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Open Access Publications from the University of California

Scholarly Works (11 results)

  • Thesis
  • Peer Reviewed
UC Berkeley Electronic Theses and Dissertations (2020)

The physiological, biological, and metabolic impacts of food insecurity experienced in childhood may influence health throughout the lifecourse. In this three-paper dissertation, we explore whether a cohort of Black and White women’s experiences of childhood food insecurity are associated with their weight in young adulthood, their weight in midlife, as well as the weight of their children. In addition, we also investigate whether a direct federal income transfer program targeting families with children can improve food insecurity parameters in Canada, particularly among economically vulnerable groups.

Paper 1 and Paper 2 derive data from one site of the National Heart, Lung and Blood Institute Growth and Health Study (NGHS). NGHS is a longitudinal cohort that recruited 883 9-10-year-old Black and White girls in 1987/8 from Contra Costa County, California. Participants provided health, lifestyle, and anthropomorphic data from annual clinic visits and questionnaires for ten years (through 1997/8). From 2015-2019, researchers re-recruited 624 original participants (ages 36-43) and 559 of their children (boys and girls, ages 2-17) to participate in a second wave, which implemented a retrospective measure to gauge the frequency in which the quantity and diversity of their available food was impacted by resource shortages from ages 5-11. We used responses to characterize experiences of childhood food insecurity.

Paper 1 assesses the relationship between childhood food insecurity and Body Mass Index (BMI) in young adulthood (age 18-20) and midlife (age 36-43) among Black and White women. We identified a higher average BMI among Black women reporting moderate childhood food insecurity than Black or White women reporting full food security in young adulthood (N=593) that abated by midlife. As well, a substantially larger average BMI among White women reporting severe childhood food insecurity compared to White women reporting full food security during midlife (N=617). These findings suggest that childhood food insecurity may have a lasting association with weight status and that racial differences and age moderate the relationship between childhood food insecurity and BMI.

Paper 2 investigates whether maternal childhood food insecurity is associated with odds of overweight/obesity among offspring (N=483), presenting findings for effect modification by age (continuous), current household food security status (food secure vs. food insecure) and maternal race (Black or White). We found no significant difference in the odds of overweight/obesity among most levels of food insecurity, but significantly lower odds among children whose mothers reported moderate child food insecurity. This relationship was strongest among children currently living in food secure homes, with White mothers, and between the ages of 2-5, respectively. We believe that mothers’ desire to protect their children from their own adverse experiences may serve as a protective factor against food and dietary behaviors that may increase overweight/obesity risk.

Paper 3 assesses whether the roll-out of the Canada Child Benefit (CCB), a federal direct income transfer program, offered protection against food insecurity among Canadian households with children among three groups with different income thresholds: households reporting any income (N=41,455), the median income or less (N=18,191) and the Low Income Measure (LIM) or less (N=7,579). Data are derived from the Canadian Community Health Survey (CCHS), an annual, cross-sectional study that collects health, sociodemographic, and health-related information at the sub-provincial level from a representative sample of Canadians.

Households with children experienced greater drops in the likelihood of experiencing severe food insecurity following CCB than those without, most dramatically among those reporting the LIM or less, which suggests that CCB disproportionately benefited families most susceptible to food insecurity. As well, that food insecurity may be impacted by even modest changes to economic circumstance, speaking to the potential of income transfers to help people meet their basic needs.

    Cover page: Childhood food insecurity: exploring long-term impacts and a public policy mitigation strategy
    • Article
    • Peer Reviewed
    International Journal of Comparative Psychology, Volume 32 (2019)

    The field of psychology has witnessed an increase in its reliance on empiricism to the point that many researchers operate with a complete disregard for the role of philosophy in their pursuit of knowledge. The resultant segmentation of the field and decline in such important areas as comparative psychology can be attributed to this trend, indicating the need for the role of both philosophical and scientific knowledge to be rightly applied and understood. A return to a proper utilization of philosophy in guiding empirical questions and interpreting results is offered as a means of revitalizing the field of comparative psychology. The philosophical approach of Aristotle and Thomas Aquinas is discussed as a means to do so, as it provides a valuable perspective in guiding research and enabling the scientist to interpret results in an integrated and informative manner, whereby the phenotypic comparisons of humans and non-humans can be understood coherently.

