This study examined whether civic engagement (CE) and social connectedness (SC) differ by sociodemographic characteristics and social determinants of health (SDOH). Baseline data were drawn from a rural community-randomized controlled trial (n = 2381). Sociodemographic characteristics included sex, age, race/ethnicity, marital status, education, employment, and income. SDOH measures included food insecurity, having a regular healthcare provider, housing instability, utility shutoffs, transportation access, and government assistance. CE measures included attitudes, behaviors, and mobilization, while SC measures included community health investment, social cohesion, and social networks. Bivariate associations were estimated using linear regression to assess relationships between CE and SC measures and sociodemographic and SDOH measures. Being married, college-educated, or employed were positively associated with multiple CE measures. SC measures were consistently higher among participants with greater educational attainment and lower among those experiencing food insecurity. Findings highlight persistent inequities in CE and SC across sociodemographic and SDOH factors within rural communities.

The IPUMS Multigenerational Longitudinal Panel (MLP) is a longitudinal population panel that links American censuses, surveys, administrative sources, and vital records spanning the period from 1850 to the present. This article explains the rationale for IPUMS MLP, outlines the design of the infrastructure, and describes the linking methods used to construct the panel. We then detail our plans for expansion and improvement of MLP over the next five years, including the incorporation of additional data sources, the development of a "linkage hub" to connect MLP with other major record linkage efforts, and the refinement of our technology and dissemination efforts. We conclude by describing a few early examples of MLP-based research.

Purpose: Smokers can spend a substantial amount on cigarettes, potentially constraining their ability to purchase food. We tested the association of smoking cessation and household food security. Methods: Using the Current Population Survey (2001–2019), we longitudinally linked the Tobacco Use Supplement and the Food Security Supplement (n = 71,278). Among adult smokers (n = 13,144), we used modified Poisson regression to model household food insecurity as a function of quit status (continuing smokers vs. recent quitters), adjusting for sex, age, household size, children in the household, and other household smokers. We also used multinomial logistic regression to examine more detailed food security status (high, marginal, low, very low). Results: The adjusted probability of household food insecurity at follow-up was 11% (95% CI: 8.7%–13%) for recent quitters and 20% (95% CI: 19%–21%) for continuing smokers. Continuing smokers had a lower adjusted probability of high food security (69% vs. 80%) and a higher adjusted probability of marginal (11% vs. 9.8%), low (12% vs. 7%), and very low food security (7.8% vs. 3.6%) compared to recent quitters. Conclusions: Cigarette cessation is associated with a lower risk of household food insecurity. Therefore, promoting tobacco cessation alongside food assistance and poverty reduction policies may help alleviate food insecurity.

The Collaborative Cohort of Cohorts for COVID-19 Research (C4R) is a national prospective study of adults at risk for coronavirus disease 2019 (COVID-19) comprising 14 established United States (US) prospective cohort studies. For decades, C4R cohorts have collected extensive data on clinical and subclinical diseases and their risk factors, including behavior, cognition, biomarkers, and social determinants of health. C4R will link this pre-COVID phenotyping to information on SARS-CoV-2 infection and acute and post-acute COVID-related illness. C4R is largely population-based, has an age range of 18-108 years, and broadly reflects the racial, ethnic, socioeconomic, and geographic diversity of the US. C4R is ascertaining severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and COVID-19 illness using standardized questionnaires, ascertainment of COVID-related hospitalizations and deaths, and a SARS-CoV-2 serosurvey via dried blood spots. Master protocols leverage existing robust retention rates for telephone and in-person examinations, and high-quality events surveillance. Extensive pre-pandemic data minimize referral, survival, and recall bias. Data are being harmonized with research-quality phenotyping unmatched by clinical and survey-based studies; these will be pooled and shared widely to expedite collaboration and scientific findings. This unique resource will allow evaluation of risk and resilience factors for COVID-19 severity and outcomes, including post-acute sequelae, and assessment of the social and behavioral impact of the pandemic on long-term trajectories of health and aging.

There is a longstanding debate about whether the fiscal and institutional arrangements for the provision of quality urban services should be more dispersed or concentrated. We contribute to the debate by exploring the link between fiscal arrangements and public service quality by compiling a unique panel dataset of the quality indicators for major U.S. urban park systems and their funding sources from different types of overlapping local jurisdictions. This article shows that a more dispersed fiscal arrangement among cities, counties, and special districts is negatively associated with the quality of urban park systems. We conclude the article by discussing possible mechanisms of why such a negative correlation between more dispersed fiscal arrangement and the quality of public services applies to shared amenities like urban parks services. The nature of public services seems to be the key to understanding this relationship.

