Ellen Smit

Oregon State University | OSU · School of Biological and Population Health Sciences

Introduction Federal food safety net programs, like the Supplemental Nutrition Assistance Program (SNAP), may not reach vulnerable populations like rural residents, immigrants, and Latinx individuals. Because these groups are overrepresented among the farm workforce, exploring SNAP utilization among farm communities may clarify the role it plays in...

Introduction Among people with bleeding disorders (PwBD), pain is a major problem and pain treatments are often ineffective. Understanding of psychological factors involved in pain processing is limited. Maladaptive pain attitudes are associated with worse pain outcomes and adaptive pain attitudes are associated with better outcomes in high pain co...

Importance The local environment remains an understudied contributor to elevated blood pressure among older adults. Untargeted approaches can identify neighborhood conditions interrelated with racial segregation that drive hypertension disparities. Objective To evaluate independent associations of sociodemographic, economic, and housing neighborho...

The health of farm owners and farmworkers has significant impacts on farm businesses, farming families, and local rural communities where agriculture is an important driver of social and economic activity. Rural residents and farmworkers have higher rates of food insecurity, but little is known about food insecurity among farm owners and the collec...

(1) Background: Arsenic (As) is a common drinking water contaminant that is regulated as a carcinogen. Yet, As is a systemic toxicant and there is considerable epidemiological data showing As adversely impacts reproductive health. This study used data from a birth cohort in Bangladesh (2008–2011) to examine associations between drinking water As le...

Background Pregnancy is a sensitive time for maternal cardiovascular functioning and exposures to arsenic or manganese may adversely affect blood pressure (BP). Objectives This study examined the associations between arsenic and manganese exposures and maternal BP measured during pregnancy. Effect modification by pre-pregnancy body mass index (BMI...

Untested psychosocial or economic factors mediate associations between perceived discrimination and suboptimal antihypertensive therapy. This study included two waves of data from the Health and Retirement Study participants with self-reported hypertension (N=8557, 73% Non-Hispanic White, 17% Non-Hispanic Black, and 10% Hispanic/Latino) over four y...

Background: Systematic evaluation of neighborhood factors which capture an array of characteristics -analogous to genome-wide-association studies- may identify important patterns in spatial determinants of blood pressure control. Methods: Our sample included Health and Retirement Study participants (N=13180; 58% women, 13% non-Hispanic Black, 4% Hi...

The objective of this research was to investigate associations among self-reported health status, chronic conditions, and use of dietary supplements containing botanicals and describe reasons for use among U.S. adult supplement users. This was a cross-sectional analysis using data from the 2009–2014 National Health and Nutrition Examination Survey...

Objectives Aim 1 was to establish updated prevalence estimates for meeting national physical activity (PA) guidelines among adolescents with and without special healthcare needs (SHCN), 12–17 years old. To identify at-risk subgroups, our sub-aim was to compare the distribution of prevalence estimates across PA levels by SHCN subtypes, and in refere...

Background: Recent studies indicate airborne PAH levels have decreased in the U.S., but it is unclear if this has resulted in PAH exposure changes in the U.S. population. Objective Examine temporal trends in urinary metabolites of Naphthalene, Fluorene, Phenanthrene, and Pyrene in U.S. non-smokers, 6+ years old. Methods: We used biomonitoring dat...

Human trafficking is a global public health and human rights issue, although it remains unknown how governmental-level systems impact survivors of human trafficking. Survivor punishment (where federal or local officials arrest, fine, imprison, deport, or otherwise punish survivors) is evident even with global promotion of survivor-centred approache...

Background: Many populations are exposed to arsenic, lead, and manganese. These metals influence immune function. We evaluated the association between exposure to single and multiple metals, including arsenic, lead, and manganese, to humoral immunity as measured by antibody concentrations to diphtheria and tetanus toxoid among vaccinated Banglades...

Objectives This study aimed to characterize injuries and illnesses among construction workers in the State of Oregon in the US and examine the association between injury frequency and severity with hour of work by using Workers’ Compensation (WC) accepted disabling claims data in the construction industry from 2007 to 2013. Methods Injury frequenc...

