Healthy Messaging
The role of positive emotion in harmful health behavior: Implications for theory and public health campaigns
Ke Wang et al.
Proceedings of the National Academy of Sciences, 9 July 2024
Abstract:
Meta-analyses have concluded that positive emotions do not reduce appetitive risk behaviors (risky behaviors that fulfill appetitive or craving states, such as smoking and excessive alcohol use). We propose that this conclusion is premature. Drawing on the Appraisal Tendency Framework and related theories of emotion and decision-making, we hypothesized that gratitude (a positive emotion) can decrease cigarette smoking, a leading cause of premature death globally. A series of multimethod studies provided evidence supporting our hypothesis (collective N = 34,222). Using nationally representative US samples and an international sample drawn from 87 countries, Studies 1 and 2 revealed that gratitude was inversely associated with likelihood of smoking, even after accounting for numerous covariates. Other positive emotions (e.g., compassion) lacked such consistent associations, as expected. Study 3, and its replication, provided further support for emotion specificity: Experimental induction of gratitude, unlike compassion or sadness, reduced cigarette craving compared to a neutral state. Study 4, and its replication, showed that inducing gratitude causally increased smoking cessation behavior, as evidenced by enrollment in a web-based cessation intervention. Self-reported gratitude mediated the effects in both experimental studies. Finally, Study 5 found that current antismoking messaging campaigns by the US Centers for Disease Control and Prevention primarily evoked sadness and compassion, but seldom gratitude. Together, our studies advance understanding of positive emotion effects on appetitive risk behaviors; they also offer practical implications for the design of public health campaigns.
COVID-19 Infections and Cognitive Function
Bas Weerman et al.
University of Southern California Working Paper, May 2024
Design: We use the nationally representative probability-based Understanding America Study (UAS) of approximately 9,600 respondents, which has regularly elicited measures of cognitive function since 2015. Collection of cognition measures took place before and during the pandemic, solely determined by a two-year cycle depending on when respondents joined the study. In addition, between March 10, 2020, and July 20, 2021, 8554 study members have participated in a COVID-19 tracking survey (29 waves total), regularly answering questions about their experiences during the pandemic, including symptoms and whether they have been infected. We tested whether cognitive change differed between respondents who experienced COVID-19 and those who did not.
Results: All six cognitive tests, measured before January 1, 2020, are significant predictors of infection status during the pandemic. The two subjective cognition measures show no significant association with infection. We replicate earlier cross-sectional findings of a negative association between COVID-19 infection and subsequent cognition. However, once accounting for baseline cognition, no significant associations are found for either the tests or the subjective measures. For three of the six cognitive tests the effects change signs.
Pandemic Stringency Measures and Hospital Admissions for Eating Disorders
Nadia Roumeliotis et al.
JAMA Pediatrics, forthcoming
Design, Setting, and Participants: This Canadian population-based cross-sectional study was performed from April 1, 2016, to March 31, 2023, and was divided into pre–COVID-19 and COVID-19–prevalent periods. Data were provided by the Canadian Institute for Health Information and the Institut National d’Excellence en Santé et Services Sociaux for all Canadian provinces and territories. Participants included all children and adolescents aged 6 to 20 years.
Results: During the study period, there were 11 289 hospitalizations for eating disorders across Canada, of which 8726 hospitalizations (77%) were for females aged 12 to 17 years. Due to low case counts in other age-sex strata, the time series analysis was limited to females within the 12- to 17-year age range. Among females aged 12 to 17 years, a 10% increase in stringency was associated with a significant increase in hospitalization rates in Quebec (adjusted rate ratio [ARR], 1.05; 95% CI, 1.01-1.07), Ontario (ARR, 1.05; 95% CI, 1.03-1.07), the Prairies (ARR, 1.08; 95% CI, 1.03-1.13), and British Columbia (ARR, 1.11; 95% CI, 1.05-1.16). The excess COVID-19–prevalent period hospitalizations were highest at the 1-year mark, with increases in all regions: Quebec (RR, 2.17), Ontario (RR, 2.44), the Prairies (RR, 2.39), and British Columbia (RR, 2.02).
