Sze Yan Liu

• PhD
• Professor (Associate) at Montclair State University

Background Disparities persist in adverse birth outcomes — preterm birth and small-for-gestational age (SGA) among racialized populations. Previous studies have indicated that voting restrictions are associated with health outcomes, such as access to health insurance and teenage birth rates. This paper examines whether the association between votin...

Background Education is strongly associated with cognitive outcomes at older ages, yet the extent to which these associations reflect causal effects remains uncertain due to potential confounding. Methods Leveraging changes in historical measures of state-level education policies as natural experiments, we estimated the effects of educational atta...

Background: This study examines whether living in US states with (1) restrictive reproductive rights and (2) restrictive abortion laws is associated with frequent mental health distress among women. Methods: We operationalize reproductive rights using an overall state-level measure of reproductive rights as well as a state-level measure of restr...

Neighborhood conditions influence people’s health; sustaining healthy neighborhoods is a New York City (NYC) Health Department priority. Gentrification is characterized by rapid development in historically disinvested neighborhoods. The gentrification burden, including increased living expenses, and disrupted social networks, disproportionally impa...

Objectives: Since the Landmark Shelby V. Holder Supreme Court Ruling, the number of laws in the United States that make it difficult to vote has increased dramatically. This may lead to legislation that limits access to health care, including options for family planning services. We determine whether voting restrictions are associated with county-...

Although women comprise 50% of the population, females remain underrepresented in government. Inequitable female political representation, a form of structural sexism, may impact population health. Previous studies focused primarily on individual health behaviors and low- or middle-income countries. To date, no study has examined the association be...

Developed countries have been related to a higher prevalence of mental disorders. This led us to hypothesize that cultural values typical of developed countries could be associated with mental disorders. Here, we sought to determine the association of indulgence (seeking momentary pleasure and freely expressing oneself) and individualism (being abl...

Background Despite the large body of research on the adverse effects of income inequality, to date, few studies have examined its impact on sleep. The objective of this investigation is to examine the association between US state income inequality and the odds for regularly obtaining inadequate (< 7 h) and very inadequate (< 5 h) of sleep in the la...

Deregulation of cannabis use has raised concerns regarding its potential effects on health, particularly in adolescents and young adults. Here, we extracted data from the Global Burden of Disease database to estimate the long-term effect (> 5 years) of medical marijuana laws (MML) on 2019 cannabis use disorders Disability Adjusted Life Years (2019...

Purpose Residential instability is associated with poor mental health, but its causal inference is challenging due to time-varying exposure and confounding, and the role of changing social environments. We tested the association between frequent residential moving and depression risk among adults exposed to the 9/11 disaster. Methods We used four...

Background Since the 2010 election, the number of laws in the U.S. that create barriers to voting has increased dramatically. These laws may have spillover effects on population health by creating a disconnect between voter preferences and political representation, thereby limiting protective public health policies and funding. We examine whether v...

Background Unconditional cash transfers (UCTs; provided without obligation) for reducing poverty and vulnerabilities (e.g. orphanhood, old age, or HIV infection) are a social protection intervention addressing a key social determinant of health (income) in low‐ and middle‐income countries (LMICs). The relative effectiveness of UCTs compared with co...

Research on the longitudinal relationship between posttraumatic stress disorder (PTSD) and social support among survivors of large-scale trauma is limited. This study assessed bidirectional relationships between PTSD and perceived social support in a large sample of the 9/11-exposed cohort over a 14-year follow-up. We used data from 23,165 World Tr...

Objectives Whether a country’s level of development is associated with an increased or decreased burden of mental and behavioural problems is an important yet unresolved question. Here, we examined the association between the burden of mental and substance use disorders and self-harm with socio-demographic development along temporal and geographica...

Objectives: In the United States, Hispanics are more likely to experience financial barriers to mental health care than non-Hispanics. We used a unique survey to study the effect of these financial barriers on the severity of depressive symptoms among Hispanics who had previously been diagnosed as having depression. Methods: This cross-sectional st...

Objective To examine the effect of Medicaid managed care (MMC) versus Medicaid fee-for-service (FFS) on emergency department (ED) use and hospitalization during the first 6 and 12 months of life among low-birth-weight (LBW) infants.Methods We used the New York City Office of Vital Statistics—Statewide Planning and Research Cooperative System (OVS-S...

