American journal of preventive medicine
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Healthcare spending occurs disproportionately among a very small portion of the population. Research on these high-cost users (HCUs) of health care has been overwhelmingly cross-sectional in nature and limited to the few sociodemographic and clinical characteristics available in health administrative databases. This study is the first to bridge this knowledge gap by applying a population health lens to HCUs. We investigate associations between a broad range of SES characteristics and future HCUs. ⋯ Findings suggest that addressing social determinants of health, such as food and housing security, may be important components of interventions aiming to improve health outcomes and reduce costs.
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Large, recent migration streams from the non-Hispanic Caribbean islands and Africa have increased the share of U.S. blacks born outside of the U.S. Little is known about health patterns in these foreign-born populations. The purpose of this study is to compare obesity levels among self-identified U.S. blacks across birth regions and examine potential explanations for subgroup differences. ⋯ Foreign-born blacks generally had lower obesity levels compared to their U.S.-born counterparts, which was not explained by SES or smoking behaviors. Despite this advantage, obesity prevalence among foreign-born black women was around 30%, suggesting that obesity poses a significant health risk this population.
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All adolescent and adult patients should be asked if they smoke. Data entered in electronic medical records offer new opportunities to study tobacco-related clinical activities. The purpose of this study is to examine the recording of tobacco use in Canadian electronic medical records. ⋯ A third of Canadians in this sample lacked data on tobacco in their electronic medical record. Younger, healthier people were less likely to have information about their smoking status. Efforts to improve the recording of tobacco-related information in electronic medical records, especially for younger patients, are needed.
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The emerging trends and rapid growth of electronic cigarettes (e-cigarettes) among adolescents are being monitored closely. The trends are critical as policy to prevent uptake among adolescents is considered. The purpose of this study is to describe the prevalence of e-cigarette use and potential correlates for use. Associations between e-cigarettes, cigarettes, and hookah are assessed. ⋯ Although e-cigarettes are being assessed as a potential replacement product for traditional tobacco, evidence from this study indicates the possibility of multiple product use among adolescents. E-cigarettes are not only associated with traditional cigarettes, but also with hookahs, a similar emerging product that offer tobacco flavors that may appeal to adolescents. Notably, many e-cigarette users also reported no cigarette or hookah use.