State-level COVID-19 vaccination rates among older adults have been uneven in the United States. Due to the immunocompromised nature of older adults, vaccine hesitancy increases the risk of morbidity and mortality. This study aims to determine the association between the social determinants of health, the structural determinants of health, and COVID-19 vaccine hesitancy among older adults in the United States. Secondary data from the Health and Retirement Study (HRS) dataset were used. A descriptive analysis and multinomial multivariable logistic regression were performed to examine the association of the independent variables—gender, age, race, immigration status, marital status, broadband internet access, social security income, Medicare coverage, education, and frequency of religious service—with the dependent variable, vaccine hesitancy. Compared to the respondents with no vaccine hesitancy and without the specific predictor, the respondents who reported religious attendance at least once/week were more likely to be “somewhat hesitant”, divorced respondents had higher odds of being “somewhat hesitant”, and older adults aged 65–74 years were more likely to be “very hesitant” or “somewhat hesitant” about the COVID-19 vaccine. Compared to the respondents with no vaccine hesitancy and without the specific predictor, females had higher odds of being “very hesitant”, “somewhat hesitant”, or a “little hesitant”, and African Americans were more likely to be “very hesitant”, “somewhat hesitant”, or a “little hesitant” about the COVID-19 vaccine. Addressing these factors may limit the barriers to vaccine uptake reported among older adults and improve herd immunity among the immunocompromised population.

Background: Health equity can only be achieved when every individual has access to quality healthcare without fear of being discriminated against. This study analyzed the sociodemographic characteristics associated with self-reported racial discrimination when receiving medical care in the United States. Methods: This quantitative cross-sectional study utilized the 2022 National Trends Survey 6. We performed a logistic regression analysis using 6102 survey responses from study participants who answered the question about perceived discrimination. Results: Older adults aged 75 years and above had significantly lower odds of reporting perceived discrimination when receiving medical care compared to those aged 18–34 years (AOR = 0.24; 95% CI: 0.10–0.58). The odds of reporting perceived discrimination were significantly higher among non-Hispanic Blacks (AOR = 7.30; 95% CI: 4.48–11.88), Hispanics (AOR = 3.56; 95% CI: 2.45–5.17), non-Hispanic Asians (AOR = 5.95; 95% CI: 2.25–15.73), and individuals identifying as non-Hispanic Other (AOR = 10.91; 95% CI: 5.42–21.98), compared to non-Hispanic Whites. Compared to individuals from households earning less than USD 20,000, the odds of reporting perceived discrimination when receiving medical care were significantly lower among individuals from households earning between USD 50,000 and <USD 75,000 (AOR = 0.42; 95% CI: 0.23–0.78) and those earning USD 75,000 or more (AOR = 0.43; 95% CI: 0.22–0.83). Conclusions: Despite having a multicultural and ethnically diverse population, racial discrimination persists in the United States and has become a barrier to achieving health equity. Health organizations should implement policies that ensure health workers attend mandatory anti-racism training.

Psychological distress, an emotional condition with symptoms of anxiety and depression, leads to impaired function, behavior, and personal traits. The current study examined the association between social determinants of health and the severity of psychological distress among adults in the United States after the COVID-19 pandemic. Using multinomial multivariable logistic regression, we analyzed data from 5106 (n = 5106) participants in the Health Information National Trends Survey (HINTS) 6. Compared to non-Hispanic Whites, African Americans (AOR = 0.62, CI = 0.42–0.93) had lower odds of reporting mild psychological distress rather than no stress. Other variables associated with a higher likelihood of reporting moderate to severe psychological distress, rather than no distress, are being in the 50–64 years age group (AOR = 2.77, CI = 1.45–5.28), divorced (AOR = 2.50, CI = 1.70–3.69), and widowed (AOR = 3.78, CI = 2.15–6.64). Respondents living in an urban area had lower odds of reporting moderate to severe psychological distress (AOR = 0.56, CI = 0.39–0.80) compared to those living in rural areas. Our findings identify several risk factors for psychological distress by sociodemographic characteristics such as age, race, marital status, and urban living, providing empirical evidence for interventions in behavioral health. These findings suggest there is an utmost need for a multi-sectoral approach to address the social determinants of health associated with psychological distress post-COVID-19 pandemic.

