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Public Health

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By Emma Sizemore MD/MPH student at Emory University going into EM
Gina M Secura, Tessa Madden, Colleen McNicholas, Jennifer Mullersman, Christina M Buckel, Qiuhong Zhao, Jeffrey F Peipert
BACKGROUND: The rate of teenage pregnancy in the United States is higher than in other developed nations. Teenage births result in substantial costs, including public assistance, health care costs, and income losses due to lower educational attainment and reduced earning potential. METHODS: The Contraceptive CHOICE Project was a large prospective cohort study designed to promote the use of long-acting, reversible contraceptive (LARC) methods to reduce unintended pregnancy in the St...
October 2, 2014: New England Journal of Medicine
Jennifer A Woo Baidal, Elsie M Taveras
Two years after their implementation, new school-nutrition standards are at risk. In response to complaints about food waste and difficulties in meeting certain goals, among other issues, lawmakers have proposed granting schools waivers if they are losing revenue.
November 13, 2014: New England Journal of Medicine
Benjamin D Sommers, Sharon K Long, Katherine Baicker
BACKGROUND: The Massachusetts 2006 health care reform has been called a model for the Affordable Care Act. The law attained near-universal insurance coverage and increased access to care. Its effect on population health is less clear. OBJECTIVE: To determine whether the Massachusetts reform was associated with changes in all-cause mortality and mortality from causes amenable to health care. DESIGN: Comparison of mortality rates before and after reform in Massachusetts versus a control group with similar demographics and economic conditions...
May 6, 2014: Annals of Internal Medicine
Cynthia Feltner, Christine D Jones, Crystal W Cené, Zhi-Jie Zheng, Carla A Sueta, Emmanuel J L Coker-Schwimmer, Marina Arvanitis, Kathleen N Lohr, Jennifer C Middleton, Daniel E Jonas
BACKGROUND: Nearly 25% of patients hospitalized with heart failure (HF) are readmitted within 30 days. PURPOSE: To assess the efficacy, comparative effectiveness, and harms of transitional care interventions to reduce readmission and mortality rates for adults hospitalized with HF. DATA SOURCES: MEDLINE, Cochrane Library, CINAHL,, and World Health Organization International Clinical Trials Registry Platform (1 January 1990 to late October 2013)...
June 3, 2014: Annals of Internal Medicine
Katherine Neuhausen, Anna C Davis, Jack Needleman, Robert H Brook, David Zingmond, Dylan H Roby
Safety-net hospitals rely on disproportionate-share hospital (DSH) payments to help cover uncompensated care costs and underpayments by Medicaid (known as Medicaid shortfalls). The Affordable Care Act (ACA) anticipates that insurance expansion will increase safety-net hospitals' revenues and will reduce DSH payments accordingly. We examined the impact of the ACA's Medicaid DSH reductions on California public hospitals' financial stability by estimating how total DSH costs (uncompensated care costs and Medicaid shortfalls) will change as a result of insurance expansion and the offsetting DSH reductions...
June 2014: Health Affairs
Sanjay Basu, Hilary Kessler Seligman, Christopher Gardner, Jay Bhattacharya
To reduce obesity and type 2 diabetes rates, lawmakers have proposed modifying Supplemental Nutrition Assistance Program (SNAP) benefits to encourage healthier food choices. We examined the impact of two proposed policies: a ban on using SNAP dollars to buy sugar-sweetened beverages; and a subsidy in which for every SNAP dollar spent on fruit and vegetables, thirty cents is credited back to participants' SNAP benefit cards. We used nationally representative data and models describing obesity, type 2 diabetes, and determinants of food consumption among a sample of over 19,000 SNAP participants...
June 2014: Health Affairs
Paula W Yoon, Brigham Bastian, Robert N Anderson, Janet L Collins, Harold W Jaffe
In 2010, the top five causes of death in the United States were 1) diseases of the heart, 2) cancer, 3) chronic lower respiratory diseases, 4) cerebrovascular diseases (stroke), and 5) unintentional injuries. The rates of death from each cause vary greatly across the 50 states and the District of Columbia (2). An understanding of state differences in death rates for the leading causes might help state health officials establish disease prevention goals, priorities, and strategies. States with lower death rates can be used as benchmarks for setting achievable goals and calculating the number of deaths that might be prevented in states with higher rates...