     

      Cover page: Aristotelean-Thomistic Approach of Comparative PsychologyCreative Commons 'BY' version 4.0 license
      • Article
      • Peer Reviewed
      UC Berkeley Previously Published Works (2023)
      OBJECTIVE: Bans on evictions were implemented to reduce the spread of COVID-19 and to protect vulnerable populations during a public health crisis. Our objective was to examine how three bans on eviction enforcement impacted eviction filings from March 2020 through January 2022 in Ontario, Canada. METHODS: Data were derived from eviction application records kept by the Ontario Landlord and Tenant Board. We used segmented regression analysis to model changes in the average weekly filing rates for evictions due to non-payment of rent (L1 filings) and reasons other than non-payment of rent (L2 filings). RESULTS: The average number of weekly L1 and L2 applications dropped by 67.5 (95% CI: 55.2, 79.9) and 31.7 (95% CI: 26.7, 36.6) filings per 100,000 rental dwellings, respectively, following the first ban on eviction enforcement (p < 0.0001). Notably, they did not fall to zero. Level changes during the second and third bans were insubstantial and slope changes for L2 applications varied throughout the study period. The L1 filing rate appeared to increase towards the end of the study period (slope change: 1.3; 95% CI: 0.1, 2.6; p = 0.0387). CONCLUSION: Our findings suggest that while the first ban on eviction enforcement appeared to substantially reduce filing rates, subsequent bans were less effective and none of them eliminated eviction filings altogether. Enacting upstream policies that tackle the root causes of displacement would better equip jurisdictions during future public health emergencies.
        Cover page: Eviction filings during bans on enforcement throughout the COVID-19 pandemic: an interrupted time series analysis.
        • Article
        • Peer Reviewed
        UC San Francisco Previously Published Works (2023)

        Background

        Evidence on the health impacts of social conditions has led US healthcare systems to consider identifying and addressing social adversity-e.g. food, housing, and transportation insecurity-in care delivery settings. Social screening is one strategy being used to gather patient information about social circumstances at the point of care. While several recent studies describe the rapid proliferation of social screening activities, little work has explored either why or how to implement social screening in clinical settings. Our study objectives were to assess diverse healthcare stakeholder perspectives on both the rationale for social screening and evidence needed to inform practice and policy-relevant implementation decisions.

        Methods

        We convened five focus groups with US experts representing different stakeholder groups: patient advocates, community-based organizations, healthcare professionals, payers, and policymakers. In total, 39 experts participated in approximately 90-minute long focus groups conducted between January-March 2021. A inductive thematic analysis approach was used to analyze discussions.

        Results

        Three themes emerged from focus groups, each reflecting the tension between the national enthusiasm for screening and existing evidence on the effectiveness and implementation of screening in clinical settings: (1) ambiguity about the rationale for social screening; (2) concerns about the relavence of screening tools and approaches, particularly for historically marginalized populations; (3) lack of clarity around the resources needed for implementation and scaling.

        Conclusion

        While participants across groups described potential benefits of social screening, they also highlighted knowledge gaps that interfered with realizing these benefits. Efforts to minimize and ideally resolve these knowledge gaps will advance future social screening practice and policy.
          Cover page: Stakeholder perspectives on social screening in US healthcare settings
          • Article
          • Peer Reviewed
          UC Berkeley Previously Published Works (2022)

          Background

          The COVID-19 pandemic and efforts to mitigate transmission resulted in sudden and widespread socioeconomic disruptions including school and child care closures, unemployment and underemployment, and housing precarity. Understanding the extent to which these disruptions may have contributed to adverse health outcomes is critical for establishing policy priorities that can mitigate further harm.

          Methods

          We explored the associations between pandemic-related child care, employment, and housing disruptions with depressive symptoms, self-rated health, and food security status among a sample of economically disadvantaged and racially diverse female caregivers of young children (n=464). Data were derived from the Assessing California Communities' Experiences with Safety Net Supports (ACCESS) study, which conducted survey-based interviews with California caregivers with low-income from August 2020 - May 2021. We implemented a series of multivariable Poisson regressions with robust standard errors to assess the potency of each exposure, independently and within the context of one another.

          Results

          Most caregivers experienced disruptions to child care (70%) and employment (63%); few experienced major housing disruptions (8%). Women that experienced child care and housing disruptions had greater depressive symptoms, lower self-rated health, and greater food insecurity, although the relationships for housing and depressive symptoms were modified by the timing of participants' interviews. Employment disruptions were not associated with any of the examined adverse health outcomes.

          Conclusion

          In the wake of socioeconomic stressors brought about by the COVID-19 pandemic, attending to structural deficits in the child care system and increasing housing supports may be critical for protecting the health of caregivers.
            Cover page: Pandemic-related socioeconomic disruptions and adverse health outcomes: a cross-sectional study of female caregivers
            • Article
            • Peer Reviewed
            UC San Francisco Previously Published Works (2024)

            Background

            Health and social sector organizations are increasingly working together to mitigate socioeconomic adversity within their communities. We sought to learn about the motivations, experiences, and perspectives of organizations engaged in these collaborations.

