Author Interviews, Smoking, Tobacco, Tobacco Research, Yale / 26.07.2019 Interview with: Abigail S. Friedman, Ph.D. Assistant Professor Department of Health Policy and Management Yale School of Public Health What is the background for this study? Response: Smoking is responsible for approximately 1 in 5 deaths in the United States each year. Despite the fact that all US states ban tobacco sales to minors, the vast majority of smokers begin this habit as adolescents. As of July 25, 2019, 18 states and over 450 localities have passed laws banning tobacco sales to those under age-21. The laws are commonly referred to as “tobacco-21” laws. Concurrently, 16 states without state-level tobacco-21 laws prohibit counties and municipalities from raising their legal sales age for tobacco products above the state-mandated age; typically, 18. If local tobacco-21 laws reduce youth smoking, then preemption policies impede population health. To consider this, we estimated the impact of county- and municipality-level tobacco-21 policies on smoking among 18 to 20 year-olds residing in MMSAs (metropolitan and micropolitan statistical areas). Specifically, regression analyses compared smoking among 18-20 year-olds in areas with more vs. less tobacco-21 coverage, before vs. after these policies were adopted. (more…)
Alcohol, Author Interviews, CMAJ, Emergency Care / 22.07.2019 Interview with: Daniel Myran, MD, MPH, CCFP Public Health & Preventive Medicine, PGY-5 University of Ottawa What is the background for this study? Response: We know that alcohol consumption results in enormous health and societal harms globally and in Canada. While several studies have looked at changes in alcohol harms, such as Emergency Department (ED) visits and Hospitalizations due alcohol, this study is the first to examine in detail how harms related to alcohol have been changing over time in Canada. (more…)
Author Interviews, Depression, Mental Health Research, Vanderbilt / 16.04.2019 Interview with: Lauren Gaydosh, PhD Assistant Professor Center for Medicine, Health, and Society Public Policy Studies Vanderbilt University What is the background for this study?   Response: Several years ago, life expectancy at birth in the United States declined, and this decline has continued every year since. Part of the cause underlying this decline is that midlife mortality – deaths among those 45-54 – has been rising. This increase in midlife mortality has been attributed by some to the “deaths of despair” – a cluster of causes of death including suicide, drug overdose, and alcohol-related disease - and has been most pronounced among middle-aged white adults with a HS degree or less. In our research, we wanted to better understand the indicators of despair that would be predictive of these causes of death. Things like depression, substance use, and suicidal ideation. And study them in individuals before the period of elevated risk of death – in other words, before they reached middle age. Our goal was to evaluate whether these markers of despair were rising for a younger cohort, and whether this pattern was isolated to white adults with low education. (more…)
AACR, Author Interviews, Colon Cancer / 04.03.2019 Interview with: Ronit Yarden, PhD, MHSA Director of Medical Affairs Colorectal Cancer Alliance, a patient advocacy organization Washington, D.C. What is the background for this study? What are the main findings?  Response: The colorectal Cancer Alliance is a patient advocacy group (the largest advocacy group for colorectal cancer) and its mission is to provide support to patients, survivors, their caregivers and family members as well as advocate on their behalf for.  The organization is also committed to raise awareness for screening and early detection of colorectal cancer to help save lives and to provide funding for innovative colorectal cancer research. As part of our support we sought to identify some of the clinical, emotional and financial experiences and unmet needs of patients under 50 years old.  We conducted an online survey that was promoted through social media and 1195 patients and survivors completed our survey.  (more…)
Author Interviews, Inflammation, JAMA, Kidney Disease, Pain Research, Stanford / 16.02.2019 Interview with: Alan Nelson, MPAS, PhD Division of Primary Care and Population Health, Department of Medicine Stanford University School of Medicine Stanford, California What is the background for this study?   Response: The past research literature has provided relatively little information on the appropriate level of concern regarding non-steroidal anti-inflammatory drugs (NSAIDs) and kidney disease risk among younger, apparently healthy patients. Clinicians are generally most concerned about the effects of these medications on the kidneys among patients with existing renal impairment and persons at risk for it, especially older patients. Given that NSAID use appears to be high and rising in the US, we were interested in developing evidence on this topic in a population of working-age adults. (more…)
Author Interviews, Heart Disease, JACC / 13.02.2019 Interview with: Srikanth Yandrapalli, MD Chief Resident in Internal Medicine at New York Medical College at Westchester Medical Center Program What is the background for this study? What are the main findings? Response: Risk factors play an important role in the development of and progression of coronary heart disease, thus necessitating strategies to address the leading modifiable risk factors to reduce the burden of coronary heart disease. Data are lacking regarding therecent temporal trends in the prevalence of these risk factors during a first AMI in US young adults. In our study, we report that among young adults in the US with a first acute myocardial infarction, the prevalence rates of major modifiable risk factors were very high with over 90% of patients having at least 1 such risk factor. Significant sex and racial disparities were observed. Sex differences in the rates of certain  risk factors were clearly evident with males having higher rates of smoking, dyslipidemia, and drug abuse, whereas females had higher rates metabolic risk factors like diabetes mellitus, hypertension, and obesity. Sex differences in the rates of certain risk factors narrowed with increasing age and over time. Blacks had higher rates of hypertension, obesity, and drug abuse, Whites had higher rates of smoking, Hispanics had higher rates of diabetes mellitus and patients of Asian/Pacific Islander race had higher rates of dyslipidemia. Prevalence rates progressively increased between 2005 and 2015 except for dyslipidemia for which a decreasing trend was noted more recently. (more…)
