American journal of preventive medicine
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Lack of insurance is associated with suboptimal receipt of diabetes preventive care. One known reason for this is an access barrier to obtaining healthcare visits; however, little is known about whether insurance status is associated with differential rates of receipt of diabetes care during visits. ⋯ Lack of insurance is associated with a lower probability of receiving recommended services that are due during a clinic visit. Thus, the association between being uninsured and receiving fewer preventive services may not be completely mediated by access to clinic visits.
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Although the association between obesity and diabetes is well known, the factors predisposing to diabetes in non-obese Asians are less clearly characterized. ⋯ Individuals with normal BMI may develop diabetes mainly through IIS, whereas individuals with high BMI may develop diabetes primarily through IR.
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Understanding the joint effects of insurance type and primary care physician density on stage at diagnosis is essential to elucidating the healthcare access and late-stage cancer relationship. ⋯ As primary care physician density increases, those with private insurance consistently benefit the most in terms of late-stage cancer diagnosis, whereas those with several other insurance types experience flatter decreases or significantly higher odds of late-stage cancer diagnosis.
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Childhood obesity remains a public health concern, and tracking local progress may require local surveillance systems. Electronic health record data may provide a cost-effective solution. ⋯ Electronic health records that are weighted and adjusted to account for intrinsic bias may create an opportunity for comparing regional disparities with precision. In PHINEX patients, childhood obesity disparities were measurable from a young age, highlighting the need for early intervention for at-risk children. The electronic health record is a cost-effective, promising tool for local obesity prevention efforts.
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Knowledge of the biological pathways and mechanisms connecting social factors with health has increased exponentially over the past 25 years, yet in most clinical settings, screening and intervention around social determinants of health are not part of standard clinical care. Electronic medical records provide new opportunities for assessing and managing social needs in clinical settings, particularly those serving vulnerable populations. ⋯ If barriers related to incentives, training, and privacy can be overcome, electronic medical record systems can improve the integration of social determinants of health into healthcare delivery systems. More evidence is needed to evaluate the impact of such integration on health care outcomes before widespread adoption can be recommended.