AJPM focus最新文献_第2页

Health- and Non–Health-Related Corporate Social Responsibility Statements in Top Selling Restaurant Chains in the U.S. Between 2012 and 2018: A Content Analysis

AJPM focus

Pub Date : 2025-02-01 DOI: 10.1016/j.focus.2024.100295

Megan P. Mueller PhD , Alyssa Leib MS , Deborah C. Glik PhD , Sara N. Bleich PhD , Jason Wang PhD , Catherine M. Crespi PhD , May C. Wang DrPH

Introduction

The aim of this study was to understand the prevalence and content of corporate social responsibility statements in the top-selling chain restaurants between 2012 and 2018 to inform the ways restaurants can impact population health.

Methods

The study used a web scraping technique to abstract relevant text information (n=6,369 text sections that contained possible corporate social responsibility statements or thematically coded portions of the text section) from the archived web pages of the 96 top-selling chain restaurants. Content analysis was used to identify key themes in corporate social responsibility statements across restaurants and over time. All data were abstracted, and analyses were completed between November 2019 and November 2023.

Results

The majority of restaurants (68.8%) included a corporate social responsibility statement on their web pages between 2012 and 2018, and approximately half of the restaurants featured a health-related corporate social responsibility statement (51.0%). There were increases in corporate social responsibility statements by chain restaurants over the study period from 186 corporate social responsibility statements in 2012 to 1,218 corporate social responsibility statements in 2018, with most statements focused on philanthropy (37.1% of coded statements), community activities that were not health related (18.4% of coded statements), and sustainability initiatives (18.3% of coded statements). Only one quarter (24.4%) of these corporate social responsibility statements were health related, and many were vague in nature (only 28% of the eligible statements could be coded by theme).

Conclusions

There is a need for more actionable health-focused initiatives in the corporate social responsibility statements for chain restaurants. Public health initiatives that engage with the restaurant industry should work to promote corporate social responsibility statements that are in line with other collective positions around improving health and reducing diet-related disease.

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引用次数: 0

The Association Between a Summary Measure of Social Determinants of Health/Health Equity and Cardiovascular Disease Burden Among Mississippi Adults 密西西比州成年人健康/健康公平的社会决定因素总结测量与心血管疾病负担之间的关系

AJPM focus

Pub Date : 2025-02-01 DOI: 10.1016/j.focus.2024.100297

Vincent L. Mendy DrPH, MPH, CPH , Tawandra L. Rowell-Cunsolo PHD , Byambaa Enkhmaa MD, PHD

Introduction

Cardiovascular disease is the leading cause of death among Mississippi adults. Social determinants of health are significant contributors to cardiovascular disease risk and associated mortality as well as health disparities. The authors examined the association between a summary measure of social determinants of health and cardiovascular disease among Mississippi adults.

Methods

Using the social determinants of health and health equity module data from 3,994 respondents to the 2022 Mississippi Behavioral Risk Factor Surveillance System survey, the authors conducted multivariable logistic regression models to examine the association between cardiovascular disease and a social determinants of health/health equity summary measure.

Results

Participants who received food stamps or were enrolled in the Supplemental Nutrition Assistance Program (AOR=2.28; 95% CI=1.35, 3.86), experienced food insecurity (AOR=1.74; 95% CI=1.08, 2.79), and experienced mental distress (AOR=2.39; 95% CI=1.54, 3.73) had significantly higher odds of cardiovascular disease than their counterparts without any of these factors. Mississippi adults experiencing 4 or more of social determinants of health/health equity risk factors had a 2.56 (AOR=2.56; 95% CI=1.49, 4.41) higher odds of cardiovascular disease than those experiencing no social determinants of health/health equity risk factors.

Conclusions

Mississippi adults with 4 or more social determinants of health/health equity risk factors had significantly higher odds of cardiovascular disease than those with no social determinants of health/health equity risk factors. These findings highlight the importance of social determinants of health/health equity factors in cardiovascular disease burden and suggest that interventions targeted at individuals with multiple social determinants of health/health equity risk factors are needed to reduce the high burden of cardiovascular disease among Mississippi adults.

