Browsing by Author "Brian Houle"

Now showing 1 - 11 of 11
  • Thumbnail Image
    Item
    Adolescent behavioral problems pretermlow birth weight children and adult life success in a prospective Australian birth cohort study
    (ACADEMIC PRESS INC ELSEVIER SCIENCE) M Roettger; J Tan; Brian Houle; J Najman; T McGee
  • Thumbnail Image
    Item
    Household structure, composition and child mortality in the unfolding antiretroviral therapy era in rural South Africa: comparative evidence from population surveillance, 2000–2015
    (2023-03-15) Brian Houle; Chodziwadziwa Kabudula; Dickman Gareta; Kobus Herbst; Samuel J Clark
    Objectives The structure and composition of the household has important influences on child mortality. However, little is known about these factors in HIVendemic areas and how associations may change with the introduction and widespread availability of antiretroviral treatment (ART). We use comparative, longitudinal data from two demographic surveillance sites in rural South Africa (2000–2015) on mortality of children younger than 5 years (n=101 105). Design We use multilevel discrete time event history analysis to estimate children’s probability of dying by their matrilineal residential arrangements. We also test if associations have changed over time with ART availability. Setting Rural South Africa. Participants Children younger than 5 years (n=101 105). Results 3603 children died between 2000 and 2015. Mortality risks differed by co-residence patterns along with different types of kin present in the household. Children in nuclear households with both parents had the lowest risk of dying compared with all other household types. Associations with kin and child mortality were moderated by parental status. Having older siblings lowered the probability of dying only for children in a household with both parents (relative risk ratio (RRR)=0.736, 95%CI (0.633 to 0.855)). Only in the later ART period was there evidence that older adult kin lowered the probability of dying for children in single parent households (RRR=0.753, 95%CI (0.664 to 0.853)). Conclusions Our findings provide comparative evidence of how differential household profiles may place children at higher mortality risk. Formative research is needed to understand the role of other household kin in promoting child well-being, particularly in one-parent households that are increasingly prevalent.
  • Thumbnail Image
    Item
    Maternal alcohol use and childrens emotional and cognitive outcomes in rural South Africa
    Tamsen Rochat; Brian Houle; Alan Stein; J Mitchell; Ruth Bland
  • Thumbnail Image
    Item
    Mortality transition over a quarter century in rural South Africa: findings from population surveillance in Agincourt 1993-2018
    (2021-10-04) Chodziwadziwa Whiteson Kabudula; Brian Houle; Daniel Ohene-Kwofie; Daniel Mahlangu; Nawi Ngd; Hoang Van Minhf; Francesc Xavier Gómez-Olivé; Stephen Tollman; Kathleen Kahn
    Background: Mortality burden in South Africa since the mid-1990s has been characterized by a quadruple disease burden: HIV/AIDS and tuberculosis (TB); other communicable diseases (excluding HIV/AIDS and TB), maternal causes, perinatal conditions and nutritional deficiencies; non-communicable diseases (NCDs); and injuries. Causes from these broad groupings have persistently constituted the top 10 causes of death. However, proportions and rankings have varied over time, alongside overall mortality levels. Objective: To provide evidence on the contributions of age and cause-of-death to changes in mortality levels in a rural South African population over a quarter century (1993–2018). Methods: Using mortality and cause-of-death data from the Agincourt Health and SocioDemographic Surveillance System (HDSS), we derive estimates of the distribution of deaths by cause, and hazards of death by age, sex, and time period, 1993–2018. We derive estimates of life expectancies at birth and years of life expectancy gained at age 15 if most common causes of death were deleted. We compare mortality indicators and cause-of-death trends from the Agincourt HDSS with South African national indicators generated from publicly available datasets. Results: Mortality and cause-of-death transition reveals that overall mortality levels have returned to pre-HIV epidemic levels. In recent years, the concentration of mortality has shifted towards older ages, and the mortality burden from cardiovascular diseases and other chronic NCDs are more prominent as people living with HIV/AIDS access ART and live longer. Changes in life expectancy at birth, distribution of deaths by age, and major cause-of-death categories in the Agincourt population follow a similar pattern to the South African population. Conclusion: The Agincourt HDSS provides critical information about general mortality, causeof-death, and age patterns in rural South Africa. Realigning and strengthening the South African public health and healthcare systems is needed to concurrently cater for the prevention, control, and treatment of multiple disease conditions.
