Preventive medicine
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Preventive medicine · Oct 2023
Dynamics of colorectal cancer screening in low and middle-income countries: A modeling analysis from Thailand.
Low and middle-income countries face constraints for early colorectal cancer (CRC) detection, including restricted access to care and low colonoscopy capacity. Considering these constraints, we studied strategies for increasing access to early CRC detection and reducing CRC progression and mortality rates in Thailand. ⋯ Until colonoscopy capacity increases, enhanced screening and symptom evaluation are needed simultaneously to curb CRC deaths, albeit not the best strategy for CRC progression prevention.
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Preventive medicine · Oct 2023
Promoting health equity through poverty alleviation policy: Factors associated with receipt of the 2021 U.S. Child Tax Credit in a Nationwide sample.
The 2021 temporary expansion of the U.S. Child Tax Credit (CTC) was a potent policy that addressed poverty as a critical social determinant of health. Yet policies can only have their intended effects if they are implemented appropriately, and it is well known that not all who were eligible for the CTC received it. In this study, we investigated which individual- and state-level factors were correlated with receipt of the 2021 expanded CTC among eligible families. ⋯ As Congress debates whether to make the CTC expansion permanent, this study provides timely evidence to inform poverty alleviation programs to increase participation among eligible and marginalized groups and achieve health equity.
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Preventive medicine · Oct 2023
Trends in unmet health care needs among adults in the U.S., 2019-2021.
To examine recent trends in unmet health care needs among US adults, cross-sectional data of 93,047 adults from 2019 to 2021 National Health Interview Survey were analyzed. The weighted prevalence and changes in prevalence of cost-related or COVID-19-related unmet health care needs were estimated, first overall and then stratified by socio-demographic characteristics. The prevalence of cost-related unmet health care needs was 8.3% (95% CI: 7.8%, 8.8%) in 2019, which significantly decreased to 6.6% (95% CI: 6.2%, 7.0%) in 2020 and 6.1% (95% CI: 5.7%, 6.4%) in 2021. ⋯ The prevalence of COVID-19-related unmet health care needs significantly decreased across most socio-demographic groups between 2020 and 2021 (absolute changes ranged from -4.9% to -2.4%), with significant reductions among the older, the unemployed, non-Hispanic Black adults, and adults with education level ≥ college. Overall, a modest decrease in the prevalence of both cost-related and COVID-19-related unmet health care needs was observed between 2019 and 2021. However, the fact that over 10% of US adults had unmet health care needs because of the COVID-19 pandemic is still concerning, warranting continued surveillance.
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Preventive medicine · Oct 2023
The prevalence and clustering of alcohol consumption, gambling, smoking, and excess weight in an English adult population.
The aim of this study was to examine the prevalence and clustering of four health risks (increasing-/higher-risk drinking, current smoking, overweight/obesity, and at-risk gambling), and to examine variation across sociodemographic groups in the English adult population. ⋯ An understanding of the prevalence, clustering, and risk factors for multiple health risks can help inform effective prevention and treatment approaches and may support the design and use of multiple behaviour change interventions.
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Preventive medicine · Oct 2023
A population-based survey of self-reported delays in breast, cervical, colorectal and lung cancer screening.
The early COVID-19 pandemic was associated with cessation of screening services, but the prevalence of ongoing delays in cancer screening into the third year of the pandemic are not well-characterized. In February/March 2022, a population-based survey assessed cancer needs in New Hampshire and Vermont. The associations between cancer screening delays (breast, cervical, colorectal or lung cancer) and social determinants of health, health care access, and cancer attitudes and beliefs were tested. ⋯ Cost was the most common reason for delayed lung cancer screening (36%). COVID-19 was indicated as a delay reason in 15-29% of respondents; 12-20% reported health system capacity during the pandemic as a reason for delay, depending on screening type. Interventions that address sub-populations and reasons for screening delays are needed to mitigate the impact of the COVID-19 pandemic on cancer burden and mortality.