American journal of preventive medicine
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The purpose of this study is to compare opioid prescribing and high-risk prescribing by race and ethnicity in a national cohort of U.S. veterans. ⋯ Non-Hispanic White and non-Hispanic American Indian/Alaska Native veterans had the greatest likelihood to receive an opioid prescription. When an opioid was prescribed, high-risk prescribing was more common in White and American Indian/Alaska Native veterans than in all other racial/ethnic groups. As the nation's largest integrated healthcare system, the Veterans Health Administration can develop and test interventions to achieve health equity for patients experiencing pain.
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Levels of gun ownership and lethal violence in the U.S. far surpass those in any other developed country, and yet, there is little known about the origins of these trends owing to a lack of historical data on the prevalence of gun ownership. To fill this gap, this study extends an existing proxy for household gun ownership rates-firearm suicides divided by suicides-from 1949 to 2020, including new coverage for the 1949 to 1972 period. ⋯ Unlike most gun prevalence measures that are representative at the national or regional level, this proxy represents household gun ownership trends at the state level and is not reliant on self-reported data that are prone to social desirability bias. This extended proxy represents the longest-ranging data set of state-level gun ownership rates to date.
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Chronic pain affects an estimated 20% of U.S. adults. Because high-deductible health plans have captured a growing share of the commercial insurance market, it is unknown how high-deductible health plans impact care for chronic pain. ⋯ By reducing the use of nonpharmacologic chronic pain treatments and marginally increasing out-of-pocket costs among those using these services, high-deductible health plans may discourage more holistic, integrated approaches to caring for patients with chronic pain conditions.
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Home blood pressure monitoring is more convenient and effective than clinic-based monitoring in diagnosing and managing hypertension. Despite its effectiveness, there is limited evidence of the economic impact of home blood pressure monitoring. This study aims to fill this research gap by assessing the health and economic impact of adopting home blood pressure monitoring among adults with hypertension in the U.S. ⋯ Home blood pressure monitoring could substantially reduce the burden of cardiovascular disease and save healthcare costs in the long term, and the benefits could be more pronounced in racial and ethnic minority groups and those living in rural areas. These findings have important implications in expanding home blood pressure monitoring for improving population health and reducing health disparities.
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People with disabilities face unique challenges that may affect skin cancer prevention, diagnosis, and access to treatment. These challenges could be exacerbated by the COVID-19 pandemic. In 2022, the prevalence of self-reported skin cancer diagnoses, delayed medical care because of the coronavirus disease 2019 (COVID-19) pandemic, and skin cancer risk factors among people with disabilities were estimated. ⋯ Because of disability-related challenges, older age, and delaying medical care during the pandemic, people with disabilities may be at increased risk for inequitable skin cancer outcomes.