Addiction, Author Interviews, Columbia, JAMA / 05.02.2021

MedicalResearch.com Interview with: Elodie C. Warren, MPH Columbia University Mailman School of Public Health Graduate MedicalResearch.com: What is the background for this study? What are the main findings?Response: We know that the US has been experiencing an opioid crisis for the past two decades. And we know that among communities of color, rates of overdose deaths are continuing to increase, even though overall national rates decreased between 2017 and 2018. To better understand how the opioid crisis has differently affected racial/ethnic groups, we looked at how heroin treatment admissions changed over time by race/ethnicity, age, and sex. We found that there were stark differences when comparing non-Hispanic Black men and women to non-Hispanic White men and women. Importantly, our study suggests the existence of an aging cohort of Black men and women (likely including survivors of a heroin epidemic that hit urban areas more than 40 years ago) that continues to struggle with heroin addiction. This points to the need for targeted interventions in chronically underserved communities. (more…)
Author Interviews, COVID -19 Coronavirus, Education, Race/Ethnic Diversity, Social Issues / 04.02.2021

MedicalResearch.com Interview with: Ankur Dalsania Rutgers New Jersey Medical School (NJMS) M.D. Candidate 2021 MedicalResearch.com: What is the background for this study? Response: Similar to past pandemics, prior studies and news articles have highlighted the disproportionate impact of COVID-19 mortality in marginalized populations, especially Black Americans. Rather than biological differences, other factors like neighborhood conditions, educational attainment, economic stability, healthcare access, and social contexts have been hypothesized to influence the racial disparities. Using county-level data, we sought to quantitatively determine how these factors, collectively referred to as social determinants of health, impact COVID-19 mortality in Black Americans.(more…)
Author Interviews, COVID -19 Coronavirus, Heart Disease, JAMA, Social Issues, University of Pennsylvania / 02.02.2021

MedicalResearch.com Interview with:Sameed Khatana MD, MPH Instructor, Cardiovascular Medicine Perelman School of Medicine, University of Pennsylvania Physician, Philadelphia VA Medical CenterMedicalResearch.com: What is the background for this study? Response: After declining for decades, the fall in cardiovascular mortality rates in the US has started to slow down and rates may be rising in certain groups. This stagnation in mortality has been most start among middle-aged adults. These trends have occurred at the same time as growing economic inequality. Our analysis aimed to study the relationship between change in cardiovascular mortality rates between 2010 and 2017 for middle-aged adults across the US and change in economic prosperity levels. (more…)
Author Interviews, COVID -19 Coronavirus, JAMA, Race/Ethnic Diversity, Social Issues / 29.01.2021

MedicalResearch.com Interview with: Renuka Tipirneni, MD, MSc, FACP Assistant Professor Holder of the Grace H. Elta MD Department of Internal Medicine Early Career Endowment Award 2019-2024 University of Michigan Department of Internal Medicine, Divisions of General Medicine and Hospital Medicine, and Institute for Healthcare Policy & Innovation Ann Arbor, MI MedicalResearch.com: What is the background for this study? Response: As there have been significant racial/ethnic disparities in US COVID-19 infections and health outcomes including death, we investigated county-level social factors that may explain these inequities. Specifically, we examined the association between the Centers for Disease Control and Prevention’s Social Vulnerability Index (a composite measure of social disadvantage) and COVID-19 incidence and mortality rates. We found that with just a one-point increase in the ten-point scale, there was a 14% increase in incidence rate and 14% increase in mortality rate. This equated to approximately 87 excess COVID-19 infections and 3 deaths per 100,000 population.(more…)
Author Interviews, JAMA, Social Issues / 04.12.2020

MedicalResearch.com Interview with: Amal Trivedi, MD, MPH Professor of Health Services, Policy & Practice Director of Graduate Studies, Health Services Research Brown University School of Public Health MedicalResearch.com: What is the background for this study?Response: Nearly all hospitals in the United States, including all Veterans Affairs Medical Centers (VAMCs), report mortality rates for patients hospitalized for common medical and surgical conditions. But these mortality rates do not adjust for socioeconomic factors that are associated with worse outcomes following hospitalization. (more…)
Author Interviews, Cannabis, Ophthalmology, Race/Ethnic Diversity, Social Issues / 09.11.2020