简介：心血管疾病是密西西比州成年人死亡的主要原因。健康的社会决定因素是造成心血管疾病风险和相关死亡率以及健康差距的重要因素。作者研究了密西西比州成年人健康的社会决定因素和心血管疾病之间的联系。方法：利用2022年密西西比州行为风险因素监测系统调查3,994名受访者的健康社会决定因素和健康公平模块数据，作者进行了多变量logistic回归模型，以检验心血管疾病与健康社会决定因素/健康公平汇总措施之间的关系。结果：领取食品券或参加补充营养援助计划的参与者(AOR=2.28；95% CI=1.35, 3.86)，经历过粮食不安全(AOR=1.74；95% CI=1.08, 2.79)，经历过精神痛苦(AOR=2.39；95% CI=1.54, 3.73)患心血管疾病的几率明显高于没有这些因素的对照组。密西西比州成年人经历4个或更多健康/健康公平风险因素的社会决定因素，AOR=2.56；95% CI=1.49, 4.41)心血管疾病的发生率高于那些没有健康/健康公平危险因素的社会决定因素的人。结论：具有4个或更多健康/健康公平社会决定因素的密西西比成年人患心血管疾病的几率明显高于没有健康/健康公平社会决定因素的成年人。这些发现强调了健康/健康公平因素的社会决定因素在心血管疾病负担中的重要性，并建议针对具有多种健康/健康公平风险因素的个体进行干预，以减少密西西比州成年人心血管疾病的高负担。

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引用次数: 0

Determining Filipinos’ Preferences for Colorectal Cancer Screening Tests: Insights From a Choice-Based Conjoint Analysis 确定菲律宾人对结直肠癌筛查试验的偏好：基于选择的联合分析的见解。

AJPM focus

Pub Date : 2025-02-01 DOI: 10.1016/j.focus.2024.100300

Austin Crochetiere MD , Marie Lauzon MS , Antwon Chaplin BA , Christopher V. Almario MD, MSHPM

Introduction

Filipinos in the U.S. have worse colorectal cancer screening rates and outcomes than non-Hispanic Whites, despite 85% of Filipinos being proficient in English and having insurance rates, education, and incomes that exceed those of the general population. To begin to address this disparity, the authors used conjoint analysis—a method that assesses complex decision making—to better understand Filipinos’ preferences for the different colorectal cancer screening test options.

Methods

The authors conducted a conjoint analysis survey among unscreened Filipinos aged ≥40 years at average risk for colorectal cancer to determine the relative importance of screening test attributes in their decision making (e.g., modality, effectiveness at reducing colorectal cancer risk, bowel prep). The authors also performed simulations to estimate the proportion of people who would prefer to do an annual fecal immunochemical test or colonoscopy every 10 years for their screening.

Results

Overall, 105 Filipinos completed the survey; most respondents were female (74.3%) and aged 40–49 years (84.8%). The authors observed that test modality was the most important factor in respondents’ decision making. After conducting simulations using the conjoint analysis data, the authors noted that 70 (66.7%) Filipinos preferred to do an annual fecal immunochemical test for their screening, whereas 35 (33.3%) wanted to do a colonoscopy every 10 years.

Conclusions

The authors found that 2 in 3 Filipinos prefer fecal immunochemical test to colonoscopy for their colorectal cancer screening. To address colorectal cancer disparities in the Filipino community, investigators, health systems, public health agencies, and community organizations need to develop culturally tailored, sustainable interventions, and such programs may want to focus on improving education on and access to fecal immunochemical test.

导言：在美国，菲律宾人的结直肠癌筛查率和结果均低于非西班牙裔白人，尽管85%的菲律宾人精通英语，其保险率、教育程度和收入均高于普通人。为了着手解决这一差距，作者采用了联合分析--一种评估复杂决策的方法--来更好地了解菲律宾人对不同结直肠癌筛查试验选项的偏好：作者对年龄≥40 岁、平均罹患大肠癌风险未接受筛查的菲律宾人进行了联合分析调查，以确定筛查检验属性在其决策中的相对重要性（如方式、降低大肠癌风险的有效性、肠道准备）。作者还进行了模拟实验，以估计愿意每年进行一次粪便免疫化学检验或每十年进行一次结肠镜检查的筛查人群比例：共有 105 名菲律宾人完成了调查；大多数受访者为女性（74.3%），年龄在 40-49 岁之间（84.8%）。作者发现，检查方式是受访者做出决定的最重要因素。在利用联合分析数据进行模拟后，作者注意到 70 名菲律宾人（66.7%）倾向于每年进行一次粪便免疫化学检验筛查，而 35 名菲律宾人（33.3%）希望每 10 年进行一次结肠镜检查：作者发现，每 3 名菲律宾人中就有 2 人喜欢用粪便免疫化学检验来筛查大肠癌，而不是结肠镜检查。为了解决菲律宾社区结直肠癌的不平等问题，调查人员、医疗系统、公共卫生机构和社区组织需要制定符合当地文化的、可持续的干预措施，这些计划可能需要重点加强粪便免疫化学检验的教育和普及。

