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1. The effect of food insecurity during college on graduation and type of degree attained: evidence from a nationally representative longitudinal survey

   https://doi.org/10.1017/S1368980021003104  

   Wolfson, Julia A ; Insolera, Noura ; Cohen, Alicia J ; Leung, Cindy W ( July 2021 , Public Health Nutrition)

   Abstract Objective: To examine the effect of food insecurity during college on graduation and degree attainment. Design: Secondary analysis of longitudinal panel data. We measured food insecurity concurrent with college enrollment using the 18-question USDA Household Food Security Survey Module. Educational attainment was measured in 2015-2017 via two questions about college completion and highest degree attained. Logistic and multinomial-logit models adjusted for sociodemographic characteristics were estimated. Setting: United States (US) Participants: A nationally representative, balanced panel of 1,574 college students in the US in 1999-2003 with follow-up through 2015-2017 from the Panel Study of Income Dynamics. Results: In 1999-2003, 14.5% of college students were food insecure and were more likely to be older, non-White, and first-generation students. In adjusted models, food insecurity was associated with lower odds of college graduation (OR 0.57, 95% CI: 0.37, 0.88, p=0.01) and lower likelihood of obtaining a Bachelor’s degree (RRR 0.57 95% CI: 0.35, 0.92, p=0.02) or graduate/professional degree (RRR 0.39, 95% CI: 0.17, 0.86, p=0.022). These associations were more pronounced among first-generation students. 47.2% of first-generation students who experienced food insecurity graduated from college; food insecure first-generation students were less likely to graduate compared to first-generation students who were food secure (47.2% vs. 59.3%, p=0.020) and non-first-generation students who were food insecure (47.2% vs. 65.2%, p=0.037). Conclusions: Food insecurity during college is a barrier to graduation and higher degree attainment, particularly for first-generation students. Existing policies and programs that help mitigate food insecurity should be expanded and more accessible to the college student population. 

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2. How Are SNAP Benefits Spent? Evidence from a Retail Panel

   https://doi.org/10.1257/aer.20170866  

   Hastings, Justine ; Shapiro, Jesse M. ( December 2018 , American Economic Review)

   null (Ed.)

   We use a novel retail panel with detailed transaction records to study the effect of the Supplemental Nutrition Assistance Program (SNAP) on household spending. We use administrative data to motivate three approaches to causal inference. The marginal propensity to consume SNAP-eligible food (MPCF) out of SNAP benefits is 0.5 to 0.6. The MPCF out of cash is much smaller. These patterns obtain even for households for whom SNAP benefits are economically equivalent to cash because their benefits are below their food spending. Using a semiparametric framework, we reject the hypothesis that households respect the fungibility of money. A model with mental accounting can match the facts. (JEL D12, H75, I12, I18, I38) 

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3. Intergenerational Associations between Parents’ and Children’s Adverse Childhood Experience Scores

   https://doi.org/10.3390/children8090747  

   Schickedanz, Adam ; Escarce, José J. ; Halfon, Neal ; Sastry, Narayan ; Chung, Paul J. ( September 2021 , Children)

   Background: Adverse childhood experiences (ACEs) are stressful childhood events associated with behavioral, mental, and physical illness. Parent experiences of adversity may indicate a child’s adversity risk, but little evidence exists on intergenerational links between parents’ and children’s ACEs. This study examines these intergenerational ACE associations, as well as parent factors that mediate them. Methods: The Panel Study of Income Dynamics (PSID) 2013 Main Interview and the linked PSID Childhood Retrospective Circumstances Study collected parent and child ACE information. Parent scores on the Aggravation in Parenting Scale, Parent Disagreement Scale, and the Kessler-6 Scale of Emotional Distress were linked through the PSID 1997, 2002, and 2014 PSID Childhood Development Supplements. Multivariate linear and multinomial logistic regression models estimated adjusted associations between parent and child ACE scores. Results: Among 2205 parent-child dyads, children of parents with four or more ACEs had 3.25-fold (23.1% [95% CI 15.9–30.4] versus 7.1% [4.4–9.8], p-value 0.001) higher risk of experiencing four or more ACEs themselves, compared to children of parents without ACEs. Parent aggravation, disagreement, and emotional distress were partial mediators. Conclusions: Parents with higher ACE scores are far more likely to have children with higher ACEs. Addressing parenting stress, aggravation, and discord may interrupt intergenerational adversity cycles. 