MedicalResearch.com Interview with: Joshua Uhr MD Ophthalmologist Philadelphia, PA MedicalResearch.com: What is the background for this study? Response: Disparities in American society have been at the forefront of the public consciousness in recent months. As part of the larger discussion about inequality, disparities in health outcomes have received much attention. In light of the renewed recognition that these disparities are stark and widespread, we felt it important to evaluate disparities in our own field, ophthalmology. Previous studies have shown disparate outcomes for individual eye conditions, such as glaucoma, cataract, and retinal detachment. Although the common and relevant endpoint of these is visual impairment, few prior studies have examined disparities in visual impairment more broadly. Our aim was to provide an updated analysis of disparity in visual impairment among adults in the United States based on race and socioeconomic status.(more…)
Author Interviews, Blood Pressure - Hypertension, Social Issues / 01.08.2020

MedicalResearch.com Interview with: Dr. Shingo Yanagiya Hokkaido University Graduate School of Medicine Sapporo, Japan MedicalResearch.com: What is the background for this study? Response: Thank you very much for your question. Hypertension is a major risk factor for cardiovascular diseases including stroke and ischemic heart disease. Due to the relatively high prevalence of hypertension, there is an increased public burden resulting mainly from cardiovascular disease. It is well known that hypertension is associated with several lifestyle factors, including excessive intake of salt or alcohol, obesity, inactivity, and other personal attributes. Since socioeconomic status affects individual lifestyles and other factors, differences in socioeconomic status may influence the risk of hypertension. Therefore, it is important to clarify whether the risk of hypertension varies among socioeconomic classes when considering an effective strategy for preventing hypertension. Based on my research of previous reports about the relationship between household income and incident hypertension, evidence is scarce for Japan. So, we investigated this in an employed population in Japan. (more…)
Author Interviews, Emergency Care, Heart Disease, Social Issues / 28.06.2020

MedicalResearch.com Interview with: Sriman Gaddam The University of Texas at Austin Austin, TX 78705 MedicalResearch.com: What is the background for this study? Response: The quality of care that patients receive from the US healthcare system continues to be influenced by socioeconomic status (SES). Given that cardiac arrest is one of the most common causes of death in the US and that the prehospital setting has an especially high mortality for cardiac arrest, we wanted to determine if the socioeconomic disparities found in the overall US healthcare system continued into the prehospital cardiac arrest setting. MedicalResearch.com: What are the main findings?Response: We found that socioeconomic disparities were present in the prehospital cardiac arrest setting. As the SES of a patient declines, so does the patient's likelihood of achieving return of spontaneous circulation (ROSC). Between the most and least wealthy patients, there was nearly a 13% difference in the probability of achieving ROSC. However, we recognized that not all patients who achieve ROSC are equal as patients can have significantly different neurological functioning depending on the length of time spent in cardiac arrest. Consequently, this paper analyzed cardiac arrest outcomes not only through the occurrence of ROSC but also through the duration of time spent in cardiac arrest. In line with the socioeconomic disparities found in ROSC occurrence, it was found that as a patient's SES declines, the duration of time spent in cardiac arrest before ROSC is achieved increases. This indicates that patients with a low SES are both more likely to not achieve ROSC and if ROSC is achieved more likely to have neurological impairment due to longer time spent in cardiac arrest compared to patients with a high SES. (more…)
Author Interviews, JAMA, Nutrition, Social Issues / 28.06.2020

MedicalResearch.com Interview with: Erin Brantley, PhD, MPH Senior Research Associate Department of Health Policy and Management Milken Institute School of Public Health Preferred pronouns: she/her/hersMedicalResearch.com: What is the background for this study? What are the main findings? Response: We looked at what happened when work requirements for the Supplemental Nutrition Assistance Program Participation, or SNAP, were turned on in many places after the Great Recession. We found large drops in participation in SNAP benefits due to work requirements, and that black recipients were more likely to lose benefits than white recipients. We think this is driven by the fact that black workers face higher unemployment rates than white workers, and work requirement policies do not take this into account. We also found that some people who report having disabilities lost benefits, even though the intent of work requirements is that they apply to people without disabilities.(more…)
Author Interviews, Beth Israel Deaconess, Race/Ethnic Diversity / 17.01.2020