Introduction: This study (1) provides annual population estimates of fatal and nonfatal injury incidence rates for older adults for 2004–2017; (2) determines if trends differ by whether the injury was fatal or nonfatal, a fall or nonfall injury, and for nonfatal injuries, minor or serious; and (3) investigates whether trends vary by age, sex, and race. Methods: This study used National Vital Statistics System and National Health Interview Survey data covering the population of adults aged ≥65 years for 2004–2017. Fatal injury incidence rates were estimated using negative binomial models; nonfatal injury incidence rates were estimated using Poisson models. All models compared overall risk and trend differences by year, age, sex, and race, and interactions between year and age, sex, and race. All analyses were conducted in 2019. Results: Fatal injury incidence was stable over time, but this apparent stability masked a 35% increase in fatal falls and a 17% decrease in fatal nonfall injuries. Increases in fall-related deaths were concentrated among those aged ≥85 years, men, and white older adults. The trend in fatal falls accelerated over time for those aged ≥85 years and white older adults. By contrast, there was a large increase in nonfatal injury incidence, occurring across all injury types. Nonfatal injury risk grew with age and was higher for women and white older adults, but trends did not vary by age, sex, or race. Conclusions: Large increases in fatal and nonfatal injuries underscore the urgency of national implementation of fall prevention programs and expanding fall prevention efforts to more general injury prevention.

Purpose The majority of research efforts centering on injury among older adults focus on fall-related injuries and short-term consequences of injury. Little is known about the long-term consequences of all-cause nonfatal injuries, including minor injuries. Using a recent, large, and nationally representative sample of the U.S. non-institutionalized civilian population, the current study examines whether older adults who sustained a nonfatal injury (serious and minor) have higher risk of long-term morbidity and mortality outcomes compared with noninjured seniors. Methods Linked National Health Interview Survey-Medical Expenditure Panel Survey (NHIS-MEPS) data were used to fit logistic and 2-part models to estimate associations between injury incidence and later injury, hospitalization incidence, and length of hospital stay during the 2.5 years following the NHIS interview among 16,109 older adults. Data from the linked National Health Interview Survey-National Death Index (NHIS-NDI) files were used to estimate a Cox proportional hazards model to examine the association between injury incidence and mortality for up to 11 years after the initial interview among 79,504 older adults. Results Relative to no injury, serious nonfatal injury was significantly associated with increased risk of another injury, hospitalization, and mortality. Minor injuries were significantly related to higher risk of later injury and mortality. Implications Because even minor injuries are strongly associated with increased risks of later injury and mortality, preventing injury among seniors may be an effective way to improve quality of life and reduce declines in functional capacity.

Objective To describe the cause and nature of injuries, and care-seeking behaviour following injury, among community-dwelling older adults. Methods We used 10years of the nationally representative Integrated Health Interview Series data, providing information on individual characteristics, cause and nature of injuries, and care-seeking behaviour for 3074 adults 65years of age and older. Univariate and bivariate analyses were used to evaluate overall patterns and test for group-level differences. Results Approximately 40% of injuries were characterised as hip fracture, head injury and/or other fracture, with the remaining 60% consisting of other, milder types of injuries like bruises, strains and sprains. Fifty-eight per cent of injuries required a visit to the emergency room or transportation via an emergency vehicle, and 19% required hospitalisation. Injuries sustained in a fall were more likely to be serious than those due to other reasons. Older women, those ages 80+, those living with others with no spouse or partner present and those with activities of daily living/instrumental activities of daily living disabilities were more vulnerable to serious injuries and serious injury consequences relative to other older adults. Conclusions Our results suggest that injuries, especially falls, are a pressing public health concern for the growing population of older adults. Injury prevention outreach should take extra measures to reach certain subgroups of older adults that have been identified as especially vulnerable. Because so many injuries are due to reasons other than falling and/or do not result in hospitalisation, more interventions should be designed for general injury prevention and outpatient settings.

Pursuant to passage of the Patient Protection and Affordable Care Act, the National Center for Health Statistics has enhanced the content of the National Health Interview Survey (NHIS)-the primary source of information for monitoring health and health care use of the US population at the national level-in several key areas and has positioned the NHIS as a source of population health information at the national and state levels. We review recent changes to the NHIS that support enhanced health reform monitoring, including new questions and response categories, sampling design changes to improve state-level analysis, and enhanced dissemination activities. We discuss the importance of the NHIS, the continued need for state-level analysis, and suggestions for future consideration.

We use injury-level data from the 1997-2013 Integrated Health Interview Series (IHIS) to describe the prevalence of injuries, causes of injuries, and where they occurred among community-dwelling elders. We also describe the outcomes of these injuries, in terms of whether elders were hospitalized and how many days of work were lost due to injury.