Author Interviews, Cancer Research, Global Health, Lancet, Weight Research / 04.02.2019 Interview with: Hyuna Sung, PHD Principal Scientist, Surveillance Research American Cancer Society, Inc. 250 Williams St. Atlanta, GA 30303 What is the background for this study? Response: This project was motivated by our previous finding on the rise of colorectal cancer among young adults before age 55. Changes in cancer trends among young age group have significant implications because the newly introduced carcinogenic agents are likely to affect trends among young people before they affect those among older people. Owing to this relationship, cancer trends among young people can be often considered as a bellwether for future disease burden. Given the dramatic increase of the obesity prevalence during 3-4 decades in the US, we wanted to expand the colorectal cancer finding to the more comprehensive list of cancers and explain them in the context of obesity epidemic. (more…)
Author Interviews, Global Health, Stroke / 26.12.2018 Interview with: Gregory A. Roth MD MPH Assistant Professor, Medicine - Cardiology Adjunct Assistant Professor, Global Health Adjunct Assistant Professor, Health Metrics Sciences School of Public Health University of Washington Seattle, WA What is the background for this study? What are the main findings?   Response:  We found that globally, one in four people over age 25 is at risk for stroke during their lifetime. But we also found large geographic variation, including a nearly five-fold difference in lifetime stroke risk worldwide, with the highest risk in East Asia (38.8%), Central Europe (31.7%), and Eastern Europe (31.6%), and the lowest risk in eastern sub-Saharan Africa (11.8%). Chinese men and Latvian women had the world’s highest estimated lifetime stroke risk in 2016. The lifetime stroke risk on average for 25-year-olds in 2016 ranges from 8% to 39%, depending on the country in which they live. This is the first time a study has produced estimates of lifetime stroke risk starting at age 25, whereas previous studies begin at age 45. These findings suggest that adults need to think about their long-term health risks, including stroke, at a much younger age. Additionally, one’s risk of stroke over the course of your lifetime depends on where you live. Given the burden of stroke among adults is dependent on modifiable risk factors and the characteristics of health systems, our findings may be useful for long-term planning, especially in terms of prevention and public education.  (more…)
Author Interviews, Blood Pressure - Hypertension, Heart Disease, JAMA / 06.11.2018 Interview with: "Blood Pressure Monitor" by Medisave UK is licensed under CC BY 2.0Seulggie Choi MD, (one of the co-first authors) Department of Biomedical Sciences Seoul National University Graduate School Seoul, South Korea What is the background for this study? What are the main findings? Response: In 2017, the American College of Cardiology (ACC) and American Heart Association (AHA) issued a new High Blood Pressure Management Guideline, in which the definition of hypertension was modified as blood pressure of 130/80 mmHg or higher. This new criteria for hypertension was based on a number of previous studies that demonstrated higher cardiovascular disease risk for participants in the systolic blood pressure of 130-139 mmHg and diastolic blood pressure of 80-89 mmHg range, which is now defined as stage 1 hypertension. However, there is a relative lack of evidence on whether this association of higher cardiovascular disease risk among those within the stage 1 hypertension category according to the 2017 ACC/AHA guidelines is also true among young adults aged 20-39 years. Our study consisted of about 2.4 million young men and women aged 20-39 years from the Korean National Health Insurance Service claims database. Compared to those with normal blood pressure, young adults with stage 1 hypertension had higher risk for cardiovascular disease, coronary heart disease, and total stroke for both men and women. Moreover, among those who were prescribed anti-hypertensive medications within the next 5 years since blood pressure measurement, young adults with stage 1 hypertension had their higher cardiovascular disease risk attenuated to that of normal blood pressure participants. (more…)
Author Interviews, Cancer Research, Lancet / 30.10.2017 Interview with: Dr Miranda M Fidler, PhD Section of Cancer Surveillance International Agency for Research on Cancer Lyon, France What is the background for this study? What are the main findings? Response: The burden of cancer among young adults has been rarely studied in depth. To our knowledge, we describe for the first time the scale and profile of cancer incidence and mortality worldwide among 20-39 year-olds, highlighting major patterns by age, sex, development level, and geographic region. Although cancer is less frequent than that observed at older ages, its impact remains considerable because these individuals have a large proportion of their expected lifespans remaining, contribute substantially to the economy, and play a major role in caring for their families. Worldwide, almost 1 million new cases of cancer and 400 000 cancer-related deaths occurred among young adults aged 20–39 years in 2012. Overall, the most common cancer types in terms of new cases were female breast cancer, cervical cancer, thyroid cancer, leukemia, and colorectal cancer, and the most common types of cancer-related deaths were those due to female breast cancer, liver cancer, leukemia, and cervical cancer. The burden was disproportionately greater among women, with an estimated 633 000 new cancer cases (65% of all new cancer cases in that age group) and 194 000 cancer-related deaths (54% of all cancer-related deaths in that age group) in 2012. (more…)