Author Interviews, Cost of Health Care, JAMA, NIH, Social Issues / 12.03.2020
Recent Older Immigrants May Rely on Public Health Insurance
MedicalResearch.com Interview with:
[caption id="attachment_53451" align="alignleft" width="200"] Dr. Becerra[/caption]
Dr. Adan Z. Becerra PhD
Senior Epidemiologist for the NIH
Social and Scientific Systems
Washington, District Of Columbia
MedicalResearch.com: What is the background for this study?
Response: Previous studies have shown that disparities in insurance coverage by immigration status exist in the United States such that immigrants compared to nonimmigrants are less likely to have insurance. However, most studies have been cross sectional with few studies investigating long term trajectories of insurance coverage over time. We addressed this gap in the literature by following a cohort of adults for 24 years from before until after reaching Medicare age-eligibility.
Dr. Becerra[/caption]
Dr. Adan Z. Becerra PhD
Senior Epidemiologist for the NIH
Social and Scientific Systems
Washington, District Of Columbia
MedicalResearch.com: What is the background for this study?
Response: Previous studies have shown that disparities in insurance coverage by immigration status exist in the United States such that immigrants compared to nonimmigrants are less likely to have insurance. However, most studies have been cross sectional with few studies investigating long term trajectories of insurance coverage over time. We addressed this gap in the literature by following a cohort of adults for 24 years from before until after reaching Medicare age-eligibility.
Dr. Kessler[/caption]
MedicalResearch.com Interview with:
Lawrence M. Kessler, PhD Research Assistant Professor
[caption id="attachment_47359" align="alignleft" width="112"]
Dr. Harris[/caption]
Matthew C. Harris, PhD Assistant Professor
Boyd Center for Business and Economic Research and Department of Economics
The University of Tennessee
MedicalResearch.com: What is the background for this study?
Response: Motivation for this study came from Co-Author, Matt Murray, who was at a speaking engagement and heard a community business leader say “we’ve got jobs, but no one is applying, could opioids be a contributing factor?” This led to a conversation back at the Boyd Center between us and Matt Murray, where we decided that if we could get data on prescription rates, we could answer this question empirically.
We started by contacting each state agency in charge of their respective prescription drug monitoring program to see if they’d be willing to share county-level data on prescription opioid rates. From this letter-writing campaign we received data from 10 states, which formed the basis for our analysis. As time went on, new data was made publicly available and we were able to expand the analysis to all 50 states.
Dr. Leas[/caption]
Eric Leas PhD, MPH
Stanford Prevention Research Center
University of California, San Diego
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Recent research has demonstrated the importance that neighborhood context has on life opportunity, health and well-being that can perpetuate across generations. A strongly defining factor that leads to differences in health outcomes across neighborhoods, such as differences in chronic disease, is the concurrent-uneven distribution of modifiable risk factors for chronic disease.
The main goal of our study was to characterize inequities in smoking, the leading risk factor for chronic disease, between neighborhoods in America's 500 largest cities. To accomplish this aim we used first-of-its-kind data generated from the 500 Cities Project—a collaboration between Robert Wood Johnson Foundation and the US Centers for Disease Control and Prevention—representing the largest effort to provide small-area estimates of modifiable risk factors for chronic disease.
We found that inequities in smoking prevalence are greater within cities than between cities, are highest in the nation’s capital, and are linked to inequities in chronic disease outcomes. We also found that inequities in smoking were associated to inequities in neighborhood characteristics, including race, median household income and the number of tobacco retailers.
Dr. Thompson[/caption]
Rebecca R. Thompson, Ph.D.
Postdoctoral Scholar
Department of Psychological Science
University of California, Irvine
MedicalResearch.com: What is the background for this study?
Response: Our research team has been interested in how people respond to the repeated threat of disaster exposure for many years. We recently published a review of the literature on evacuation from natural disasters, and one of our main findings was that there have been no studies that include assessments of individuals’ intentions, perceptions, and psychological states assessed prior to an approaching storm’s landfall – all prior research has been retrospective, and recall is undoubtedly biased and unreliable. Our goal in undertaking this study was to fill this hole in the literature. We sought to assess individuals' responses to Hurricane Irma in the days leading up to and immediately after its landfall in the State of Florida.
Josephine Funck Bilsteen, MSc
Department of Pediatrics, Hvidovre University Hospital, Hvidovre,
Section of Epidemiology, Department of Public Health
University of Copenhagen
Copenhagen, Denmark
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The background of this study is that there is increasing recognition of the longer-term health and social outcomes associated with preterm birth such as independent living, quality of life, self-perception and socioeconomic achievements. However, much less is known about differences in education and income among adults born at different gestational weeks in the term period.
In this study shorter gestational duration, even within the term range, was associated with lower chances of having a high personal income and having completed a secondary or tertiary education at age 28 years. This is the first study to show that adults born at 37 and 38 completed weeks of gestation had slightly lower chances of having a high income and educational level than adults born at 40 completed weeks of gestation. 
Dr. Wadhera[/caption]
Dr. Rishi Wadhera, MD
Cardiology Fellow
Brigham and Women's Hospital
Harvard Medical School.
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In the United States, an estimated half a million people are homeless on any given night. In recent years, policy efforts to improve the health of homeless individuals have intensified, but there is little large-scale, contemporary data on how these efforts have impacted patterns of acute illness in this vulnerable population.
In this study, we examined trends, causes, and outcomes of hospitalizations among homeless individuals in three states – Massachusetts, Florida, and California – from 2007 to 2013. We found that hospitalization rates among homeless adults increased over this period of time.
Strikingly, over one-half of these hospitalizations were for mental illness and substance use disorder. More broadly, homeless adults were hospitalized for a very different set of reasons compared with demographically similar non-homeless adults. In addition, homeless individuals had longer lengths of hospitalization but lower total costs per hospitalization.