Preventive medicine
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Preventive medicine · Dec 2021
Healthcare lobbying on upstream social determinants of health in the US.
Healthcare stakeholders are increasingly investing to address social determinants of health (SDOH) as they seek to improve health outcomes and reduce total healthcare costs in their communities. Policy heavily shapes SDOH, and healthcare lobbying on SDOH issues may offer large impacts through positive policy change. ⋯ Lobbying has been a missed opportunity for addressing SDOH. Healthcare organizations have the opportunity to expand their lobbying on upstream SDOH policy issues to increase the impact of their SDOH strategy and further improve population health.
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Preventive medicine · Dec 2021
Prenatal cannabis use disorder and future risk of road traffic injuries in Canadian children.
The extent to which child traffic injuries may be attributed to parents who use cannabis before driving is unknown. We investigated whether prenatal cannabis use disorders may predict future road traffic injuries in children. We conducted a cohort study of 792,082 children in Quebec, Canada with 6,280,663 years of follow-up between 2006 and 2019. ⋯ The risk increased with the child's age. Prenatal cocaine, opioid, and other drug use disorders were not associated with pediatric transport-related injuries. Maternal cannabis use disorders before birth may be an early predictor of childhood injuries from motor vehicle crashes.
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Preventive medicine · Dec 2021
A nationwide cohort investigation on pay-for-performance and major adverse limb events in patients with diabetes.
A retrospective cohort study was conducted using claims data from Taiwan's National Health Insurance program to assess the effect of diabetic pay-for-performance (P4P) program on major adverse limb events (MALE) and major adverse cardiovascular events (MACE) in patients with type 2 diabetes mellitus (T2DM). This study included patients with T2DM who had completed or not completed a 1-year P4P program from 2002 to 2013. Propensity-score matching was used to balance the baseline characteristics between groups. ⋯ Regarding the individual components, the P4P group demonstrated lower risks for foot ulcer (1.1% vs 1.3%, SHR 0.80, 95% CI 0.77-0.84), gangrene (0.57% vs 0.93%, SHR 0.59, 95% CI 0.56-0.63), percutaneous transluminal angioplasty (0.61% vs 0.79%, SHR 0.72, 95% CI 0.68-0.77), and amputation (0.46% vs 0.75%, SHR 0.58, 95% CI 0.55-0.62). In addition, the risks of MACE, ST, HF hospitalization, and all-cause mortality were remarkably lower in the P4P group. The P4P program might significantly reduce critical events of MALE, MACE, ST, HF, and mortality in the diabetic population.
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Preventive medicine · Dec 2021
Issues surrounding incentives and penalties for COVID-19 vaccination: The Israeli experience.
The purpose of this study was to examine patterns of COVID-19 vaccination in Israel and how these relate to different proposals made about benefits for those vaccinated, and to present the legal and ethical dilemmas surrounding these issues. A retrospective study of COVID-19 vaccination rates in Israel was conducted, with data obtained from the Ministry of Health (MOH). Information on benefits proposed or offered for vaccination and restrictions for non-vaccination were obtained from the MOH and presented in a timeline. ⋯ Incentive schemes which impose limitations on those who choose not to vaccinate may motivate some people to take action. Policymakers should use a measured approach to protect public health, with minimum infringement on citizens' rights. Providing transparent and culturally appropriate information on immunization and ensuring maximal and equitable access to COVID-19 vaccines may help build trust.
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Preventive medicine · Dec 2021
Associations between breast cancer screening participation and residential area sociodemographic features, geographic accessibility, and features of screening venue location in Greater Sydney, Australia.
Breast cancer screening (BCS) participation rates are often suboptimal and vary geographically. Environmental features may influence BCS participation, but few studies have assessed this relationship. This study assessed the associations between BCS participation, residential area sociodemographic characteristics, distance to BCS venue, and venue location attributes. ⋯ Residential sociodemographic features, geographic access, and venue location attributes are associated with BCS participation. These findings implicate the relevance of social and built environmental factors to programmatic aims to raise BCS participation. Additional research on venue location features is required to understand where best to site BCS venues.