Workplace harassment is associated with harmful health outcomes for the victim. However, there is limited research on whether an individual’s experience of workplace harassment affects the health of his/her household members. This study examines the association between an adult’s recent experience of workplace harassment and the child in the househ...

Background: Many states in the United States (US) have introduced barriers to impede voting among individuals from socio-economically disadvantaged groups. This may reduce representation thereby decreasing access to lifesaving goods, such as health insurance. Methods: We used cross-sectional data from 242,727 adults in the 50 states and District of...

Our study examines the association between perceived discrimination due to race and unmet medical needs among a nationally representative sample of children in the United States. We used data from the 2016-2017 National Survey of Children's Health, a population-based cross-sectional survey of randomly selected parents or guardians in the United Sta...

Download PDFPDF Original research Impact of law enforcement-related deaths of unarmed black New Yorkers on emergency department rates, New York 2013–2016 http://orcid.org/0000-0002-7148-356XSze Yan Liu1,2, http://orcid.org/0000-0002-4890-0396Sungwoo Lim2, L Hannah Gould2 Author affiliations Abstract Background Law enforcement-related deaths of u...

PurposeInterpersonal racial discrimination is associated with poor health. Social relationships may moderate the impact of discrimination and represent modifiable behaviors that can be targeted by public health interventions. We described citywide associations between self-reported racial discrimination and health-related quality of life among the...

Background Previous research indicates that income inequality is associated with risk for mortality, self-rated health status, chronic conditions, and health behavior, such as physical activity. However, little is known about the relationship between income inequality and dietary intake, which is a major risk factor for common chronic diseases incl...

Public housing provides affordable housing and, potentially, housing stability for low-income families. Housing stability may be associated with lower incidence or prevalence and better management of a range of health conditions through many mechanisms. We aimed to test the hypotheses that public housing residency is associated with both housing st...

Objectives: Since the US Supreme Court's 1973 Roe v. Wade decision legalizing abortion, states have enacted laws restricting access to abortion services. Previous studies suggest that restricting access to abortion is a risk factor for adverse maternal and infant health. The objective of this investigation is to study the relationship between the...

Introduction Population health surveys inform and demonstrate the impact of public health policies. However, the performance of such surveys in specific groups of interest (e.g., Hispanics/Latinos in a neighborhood of New York City) is rarely studied. Method We compared measures for obesity, hypertension, diabetes, and current smoking based on the...

Mental health hospitalization rates among U.S. children have been increasing locally and nationally in recent decades. Children in New York State (NYS) have also witnessed several collective traumatic events during the last two decades including the September 11, 2001, terrorist attacks (9/11), the Great Recession, and Hurricane Sandy (2012) and it...

Residential mobility is hypothesized to impact health through changes to the built environment and disruptions in social networks, and may vary by neighborhood deprivation exposure. However, there are few longitudinal investigations of residential mobility in relation to health outcomes. This study examined enrollees from the World Trade Center Hea...

We used differences in state school policies as natural experiments to evaluate the joint influence of educational quantity and quality on late-life physical and mental health. Using US census microsample data, historical measures of state compulsory schooling and school quality (term length, student-teacher ratio, and attendance rates) were combin...

Objectives While ecological studies indicate that high levels of structural racism within US states are associated with elevated infant mortality rates, studies using individual-level data are needed. To determine whether indicators of structural racism are associated with the individual odds for infant mortality among white and black infants in th...

Objective We examined the association between county-level structural racism indicators and the odds of severe maternal morbidity (SMM) in New York State. Design We merged individual-level hospitalization data from the New York State Department of Health Statewide Planning and Research Cooperative System (SPARCS) with county-level data from the Am...

Objective: We examined the association between county-level structural racism indicators and the odds of severe maternal morbidity (SMM) in New York State. Design: We merged individual-level hospitalization data from the New York State Department of Health Statewide Planning and Research Cooperative System (SPARCS) with county-level data from the...

Introduction: Although the Hospital Readmissions Reduction Program (HRRP) has decreased readmissions in targeted conditions, outcomes in high-risk subgroups are unknown. This study analyzed the impact of cirrhosis as a comorbidity on readmissions in conditions subjected to the HRRP. Methods: Using a longitudinal analysis of the New York, Florida...

Abstract Objectives To examine trends and utilization patterns of NYC abortion services by non-residents since growing abortion restrictions across many states could drive women to seek care in less restrictive jurisdictions including NYC. Study design We used data from Induced Termination of Pregnancy certificates filed with the NYC Department of...