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引用次数: 0

Demographic Characteristics Associated With Adolescent Receipt of Provider E-Cigarette Screening and Advice and the Impact on Harm Perception

AJPM focus

Pub Date : 2025-02-01 DOI: 10.1016/j.focus.2024.100309

John S. Acosta-Peñaloza MS, Karen W. Geletko MPH, Jon Mills PhD

Introduction

The growing prevalence of E-cigarette use among adolescents is alarming because it increases the probability of persistent tobacco use and addiction to nicotine. Healthcare providers are in a unique position to influence their patients’ use of E-cigarettes. The purpose of the study is to determine the frequency at which providers screen adolescents for E-cigarette use and advise against use during healthcare visits. The study also examines associations between provider intervention and adolescent harm perception.

Methods

Using data from the 2021 National Youth Tobacco Survey, the authors examined provider E-cigarette screening and advice to not use from 16,910 participants who self-reported receiving medical care within the preceding year. Multivariable logistic regression models were used to assess whether the odds of provider intervention varied by age, sex, and race/ethnicity and whether receiving provider intervention was associated with a likelihood for harm perception.

Results

Provider intervention was more likely among those aged 13–18 years, who are male, and who are White and/or non-Hispanic (p<0.001). The authors found no association between provider intervention and increased harm perception of E-cigarettes; however, provider intervention was associated with the belief that E-cigarettes are equally or more addictive than cigarettes (p<0.0001).

Conclusions

Study findings emphasize the significance of addressing disparities in E-cigarette use and healthcare provider intervention among minority adolescents, underscoring the need for healthcare providers to be thorough in screening for E-cigarette use and providing appropriate cessation support.

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引用次数: 0

Person-Centered Preventive Health Care: Gathering Stakeholder Input on Evidence and Implementation

AJPM focus

Pub Date : 2025-01-31 DOI: 10.1016/j.focus.2025.100319

Leila C. Kahwati MD, MPH , Hanan J. Aboumatar MD, MPH , Alison K. Banger MPH , Sarah I. Bean MPH , Laurie W. Hinnant PhD , Daniel E. Jonas MD, MPH , Julia M. Kim MD, MPH , Jennifer S. Lin MD, MCR , Carrie D. Patnode PhD , Meagan R. Pilar PhD , Samantha I. Pitts MD, MPH , Shivani M. Reddy MD, MSc , Ritu Sharma BSc , Christiane E. Voisin MSLS , Elizabeth M. Webber MS , Jodi Blake MBA , Nora M. Mueller PhD, MAA

Introduction

Clinical preventive services, such as screening tests, vaccinations, behavioral counseling, or preventive medication, are offered to most people on the basis of age, sex, health behaviors, or clinical risk factors, with goals of detecting early disease, preventing future disease, or mitigating the impact of unhealthy behaviors on future health. However, many people do not receive all the recommended services for which they are eligible.

Methods

The Agency for Healthcare Research and Quality identified 4 topics for gathering stakeholder input on evidence and implementation for the equitable delivery of clinical preventive services. These included technology, innovative delivery models, public health linkages, and disparities. For each topic, the authors conducted an environmental scan to identify existing programs or interventions to promote the delivery of clinical preventive services, a technical expert panel meeting, and key informant interviews. The authors synthesized input from each topic's technical expert panel and key informant interviews and used inductive reasoning to identify themes. Within each overarching theme, the authors identified subthemes supported by specific statements, examples, and illustrative quotes.

Results

A total of 90 individuals participated on stakeholder panels, technical expert panels, or key informant interviews; some individuals participated in multiple roles. Across the topics, the authors identified 3 overarching themes from synthesis of the technical expert panel and key informant interview comments across topics: (1) transitioning to holistic healthcare delivery and financing models, (2) including community and patient voice in healthcare system design, and (3) leveraging technology to improve clinical preventive services delivery.

