Comparison of Local Public Health Departments Highlights Social Inequities

MedicalResearch.com Interview with:

Megan Wallace, DrPH Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore, Maryland

Dr. Wallace

Megan Wallace, DrPH
Department of Epidemiology
Johns Hopkins Bloomberg School of Public Health
Baltimore, Maryland

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Local health departments are often evaluated on a nationwide or statewide basis, however, given diversity among counties that exists even at the state level, we felt there might be a better way to group health departments for evaluation.

In this study, we created county-level clusters using local characteristics most associated with the outcomes of interest, which were smoking, motor vehicle crash deaths, and obesity. We then compared county-level percentile rankings for the outcomes within sociodemographic peer clusters vs nationwide rankings. We identified 8 groups of counties with similar local characteristics.

Percentile ranks for the outcomes of interest often differed when counties were compared within their peer groups in comparison with a nationwide scale.  Continue reading

Adolescent Gun Injuries Peak at Ages 15-17

MedicalResearch.com Interview with:
“Me holding USP gun” by Nghị Trần is licensed under CC BY 2.0
Faiz Gani, PhD
Postdoctoral research fellow
Department of Surgery
Johns Hopkins University School of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Firearm related injuries are a leading cause of injury and death in the United States, yet, due to combination of factors, limited data exist that evaluate these injuries, particularly among younger patients (patients younger than 18 years).

The objective of this study was to describe emergency department utilization for firearm related injuries and to quantitate the financial burden associated with these injuries.

In our study of over 75,000 emergency department visits, we observed that each year, over 8,300 children and adolescents present to the emergency department for the treatment / management of a gunshot injury. Within this sub-population of patients, we observed that these injuries are most frequent among patients aged 15-17 years and while these injuries decreased over time initially, were observed to increase again towards the end of the time period studied.

In addition to describing the clinical burden of these injuries, we also sought to describe the financial burden associated with these injuries. For patients discharged from the emergency department, the average (median) charge associated with their care was $2,445, while for patients admitted as inpatients for further care, the average (median) charge was $44,966.

Collectively these injuries resulted in $2.5 billion in emergency department and hospital charges over the time period studied. This translates to an annual financial burden of approximately $270 million. Continue reading

Following Maria in Puerto Rico Over 1100 Deaths

MedicalResearch.com Interview with:

Dr. Alexis R. Santos-Lozada

Dr. Santos-Lozada

Dr. Alexis R. Santos-Lozada
Director, Graduate Program in Applied Demography
Assistant Teaching Professor, Department of Sociology and Criminology
Research Affiliate, Population Research Institute
College of Liberal Arts
Penn State University

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Dr. Howard and I have been working on the topic of deaths attributable to Hurricane Maria since November, and provided rapid-response estimates by the end of November about the humanitarian crisis experienced by Puerto Ricans following the Hurricane.

Our main findings are that there are approximately 1,139 deaths in excess of historical patterns between September, October and November in Puerto Rico.

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Alarming Increase in Violent and Unintentional Injuries Since 2014

MedicalResearch.com Interview with:

Dr. Angela Sauaia, MD, PhD Professor of Public Health and Surgery University of Colorado Denver Statistical Editor, Journal of Trauma and Acute Care Surgery Statistical Consultant, Department of Surgery Denver Health Medical Cente

Dr. Sauaia

Dr. Angela Sauaia, MD, PhD
Professor of Public Health and Surgery
University of Colorado Denver
Statistical Editor, Journal of Trauma and Acute Care Surgery
Statistical Consultant, Department of Surgery
Denver Health Medical Center 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: As injury researchers we monitor national trends in injury.

The CDC WISQARS (Web-based Injury Statistics Query and Reporting System) is one of the few available open sources of injury data we can use. During the 1980’s and 1990’s, we saw much improvement in deaths due to most injury mechanisms, such as car accidents fatalities. Our study shows, however, that recent trends seem to be eroding these promising survival gains.

Both violent and unintentional injuries alike seem to be increasing, especially since 2014. We are unclear about the causes of this recent increase in trauma-related deaths, but it is an alarming trend.

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Affordable Care Act Linked To Increased Duration of BreastFeeding

MedicalResearch.com Interview with:
“Babies at Brunch!” by TJ DeGroat is licensed under CC BY 2.0
Kandice A. Kapinos, Ph.D.
Economist
Professor
RAND Corporation
Pardee RAND Graduate School

MedicalResearch.com: What is the background for this study?

Response: In the U.S., we have relatively high rates of breastfeeding initiation – about 80% of mothers will attempt breastfeeding, but rates drop off precipitously in the first few months of an infant’s life. There are tremendous health benefits for both the mother and child from breastfeeding and estimates of significant cost savings from diseases prevented from breastfeeding. However, breastfeeding can be difficult, especially when you need to return to work or school. The American Academy of Pediatrics recommends exclusive breastfeeding for 6 months, but only 22% of mothers breastfeed exclusively for 6 months.

My coauthors, Tami Gurley-Calvez and Lindsey Bullinger, and I were interested in evaluating provisions in recent healthcare legislation (the Affordable Care Act) that required private insurers to cover lactation support services, including breast pumps and visits with lactation consultants, without cost-sharing.

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“Shall Issue” Gun Law States Associated With Higher Homicide and Firearm Death Rates

MedicalResearch.com Interview with:

Michael Siegel, MD, MPH Professor, Department of Community Health Sciences Boston University School of Public Health Boston, MA 02118

Prof. Siegel

Michael Siegel, MD, MPH
Professor, Department of Community Health Sciences
Boston University School of Public Health
Boston, MA 02118

MedicalResearch.com: What is the background for this study?

Response: A central question in the debate about public policies to reduce firearm violence is whether easier access to concealed handguns increases or decreases the rate of firearm-related homicides. Previous studies on the impact of concealed carry permitting laws have yielded inconsistent results. Most of these studies were conducted more than a decade ago. This study provided a reexamination of this research question with more recent data, up to and including the year 2015.

While all states allow certain persons to carry concealed handguns, there are 3 major variations in permitting policy. In 9 states, law enforcement officials have wide discretion over whether to issue concealed carry permits; these are referred to as “may issue” states because police chiefs can deny a permit if they deem the applicant to be at risk of committing violence, even if there is not a criminal history. In 29 states, there is little or no discretion; these are referred to as “shall-issue” states because permits must be issued if requisite criteria are met. In an additional 12 states, no permit is necessary to carry a concealed handgun.

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Increased Odds of Quitting Smoking When Distance To Store Increased

MedicalResearch.com Interview with:

Anna Pulakka PhD, Postdoctoral Researcher Department of Public Health University of Turku, Finland

Dr. Anna Pulakka

Anna Pulakka PhD, Postdoctoral Researcher
Department of Public Health
University of Turku, Finland

MedicalResearch.com: What is the background for this study?

Response: Smoking is the one of the leading health risks globally. Finland, among some other countries, has set a target for a tobacco-free society by 2040. However, with the current rate of decline in smoking prevalence, the target will not be met. It is therefore important to explore new avenues for helping people to quit smoking.

Recently, researchers have become more interested in availability of tobacco as one determinant for smoking habit. We have learned from cross-sectional studies that people who live in neighborhoods with many stores that sell tobacco, smoke more than those who have less tobacco stores in their neighborhood. What has been lacking is more robust evidence from longitudinal studies on the association between availability of tobacco in neighborhoods and smoking behaviours. We sought to determine whether change in the location of tobacco stores nearby people’s place of residence was associated with the odds of quitting smoking or smoking relapse in a longitudinal setting.

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