Objectives Severe maternal morbidity (SMM) is an important indicator for identifying and monitoring efforts to improve maternal health. Studies have identified independent risk factors, including race/ethnicity; however, there has been limited investigation of the modifying effect of socioeconomic factors. Study aims were to quantify SMM risk facto...

Background Infections caused by Mycobacterium abscessus group strains are usually resistant to multiple antimicrobials and challenging to treat worldwide. We describe the risk factors, treatment, and clinical outcomes of patients in 2 large academic medical centers in the United States. Methods A retrospective cohort study of hospitalized adults w...

Background: Unconditional cash transfers (UCTs; provided without obligation) for reducing poverty and vulnerabilities (e.g. orphanhood, old age or HIV infection) are a type of social protection intervention that addresses a key social determinant of health (income) in low- and middle-income countries (LMICs). The relative effectiveness of UCTs com...

Objective: To determine whether physical activity and body mass index (BMI) predict instrumental or basic activities of daily living (I/ADL) trajectories before or after stroke compared to individuals who remained stroke-free. Methods: Using a prospective cohort, the Health and Retirement Study, we followed adults without a history of stroke in...

Objectives: Chronic stress from experiencing discrimination can lead to long-term changes in psychological and physiologic responses, including shorter leukocyte telomere length. We examined the association between leukocyte telomere length and variations in the association by race or type of discrimination. Methods: Our study consisted of 3868...

Importance: Many genetic variants are associated with body mass index (BMI). Associations may have changed with the 20th century obesity epidemic and may differ for black vs white individuals. Objective: Using birth cohort as an indicator for exposure to obesogenic environment, to evaluate whether genetic predisposition to higher BMI has a large...

Objective: To determine whether social contacts and spousal characteristics predict incident instrumental or basic activities of daily living (I/ADL) limitations and whether effects differ for individuals with high risk of dementia. Design: Cohort study. Setting: Biennial interviews of Health and Retirement Study participants over up to 12 yea...

Purpose: Education is an established correlate of cognitive status in older adulthood, but whether expanding educational opportunities would improve cognitive functioning remains unclear given limitations of prior studies for causal inference. Therefore, we conducted instrumental variable (IV) analyses of the association between education and deme...

Racially patterned disadvantage in Southern states, especially during the formative years of primary school, may contribute to enduring disparities in adult cognitive outcomes. Drawing on a lifecourse perspective, we examine whether state of school attendance affects cognitive outcomes in older adults and partially contributes to persistent racial...

Unconditional cash transfers (UCTs) are a common social protection intervention that increases income, a key social determinant of health, in disaster contexts in low- and middle-income countries (LMICs). OBJECTIVES: To assess the effects of UCTs in improving health services use, health outcomes, social determinants of health, health care expenditu...

Introduction Legally mandated segregation policies dictated significant differences in the educational experiences of black and white Americans through the first half of the 20^th century, with markedly lower quality in schools attended by black children. We determined whether school term length, a common marker of school quality, was as...

We investigated associations of work-family conflict and work and family conditions with objectively measured cardiometabolic risk and sleep. Multilevel analyses assessed cross-sectional associations between employee and job characteristics and health in analyses of 1,524 employees in 30 extended-care facilities in a single company. We examined wor...

The prevalence of type 2 diabetes (T2D) and obesity has recently increased dramatically. These common diseases are likely to arise from the interaction of multiple genetic, socio-demographic and environmental risk factors. While previous research has found genetic risk and education to be strong predictors of these diseases, few studies to date hav...

Background: Unconditional cash transfers (UCTs) are a common social protection intervention that increases income, a key social determinant of health, in disaster contexts in low- and middle-income countries (LMICs). Objectives: To assess the effects of UCTs in improving health services use, health outcomes, social determinants of health, health...

This is the protocol for a review and there is no abstract. The objectives are as follows: The primary objective of this review is to assess the effect of UCTs for reducing poverty and vulnerabilities on the use of health services and health outcomes in children and adults in LMICs. Secondary objectives of the review are: to assess the effect of UC...

Few longitudinal studies compare changes in instrumental activities of daily living (IADLs) among stroke-free adults to prospectively document IADL changes among adults who experience stroke. We contrast annual declines in IADL independence for older individuals who remain stroke free to those for individuals who experienced stroke. We also assess...