MedicalResearch.com Interview with: John Danziger, MD Harvard Medical Faculty Physicians, Nephrology Beth Israel Deaconess Medical Center MedicalResearch.com: What is the background for this study? Response: Racial health disparities have long been described, extending even into the highest levels of medical care, namely the Intensive Care Unit (ICU). Accordingly, we wanted to know whether improvements in ICU care seen over the last decade are equally observed in minority and non-minority serving hospitals. (more…)
Author Interviews, Education, Opiods, Social Issues / 16.06.2019

MedicalResearch.com Interview with: Arline T. Geronimus Sc.D Professor, Health Behavior and Health Education School of Public Health Research Professor Population Studies Center Institute for Social Research University of Michigan Member, National Academy of MedicineMedicalResearch.com: What is the background for this study? Response: The gap in life expectancy between less and more educated Americans grew over the last 30 years, a deeply troubling fact. We are alone among western nations in these trends. We aimed to determine what causes of death account for this growing educational gap in life expectancy and whether the gap has continued to grow in the most recent years. Disturbingly, we found the educational gap in life expectancy has continued to grow. Why? A common theory is that this growing inequality is due to the opioid epidemic. Some even speculate that the less educated are dying from a composite of what they call “deaths of despair” – opioid and other drug overdose, suicide and alcoholic liver disease – with the theory being that as less educated and working class Americans have faced job loss and stagnating wages, they experience hopelessness and despair and turn to drugs, alcohol, or even suicide to ease or end their pain and feelings of hopelessness. However, while opioid, suicide and alcoholic liver disease deaths have increased among white youth and young adults and is cause for concern, this does not imply that these deaths should be grouped together as “deaths of despair” (DOD) or that they explain the growing educational gaps in life expectancy across all groups – men, women, whites, blacks, or older as well as younger adults. (more…)
Author Interviews, Social Issues / 29.05.2019

MedicalResearch.com Interview with: Peter Belmi PhD Assistant Professor of Leadership and Organizational Behavior Darden School of Business University of Virginia MedicalResearch.com: What is the background for this study? Response: We wanted to understand how socioeconomic inequalities perpetuate from one generation to the next. Some scholars have suggested that social inequalities persist because of systemic prejudice that make it difficult for those at the bottom to improve their standing. Other scholars have suggested that structural inequalities may be hard to dismantle because those who wield the most influence are motivated to preserve their advantages. And other scholars have suggested that inequality may perpetuate when mainstream institutions do not acknowledge the values and norms of individuals from underrepresented groups. (more…)
Accidents & Violence, Author Interviews, Mental Health Research, Race/Ethnic Diversity, Social Issues / 26.11.2018

MedicalResearch.com Interview with: "USA - NY - City of New York Police VARIATION" by conner395 is licensed under CC BY 2.0Dr. Jordan E. DeVylder, PhD Graduate School of Social Service Fordham University, New York, New York MedicalResearch.com: What is the background for this study? What are the main findings?Response: This study is intended to address the lack of empirical research on police violence from a public health perspective. The main findings are that police violence is relatively widespread in Baltimore and New York City, is disproportionately directed toward people of color and sexual or gender minorities, and is associated with psychological distress, suicidal behavior, and psychosis-like symptoms. (more…)
Author Interviews, Breast Cancer, Race/Ethnic Diversity, Social Issues / 30.09.2018

MedicalResearch.com Interview with: Sage J. Kim, PhD Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL 60612MedicalResearch.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. (more…)
Author Interviews, Cancer Research, JAMA, Pediatrics / 20.08.2018

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. (more…)
Author Interviews, Environmental Risks, PLoS, UCSF / 12.07.2018

MedicalResearch.com Interview with: 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. (more…)
Aging, Author Interviews, Social Issues / 25.06.2018

MedicalResearch.com Interview with: 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. Additionally, research conducted from financial services firm Sambla, Norway's largest bank and lender for medical loans, found that doctors and pharmacists are among Scandinavia's financial services most financially savvy, often saving for retirement 5-7 years before others working in the medical field. 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. (more…)
Author Interviews, Cost of Health Care, JAMA, Social Issues / 07.08.2017

MedicalResearch.com Interview with: Arlene S. Ash, PhDDepartment of Quantitative Health Sciences University of Massachusetts Medical School WorcesterMedicalResearch.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. (more…)