Background: Children and adolescents with disabilities often report low levels of physical activity (PA). Estimating the magnitude of PA disparities has been previously challenged by underreporting and variability in subsampling of disability. Using the National Survey of Children's Health, this study estimated the population-level PA disparities...

A secondary data analysis of 33,093 children and adolescents age 6–17 years (12% with disabilities) from a 2016–2017 National Survey of Children’s Health nonrepresentative sample aimed to identify (a) unique clusters of sociodemographic characteristics and (b) the relative importance of disability status in predicting participation in daily physica...

Background: Arsenic can impair immune function. Timing of exposure can influence potential immunotoxicity of arsenic exposure. We examined the association between drinking water arsenic concentrations (W-As) measured repeatedly during different exposure windows in early life and serum concentrations of IgG antibodies against diphtheria and tetanus...

Food insecurity among U.S. older adults has more than doubled since 2001 and is higher in those who are frail. Given the growing aging population and the importance of physical functioning and adequate food intake, the increase in food insecurity is a public health concern. This study examined the association between domains of physical limitations...

Biomonitoring studies have shown that humans are exposed to numerous environmental chemicals. Previous work provides limited insights into the dynamic relationship between different chemicals within a population. The objective of this study is to develop an analytical method identifying exposure profiles of seven common environmental chemicals and...

Objective To determine, among a sample of young CSHCN with developmental conditions, (1) characteristics associated with receipt of both patient-centered medical home (PCMH) and Part C early intervention, (2) the association between each PCMH criterion and receipt of Part C generally, and (3) for CSHCN with disabilities versus delays. Methods Secon...

Background: Arsenic alters immunological parameters including antibody formation and antigen-driven T-cell proliferation. Objective: We evaluated the cross-sectional relationship between urinary arsenic and the seroprevalence of hepatitis B (HBV) infection in the United States using data from six pooled cycles of the National Health and Nutritio...

Background: In 2001, the United States revised the arsenic maximum contaminant level for public drinking water systems from 50µg/L to 10µg/L. This study aimed to examine temporal trends in urinary arsenic concentrations in the U.S. population from 2003 to 2014 by drinking water source among individuals aged 12 years and older who had no detectable...

Background: Current policy in Oregon limits eligibility of children diagnosed with developmental delay for school-based services. Due to eligibility definitions, children with developmental delay may face additional barriers transitioning from early intervention/early childhood special education into school-based special education services. Aims:...

Frailty is an age-related medical syndrome of decreased resilience to stressors and is associated with numerous adverse outcomes. Although there is preponderance of literature on frailty in developed countries, limited investigations have been conducted in developing countries including China, which has the world’s largest aging population. We exam...

Background.: Frailty is an age-related clinical syndrome of decreased resilience to stressors and is associated with numerous adverse outcomes. Although there is preponderance of literature on frailty in developed countries, limited investigations have been conducted in less developed regions including China-a country that has the world's largest...

Background Polychlorinated biphenyls (PCBs) and metals (lead and cadmium) are neurotoxic and affect neurobehavioral performance. Yet little is known about the association between exposure to multiple neurotoxic compounds and cognitive functioning in older adults. Methods Using data from two consecutive cycles of the National Health and Nutrition an...

Background: Few occupational health and safety studies have focused on the US seafood preparation and packaging industry, and none on Oregon's seafood industry. Methods: Oregon workers' compensation (WC) disabling claims data were analyzed. Oregon Employment Department and US Census Bureau data were used as denominators for rates. Results: Dur...

Objective: To examine whether grip strength, gait speed, and the combination of the two physical functioning measures modified the association of systolic BP (SBP) and diastolic BP (DBP) with mortality. Design: Nationally representative cohort study. Setting: Health and Retirement Study. Participants: 7,492 U.S. adults aged ≥65 years. Measu...

Background: The primary route of exposure to methylmercury (MeHg), a known developmental neurotoxicant, isf rom ingestion of seafood. Since 2004, women of reproductive age in the U.S. have been urged to eat fish and shellfish as part of a healthy diet while selecting species that contain lower levels MeHg. Yet few studies have examined trends in Me...

