PCOM Library / Hot Topics in Research / Archive for "Public Health"

Category: Public Health

Hot Topics: Race and Class Affect COVID-19 Risk

jackiewe Hot Topics in Research, Infectious Disease, Public Health

Disparities in the Population at Risk of Severe Illness From COVID-19 by Race/Ethnicity and Income

Raifman M, Raifman J. Disparities in the population at risk of severe illness from COVID-19 by race/ethnicity and income. American Journal of Preventive Medicine. 2020. https://doi.org/10.1016/j.amepre.2020.04.003.

Identifying those at heightened risk of severe illness from novel coronavirus disease 2019 (COVID-19) is essential for modeling disease, designing return-to-work criteria, allocating economic assistance, advancing health equity, and limiting morbidity and mortality. The U.S. Centers for Disease Control and Prevention has identified criteria associated with risk of severe complications from COVID-19 infection. Structural inequities have shaped racial, ethnic, and income disparities for many of these criteria. To date, there has been limited analysis of the proportion of the population at risk in the U.S. based on these criteria, or risk factors by race/ethnicity or income. Preliminary national data on cases by race/ethnicity suggest that disparities in hospitalization are already developing. Quantifying disparities in risk is important for allocating resources to prevent, identify, and treat COVID-19-related severe illness and limit diverging outcomes for already vulnerable subgroups.

Hot Topics: Soda Tax Did Not Affect Soda Consumption

jackiewe Hot Topics in Research, Public Health

Sugar-Sweetened and Diet Beverage Consumption in Philadelphia One Year after the Beverage Tax

Zhong Y, Auchincloss AH, Lee BK, McKenna RM, Langellier BA. Sugar-Sweetened and Diet Beverage Consumption in Philadelphia One Year after the Beverage Tax. International Journal of Environmental Research and Public Health. 2020; 17(4):1336. https://doi.org/10.3390/ijerph17041336

In January 2017, Philadelphia (Pennsylvania) implemented an excise tax ($ 0.015/ounce) on sugar-sweetened and diet beverages. This study is a general population-based study to report on the longer-term impacts of the tax on within-person changes in consumption 12 months after implementation. A quasi-experimental difference-in-difference design was used to contrast Philadelphia vs. nearby comparison cities (Trenton, New Jersey; Camden, New Jersey; and Wilmington, Delaware) at baseline (December 2016–January 2017) vs. 12-month follow-up (December 2017–February 2018). A random-digit-dialing phone survey was administered to a population-based cohort. Analyses assessed changes in 30-day consumption frequency and ounces of sugar-sweetened and diet beverages (and a substitution beverage, bottled water) in the analytic sample (N = 515). After 12 months, relative to the comparison group, Philadelphians were slightly more likely to decrease their frequency of sugar-sweetened beverage consumption (39.2% vs. 33.5%), and slightly less likely to increase their frequency of sugar-sweetened beverage consumption (38.9% vs. 43.0%). The effects of the tax estimated in the adjusted difference-in-difference analysis were very small (for example, changes in monthly sugar-sweetened beverage consumption in Philadelphia relative to comparison cities was −3.03 times or −51.65 ounces) and confidence intervals were very wide. Results suggested that, one year after implementation, there was no major overall impact of the tax on general population-level consumption of sugar-sweetened or diet beverages, or bottled water. Future studies should test whether the tax’s effect differs in vulnerable sub-populations.

Hot Topics: Stroke Care Affected by Traffic

jackiewe Hot Topics in Research, Neurology, Public Health

Rubber Meeting the Road: Access to Comprehensive Stroke Care in the Face of Traffic

Dworkis DA, Axeen S, Arora S. Rubber meeting the road: Access to comprehensive stroke care in the face of traffic. Acad Emerg Med. 2020. https://doi.org/10.1111/acem.13909.

Acute stroke is one of the leading causes of death in the United States, with an estimated annual cost of $34 billion and a death from stroke occurring approximately every 4 minutes. Early access to specialized stroke care is critically important in the treatment of suspected acute stroke, but access to dedicated stroke centers is unequal and varies geographically. Among the different levels of hospitals providing stroke care, the comprehensive stroke center (CSC) is the highest designation: CSCs utilize multidisciplinary stroke teams to provide the most advanced stroke care, including therapies like endovascular clot retrieval that are not available at most non‐CSC hospitals.

Hot Topics: US Cancer Survivors Suffer Financial Hardship

jackiewe Hot Topics in Research, Oncology, Public Health

Medical Financial Hardship Intensity and Financial Sacrifice Associated with Cancer in the United States

Han X, Zhao J, Zheng Z, de Moor JS, Virgo KS, Yabroff KR. Medical financial hardship intensity and financial sacrifice associated with cancer in the united states. Cancer Epidemiol Biomarkers Prev. 2020. https://dx.doi.org/10.1158/1055-9965.EPI-19-0460.

Background: With rising costs of cancer care, this study aims to estimate the prevalence of, and factors associated with, medical financial hardship intensity and financial sacrifices due to cancer in the United States.

Methods: We identified 963 cancer survivors from the 2016 Medical Expenditures Panel Survey – Experiences with Cancer. Medical financial hardship due to cancer was measured in material (e.g., filed for bankruptcy), psychological (e.g., worry about paying bills and finances), and behavioral (e.g., delaying or forgoing care due to cost) domains. Nonmedical financial sacrifices included changes in spending and use of savings. Multivariable logistic models were used to identify characteristics associated with hardship intensity and sacrifices stratified by age group (18–64 or 65+ years).

Results: Among cancer survivors ages 18 to 64 years, 53.6%, 28.4%, and 11.4% reported at least one, two, or all three domains of hardship, respectively. Among survivors ages 65+ years, corresponding percentages were 42.0%, 12.7%, and 4.0%, respectively. Moreover, financial sacrifices due to cancer were more common in survivors ages 18 to 64 years (54.2%) than in survivors 65+ years (38.4%; P < 0.001). Factors significantly associated with hardship intensity in multivariable analyses included low income and educational attainment, racial/ethnic minority, comorbidity, lack of private insurance coverage, extended employment change, and recent cancer treatment. Most were also significantly associated with financial sacrifices.

Conclusions: Medical financial hardship and financial sacrifices are substantial among cancer survivors in the United States, particularly for younger survivors.

Impact: Efforts to mitigate financial hardship for cancer survivors are warranted, especially for those at high risk.