Preventive medicine
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Preventive medicine · Jul 2021
Health-related behaviors and health insurance status among US adults: Findings from the 2017 behavioral risk factor surveillance system.
Health insurance coverage has increased overtime in the US. This study examined the associations between health insurance status and adoption of health-related behaviors among US adults. Using data collected through the 2017 Behavioral Risk Factor Surveillance System on health insurance coverage and type of insurance, we examined four health-related behaviors (i.e., no tobacco use, nondrinking or moderate drinking, meeting aerobic physical activity recommendations, and having a healthy body weight) and their associations with health insurance status. ⋯ Adults with public insurance were 7% more likely to report no tobacco use than adults who were uninsured. Additionally, adults with private insurance were 8% and 7% more likely to report no tobacco use and meeting physical activity recommendations, respectively, but 10% less likely to report nondrinking or moderate drinking than adults with public insurance. In conclusion, we found significant associations existed between having health insurance coverage and engaging in some health-related behaviors among US adults.
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Preventive medicine · Jul 2021
Development and validation of a risk prediction model for high-risk adenomas at the time of first screening colonoscopy among screening aged Canadians.
The aim of this study was to develop a risk prediction model for high risk adenomas (HRAs) detected at screening colonoscopy based on readily available participant information. The cohort consisted of 3035 participants aged 50 to 74 years with no history of cancer who underwent a primary screening colonoscopy at a centralized colon cancer screening centre between 2008 and 2016. A multivariable logistic regression model was created using CRC risk factors identified from prior research. ⋯ Our model has moderate predictive ability, with strengths in being able to rule out those with an absence of HRAs on screening colonoscopy. Maximizing screening efficiency through improved risk prediction can enhance resource allocation. Ultimately, this model has the potential to improve patient care by reducing unnecessary colonoscopies, limiting this invasive procedure to those most likely to have significant findings.
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Preventive medicine · Jul 2021
Social distancing attitudes, national context, and health outcomes during the COVID-19 pandemic: Findings from a global survey.
This study analyzes global health consequences of the new coronavirus disease by focusing on the roles of normative beliefs on social distancing and country-level factors, i.e., mobility estimate and globalization index. We fitted mixed effects models to examine the associations between two outcome measures, depression and self-rated health, and their multilevel determinants using a subset of Global Behaviors and Perceptions in the COVID-19 Pandemic, an online survey consisting of more than 100,000 participants from 67 nations. Results show that both personal beliefs and general beliefs significantly predict depression and poor health. ⋯ With respect to poor health, the effect of general beliefs similarly varies inversely with the level of globalization. Our study indicates that one's own beliefs and the perception of others' regarding social distancing, along with contextual factors (measures of mobility and globalization), critically shape mental and physical health. Subjective and objective factors should be considered, in other words, in properly understanding the differential impact of COVID-19 across the world.
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Preventive medicine · Jul 2021
Suicide as a hidden contributor to the opioid crisis and the role that primary care and emergency medicine play in addressing it.
Deaths from overdose have risen dramatically over the past decade, driven mainly by opioids. In response, the Centers for Disease Control and Prevention released guidance on safe prescribing, safe storage of medications, Medication-Assisted Treatment (MAT), and the use of Naloxone to reverse an overdose. Even with this guidance, overdose deaths continue to rise. ⋯ Primary care and emergency departments have a major role to play. This commentary describes suicide as a hidden contributor to the opioid crisis; the rationale for integration of suicide prevention in primary care and emergency departments; and screening, education, brief intervention, and follow up and monitoring techniques that these settings can employ. Done effectively, this strategy has the potential to save countless lives.
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Preventive medicine · Jul 2021
Public guns, private violence: The association of city-level firearm availability and intimate partner homicide in the United States.
This city-level study examines the association of federally licensed firearm dealers (FFLs) and measures of illegal firearm availability with the risk of intimate partner homicide. Annual data for a sample of 286 large cities in the United States were collected for the years 2010-2019, incorporating city-level information on the number of gun-perpetrated homicides, the rate of licensed firearm dealers, and guns reported lost or stolen. All data were compiled and analyzed in 2020. ⋯ Results indicate that a higher rate of licensed firearm dealers was associated with a higher risk of intimate partner homicide, although more pronounced in states with lower-than-average existing gun ownership. This association was robust to different analytical methods and alternate ways of capturing illegal guns. A supplementary analysis using unique data from The Trace further supports the argument that FFL presence is a risk factor for intimate partner firearm homicide specifically, but not necessarily firearm homicide characterized by other motives.