Much research has focused on the demographic, familial, and social factors associated with racial disparity in cognitive outcomes among older adults. Less is known about the role of geographical and contextual factors. Historically, segregation in the US has led to drastically different living environments. Older African-Americans are more likely t...

Past research shows that spousal death results in elevated mortality risk for the surviving spouse. However, most prior studies have inadequately controlled for socioeconomic status (SES), and it is unclear whether this 'widowhood effect' persists over time. Health and Retirement Study participants aged 50+ years and married in 1998 (n = 12 316) we...

Objectives: To compare typical age-related changes in activities of daily living (ADLs) independence in stroke-free adults with long-term ADL trajectories before and after stroke. Design: Prospective, observational study. Setting: Community-dwelling Health and Retirement Study (HRS) cohort. Participants: HRS participants who were stroke free...

While the association between education and adult health is well documented, it is unclear whether quantity (i.e. years of schooling) or credentials (i.e. degrees) drive this association. Individuals with degrees may have better health than their non-credentialed counterparts given similar years of schooling, the so-called "sheepskin" effect. This...

Purpose: Educational attainment is a robust predictor of disability in elderly Americans: older adults with high-school (HS) diplomas have substantially lower disability than individuals who did not complete HS. General Educational Development (GED) diplomas now comprise almost 20% of new HS credentials issued annually in the United States but it...

Concerns have been raised that education may have greater benefits for persons at high risk of coronary heart disease (CHD) than for those at low risk. We estimated the association of education (less than high school, high school, or college graduates) with 10-year CHD risk and body mass index (BMI), using linear and quantile regression models, in...

Although the socioeconomic impact of school desegregation in the U.S. has been well documented, little is known about the health consequences of this policy. The purpose of this study was to quantify the associations between school desegregation and adolescent births among black and white females. We compared the change in prevalence of adolescent...

Self-reported hypertension is frequently used for health surveillance. However, little is known about the validity of self-reported hypertension among older Americans by nativity status. This study compared self-reported and measured hypertension among older black, white, and Hispanic Americans by nativity using the 2006 and 2008 Health and Retirem...

Attaining a degree may offer greater opportunities for health than years of schooling alone. This study examines whether there is a degree, or "sheepskin," effect on the association between education and blood pressure. Multivariable-adjusted ordinal and linear regression models assessed associations of years of schooling and degree attainment with...

The purpose of this study is to quantify the effect of residential modification on decreasing risk of physical function decline in 2 years. Cohort study using propensity scores method to control for baseline differences between individuals with residential modifications and those without residential modifications. Participants (N = 9,447) were from...

This study used a Cox proportional hazards model to determine whether neighborhood characteristics are associated with risk of readmission for childhood asthma independently of individual characteristics. Rhode Island Hospital Discharge Data from 2001 to 2005 were used to identify children younger than 19 years of age at the time of the index (i.e....

Older adults remain at the highest risk of disability compared to all other age groups. Geography-specific features can affect the disability process. In addition, these factors can impose constraints which may lead to spatial clustering of people with common characteristics. I conducted both standard and spatial linear regression models to assess...

Women with disabilities (WWD) face significant barriers accessing healthcare, which may affect rates of routine preventive services. We examined the relationship between disability status and routine breast and cervical cancer screening among middle-aged and older unmarried women and the differences in reported quality of the screening experience....

Residential modifications and personal assistive devices may prevent disability by reducing task demand. While use of personal assistive devices has been associated with lower self-reports of disability, the effect of residential modifications alone has not been well-studied. Using the nationally representative Second Longitudinal Study on Aging (1...

In 2004, nine million children in the US have been diagnosed with asthma. Asthma risk factors include substandard housing, exposure to environmental pollution, and living in an impoverished neighborhood. To assess the association between neighborhood characteristics and hospital readmissions for pediatric asthma, we merged data from the 2000 US Cen...

A large urban tuberculosis (TB) control program. To identify factors associated with directly observed therapy (DOT) participation and to quantify how early use of DOT affected treatment duration. A retrospective study of 731 Asian-born patients with drug-susceptible Mycobacterium tuberculosis isolates who were verified in New York City between 199...

Background: After an increase in cigarette taxes and implementation of smoke-free workplace legislation, the New York City Department of Health and Mental Hygiene, the New York State Department of Health, and the Roswell Park Cancer Institute undertook large-scale distribution of free nicotine replacement therapy (NRT). We did a 6 month follow-up...