Mammograms: Minorities and Poor Less Likely To Report Barriers to Care

MedicalResearch.com Interview with:

Mammogram showing small lesion - Wikipedia

Mammogram showing small lesion
– Wikipedia

Sage J. Kim, PhD
Division of Health Policy and Administration,
School of Public Health,
University of Illinois at Chicago,
Chicago, IL 60612 

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

Response: Our study examined the rates at which women who received patient navigation in a randomized clinical trial reported barriers to obtaining a screening mammogram. The trial, called the Patient Navigation in Medically Underserved Areas (PNMUA) study, randomly assigned patients to one of two groups: one received a patient navigation support intervention and the other served as a control. Of the 3,754 women who received the patient navigation intervention, only 14 percent identified one or more barriers to care, which led to additional interactions with navigators who helped overcome barriers.

Black women, women living in poverty, and women who reported high levels of distrust of the health care system were the least likely to report barriers. Women who reported barriers were more likely to have additional contact with navigators and obtain a subsequent screening mammogram. The extra support could help with early diagnosis and better survival and mortality outcomes. Continue reading

Complex Racial and Ethnic Disparities in Childhood Cancer Survival

MedicalResearch.com Interview with:
Rebecca D. Kehm, PhD
Division of Epidemiology and Community Health
University of Minnesota School of Public Health
Minneapolis, MN  

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

Response: Racial and ethnic differences in childhood cancer survival have long been known, and there has been some research indicating that SES could explain disparities. However, our study is the first to use statistical methods that put numbers to the relative contribution of SES to survival disparities for different types of childhood cancer. We set out to investigate whether racial and ethnic disparities in childhood cancer survival are attributed to underlying differences in socioeconomic status, defined as one’s social and economic position in relation to others based on income, education, and occupation, which scientists abbreviate as SES. Our findings provide evidence that SES does in fact contribute to racial and ethnic disparities in survival for some types of childhood cancer. Specifically, we found that SES accounted for 28-73% of the racial and ethnic survival disparity for acute lymphoblastic leukemia, acute myeloid leukemia, neuroblastoma, and non-Hodgkin lymphoma. However, SES did not significantly contribute to racial and ethnic disparities in survival for other types of childhood cancer including central nervous system tumors, soft tissue sarcomas, Hodgkin lymphoma, Wilms tumor, and germ cell tumors. These tumor-specific results help inform where to place resources to best reduce racial and ethnic survival disparities for each of the major types of childhood cancer.

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Opioid Prescription Rates Higher in South, Appalachia and Rural West

MedicalResearch.com Interview with:

Dr. Lyndsey Rolheiser MD Postdoctoral Research Fellow at Harvard Center for Population Studies Cambridge, Massachusetts

Dr. Rolheiser

Dr. Lyndsey Rolheiser PhD
Postdoctoral Research Fellow at Harvard Center for Population Studies
Cambridge, Massachusetts

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

Response: The opioid crisis was declared a “public health emergency” in 2017. Opioid related overdoses and prescribing rates have increased dramatically over the past decade and previous literature has identified a relationship between high-dose prescriptions and overdose deaths. Thus, understanding the variation and trends in the opioid prescribing rate is crucial in understanding the nature of the opioid epidemic. Opioid prescribing data is publicly available at the county and state level.

County level data represents an administrative boundary that lacks political representation and accountability. In contrast, the congressional district represents a geography that has both of these characteristics. Further, knowing the congressional district level rates allows for policy makers and researchers to observe the variation that exists within states.

The main findings are high prescribing rate districts are concentrated in the South, Appalachia and the rural West. Low-rate districts are concentrated in urban centers.

MedicalResearch.com: What should readers take away from your report?

Response: There is a great deal of variation across congressional districts, but there are also very clear geographical patterns. In terms of policy, this paper highlights the importance of constructing and disseminating crucial public health data at a politically relevant boundary.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Our hope is that the estimates we have created can be used within health related public policy research.

Citation: Lyndsey A. Rolheiser, Jack Cordes, BSPH, S.V. Subramanian. Opioid Prescribing Rates by Congressional Districts, United States, 2016. American Journal of Public Health, 2018; e1 DOI: 10.2105/AJPH.2018.304532

Jul 22, 2018 @ 11:46 am

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Disadvantaged Communities More Likely to Have Increase in Greenhouse Gases Under Cap-and-Trade Policies

MedicalResearch.com Interview with:

Lara Cushing PhD Assistant Professor of Health Education, College of Health and Social Sciences San Francisco State University 1600 Holloway Avenue San Francisco, CA 94132

Dr. Cushing

Lara Cushing PhD
Assistant Professor of Health Education, College of Health and Social Sciences
San Francisco State University
San Francisco, CA 94132

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

Response: More and more countries are adopting cap-and-trade programs as a way to reduce emissions of greenhouse gases to address climate change. These efforts can lead to short-term health benefits because when you reduce greenhouse gas emissions, you usually also reduce emissions other harmful air pollutants that can cause cardiovascular disease, asthma and cancer.

However, environmental equity concerns were raised early on about whether cap-and-trade would result in localized differences in emissions reductions that would also result in uneven reductions in harmful co-pollutants, such as particulate matter and air toxics. This is because companies can trade pollution permits under a cap-and-trade system and choose to buy more permits rather than reduce their emissions locally. Prior studies show that low income communities and communities of color are much more likely to live near polluting industries.

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Financial Savvy Linked To Better Later Life Outcomes

MedicalResearch.com Interview with:

Bryan D. James, PhD Assistant Professor Rush Alzheimer's Disease Center Chicago, IL 60612

Dr. James

Bryan D. James, PhD
Assistant Professor
Rush Alzheimer’s Disease Center
Chicago, IL 60612

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

Response: This study is part of a larger body of research examining how literacy and decision making abilities in different areas of life can affect the health and well-being of older adults.

The main finding of this study is that a better ability to understand and utilize financial concepts was related to a lower risk of hospitalization in old age.

Over almost 2 years of follow-up, 30 percent of the 388 older men and women in this study were hospitalized at least once. A 4-point higher score on the scale of financial literacy, representing one standard deviation, was associated with about a 35 percent lower risk of hospitalization. This was after adjusting for a number of factors including physical and mental health indicators and income. The association appeared to be stronger for knowledge of financial concepts such as stocks and bonds, as opposed to the ability to perform numerical calculations. Additionally, the association was stronger for elective hospital admissions as opposed to emergency or urgent hospitalizations; this may support the notion that financial literacy is related to medical decision-making surrounding the decision to be hospitalized, such as which procedures are covered by Medicare.

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Patients With Social Risks Are More Expensive and Require Greater Medicaid Resources

MedicalResearch.com Interview with:

Dr-arlene-S-Ash.jpg

Dr. Ash

Arlene S. Ash, PhD
Department of Quantitative Health Sciences
University of Massachusetts Medical School
Worcester 

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

Response: State Medicaid programs (and other health care purchasers) often contract with several managed care organizations, each of which agrees to address all health care needs for some of their beneficiaries. Suppose a Medicaid program has $5000 to spend, on average, for each of its 1 million beneficiaries. How much should they pay health plan “A” for the particular 100,000 beneficiaries it enrolls? If some group, such as those who are homeless, is much more expensive to care for than the payment, plans that try to provide good care for many such people will go broke. We describe the model now used by MassHealth to ensure that plans get more money for enrolling patients with greater medical and social needs. In this medical-social model, about 10% of total dollars is allocated by factors other than the medical-morbidity risk score.

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