Conclusions

Promoting the equitable delivery of clinical preventive services requires improving access to primary care but also expanding efforts beyond clinical settings to encompass public health and community infrastructure and engagement. Experts recommended that person-centered preventive care should empower patients to make informed decisions about clinical preventive services on the basis of their values, risks, and preferences. This more individualized approach tailored to needs and context may reduce barriers to receipt of clinical preventive services.

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引用次数: 0

Preference for Long-Acting Injectable PrEP Compared With Daily Oral PrEP Among Transgender Women in the U.S.: Findings From a Multisite Cohort

AJPM focus

Pub Date : 2025-01-08 DOI: 10.1016/j.focus.2025.100313

Erin E. Cooney PhD, MSPH , Sari L. Reisner ScD, MA , Tonia C. Poteat PhD, MPH, PA-C , Asa E. Radix MD, PhD, MPH , Kenneth H. Mayer MD , Chris Beyrer MD, MPH , Meg Stevenson MSPH , Rodrigo A. Aguayo-Romero PhD , Jason S. Schneider MD , Andrew J. Wawrzyniak PhD , Christopher M. Cannon MPH , Carolyn A. Brown PhD, MPH , Leigh Ragone MS , Vani Vannappagari PhD , Andrea L. Wirtz PhD, MHS , American Cohort to Study HIV Acquisition Among Transgender Women (LITE) Study Group

Introduction

Pre-exposure prophylaxis (PrEP) use among transgender women in the U.S. has not reached levels optimal to change the trajectory of the HIV epidemic owing to multilevel barriers. Long-acting injectable PrEP received Food and Drug Administration approval in 2021 and may potentially address some of the barriers experienced in initiating and adhering to daily oral PrEP (e.g., pill fatigue, medication storage). However, preferences for long-acting injectable PrEP compared with daily oral PrEP have not been well studied among transgender women.

Methods

The authors analyzed data collected from transgender women not living with HIV in eastern and southern U.S. in 2020–2022. Using multivariable Poisson regression with robust standard errors, the authors estimated prevalence ratios and 95% CIs for factors associated with preference for long-acting injectable PrEP.

Results

The study sample (N=789) was racially and ethnically diverse, with 42.6% identifying as Black, Latina, and/or multiracial and 12% using daily oral PrEP. Fifty-eight percent preferred long-acting injectable PrEP to daily oral PrEP. In multivariable regression analyses, preference for long-acting injectable PrEP was associated with residence in Midwest (reference group=Northeast, adjusted prevalence ratio=1.33; 95% CI=1.10, 1.60), current PrEP indications (adjusted prevalence ratio=1.14; 95% CI=1.01, 1.30), and history of gender-affirming hormone injection (adjusted prevalence ratio=1.36; 95% CI=1.18, 1.57).

Conclusions

Transgender women may prefer long-acting injectable PrEP to daily oral PrEP, especially those with current PrEP indications and experience with gender-affirming hormone injections. Increasing availability and access to long-acting injectable PrEP may improve PrEP uptake in transgender women, particularly in combination with other interventions to reduce multilevel PrEP barriers.

