Preventive medicine
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Preventive medicine · Jun 2018
Projected impacts of federal tax policy proposals on mortality burden in the United States: A microsimulation analysis.
The public health consequences of federal income tax policies that influence income inequality are not well understood. I aimed to project the impacts on mortality of modifying federal income tax structures based on proposals by two recent United States (U. S.) Presidential candidates: Donald Trump and Senator Bernie Sanders. ⋯ Under the modified Sanders plan with redistribution, 333,504 (95% CI: 192,897-473,787) fewer deaths/year are expected. Policies that both raise federal income tax rates and redistribute tax revenue could confer large reductions in the total number of annual deaths among Americans. In this era of high income inequality and growing public support to address the rich-poor gap, policymakers should consider joint federal tax and redistributive policies as levers to reduce the burden of mortality in the United States.
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Preventive medicine · Jun 2018
Medical-encounter mental health diagnoses, non-fatal injury and polypharmacy indicators of risk for accident death in the US Army enlisted soldiers, 2004-2009.
Accidents are a leading cause of deaths in U. S. active duty personnel. Understanding accident deaths during wartime could facilitate future operational planning and inform risk prevention efforts. ⋯ Further research could test for replicability and expand models to include unobserved factors or modifiable mechanisms related to high risk. PTSD predicted high risk among those never deployed, suggesting importance of identification, treatment, and prevention of non-combat traumatic events. Finally, risk predictors overlapped with those identified for suicides, suggesting effective intervention might reduce both types of deaths.
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Preventive medicine · Jun 2018
Multilevel model to estimate county-level untreated dental caries among US children aged 6-9years using the National Health and Nutrition Examination Survey.
Because conducting population-based oral health screening is resource intensive, oral health data at small-area levels (e.g., county-level) are not commonly available. We applied the multilevel logistic regression and poststratification method to estimate county-level prevalence of untreated dental caries among children aged 6-9years in the United States using data from the National Health and Nutrition Examination Survey (NHANES) 2005-2010 linked with various area-level data at census tract, county and state levels. We validated model-based national estimates against direct estimates from NHANES. ⋯ The model-based national estimate (19.9%) matched the NHANES direct estimate (19.8%). We found significantly positive correlations between model-based estimates for 8-year-olds and direct estimates from the third-grade State Oral Health Surveys (SOHS) at state level for 34 states (Pearson coefficient: 0.54, P=0.001) and SOHS estimates at county level for 53 New York counties (Pearson coefficient: 0.38, P=0.006). This methodology could be a useful tool to characterize county-level disparities in untreated dental caries among children aged 6-9years and complement oral health surveillance to inform public health programs especially when local-level data are not available although the lack of external validation due to data unavailability should be acknowledged.
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Preventive medicine · Jun 2018
Attitudes toward smokeless tobacco use at all public sports venues among U.S. adults, 2016.
Policies prohibiting smokeless tobacco (SLT) use at sports venues have been enacted in California and nine U. S. cities. We measured opposition toward SLT use at all public sports venues and its correlates among U. ⋯ Most U. S. adults, including three-fifths of current tobacco product users, oppose SLT use at all public sports venues. Complete tobacco-free policies for sports venues that prohibit all forms of tobacco product use can help reduce the social acceptability of SLT use.