May 2, 2014: MMWR. Morbidity and Mortality Weekly Report
Shanna Cox, Karen Pazol, Lee Warner, Lisa Romero, Alison Spitz, Lorrie Gavin, Wanda Barfield
BACKGROUND: Teens who give birth at age 15-17 years are at increased risk for adverse medical and social outcomes of teen pregnancy. METHODS: To examine trends in the rate and proportion of births to teens aged 15-19 years that were to teens aged 15-17 years, CDC analyzed 1991-2012 National Vital Statistics System data. National Survey of Family Growth (NSFG) data from 2006-2010 were used to examine sexual experience, contraceptive use, and receipt of prevention opportunities among female teens aged 15-17 years...
April 11, 2014: MMWR. Morbidity and Mortality Weekly Report
Jasper V Been, Ulugbek B Nurmatov, Bianca Cox, Tim S Nawrot, Constant P van Schayck, Aziz Sheikh
BACKGROUND: Smoke-free legislation has the potential to reduce the substantive disease burden associated with second-hand smoke exposure, particularly in children. We investigated the effect of smoke-free legislation on perinatal and child health. METHODS: We searched 14 online databases from January, 1975 to May, 2013, with no language restrictions, for published studies, and the WHO International Clinical Trials Registry Platform for unpublished studies. Citations and reference lists of articles of interest were screened and an international expert panel was contacted to identify additional studies...
May 3, 2014: Lancet
Amy Nunn, Annajane Yolken, Blayne Cutler, Stacey Trooskin, Phill Wilson, Susan Little, Kenneth Mayer
African Americans and Hispanics are disproportionately affected by the HIV/AIDS epidemic. Within the most heavily affected cities, a few neighborhoods account for a large share of new HIV infections. Addressing racial and economic disparities in HIV infection requires an implementation program and research agenda that assess the impact of HIV prevention interventions focused on increasing HIV testing, treatment, and retention in care in the most heavily affected neighborhoods in urban areas of the United States...
May 2014: American Journal of Public Health
Jennifer Singleterry, Zach Jump, Elizabeth Lancet, Stephen Babb, Allison MacNeil, Lei Zhang
Medicaid enrollees have a higher smoking prevalence than the general population (30.1% of adult Medicaid enrollees aged <65 years smoke, compared with 18.1% of U.S. adults of all ages), and smoking-related disease is a major contributor to increasing Medicaid costs. Evidence-based cessation treatments exist, including individual, group, and telephone counseling and seven Food and Drug Administration (FDA)-approved medications. A Healthy People 2020 objective (TU-8) calls for all state Medicaid programs to adopt comprehensive coverage of these treatments...
March 28, 2014: MMWR. Morbidity and Mortality Weekly Report
Rachel A Grana, Lucy Popova, Pamela M Ling
No abstract text is available yet for this article.
May 2014: JAMA Internal Medicine
Daniel R Hale, Natasha Fitzgerald-Yau, Russell Mark Viner
We systematically searched 9 biomedical and social science databases (1980-2012) for primary and secondary interventions that prevented or reduced 2 or more adolescent health risk behaviors (tobacco use, alcohol use, illicit drug use, risky sexual behavior, aggressive acts). We identified 44 randomized controlled trials of universal or selective interventions and were effective for multiple health risk behaviors. Most were school based, conducted in the United States, and effective for multiple forms of substance use...
May 2014: American Journal of Public Health
Helena H Laroche, Christopher Ford, Kate Hansen, Xueya Cai, David R Just, Andrew S Hanks, Brian Wansink
BACKGROUND: Concession stands at high school events are exempt from the US Department of Agriculture regulations for school foods. Concessions are generally stocked with unhealthy foods since healthy foods are believed to have lower sales and profit margins. METHODS: Concession stand sales for two seasons of high school fall sports in Muscatine, Iowa were compared. In between seasons, two types of changes were made: (i) addition of new healthier concession options and (ii) substitution of healthier ingredients (less saturated fat, no trans fat)...
