Preventive medicine
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Preventive medicine · Dec 2021
Re-evaluating Perinatal Group B Streptococcal screening in Israel - Is it time for a change in policy?
Group B streptococcal early-onset disease (EOGBSD) is a significant cause of morbidity and fatality in newborns. Current policy in Israel is risk-based management. Our aim was to re-evaluate the current screening policy for Group B Streptococcus (GBS), considering colonization and prevalence rates and costs estimates. ⋯ Universal culture-based screening was found to be 50% less costly than the current risk-based policy, and would have prevented 20.29 per 100,000 cases. Universal GBS culture-based screening was found to be more cost-effective, compared to the current policy and screening behaviors. Due to the clinical and economic benefits, we recommend that a change in policy should be considered.
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Preventive medicine · Dec 2021
The association between three key social determinants of health and life dissatisfaction: A 2017 behavioral risk factor surveillance system analysis.
Poor health outcomes disproportionately impact certain populations in the United States owing to the inequitable distribution of social determinants of health (SDOH). Using the 2017 Behavioral Risk Factor Surveillance System (BRFSS), we estimated the association of three adverse SDOH (housing insecurity, food insecurity, and financial instability) with life dissatisfaction. Participants were from Wisconsin, Minnesota, and Ohio, the only states that included the SDOH and Emotional Support and Life Satisfaction modules (n = 25,850). ⋯ Participants with frequent mental distress (FMD) had greater prevalence differences than those without FMD (for housing insecurity, food insecurity, and financial instability, respectively: with FMD, PD = 15.4 [7.5, 23.3], 10.7 [4.7, 16.7], 14.4 [9.6, 19.3]; without FMD, PD = 6.1 [-0.5, 12.5], 5.3 [1.6, 9.0], 2.5 [2.0, 3.0]). Social determinants may not only influence physical health but also have an impact on psychological well-being. This impact may be altered by levels of emotional support and FMD.
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Preventive medicine · Dec 2021
Impact of geographic access to primary care providers on pediatric behavioral health screening.
Behavioral Health (BH) screening is critical for early diagnosis and treatment of pediatric mental disorders. The objective of this study was to assess the impact of geographic access to primary care providers (PCP) on pediatric BH screening in children with different race/ethnicity. A retrospective cohort study was conducted using the 2013-2016 administrative claims data from a large pediatric Medicaid Managed Care Plan that have been linked to 2010 US Census data and the 2017 National Provider Identifier (NPI) Registry. ⋯ Multivariable analysis stratified by individual race/ethnicity revealed that Hispanic and Black children were more vulnerable to the geographic access barriers than their non-Hispanic White counterparts. The increase in travel distance to the nearest PCP was negatively associated with screening uptake only among Hispanics (10-20 miles vs. 0-10 miles: OR = 0.78, 95% CI [0.71-0.86]; 20-30 miles vs. 0-10 miles: OR = 0.35, 95% CI [0.23-0.54]). In a subgroup that had access to at least one PCP within 10 miles of travel distance, the variation in PCP density had a greater impact on the screening uptake among Hispanics and Blacks than that in non-Hispanic Whites.
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Preventive medicine · Dec 2021
Changes in parental smoking behavior and children's health status in Chile.
Studies on parental smoking behavior have mostly been conducted for developed countries and show that current parental smoking is negatively associated with children's current health. Using four waves of a Chilean longitudinal survey (Encuesta de Protección Social), we estimate probit and ordinary least squares models relating parents' self-report of their children's current health status to several covariates, including current parental smoking status and change (transitions) in parental smoking status across the waves of the survey. The data were collected in the years 2004, 2006, 2009, and 2015. ⋯ Cessation among mothers who are unemployed or inactive is also associated with a more positive assessment of their children's health status. The findings suggest that cessation programs may have health benefits not only for smoking parents, but also for their children. Improving coverage or establishing a national cessation program may have important present and future effects on population health and well-being.
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Preventive medicine · Dec 2021
Association between opioid overdose death rates and educational attainment - United States, 2010-2019.
Educational attainment may be an indicator of disparities in the ongoing opioid-overdose crisis. To understand the association between educational attainment and fatal opioid overdose, death records in the mortality files published by the Centers for Disease Control and Prevention (CDC) from 2010 to 2019 were analyzed. Proportionate mortality due to opioid overdose, PMOD, was used, as age-adjusted death rates suffer dual data-source errors caused by differences in educational data reported in death records and in population surveys. ⋯ These results suggest that the impact of lower educational attainment may be getting worse and furthering inequities in health. Responses to the opioid-overdose epidemic should consider the large educational gradient. Extra attention to the most vulnerable groups is necessary.