Unintended Consequences of Life-Saving Pharmaceutical Innovations: How HAART Led to the Resurgence of Syphilis
David Beheshti & Scott Cunningham & Nir Eilam
Baylor University Working Paper, June 2024
Abstract:
Syphilis, a sexually transmitted infection that can lead to serious health complications, was almost eliminated in the United States by 2000. But since then, its incidence began to increase, recently reaching a 60-year peak. We suggest that the introduction of the highly active antiretroviral therapy (HAART) drug regimen, which transformed HIV into a manageable chronic disease, is partly responsible, as HIV+ and HIV-individuals altered their sexual behavior after the introduction of HAART. To test this empirically, we exploit variation in HAART takeup based on spatial variation in pre-HAART AIDS prevalence, sex, and time in a triple differences framework. We find that a one standard deviation increase in the pre-HAART AIDS prevalence rate led to a 21 percent increase in the syphilis incidence rate, and that in the absence of HAART, there would have been 78 percent fewer syphilis cases between 1996 and 2006. These results highlight the need to consider unintended consequences that could stem from behavioral changes following the introduction of life-saving medical innovations.
Advantageous early-life environments cushion the genetic risk for ischemic heart disease
Samuel Baker et al.
Proceedings of the National Academy of Sciences, 2 July 2024
Abstract:
In one of the first papers on the impact of early-life conditions on individuals’ health in older age, Barker and Osmond [Lancet, 327, 1077–1081 (1986)] show a strong positive relationship between infant mortality rates in the 1920s and ischemic heart disease in the 1970s. We merge historical data on infant mortality rates to 370,000 individual records in the UK Biobank using information on local area and year of birth. We replicate the association between the early-life infant mortality rate and later-life ischemic heart disease in our sample. We then go “beyond Barker,” by showing considerable genetic heterogeneity in this association that is robust to within-area as well as within-family analyses. We find no association between the polygenic index and heart disease in areas with the lowest infant mortality rates, but a strong positive relationship in areas characterized by high infant mortality. These findings suggest that advantageous environments can cushion one’s genetic disease risk.
The Flynn Effect and Cognitive Decline Among Americans Aged 65 Years and Older
Yun Zhang et al.
Psychology and Aging, August 2024, Pages 457–466
Abstract:
To contribute to our understanding of cohort differences and the Flynn effect in the cognitive decline among older Americans, this study aims to compare rates of cognitive decline between two birth cohorts within a study of older Americans and to examine the importance of medical and demographic confounders. Analyses used data from the National Health and Aging Trends Study (2011–2019), which recruited older Americans in 2011 and again in 2015 who were then followed for 5 years. We employed mixed-effect models to examine the linear and quadratic main and interaction effects of year of birth while adjusting for covariates such as annual round, sex/gender, education, race/ethnicity, heart disease, hypertension, diabetes, test unfamiliarity, and survey design. We analyzed data from 11,167 participants: 7,325 from 2011 to 2015 and 3,842 from 2015 to 2019. The cohort recruited in 2015 was born, on average, 5.33 years later than that recruited in 2011 and had higher functioning than the one recruited in 2011 across all observed cognitive domains that persisted after adjusting for covariates. In multivariable-adjusted analyses, a 1-year increase in year of birth was associated with increased episodic memory (β = 0.045, SE = 0.001, p < .001), orientation (β = 0.034, SE = 0.001, p < .001), and executive function (β = 0.036, SE = 0.001, p < .001). Participants born 1 year later had slower rates of decline in episodic memory (β = 0.004, SE = 0.000, p < .001), orientation (β = 0.003, SE = 0.000, p < .001), and executive function (β = 0.001, SE = 0.000, p = .002). Additionally, sex/gender modified this relationship for episodic memory (−0.007, SE = 0.002, p < .001), orientation (−0.005, SE = 0.002, p = .008), and executive function (−0.008, SE = 0.002, p < .001). These results demonstrate the persistence of the Flynn effect in old age across cognitive domains and identified a deceleration in the rate of cognitive decline across cognitive domains.