March 2015: Journal of Public Health
Katherine Gonzales, Jim Roeber, Dafna Kanny, Annie Tran, Cathy Saiki, Hal Johnson, Kristin Yeoman, Tom Safranek, Kathleen Creppage, Alicia Lepp, Tracy Miller, Nato Tarkhashvili, Kristine E Lynch, Joanna R Watson, Danielle Henderson, Megan Christenson, Sarah Dee Geiger
Excessive alcohol consumption, the fourth leading preventable cause of death in the United States, resulted in approximately 88,000 deaths and 2.5 million years of potential life lost (YPLL) annually during 2006-2010 and cost an estimated $223.5 billion in 2006. To estimate state-specific average annual rates of alcohol-attributable deaths (AAD) and YPLL caused by excessive alcohol use, 11 states analyzed 2006-2010 data (the most recent data available) using the CDC Alcohol-Related Disease Impact (ARDI) application...
March 14, 2014: MMWR. Morbidity and Mortality Weekly Report
Steven S Fu, Michelle van Ryn, Scott E Sherman, Diana J Burgess, Siamak Noorbaloochi, Barbara Clothier, Brent C Taylor, Carolyn M Schlede, Randy S Burke, Anne M Joseph
IMPORTANCE: Current tobacco use treatment approaches require smokers to request treatment or depend on the provider to initiate smoking cessation care and are therefore reactive. Most smokers do not receive evidence-based treatments for tobacco use that include both behavioral counseling and pharmacotherapy. OBJECTIVE: To assess the effect of a proactive, population-based tobacco cessation care model on use of evidence-based tobacco cessation treatments and on population-level smoking cessation rates (ie, abstinence among all smokers including those who use and do not use treatment) compared with usual care among a diverse population of current smokers...
May 2014: JAMA Internal Medicine
Ronald C Kessler, Greg J Duncan, Lisa A Gennetian, Lawrence F Katz, Jeffrey R Kling, Nancy A Sampson, Lisa Sanbonmatsu, Alan M Zaslavsky, Jens Ludwig
IMPORTANCE: Youth in high-poverty neighborhoods have high rates of emotional problems. Understanding neighborhood influences on mental health is crucial for designing neighborhood-level interventions. OBJECTIVE: To perform an exploratory analysis of associations between housing mobility interventions for children in high-poverty neighborhoods and subsequent mental disorders during adolescence. DESIGN, SETTING, AND PARTICIPANTS: The Moving to Opportunity Demonstration from 1994 to 1998 randomized 4604 volunteer public housing families with 3689 children in high-poverty neighborhoods into 1 of 2 housing mobility intervention groups (a low-poverty voucher group vs a traditional voucher group) or a control group...
March 5, 2014: JAMA: the Journal of the American Medical Association
Kavita Patel, Amy Boutwell, Bradley W Brockmann, Josiah D Rich
Under the Affordable Care Act, up to thirteen million adults have the opportunity to obtain health insurance through an expansion of the Medicaid program. A great deal of effort is currently being devoted to eligibility verification, outreach, and enrollment. We look beyond these important first-phase challenges to consider what people who are transitioning back to the community after incarceration need to receive effective care. It will be possible to deliver cost-effective, high-quality care to this population only if assistance is coordinated between the correctional facility and the community, and across diverse treatment and support organizations in the community...
March 2014: Health Affairs
M Kit Delgado, Michael A Yokell, Kristan L Staudenmayer, David A Spain, Tina Hernandez-Boussard, N Ewen Wang
IMPORTANCE: Trauma is the leading cause of potential years of life lost before age 65 years in the United States. Timely care in a designated trauma center has been shown to reduce mortality by 25%. However, many severely injured patients are not transferred to trauma centers after initially being seen at non–trauma center emergency departments (EDs). OBJECTIVES: To determine patient-level and hospital-level factors associated with the decision to admit rather than transfer severely injured patients who are initially seen at non–trauma center EDs and to ascertain whether insured patients are more likely to be admitted than transferred compared with uninsured patients...
May 2014: JAMA Surgery
Donna Shelley, Gbenga Ogedegbe, Brian Elbel
In March 2013 a state judge invalidated New York City's proposal to ban sales of sugar-sweetened beverages larger than 16 ounces; the case is under appeal. This setback was attributable in part to opposition from the beverage industry and racial/ethnic minority organizations they support. We provide lessons from similar tobacco industry efforts to block policies that reduced smoking prevalence. We offer recommendations that draw on the tobacco control movement's success in thwarting industry influence and promoting public health policies that hold promise to improve population health...
April 2014: American Journal of Public Health
2014-03-18 16:25:38
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