Background: Family homes are a key setting for developing lifelong eating and physical activity habits, yet little is known about how family home nutrition and physical activity (FNPA) environments influence food insecurity (FI) and childhood obesity, particularly in rural settings. Aims: This study examined associations among FNPA, FI, and body...

Background Comorbidity indices that are based on clinically recognized disease do not capture the full spectrum of health. The Healthy Aging Index (HAI) was recently developed to describe a wider range of health and disease across multiple organ systems. We characterized the distribution of a modified HAI (mHAI) by sociodemographics in a representa...

Objective: To estimate the prevalence of healthy lifestyle characteristics and to examine the association between different combinations of healthy lifestyle characteristics and cardiovascular disease biomarkers. Patients and methods: The prevalence of healthy lifestyle characteristics was estimated for the US adult population (N=4745) using 200...

We evaluated the association between urinary arsenic and the seroprevalence of total hepatitis A antibodies (total anti-HAV: IgG and IgM) in 11 092 participants aged ⩾6 years using information collected in the US National Health and Nutrition Examination Survey (2003–2012). Multivariate logistic regression models evaluated associations between tota...

Background. Animal toxicity tests and epidemiological studies suggest that exposure to PBDEs can alter attention behavior, yet few studies have examined their association with diagnosis of attention deficit hyperactivity disorder (ADHD) in adolescents. Methods. Logistic regression was used to examine the cross-sectional association between ADHD and...

Background: Nutritional status and food insecurity are associated with frailty in the general U.S. population, yet little is known about this in the aging population of people living with HIV (PLWH). Objectives: Given the potential importance of nutrition and the amenability to intervention, we examined the association between nutritional status...

Obesity and food insecurity rates are higher among rural compared to non-rural populations. Little is known, however, about how family-home environments influence childhood obesity-related behaviors, particularly in rural settings. This study examined associations between the family-home nutrition (FN) environment, food insecurity, and dietary inta...

The illicit use of prescription stimulants (IUPS) is a substance use behavior that remains prevalent on college campuses. As theory can guide research and practice, we provide a systematic review of the college-based IUPS epidemiological literature guided by one ecological framework, the theory of triadic influence (TTI). We aim to assess prevalenc...

Background: Older adults frequently have several chronic health conditions which require multiple medications. We illustrated trends in prescription medication use over 20 years in the United States, and described characteristics of older adults using multiple medications in 2009-2010. Methods: Participants included 13,869 adults aged 65 years a...

Background Poorly ventilated combustion stoves and pollutants emitted from combustion stoves increase the risk of acute lower respiratory illnesses (ALRI) in children living in developing countries but few studies have examined these issues in developed countries. Our objective is to investigate behaviors related to gas stove use, namely using them...

Objective Individuals who experience or anticipate negative interactions from medical providers related to conditions such as obesity may preferentially use the Internet for health information. Our objectives in this study were to (1) examine the association between body mass index (BMI) and Internet health information–seeking and (2) examine wheth...

Arsenic is an immunotoxicant. Clinical reports observe the reactivation of varicella zoster virus (VZV) in people who have recovered from arsenic poisoning and in patients with acute promyelocytic leukemia that have been treated with arsenic trioxide. To evaluate the association between arsenic and the seroprevalence of VZV immunoglobulin G (IgG) a...

Objectives: Associations between family nutrition and physical activity (FNPA) and elementary students' learning behaviors were examined. Methods: Parents (N = 85) of elementary-age students completed a survey about FNPA factors. Children's learning behavior scores, reported as Characteristics of Successful Learning (CSL), were transcribed from sch...

Purpose: Examine whether concurrently consuming a healthy diet and regularly being physically active among U.S. youth is more favorably associated with cardiovascular disease (CVD) biomarkers than other physical activity and dietary patterns. Design: Cross-sectional. Setting: United States (National Health and Nutrition Examination Survey) 200...

Few studies have examined the underweight-morbidity relationship, and those that have were conducted in non-U.S. populations and limited in their evaluation of cardiovascular disease (CVD) risk factors. To examine the associations among underweight (along with overweight and obese) and various CVD risk factors in a national sample of U.S. adults (a...