  • Thumbnail Image
    Item
    Parental imprisonment as a risk factor for cardiovascular and metabolic disease in adolescent and adult offspring: A prospective Australian birth cohort study
    (2022-04-28) Michael E Roettger; Brian Houle; Jake Najman; Tara R McGee
    Objectives: Parental imprisonment is linked with child health in later life. The present study provides the first prospective cohort analysis and non-U.S. based study examining parental imprisonment and cardiometabolic risk factors in adolescence and adulthood. Methods: The study followed 7,223 children born from live, singleton births from 1981 to 1984 in Brisbane, Australia. Data on parental imprisonment was collected at mother interview when the children were ages 5 and 14. Our sample analyzes offspring with biometric data collected by health professionals, including 3,794 at age 14, 2,136 at age 21, and 1,712 at age 30. Analyses used multivariate linear and logistic regression, and time-varying growth curve models. Results: Among female respondents, parental imprisonment at ages ≤5 was associated with higher body-mass index (BMI) at ages 14, 21, and 30; higher systolic blood pressure (SBP) and diastolic blood pressure (DBP) at age 30; and increased sedentary hours, larger waist circumference, and odds of a high-risk waist circumference at age 30. Parental imprisonment when the child was aged ≤14 was associated with increased BMI and SBP at age 30 for females. In growth-curve models, parental imprisonment when the child was aged ≤5 and ≤ 14 among females was linked with increased BMI; parental imprisonment when the child was aged ≤5 was associated with increased SBP and DBP. No significant associations were observed for males. Conclusions: Using prospective cohort data, our results support research showing that parental imprisonment, particularly in early childhood, is associated with increased BMI, blood pressure, sedentary hours, and waist circumference in females in early adulthood. These findings implicate parental imprisonment as a risk factor for cardiometabolic health issues in later life among females.
  • Thumbnail Image
    Item
    Parental imprisonment, delinquent behavior, and BMI gain in a U.S. nationally representative cohort study of adolescents and adults ages 12-32
    (2023) Michael E. Roettger; Brian Houle; Jason; Jason D. Boardman
    Children who experience parental imprisonment report greater mental and physical health adversities in adolescence and adulthood relative to comparable individuals whose parents did not serve time in prison. Research has linked BMI gain with parental imprisonment among females, but other studies have shown null or negative associations between parental imprisonment and weight increases for their offspring. Using longitudinal data from the National Longitudinal Study of Adolescent to Adult Health, this study attempts to resolve these differential findings by examining the interrelationship between delinquent behavior and BMI associated with parental imprisonment as individuals progress from adolescence into adulthood (ages 12–32). We show that higher delinquency levels are associated with lower BMI among men and women. With the transition from adolescence to adulthood, parental imprisonment is linked with increased BMI gain and obesity among females who are not delinquent. These findings highlight the need to consider how the decline in delinquent behavior and increasing health disparities between adolescence and adulthood may intersect as individuals experiencing parental imprisonment transition from adolescence to adulthood.
  • Thumbnail Image
    Item
    Quantifying impacts of the COVID-19 pandemic on Australian life expectancy
    (2022-10-13) Vladimir Canudas-Romo; Brian Houle; Tim Adair
    Global excess mortality caused by the COVID-19 pandemic1 can be clearly assessed from the perspective of years of life expectancy lost.2 The study by Aburto et al., on quantifying the impacts of the COVID-19 pandemic through life expectancy losses,2 presents changes in life expectancy between 2019 and 2020 for 29 populations with high-quality data, ranging from losses of 1.7 and 2.2 years for American females and males, respectively, to small increases of 0.1 and 0.2 years for females and males in Denmark and Norway, respectively. However Australia, with its relatively strict COVID-19 containment measures of international border closures and lockdowns, resulting in just 898 COVID-19-related deaths in 2020,3 was not included in the study. Now official data are available (based on year of registration of death),3,4 and we present the results for Australia, with a comparison with Denmark and the USA which were clearly strong and poor performers, respectively, in terms of changes in life expectancy between 2019 and 2020.2 Given the relatively high number of deaths registered in 2019 in Australia that had occurred in earlier years, we used the average of 2017–19 to provide a clearer comparison of the past trend with the deaths in 2020 (sensitivity analysis on the years-comparison selection is included in the Supplementary data, available at IJE online).
  • Thumbnail Image
    Item
    Significant Improvement in Blood Pressure Levels Among Older Adults With Hypertension in Rural South Africa
    (2023-08-08) Enrico G. Ferro; Shafika Abrahams-Gessel; David Kapaon; Brian Houle; Jacques Du Toit; Ryan G. Wagner; F. Xavier Gómez-Olivé; Alisha N. Wade; Chodziwadziwa W. Kabudulah; Stephen Tollman; Thomas A. Gaziano
    Background:Sub-Saharan Africa is undergoing an epidemiologic transition from infectious diseases to cardiovascular diseases. From 2014 to 2019, sociodemographic surveillance was performed in a large cohort in rural South Africa. Methods:Disease prevalence and incidence were calculated using inverse probability weights. Poisson regression was used to identify disease predictors. The percentage of individuals with controlled (<140/90 mm Hg) versus uncontrolled hypertension was compared between 2014 and 2019. Results:Compared with 2014 (n=5059), study participants in 2019 (n=4176) had similar rates of obesity (mean body mass index, 27.5±10.0 versus 27.0±6.5) but higher smoking (9.1% versus 11.5%) and diabetes (11.1% versus 13.9%). There was no significant increase in hypertension prevalence (58.4% versus 59.8%; age adjusted, 64.3% versus 63.3%), and there was a significant reduction in mean systolic blood pressure (138.0 versus 128.5 mm Hg; P<0.001). Among hypertensive individuals who reported medication use in 2014 and 2019 (n=796), the proportion with controlled hypertension on medication increased from 44.5% to 62.3%. Hypertension incidence was 6.2 per 100 person-years, and age was the only independent predictor. Among normotensive individuals in 2014 (n=2257), 15.2% developed hypertension by 2019, with the majority already controlled on medications by 2019. Conclusions:The hypertension prevalence and incidence are plateauing in this aging cohort. There was a statistically and clinically significant decline in mean blood pressure and a substantial increase in individuals with controlled hypertension on medication. The prevalence of cardiometabolic risk factors did not decrease over time, suggesting that the blood pressure decrease is likely due to increased medication access and adherence, promoted by local health systems.