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4. Factors Associated With Nonadherence to Lung Cancer Screening Across Multiple Screening Time Points

   https://doi.org/10.1001/jamanetworkopen.2023.15250  

   Lin, Yannan ; Liang, Li-Jung ; Ding, Ruiwen ; Prosper, Ashley Elizabeth ; Aberle, Denise R. ; Hsu, William ( May 2023 , JAMA Network Open)

   Screening with low-dose computed tomography (CT) has been shown to reduce mortality from lung cancer in randomized clinical trials in which the rate of adherence to follow-up recommendations was over 90%; however, adherence to Lung Computed Tomography Screening Reporting & Data System (Lung-RADS) recommendations has been low in practice. Identifying patients who are at risk of being nonadherent to screening recommendations may enable personalized outreach to improve overall screening adherence.

   To identify factors associated with patient nonadherence to Lung-RADS recommendations across multiple screening time points.

   This cohort study was conducted at a single US academic medical center across 10 geographically distributed sites where lung cancer screening is offered. The study enrolled individuals who underwent low-dose CT screening for lung cancer between July 31, 2013, and November 30, 2021.

   Low-dose CT screening for lung cancer.

   The main outcome was nonadherence to follow-up recommendations for lung cancer screening, defined as failing to complete a recommended or more invasive follow-up examination (ie, diagnostic dose CT, positron emission tomography–CT, or tissue sampling vs low-dose CT) within 15 months (Lung-RADS score, 1 or 2), 9 months (Lung-RADS score, 3), 5 months (Lung-RADS score, 4A), or 3 months (Lung-RADS score, 4B/X). Multivariable logistic regression was used to identify factors associated with patient nonadherence to baseline Lung-RADS recommendations. A generalized estimating equations model was used to assess whether the pattern of longitudinal Lung-RADS scores was associated with patient nonadherence over time.

   Among 1979 included patients, 1111 (56.1%) were aged 65 years or older at baseline screening (mean [SD] age, 65.3 [6.6] years), and 1176 (59.4%) were male. The odds of being nonadherent were lower among patients with a baseline Lung-RADS score of 1 or 2 vs 3 (adjusted odds ratio [AOR], 0.35; 95% CI, 0.25-0.50), 4A (AOR, 0.21; 95% CI, 0.13-0.33), or 4B/X, (AOR, 0.10; 95% CI, 0.05-0.19); with a postgraduate vs college degree (AOR, 0.70; 95% CI, 0.53-0.92); with a family history of lung cancer vs no family history (AOR, 0.74; 95% CI, 0.59-0.93); with a high age-adjusted Charlson Comorbidity Index score (≥4) vs a low score (0 or 1) (AOR, 0.67; 95% CI, 0.46-0.98); in the high vs low income category (AOR, 0.79; 95% CI, 0.65-0.98); and referred by physicians from pulmonary or thoracic-related departments vs another department (AOR, 0.56; 95% CI, 0.44-0.73). Among 830 eligible patients who had completed at least 2 screening examinations, the adjusted odds of being nonadherent to Lung-RADS recommendations at the following screening were increased in patients with consecutive Lung-RADS scores of 1 to 2 (AOR, 1.38; 95% CI, 1.12-1.69).

   In this retrospective cohort study, patients with consecutive negative lung cancer screening results were more likely to be nonadherent with follow-up recommendations. These individuals are potential candidates for tailored outreach to improve adherence to recommended annual lung cancer screening.

    

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5. Body Mass Index Trajectories From Childhood to Adulthood and Age at Onset of Overweight and Obesity: The Influence of Parents’ Weight Status

   https://doi.org/10.1093/aje/kwac124  

   Nielsen, Jannie ; Hulman, Adam ; Narayan, K. M. Venkat ; Cunningham, Solveig A. ( July 2022 , American Journal of Epidemiology)

   We investigated the influence of parents’ weight status on their children’s growth trajectories and its association with age at onset of overweight and obesity. We used 16,396 height and weight records from 3,284 youths from the Panel Study of Income Dynamics, followed across childhood into adulthood (United States, 1997–2017). Across age groups, we modeled body mass index trajectories (ages 5–32 years) according to parents’ weight status, using mixed-effect models to estimate age at onset of overweight and obesity and proportion with obesity from childhood to adulthood. There were large differences in growth patterns according to parents’ weight status: Children of parents with obesity had, on average, overweight at age 6 (95% confidence interval (CI): 5, 7) and steep growth trajectories until age 12; children of normal-weight parents had slower increases in body mass index, reaching overweight on average at age 25 (95% CI: 24, 27). By age 30, 30% (95% CI: 28, 31) of youths had obesity. Differences in early-life growth persisted into adulthood: 48% (95% CI: 45, 52) of adult children of parents with obesity had obesity versus 16% (95% CI: 14, 19) of those of normal-weight parents. Trajectories to unhealthy weight were heavily influenced by parents’ weight status, especially before age 12, children of parents with obesity having overweight 19 earlier in life than children of normal-weight parents.

    

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