Gas stoves emit pollutants that are respiratory irritants. U.S. children under age 6 who live in homes where gas stoves are used for cooking or heating have an increased risk of asthma, wheeze and reduced lung function. Yet few studies have examined whether using ventilation when operating gas stoves is associated with a decrease in the prevalence...

Background: No studies have addressed the "fit but fat" paradigm using accelerometry data. Aim: The study was to determine if 1) higher levels of accelerometer-determined physical activity are favorably associated with biomarkers in overweight or obese persons (objective 1); and 2) overweight or obese individuals who are sufficiently active have...

Background: Chronic kidney disease (CKD) and hyperuricemia often coexist, and both conditions are increasing in prevalence in the United States. However, their shared role in cardiovascular risk remains highly debated. Study design: Cross-sectional and longitudinal. Setting & participants: Participants in the National Health and Nutrition Exam...

Objective To test a theory-driven model of health behavior to predict the illicit use of prescription stimulants (IUPS) among college students. Participants A probability sample of 554 students from one university located in California (response rate = 90.52%). Methods Students completed a paper-based survey developed with guidance from the Theor...

To examine the association between objectively measured physical activity and dietary behavior and their combined effect on health. Data for this study were obtained from the 2003-2006 National Health and Nutrition Examination Survey cycles. The data were evaluated between September 9, 2012, and August 14, 2013. As part of the national survey, part...

Purpose: To examine whether there are differences between demographic, behavioral, and biological variables for those with invalid accelerometry data (IAD) and those with valid accelerometry data (VAD). Design: Cross-sectional. Setting: Data from 2003-2006 National Health and Nutrition Examination Survey (NHANES) were used. Subjects: Partici...

Objective: To examine the association between hearing and vision impairment (with the focus on dual sensory impairment) and accelerometer-assessed physical activity (PA) in a national sample of US adults because limited research has examined this association. Patients and methods: Data from the cross-sectional 2003-2006 National Health and Nutri...

Background: The illicit use of prescription stimulants (IUPS) has emerged as a high-risk behavior of the 21st century college student. As the study of IUPS is relatively new, we aimed to understand (1) characteristics of IUPS (i.e., initiation, administration routes, drug sources, motives, experiences), and (2) theory-guided intrapersonal, interpe...

A theory-guided instrument for examining prescription stimulant misuse in the college population was developed and its psychometric properties were evaluated from 2011 to 2012 at one Pacific Northwest (United States) university. Study methods included instrument development, assessment by five health and measurement professionals, group interviews...

Nonprescription stimulant use is a high-risk behavior prevalent in the college population. To date, research on this substance use behavior lacks a comprehensive theoretical lens as well as geographical diversity. Guided by the Theory of Triadic Influence (TTI), multilevel (i.e., students within schools) modeling was used to analyze survey data fro...

Objective. Individuals with diabetes may be at an increased risk for depression given the potential diabetes-induced link between sensory impairment, physical functioning, and depression. As a result, the purposes of this study were 1) to examine the association between sensory impairment and depression among adults of all ages with diabetes, 2) to...

The exclusion of participants with invalid accelerometry data (IAD) may lead to biased results and/or lack of generalizability in large population studies. The purpose of this study was to investigate whether demographic, behavioral, and biological differences occur between those with IAD and valid accelerometry data (VAD) among adults using a repr...

Frailty is a state of decreased physical functioning and a significant complication of ageing. We examined frailty, energy and macronutrient intake, biomarkers of nutritional status and food insufficiency in US older adult (age ≥ 60 years) participants of the Third National Health and Nutrition Examination Survey (n 4731). Frailty was defined as me...

Introduction: Naphthalene is an important contaminant in indoor and outdoor air. Acute overexposure can have toxic effects, resulting in hemolysis. We examined 1- and 2-hydroxynaphthalene urinary metabolites (NAP1 and NAP2) in White, Black and Hispanic U.S. adults, and their relationship with hemoglobin (HGB) and hematocrit (HCT). Methods: Using th...