  • Thumbnail Image
    Item
    The double-edged role of accessed status on health and well-being among middle- and older-age adults in rural South Africa: The HAALSI study
    (2022-09) Shao-Tzu Yu; Brian Houle; Lenore Manderson; Elyse A Jennings; Stephen M Tollman; Lisa F Berkman; Guy Harling
    Background: Social capital theory conceptualizes accessed status (the socioeconomic status of social contacts) as interpersonal resources that generate positive health returns, while social cost theory suggests that accessed status can harm health due to the sociopsychological costs of generating and maintaining these relationships. Evidence for both hypotheses has been observed in higher-income countries, but not in more resource-constrained settings. We therefore investigated whether the dual functions of accessed status on health may be patterned by its interaction with network structure and functions among an older population in rural South Africa. Method: We used baseline survey data from the HAALSI study ("Health and Aging in Africa: a Longitudinal Study of an INDEPTH Community in South Africa") among 4,379 adults aged 40 and older. We examined the direct effect of accessed status (measured as network members' literacy), as well as its interaction with network size and instrumental support, on life satisfaction and self-rated health. Results: In models without interactions, accessed status was positively associated with life satisfaction but not self-rated health. Higher accessed status was positively associated with both outcomes for those with fewer personal contacts. Interaction effects were further patterned by gender, being most health-protective for women with a smaller network and most health-damaging for men with a larger network. Conclusions: Supporting social capital theory, we find that having higher accessed status is associated with better health and well-being for older adults in a setting with limited formal support resources. However, the explanatory power of both theories appears to depending on other key factors, such as gender and network size, highlighting the importance of contextualizing theories in practice.
  • Thumbnail Image
    Item
    The doubleedged role of accessed status on health and wellbeing among middle and olderage adults in rural South Africa The HAALSI study
    S T Yu; Brian Houle; Lenore Manderson; E A Jennings; Stephen Tollman; Lisa Berkman; Guy Harling
  • Thumbnail Image
    Item
    Twin epidemics: the effects of HIV and systolic blood pressure on mortality risk in rural South Africa, 2010-2019
    (2022-02-22) Brian Houle; Chodziwadziwa W Kabudula; Andrea M Tilstra; Sanyu A Mojola; Enid Schatz; Samuel J Clark; Nicole Angotti; F Xavier Gómez-Olivé; Jane Menken
    Background: Sub-Saharan African settings are experiencing dual epidemics of HIV and hypertension. We investigate effects of each condition on mortality and examine whether HIV and hypertension interact in determining mortality. Methods: Data come from the 2010 Ha Nakekela population-based survey of individuals ages 40 and older (1,802 women; 1,107 men) nested in the Agincourt Health and socio-Demographic Surveillance System in rural South Africa, which provides mortality follow-up from population surveillance until mid-2019. Using discrete-time event history models stratified by sex, we assessed differential mortality risks according to baseline measures of HIV infection, HIV-1 RNA viral load, and systolic blood pressure. Results: During the 8-year follow-up period, mortality was high (477 deaths). Survey weighted estimates are that 37% of men (mortality rate 987.53/100,000, 95% CI: 986.26 to 988.79) and 25% of women (mortality rate 937.28/100,000, 95% CI: 899.7 to 974.88) died. Over a quarter of participants were living with HIV (PLWH) at baseline, over 50% of whom had unsuppressed viral loads. The share of the population with a systolic blood pressure of 140mm Hg or higher increased from 24% at ages 40-59 to 50% at ages 75-plus and was generally higher for those not living with HIV compared to PLWH. Men and women with unsuppressed viral load had elevated mortality risks (men: adjusted odds ratio (aOR) 3.23, 95% CI: 2.21 to 4.71, women: aOR 2.05, 95% CI: 1.27 to 3.30). There was a weak, non-linear relationship between systolic blood pressure and higher mortality risk. We found no significant interaction between systolic blood pressure and HIV status for either men or women (p>0.05). Conclusions: Our results indicate that HIV and elevated blood pressure are acting as separate, non-interacting epidemics affecting high proportions of the older adult population. PLWH with unsuppressed viral load were at higher mortality risk compared to those uninfected. Systolic blood pressure was a mortality risk factor independent of HIV status. As antiretroviral therapy becomes more widespread, further longitudinal follow-up is needed to understand how the dynamics of increased longevity and multimorbidity among people living with both HIV and high blood pressure, as well as the emergence of COVID-19, may alter these patterns.