Preventive medicine
-
Preventive medicine · Apr 2022
Changes in preventive services use by race and ethnicity after medicare eligibility in the United States.
Use of recommended preventive care services in the United States is not universal and varies considerably by socio-economic status. We examine whether widespread eligibility for Medicare at age 65 narrows disparate preventive service use by race and ethnicity. Using data across 12 cycles of the Household Component of the Medical Expenditure Panel Survey (2005-2016), we employ a regression discontinuity design to assess changes in the use of preventive services. ⋯ For non-Hispanic Black adults, we found that preventive service use increased after age 65 across a range of measures including a 4.8 percentage-point (95% confidence interval (CI)1.4, 8.2) increase in blood cholesterol screening, and a 9.1 percentage-point (95% CI 2.1, 15.9) increase in mammograms for Black women. For all four preventive health measures that were lower for Hispanic adults compared with non-Hispanic White adults prior to age 65, service use was indistinguishable (p > 0.10) between these groups after reaching the Medicare eligibility age. Medicare eligibility appeared to reduce most racial and ethnic disparities in preventive service use.
-
Preventive medicine · Apr 2022
Randomized Controlled TrialPostal reminder with reduced burden of clinic information seeking for equitable participation in general health check-ups: A randomized controlled trial.
High participation rate and low inequality in participation are key to the program success of general health check-ups in Japan. This study examined the effectiveness of a postal reminder including nearest clinic information, compared to the standard postal reminder including details of all local clinics, on participation rate and income-based participation rate in general health checks. This was a single-blind, two-arm, prospective, randomized controlled study conducted at the Fukuoka Branch of Japan Health Insurance Association. ⋯ The intervention effect was estimated to decrease as the income category increased (P for interaction = 0.037). Tailored postal reminders with information on the nearest clinic were able to improve the overall participation rate and reduce income-based inequality in participation for general health check-ups in Japan. Trial registration: UMIN-CTR, UMIN000042509, Registered 26 November 2020 - Retrospectively registered.
-
Preventive medicine · Apr 2022
Prevalence and factors associated with self-reported exposure to secondhand cannabis smoke in the United States and Canada in 2019.
Little is known about exposure to secondhand cannabis smoke (SHCS) among residents of detached single-family homes and multiunit housing (MUH). Using data from the 2019 International Cannabis Policy Study, the prevalence of (a) self-reported exposure to SHCS at home (n = 33,024) and (b) self-reported SHCS incursions into MUH (defined as SHCS from another unit/the outdoors, n = 15,634) was estimated in (1) Canada; (2) US states where non-medical cannabis use was legal, and (3) US states where it remained illegal. Factors associated with exposures and incursions were assessed using weighted logistic regression. ⋯ One quarter (25.7%) of Canadian MUH residents, 26.6% from US legal states, and 20.1% from US illegal states reported at least monthly incursions. Sociodemographic factors associated with incursions suggested MUH residents reporting incursions lived in qualitatively different MUH than those not reporting incursions. Irrespective of the legality of non-medical cannabis use, smoke-free policies in MUH should protect residents from involuntary exposure to all types of secondhand smoke.
-
Preventive medicine · Apr 2022
Optimizing screening with faecal immunochemical test for both sexes - Cost-effectiveness analysis from Finland.
A faecal immunochemical test (FIT) screening pilot was introduced in Finland in 2019 with sex-specific screening strategies. This study aims to model cost-effectiveness of sex-specific strategies for the whole population, and to assess whether the current strategies are optimal. We developed separate MISCAN-Colon models, including different FIT performances, for the Finnish men and women using the first-year data of the FIT screening pilot. ⋯ Among strategies with the same target age and interval for both sexes, expected benefits from optimal screening were lower but still reasonable. Our results support a wider age range of screening in men, and a lower cut-off for a positive test in women when restrictions on colonoscopy capacity and costs are in place. National FIT screening program should start at younger age.