a link between community characteristics and severe child maltreatment. None have taken a multilevel approach to study whether neighborhoods affect the amount of corporal punishment and/or physical abuse used by individual families. Data for this article come from the Project on Human Development in Chicago Neighborhoods and were analyzed using hierarchical linear modeling. An interval scale of PCPA was developed. Values obtained show that several neighborhood characteristics were associated with PCPA. Immigrant concentration remained significant after controlling for family composition. A cross-level interaction was found between neighborhood social networks and Hispanic race/ethnicity. The article's conclusion is that neighborhood characteristics may influence the amount of PCPA used by families. Neighborhood intervention strategies hold promise.

Adolescent↗

How beliefs about substance use differ by socio-demographic characteristics, individual experiences, and neighborhood environments among urban adolescents.

In this article, we tested a series of Item Response Theory (IRT) models to examine the individual and neighborhood variation in perceived risk along dimensions of substance use (alcohol, marijuana, and hard drugs) and usage patterns (light/experimental use, moderate use, heavy/regular use). Data were gathered from 2266 adolescents aged 9, 12, and 15 residing in 79 Chicago neighborhoods. Developmental patterns for age and amount of use were observed whereby older respondents rated alcohol and marijuana as less harmful compared to the younger respondents, but rated hard drugs as more harmful. Risk perceptions were found to be more closely tied to one's direct experience with drugs rather than a general constellation of beliefs. Neighborhood variation in risk perceptions was also observed for hard drugs and three patterns of use, controlling for characteristics of individual residents. Neighborhoods did not vary in risk perceptions toward alcohol use. Individual-level factors rather than characteristics of the neighborhoods explained the observed neighborhood variation in perceptions toward marijuana use. These findings illustrate the complex links between individual and contextual factors in the development of beliefs about the health risks associated with substance use.

Adolescent↗

Socioeconomic status in childhood and the lifetime risk of major depression.

BACKGROUND: Major depression occurs more frequently among people of lower socioeconomic status (SES) and among females. Although the focus of considerable investigation, the development of SES and sex differences in depression remains to be fully explained. In this study, we test the hypotheses that low childhood SES predicts an increased risk of adult depression and contributes to a higher risk of depression among females. METHODS: Participants were 1132 adult offspring of mothers enrolled in the Providence, Rhode Island site of the US National Collaborative Perinatal Project between 1959 and 1966. Childhood SES, indexed by parental occupation, was assessed at the time of participants' birth and seventh year. A lifetime history and age at onset of major depressive episode were ascertained via structured interviews according to diagnostic criteria. Survival analyses were used to model the likelihood of first depression onset as a function of childhood SES. RESULTS: Participants from lower SES backgrounds had nearly a twofold increase in risk for major depression compared to those from the highest SES background independent of childhood sociodemographic factors, family history of mental illness, and adult SES. Analyses of sex differences in the effect of childhood SES on adult depression provided modest support for the hypothesis that childhood SES contributes to adult sex differences in depression. CONCLUSIONS: Low SES in childhood is related to a higher risk of major depression in adults. Social inequalities in depression likely originate early in life. Further research is needed to identify the pathways linking childhood conditions to SES differences in the incidence of major depression.

Adult↗

Differences in onset and persistence of substance abuse and dependence among whites, blacks, and Hispanics.

OBJECTIVE: This article describes patterns of onset, persistence, and cessation of substance abuse among whites, blacks, and Hispanics that are masked in cross-sectional prevalence data. METHODS: The authors analyzed longitudinal data from a sample of 1,004 white, black, and Hispanic respondents from Chicago to investigate processes of onset, persistence, and cessation of substance abuse and dependence for two age cohorts, 15 and 18 at baseline and 17 and 20 at follow-up. RESULTS: The data show few racial or ethnic differences in the prevalence of alcohol and marijuana abuse and dependence at age 15. Rates of onset of alcohol abuse and dependence among whites between ages 15 and 17 were significantly higher than for blacks and Hispanics, and the rates of onset of marijuana abuse and dependence among blacks between ages 18 and 20 were significantly higher than for whites and Hispanics of the same age group. There were few significant differences among the three groups in the persistence rates of abuse and dependence. CONCLUSION: By age 20 the rates of marijuana abuse and dependence are significantly higher among blacks than among whites and Hispanics.

Adolescent↗

Disparities in health status and substance use: ethnicity and socioeconomic factors.

OBJECTIVE: This article reviews the literature on racial, ethnic, and socioeconomic disparities in morbidity and mortality, focusing on substance use and abuse. OBSERVATIONS: In most populations and societies, people of higher social position live longer and remain healthier than those of lower position. Disparities in morbidity and mortality across ethnic groups also exist. Mortality rates for African Americans are about 1.6 times higher than those for white, with much higher disparities for certain causes, such as HIV/AIDS and diabetes. Disparities also exist in the level of substance use and abuse. CONCLUSION: Racial and ethnic differences in health and health behaviors, including substance use and abuse, may partly reflect biological differences, but it is more likely that they can be explained largely by socioeconomic differences, cultural factors, and prejudice and discrimination, both institutional and individual.

Black or African American↗

Unsafe to play? Neighborhood disorder and lack of safety predict reduced physical activity among urban children and adolescents.

PURPOSE: Lack of physical activity is associated with increased risk of overweight and cardiovascular disease, conditions associated with lower socioeconomic status (SES). Associations between activity levels of urban youth and limited access to safe recreation areas in their neighborhoods of residence were investigated. DESIGN: Analyses of data from the Project on Human Development in Chicago Neighborhoods, a multilevel longitudinal study of families and communities, are reported. SETTING: Chicago, Illinois. SUBJECTS: Individual-level data were obtained from 1378 youth 11 to 16 years old and caregivers living in 80 neighborhood clusters. Neighborhood-level data were collected from 8782 community residents and videotapes of 15,141 block faces. MEASURES: Parental estimates of hours youth spent in recreational programming were used to estimate physical activity. A scale of residents' assessment of neighborhood safety for children's play was created; disorder measures came from videotaped observations. RESULTS: Physical activity averaged 2.7 hours/week (SD = 5.0), varying significantly across neighborhoods. Using hierarchical linear regression, SES, age, and male gender, but not body mass index, were independently associated with physical activity. Lower neighborhood safety and social disorder were significantly associated with less activity, controlling for demographics. CONCLUSIONS: One mechanism for reduced physical activity among youth may be the influence of unsafe neighborhoods. Neighborhood interventions to increase safety and reduce disorder may be efficacious in increasing physical activity, thereby reducing risk of overweight and cardiovascular disease.

Adolescent↗