            Methods

            We conducted semi-structured, 60-minute interviews with 34 leaders from 25 health and social sector organizations between January-April 2021. Interviews explored motivations, benefits and challenges, and ways in which health sector organizations can most effectively address community-level socioeconomic adversity. Interviews were audio recorded and transcribed; themes were coded using Dedoose software.

            Results

            Partnerships were primarily motivated by mission-driven organizations and key health sector leaders who were interested in addressing root causes of poor health; policies such as certificate of need laws and value-based care incentives that aligned community-level investments with health sector organizations' financial interests facilitated these efforts. While partnerships were mostly regarded as mutually beneficial ways to increase impact (for the health sector) and resource access (for the social sector), social sector organizations voiced frustrations regarding the outsized expectations, unsustained interest, and lack of partnership from their health sector collaborators. Despite these frustrations, both health and social sector interviewees supported the health sector's continued involvement in community-level socioeconomic initiatives and expansion of policy and systems efforts.

            Conclusions

            Cross-sector, community-level socioeconomic initiatives were mutually beneficial, but social sector organizations experienced more frustrations. Policy and organizational changes within the health sector can further mobilize and sustain support for these efforts.
              Cover page: “I would love to see these big institutions… throwing their weight around”: qualitative findings regarding health and social sector collaborations to address community-level socioeconomic adversity
              • Article
              • Peer Reviewed
              LBL Publications (2006)

              Centrosomes are small organelles that organize the mitotic spindle during cell division and are also involved in cell shape and polarity. Within epithelial tumors, such as breast cancer, and some hematological tumors, centrosome abnormalities (CA) are common, occur early in disease etiology, and correlate with chromosomal instability and disease stage. In situ quantification of CA by optical microscopy is hampered by overlap and clustering of these organelles, which appear as focal structures. CA has been frequently associated with Tp53 status in premalignant lesions and tumors. Here we describe an approach to accurately quantify centrosomes in tissue sections and tumors. Considering proliferation and baseline amplification rate the resulting population based ratio of centrosomes per nucleus allow the approximation of the proportion of cells with CA. Using this technique we show that 20-30 percent of cells have amplified centrosomes in Tp53 null mammary tumors. Combining fluorescence detection, deconvolution microscopy and a mathematical algorithm applied to a maximum intensity projection we show that this approach is superior to traditional investigator based visual analysis or threshold-based techniques.

                Cover page: Intensity-based signal separation algorithm for accurate quantification of clustered centrosomes in tissue sections
                • Article
                • Peer Reviewed
                UC San Francisco Previously Published Works (2024)

                Introduction

                Although adverse childhood experiences (ACEs) have been positively associated with adiposity, few studies have examined long-term race-specific ACE-BMI relationships.

                Methods

                A Black and White all-women cohort (N=611; 48.6% Black) was followed between 1987 and 1997 from childhood (ages 9-10 years) through adolescence (ages 19-20 years) to midlife (ages 36-43 years, between 2015 and 2019). In these 2020-2022 analyses, the interaction between race and individual ACE exposures (physical abuse, sexual abuse, household substance abuse, multiple ACEs) on continuous BMI at ages 19-20 years and midlife was evaluated individually through multivariable linear regression models. Stratification by race followed as warranted at α=0.15.

                Results

                Race only modified ACE-BMI associations for sexual abuse. Among Black women, sexual abuse was significantly associated with BMI (Badjusted=3.24, 95% CI=0.92, 5.57) at ages 19-20 years and marginally associated at midlife (Badjusted=2.37, 95% CI= -0.62, 5.35); among White women, corresponding associations were null. Overall, having ≥2 ACEs was significantly associated with adolescent BMI (Badjusted=1.47, 95% CI=0.13, 2.80) and was marginally associated at midlife (Badjusted=1.45, 95% CI= -0.31, 3.22). This was similarly observed for physical abuse (adolescent BMI: Badjusted=1.23, 95% CI= -0.08, 2.54; midlife BMI: Badjusted=1.03, 95% CI= -0.71, 2.78), but not for substance abuse.

