Preventive medicine
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Preventive medicine · Dec 2020
Development and nationwide application of an antibiotic knowledge scale.
Misconceptions about antibiotics among the public can potentially lead to their inappropriate use. Currently, there is no antibiotic knowledge assessment tool to address this issue. This study aimed to develop and validate an antibiotic knowledge scale (AKS) and apply this scale to assess public knowledge about antibiotics in China. ⋯ The AKS demonstrated satisfactory reliability and validity in identifying the population with poor antibiotic knowledge. Importantly, the majority of participants had inadequate knowledge about antibiotics. Thus, it is necessary to conduct interventions focusing on improving public knowledge about antibiotics.
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Preventive medicine · Dec 2020
The impact of acculturation to the US environment on the dietary share of ultra-processed foods among US adults.
This study examined the association between measures of acculturation to the US environment including place of birth, and language spoken at home and proportion of life in the US among foreign-born, in relation to the dietary contribution of ultra-processed foods. Ultra-processed foods, as defined by the NOVA food classification system, are formulations of macronutrients (starches, sugars, fats and protein isolates) with little, if any, whole food and often with added flavors, colors, emulsifiers and other cosmetic additives. We studied 14,663 participants from the National Health and Nutrition Examination Survey 2011-2016, aged 20+ years, who completed a 1-day 24-h dietary recall. ⋯ Within foreign-born adults, ultra-processed food consumption increased with English permeation at home from 40% among individuals speaking non-English languages only to 50% among those speaking English only (p for linear trend <0.001). In addition, ultra-processed food consumption increased from 41% among foreign-born adults who spent less than 30% of their life in the US to 48% among those who lived in the US for more than 50% of their lives (p for linear trend <0.001). Race/ethnicity emerged as an important effect modifier for the observed associations.
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Preventive medicine · Dec 2020
Ranking sociodemographic, health behavior, prevention, and environmental factors in predicting neighborhood cardiovascular health: A Bayesian machine learning approach.
Cardiovascular disease is the leading cause of death in the United States. While abundant research has been conducted to identify risk factors for cardiovascular disease at the individual level, less is known about factors that may influence population cardiovascular health outcomes at the neighborhood level. ⋯ Results showed that neighborhood behavioral factors such as the proportions of people who are obese, do not have leisure-time physical activity, and have binge drinking emerged as top five predictors for most of the neighborhood cardiovascular health outcomes. Findings from this study would allow public health researchers and policymakers to prioritize community-based interventions and efficiently use limited resources to improve neighborhood cardiovascular health.
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Preventive medicine · Dec 2020
Adverse social factors and all-cause mortality among male and female patients receiving care in the Veterans Health Administration.
Social factors account more for health outcomes than medical care, yet health services research in this area is limited due to the lack of social factors data contained within electronic health records (EHR) systems. Few investigations have examined how cumulative burdens of co-occurring adverse social factors impact health outcomes. From 293,872 patients in one region of the Veterans Health Administration (VHA), we examined how increasing numbers of adverse social factors extracted from the EHR were associated with mortality across a one-year period for male and female patients. ⋯ Non-specific psychosocial factors were most strongly associated with mortality, followed by social or familial problems. Although women were more likely than men to have multiple adverse social factors, social factors were not associated with mortality among women as they were among men. By incorporating social factors data, health care systems can better understand patient all-cause mortality and identify potential prevention efforts built around social determinants.
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Preventive medicine · Dec 2020
Comparative StudyCOVID-19 treatment resource disparities and social disadvantage in New York City.
Black and Hispanic communities in the U. S. have endured a disproportionate burden of COVID-19-related morbidity and mortality. Racial and ethnic health disparities such as these are frequently aggravated by inequitable access to healthcare resources in disadvantaged communities. ⋯ In contrast, majority Black and Hispanic ZCTAs had fewer licensed and ICU beds (CI [6.50, 124.25]; CI [0.69, 7.16]), with social disadvantage predicting lower licensed and ICU bed access per 1000 persons (p < 0.01). While news reports of inequitable access to COVID-19-related healthcare resources in ethnocultural minority communities have emerged, this is the first study to reveal that social disadvantage may be a major driver of hospital resource inequities in Black and Hispanic communities. Thus, it will be imperative to enact policies that ensure equitable allocation of healthcare resources to socially disadvantaged communities to address current and future public health crises.