The number of physically and mentally unhealthy days as a measure of health-related quality of life (HRQOL) is used to examine the different effects of the adverse childhood experiences (ACEs) on physical and mental health outcomes. The data, a cross-sectional state-level survey, is obtained from the Behavioral Risk Factor Surveillance System (BRFSS) collected by the Centers for Disease Control and Prevention (CDC) in 2012. Multiple regression analyses are conducted for the study. The results indicate that all individual ACE categories are inversely associated with both physical and mental health, as respondents who exposed to any adverse childhood experience are likely to have physically- and mentally-related poor HRQOL in adulthood. The estimated coefficients for individual ACEs in magnitude on the mental health outcome are, in overall, greater than the estimated coefficients on the physical health outcome. The regression results with accumulative ACE scores indicate that higher levels of the ACE score would affect higher negative health outcomes, such as the dosage effects that appear again in this study. The estimated coefficients of accumulative ACE scores on the mental health outcome exceed the coefficients of ACE scores on physical health outcome for an ACE score of 2 and above. The gap in the estimated coefficients of ACE scores between physically and mentally unhealthy days increases as the ACE score rises. The estimated coefficient at the score ACE8 for the mentally unhealthy days becomes almost twice as large as the coefficient for the physically unhealthy days. Importantly, the negative effects of ACEs on mental health outcomes are significantly greater than the negative effects on physical health outcomes.

The present study investigated the effects of characteristics of caregivers and the caregiving situation on family caregivers’ physical/mental health, using the multiple regression analysis with the time-series and cross-sectional data from the 2015-2018 Behavioral Risk Factor Surveillance System (BRFSS). The regression results indicated that the caregiving role could increase the risk of developing physical/mental health problems. Importantly, this study revealed that the characteristics of caregivers and care recipients were significantly associated with caregivers’ physical/mental health outcomes. Especially the results showed that the caregiver support program was the most significant factor linked to caregivers’ physical/mental health. It pointed to the importance of caregiver education and support programs for family caregivers to cope with the stress from providing care or daily assistance. The results also pinpointed which area of support services for informal caregivers would be a priority to enhance. Thus, the public health policymakers should re-evaluate the current long-term care program to establish a more effective caregiving structure, especially caregiver education and support programs for family caregivers, to improve the informal caregivers’ quality of life.     

This study identifies the differences in the effects of retirement on physical/mental health as health-related quality of life (HRQOL) across marital status subgroups for the retirement-aged population from 2005 to 2016. This study conducts a Two-Stage least squares (2SLS) regression analysis using cross-sectional and time series data drawn from the Behavioral Risk Factor Surveillance System (BRFSS). The empirical results suggest that retirement is negatively associated with physical health outcomes, whereas retirement is positively associated with mental health outcomes. Divorced men who are retired are likely to have 2.028 more physically unhealthy days per month than divorced men who are employed. Widowed or never married women who are retired are likely to have 2.208 and 2.203 respectively more physically unhealthy days than widowed or never married women who are employed. These retired females in the marital status subgroups have the worst negative retirement effect on physical health. Divorced respondents who are retired are likely to have 1.478 and 1.129 more mentally unhealthy days per month for males and females respectively than the counterparts of those who are employed. In conclusion, this study finds the existence of disparities in the effects of retirement on HRQOL, such as physical/mental health outcomes by marital status.

This study aimed to scrutinize the association of the number of chronic health conditions with health behavior. The health behavior was measured by meeting the 2008 Physical Activity Guidelines (PAGs) for Americans for five physical activity levels for adults aged 18 years or older in the United States using data from the 2017 Behavioral Risk Factor Surveillance System (BRFSS). The empirical results of a multivariate logistic regression analysis revealed that respondents living with chronic health conditions were more likely to participate in aerobic physical activities, but not meeting the PAGs. In the insufficient physical activity subgroup, all of the predicted odds ratios were greater than one and increased as the number of chronic health conditions increased. It implied that the increase in the number of chronic conditions was positively associated with participating in insufficient physical activity. Respondents who reported having less than three chronic health conditions were more likely to meet the aerobic physical activity guidelines compared with respondents living with three or more chronic health conditions. Importantly, respondents who reported having 4 or more chronic health conditions had a higher likelihood of meeting the recommendations for muscle-strengthening activity. However, chronic health conditions would significantly discourage respondents from participating in both aerobic and muscle-strengthening physical activities. In conclusion, this study found that chronic health conditions played an important role in determining regular participation in the level of physical activity for individuals living with chronic health conditions.

This study investigated the effect of physical activity on the attitudes toward engaging in driving while impaired by alcohol among adults aged 18 years or older who reported consuming alcohol in the 30 days before the interview. This study conducted the multivariate logistic regression to examine the association between health behavior and attitudes toward driving while impaired by alcohol. Data about self-reported alcohol-impaired driving episodes and the majority of the variables presented in this study were taken from the 2020 Behavioral Risk Factor Surveillance System (BRFSS), a large-scale national health survey data and a cross-sectional state-level survey data set, collected by the Centers for Disease Control and Prevention (CDC). The empirical results indicated that physical activity was associated with reduced engagement in alcohol-impaired driving. The estimated odds ratios from the multivariate logistic regression results were 0.87, 0.87, and 0.85 for overall, males, and females, respectively. In other words, respondents who participated in physical activities were less likely than respondents who were inactive to operate a motor vehicle when they were impaired by alcohol consumption. In short, physical activity was significantly associated with a decrease in the propensity toward engaging in driving while impaired by alcohol for alcohol drinkers.