                Conclusions

                Direct exposure to certain severe ACEs is associated with increased BMI among Black and White women. It is important to consider race, ACE type, and life stage to gain a more sophisticated understanding of ACE-BMI relationships. This knowledge can help strengthen intervention, prevention, and policy efforts aiming to mitigate the impacts of social adversities and trauma on persistent cardiometabolic health disparities over the lifecourse.
                  Cover page: Adverse Childhood Experiences and BMI: Lifecourse Associations in a Black–White U.S. Women CohortCreative Commons 'BY-NC-ND' version 4.0 license
                  • Article
                  • Peer Reviewed
                  UC Berkeley Previously Published Works (2023)

                  Purpose

                  The National Heart, Lung and Blood Institute Growth and Health Study (NGHS) prospectively collected anthropometric, biospecimens, clinical, health behaviour and psychosocial measures associated with cardiovascular disease from childhood to young adulthood. The aim of the current study was to assess the impact of stress, dysregulated eating and social genomic biomarkers on cardiometabolic risk factors among the original participants now in midlife and their children.

                  Participants

                  Beginning in 1987-1988, NGHS recruited black and white girls (age 9-10 years) from socioeconomically diverse backgrounds from from three sites: Cincinnati, Ohio; Washington, DC; and Western Contra Costa County, California (N=2379) and followed them for 10 years. The study maintained an 89% retention rate. The current study is 30 years after the start of the original study and focused on the participants of California (n=887) and their children aged 2-17 years. We re-enrolled 624 of 852 eligible participants (73%): 49.2% black and 50.8% white. The mean age was 39.5 years. Among the 645 eligible biological children, 553 were enrolled; 49% black and 51% white, with 51.5% girls and 48.5% boys. The mean age was 9.3 years.

                  Findings to date

                  Longitudinal analysis of adolescent drive for thinness predicted higher scores for drive for thinness during midlife, which was indirectly associated with greater adult body mass index through adult drive for thinness. Latent trajectory modelling of adolescent growth over 10 years found that women with persistently high weight trajectory had twice the odds of having children who met the definition for obesity compared with the persistently normal group, adjusting for adult weight.

                  Future plans

                  New studies on neighbourhood socioeconomic status, food insecurity and additional biomarkers of chronic stress, microbiome and accelerated ageing (ie, telomere length and epigenetic clock) are underway. We are developing a 10-year follow-up to understand changes in ageing biomarkers of the participants and their children.

                  Trial registration number

                  NCT00005132.
                    Cover page: Cohort profile: the longitudinal National Growth and Health Study (NGHS) of black and white girls from Northern California tracking how behavioural and psychosocial risk factors predict cardiovascular risk and biological ageing in midlife and in offspring
                    • Article
                    • Peer Reviewed
                    UC San Francisco Previously Published Works (2023)

                    Background

                    Mothers and their children demonstrate dyadic synchrony of hypothalamic-pituitary-adrenal (HPA) axis function, likely influenced by shared genetic or environmental factors. Although evidence has shown that chronic stress exposure has physiologic consequences for individuals-including on the HPA axis-minimal research has explored how unmet social needs such as food and housing instability may be associated with chronic stress and HPA axis synchrony in mother-child dyads.

                    Methods

                    We conducted a secondary analysis of data from 364 mother-child dyads with low-income recruited during a randomized trial conducted in an urban pediatric clinic. We used latent profile analysis (LPA) to identify subgroups based on naturally occurring patterns of within-dyad hair cortisol concentration (HCC). A logistic regression model predicted dyadic HCC profile membership as a function of summative count of survey-reported unmet social needs, controlling for demographic and health covariates.

                    Results

                    LPA of HCC data from dyads revealed a 2-profile model as the best fit. Comparisons of log HCC for mothers and children in each profile group resulted in significantly "higher dyadic HCC" versus "lower dyadic HCC" profiles (median log HCC for mothers: 4.64 vs 1.58; children: 5.92 vs 2.79, respectively; P < .001). In the fully adjusted model, each one-unit increase in number of unmet social needs predicted significantly higher odds of membership in the higher dyadic HCC profile when compared to the lower dyadic HCC profile (odds ratio  =  1.13; 95% confidence interval [1.04-1.23]; P  =  .01).

                    Conclusion

                    Mother-child dyads experience synchronous patterns of physiologic stress, and an increasing number of unmet social needs is associated with a profile of higher dyadic HCC. Interventions aimed at decreasing family-level unmet social needs or maternal stress are, therefore, likely to affect pediatric stress and related health inequities; efforts to address pediatric stress similarly may affect maternal stress and related health inequities. Future research should explore the measures and methods needed to understand the impact of unmet social needs and stress on family dyads.
                      Creative Commons 'BY-NC' version 4.0 license
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