Since the modern era of cancer chemotherapy that began in the mid-1940s, survival rates for children afflicted with cancer have steadily improved from 10% to current rates that approach 80% (60). Unfortunately, many long-term survivors of pediatric cancer develop chemotherapy-related health effects; 25% are afflicted with a severe or life-threatening medical condition, with cardiovascular disease being a primary risk (96). Childhood cancer survivors have markedly elevated incidences of stroke, congestive heart failure (CHF), coronary artery disease, and valvular disease (96). Their cardiac mortality is 8.2 times higher than expected (93). Anthracyclines are a key component of most curative chemotherapeutic regimens used in pediatric cancer, and approximately half of all childhood cancer patients are exposed to them (78). Numerous epidemiologic and observational studies have linked childhood anthracycline exposure to an increased risk of developing cardiomyopathy and CHF, often decades after treatment. The...

Background Potentially harmful workplace conditions have been linked to occupationally-related illness and injury, costing billions of dollars in health care and lost wages. This study compares workers in the same jobs to see whether demographic differences in exposures persist. Methods Data were from the 2010 National Health Interview Survey. Descriptive analyses and logistic regression models controlling for job assessed differences in three exposures: 1) skin contact with chemicals, 2) vapors, gas, dust, and fumes, and 3) second-hand smoke among non-smokers. Results Comparing workers in the same jobs, women and college graduates experienced a lower risk of exposure. White workers experienced the highest risks of exposure, except for the heightened risk of second-hand smoke exposure faced by black non-smokers. Conclusion Disparities in exposure to chemicals, vapors, and second-hand smoke persist by sex, race/ethnicity, and educational attainment, even within the same jobs. Workplace policies should ensure safety equally for all employees.

Although grade retention may be consequential for a number of important educational and socioeconomic outcomes, we know surprisingly little about the actual rate at which students are made to repeat grades. We build on Hauser, Frederick, and Andrew's (2007) measure of grade retention using data from the 1995 through 2010 Current Population Surveys. We make technical improvements to their measure; provide more recent estimates; and validate the measure against external criteria. Our measure describes large disparities in grade retention rates by sex, race/ethnicity, geographic locale, and students' socioeconomic circumstances. However, both absolute retention rates and disparities in retention rates have declined markedly since 2005. We conclude by describing how our measures might be used to model the impact of economic and policy contexts on grade retention rates.

Data from the Current Population Survey (CPS) are rarely analyzed in a way that takes advantage of the CPS's longitudinal design. This is mainly because of the technical difficulties associated with linking CPS files across months. In this paper, we describe the method we are using to create unique identifiers for all CPS person and household records from 1989 onward. These identifiers-available along with CPS basic and supplemental data as part of the on-line Integrated Public Use Microdata Series (IPUMS)-make it dramatically easier to use CPS data for longitudinal research across any number of substantive domains. To facilitate the use of these new longitudinal IPUMS-CPS data, we also outline seven different ways that researchers may choose to link CPS person records across months, and we describe the sample sizes and sample retention rates associated with these seven designs. Finally, we discuss a number of unique methodological challenges that researchers will confront when analyzing data from linked CPS files.

Studies of trends in disability prevalence focus on observed declines in disability prevalence among the population of retirement age or elderly adults, but fail to address whether this trend has also affected U.S. children and adolescents. The goals of this study are to 1) provide new evidence on trends in disability among children between the ages of 6 and 17; and 2) test potential explanations for the observed trends in youth disability. Using a pooled sample of the 1998-2011 National Health Interview Surveys, I first present annual population estimates of childhood disability prevalence over the 1998-2011 time period. I then decompose these trends into the parts attributable to changes in the sociodemographic composition of youths and changes in the relationship between sociodemographic characteristics and the probability of disability.

Hysterectomies are the second most common surgery performed on women in the United States, and most are done for elective reasons. Although women with disabilities appear to have an increased risk of undergoing the procedure, little research has evaluated the relationship between disability and hysterectomy.

Over the past forty years, the U.S. has seen the passage of several significant pieces of legislation aimed at improving educational and employment outcomes among people with disabilities. Current trends show that, while the share of working-aged adults with disabilities who have obtained at least some post-secondary education has doubled, the share who are working has fallen sharply. This study examines whether cohorts of young adults with disabilities -- that is, those who have come of age under different sets of policy and institutional regimes -- demonstrate important variations in education and employment outcomes that period trends disguise.

Women immigrating to the United States from the Former Soviet Union (FSU) were expected to incorporate seamlessly into the US labor force because of their strong educational and professional backgrounds. Using 2000 Census data, we find that FSU women were less successful than both FSU men and other non-Hispanic white female immigrants. After controlling for other factors, FSU women were more likely to rely on public assistance and less likely to be employed. If employed, they worked in less prestigious occupations and earned much less. These findings draw attention to the particular difficulties of incorporation of this wave of relatively advantaged immigrants.