The use of the internet and supported apps is at historically unprecedented levels for the exchange of health information. The increasing use of the internet and social media platforms can affect patients’ health behavior. This study aims to assess the variations in patterns of social media engagement between individuals diagnosed with either chronic diseases or mental health conditions. Data from four iterations of the Health Information National Trends Survey Cycle 4 from 2017 to 2020 were used for this study with a sample size (N) = 16,092. To analyze the association between the independent variables, reflecting the presence of chronic conditions or mental health conditions, and various levels of social media engagement, descriptive statistics and logistic regression were conducted. Respondents who had at least one chronic condition were more likely to join an internet-based support group (Adjusted Odds Ratio or AOR = 1.5; Confidence Interval, CI = 1.11–1.93) and watch a health-related video on YouTube (AOR = 1.2; CI = 1.01–1.36); respondents with a mental condition were less likely to visit and share health information on social media, join an internet-based support group, and watch a health-related video on YouTube. Race, age, and educational level also influence the choice to watch a health-related video on YouTube. Understanding the pattern of engagement with health-related content on social media and how their online behavior differs based on the patient’s medical conditions can lead to the development of more effective and tailored public health interventions that leverage social media platforms.

Intimate partner violence (IPV) against women is recognized as a public health and human rights issue globally. Nigeria continues to experience a substantial burden of IPV. This study analyzed patterns and multilevel factors associated with violence against women in Nigeria, including emotional, physical, and sexual violence. This study analyzed data from 5458 women aged 15 to 49 years who participated in the 2024 Nigeria Demographic and Health Survey (NDHS). We computed multivariable binary logistic regression and Firth logistic regression (for relatively rare events). Women whose partners consumed alcohol had higher odds of experiencing emotional violence (AOR = 2.97), less severe physical violence (AOR = 3.11), severe physical violence (AOR = 3.22), and sexual violence (AOR = 2.07). Partner controlling behaviors, including restricting contact with family or friends, was also consistently linked to elevated IPV risk. Women living with a partner had higher odds of severe physical and sexual violence. Higher education and greater household wealth were associated with lower IPV outcomes. Our study provides practice-relevant evidence and policy implications, including the need for integrated prevention strategies that address behavioral risk factors, strengthen early screening for controlling behaviors, and promote women’s socioeconomic empowerment.

Background: There is a growing incidence of colorectal cancer and related deaths in the United States, despite screening recommendations. This study analyzed the factors associated with having ever undergone endoscopic colorectal cancer testing among adults aged 45–85 years. Methods: This study analyzed data from the 2023 National Health Interview Survey (N = 17,087 participants). A multivariable logistic regression analysis was conducted to assess the relationship between sociodemographic and healthcare-related factors and the likelihood of having ever (a) undergone a colonoscopy or sigmoidoscopy and (b) taken a fecal immunochemical test (FIT). Results: The majority of the respondents had undergone an endoscopic colorectal exam (66%) vs. FIT (22%) in their lifetime. Compared to respondents aged 45–49 years, those in older age groups (50–85 years) were more likely to have ever undergone an endoscopic colorectal exam or FIT testing. African Americans were more likely to have ever undergone an endoscopic colorectal exam (Adjusted Odds Ratio (AOR) = 1.26, CI = 1.07–1.48), while American Indian/American Native and others (AOR = 1.35, CI = 1.02–1.80) were more likely to have ever undergone a FIT compared to White people. While education and health insurance were associated with having ever undergone an endoscopic colorectal exam, neither was associated with FIT. Compared to married respondents, widowed, separated, or divorced respondents (AOR = 0.88, CI = 0.79–0.98), and unmarried respondents (AOR = 0.70, CI = 0.60–0.82) were less likely to have ever undergone an endoscopic colorectal exam. Conclusions: Variations in factors associated with having ever undergone endoscopic colorectal cancer testing can help to understand disparities in screening uptake better and guide the development of targeted public health interventions to improve colorectal cancer prevention and early detection.