Background: Although some reports have shown disparities in healthcare (HC) for persons with intellectual disabilities (ID) compared to persons with no disabilities (ND), this has not been examined in a national representative sample. The purpose of this study is to examine HC coverage among non-institutionalized US adults (18+ years) with and with...

Naphthalene is an important contaminant in indoor and outdoor air. Acute overexposure can have toxic effects, resulting in hemolysis. There have been no studies evaluating the impact of environmental exposure on red blood cell indices. We examined 1- and 2-hydroxynaphthalene urinary metabolites (NAP1 and NAP2) in non-Hispanic White, non-Hispanic Bl...

The purpose of this study was to examine the influence of child and adult cut-points on physical activity (PA) intensity, the prevalence of meeting PA guidelines, and association with selected health outcomes. Participants (6,578 adults > or = 18 years, and 3,174 children and adolescents < or = 17 years) from the National Health and Nutrition Exami...

Although both frailty and low vitamin D have been separately associated with an increased risk for adverse health, their joined effects on mortality have not been reported. The current study examined prospectively the effects of frailty and vitamin D status on mortality in US older adults. Participants aged 60 years in The Third National Health an...

To provide the current evidence linking physical activity to breast cancer risk, the objectives of this review were twofold: (1) to review the epidemiological literature examining the relationship between physical activity and breast cancer risk; and (2) to summarize the mechanisms through which physical activity can influence risk. A review of the...

Purpose To examine the effect of 25-hydroxyvitamin D (serum 25 (OH) D), body mass index and leisure time physical activity on all-cause mortality and determine the association between serum 25 (OH) D and leisure time physical activity among US adults. Methods We used data from 16,285 adults 20 years and older who participated in a home interview an...

To examine the association between physical activity and breast cancer mortality and recurrence, and to provide an overview of factors related to physical activity behavior in women with breast cancer. An extensive review of the epidemiologic literature on the effect of physical activity on breast cancer recurrence and mortality was conducted using...

Impairments in physical performance increase sharply with age. Low serum 25-hydroxyvitamin D (25-OHD) levels may be a modifiable risk factor for physical performance decline. Five hundred thirty-two participants in the Women's Health Initiative Clinical Trial (WHI CT) were among a 25% randomly selected subsample of women who participated in perform...

The association between physical activity (PA) and C-reactive protein (CRP) is inconsistent, with nearly all studies using self-report measures of PA. The purpose of this study was to examine the association between objectively measured PA and CRP in US adults and children. Adults (N=2912) and children (N=1643) with valid accelerometer data and CRP...

The risk of cancer among Hispanics with Acquired Immune Deficiency Syndrome (AIDS) in the United States and Puerto Rico (PR) has not been well described. The purpose of this study was to determine the risk of AIDS related and non-AIDS related cancers among Hispanics with AIDS in PR. A probabilistic record linkage of the PR AIDS Surveillance Program...

We examined alcohol intake and all cause mortality in White, Black and Hispanic adults using the 1988 and 1990 National Health Interview Survey (NHIS). The NHIS and National Death Index are public use data sets with follow‐up for mortality through 2002. Alcohol intake was classified as: Lifetime abstainers (<12 drinks ever); Irregular abstainers (<...

Studies on the association between physical activity and fatal prostate cancer have produced inconclusive results. The Puerto Rico Heart Health Program was a cohort study of a randomly selected sample of 9824 men age 35 to 79 years at baseline who were followed for mortality until 2002. Multiple examinations collected information on lifestyle, diet...

To study prospectively the association of coffee intake with incident diabetes in the Puerto Rico Heart Health Program cohort, comprising 9824 middle-aged men (aged 35-79 years). Of 9824 men, 3869 did not provide a fasting blood sample at baseline, 1095 had prevalent diabetes and 131 were not given fasting glucose tests at any subsequent study visi...

Limited information is available regarding physical activity (PA) and its assessment in Hispanics living with HIV. This study compared self-reported PA using the International Physical Activity Questionnaire (IPAQ) with objectively measured PA using the ActiGraph accelerometer and DigiWalker pedometer in 58 Hispanic adults with HIV. IPAQ was admini...