{"title":"Preference for Long-Acting Injectable PrEP Compared With Daily Oral PrEP Among Transgender Women in the U.S.: Findings From a Multisite Cohort","authors":"Erin E. Cooney PhD, MSPH , Sari L. Reisner ScD, MA , Tonia C. Poteat PhD, MPH, PA-C , Asa E. Radix MD, PhD, MPH , Kenneth H. Mayer MD , Chris Beyrer MD, MPH , Meg Stevenson MSPH , Rodrigo A. Aguayo-Romero PhD , Jason S. Schneider MD , Andrew J. Wawrzyniak PhD , Christopher M. Cannon MPH , Carolyn A. Brown PhD, MPH , Leigh Ragone MS , Vani Vannappagari PhD , Andrea L. Wirtz PhD, MHS , American Cohort to Study HIV Acquisition Among Transgender Women (LITE) Study Group","doi":"10.1016/j.focus.2025.100313","DOIUrl":"10.1016/j.focus.2025.100313","url":null,"abstract":"<div><h3>Introduction</h3><div>Pre-exposure prophylaxis (PrEP) use among transgender women in the U.S. has not reached levels optimal to change the trajectory of the HIV epidemic owing to multilevel barriers. Long-acting injectable PrEP received Food and Drug Administration approval in 2021 and may potentially address some of the barriers experienced in initiating and adhering to daily oral PrEP (e.g., pill fatigue, medication storage). However, preferences for long-acting injectable PrEP compared with daily oral PrEP have not been well studied among transgender women.</div></div><div><h3>Methods</h3><div>The authors analyzed data collected from transgender women not living with HIV in eastern and southern U.S. in 2020–2022. Using multivariable Poisson regression with robust standard errors, the authors estimated prevalence ratios and 95% CIs for factors associated with preference for long-acting injectable PrEP.</div></div><div><h3>Results</h3><div>The study sample (N=789) was racially and ethnically diverse, with 42.6% identifying as Black, Latina, and/or multiracial and 12% using daily oral PrEP. Fifty-eight percent preferred long-acting injectable PrEP to daily oral PrEP. In multivariable regression analyses, preference for long-acting injectable PrEP was associated with residence in Midwest (reference group=Northeast, adjusted prevalence ratio=1.33; 95% CI=1.10, 1.60), current PrEP indications (adjusted prevalence ratio=1.14; 95% CI=1.01, 1.30), and history of gender-affirming hormone injection (adjusted prevalence ratio=1.36; 95% CI=1.18, 1.57).</div></div><div><h3>Conclusions</h3><div>Transgender women may prefer long-acting injectable PrEP to daily oral PrEP, especially those with current PrEP indications and experience with gender-affirming hormone injections. Increasing availability and access to long-acting injectable PrEP may improve PrEP uptake in transgender women, particularly in combination with other interventions to reduce multilevel PrEP barriers.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 2","pages":"Article 100313"},"PeriodicalIF":0.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143427995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Health and Economic Impact of COVID-19 Surveillance Testing in Seattle Homeless Shelters: A Cost-Effectiveness Analysis

AJPM focus

Pub Date : 2024-12-05 DOI: 10.1016/j.focus.2024.100307

Sarah N. Cox PhD , Eric J. Chow MD , Melissa A. Rolfes PhD , Emily Mosites PhD , Monisha Sharma PhD , Helen Y. Chu MD , Marita Zimmermann PhD

Introduction

COVID-19 surveillance in congregate settings is important to mitigating disease, but the health and economic impact of testing remains unclear.

Methods

The authors developed a Markov model to project the cost-utility of COVID-19 testing strategies in homeless shelters from the healthcare payer and societal perspective over 1 year. Model inputs utilized data from residents aged ≥18 years across 23 Seattle shelters from January 1, 2020, to May 31, 2021. No in-shelter surveillance was compared with scenarios of 2 COVID-19 testing strategies implemented monthly: polymerase chain reaction (PCR) testing and rapid antigen testing; scenarios in which only PCR testing was available were also evaluated. The primary health outcome was quality-adjusted life years. Interventions were considered cost-effective if the incremental cost-effectiveness ratio was ≤$150,000 per quality-adjusted life year and dominant if they saved costs and provided health effects.

Results

When assuming the availability of both antigen and PCR tests, most rapid antigen testing strategies were cost-effective, whereas PCR testing was dominated by antigen testing. Compared with no in-shelter surveillance, antigen testing increased mean quality-adjusted life years by 0.0009 (0.03% infections averted) at an incremental cost of $97/resident from the healthcare perspective (incremental cost-effectiveness ratio=$112,352/quality-adjusted life year gained) and $8/resident from the societal perspective (incremental cost-effectiveness ratio=$9,627/quality-adjusted life year gained) at 75% vaccination coverage. PCR testing was not cost-effective when antigen testing was available but was cost-effective compared with no surveillance at low vaccination coverage levels (<30% coverage from the healthcare perspective and ≤48% coverage from the societal perspective). Probabilistic sensitivity analysis showed that antigen testing was cost-effective in 62% and 86% of simulations from the healthcare and societal perspectives, respectively.

Conclusions

Modeled findings show that COVID-19 testing in shelters can be a cost-effective pandemic response. Antigen testing remained cost-effective at high vaccination levels, whereas PCR testing was most effective at low vaccination levels if antigen testing was not available.

{"title":"Health and Economic Impact of COVID-19 Surveillance Testing in Seattle Homeless Shelters: A Cost-Effectiveness Analysis","authors":"Sarah N. Cox PhD , Eric J. Chow MD , Melissa A. Rolfes PhD , Emily Mosites PhD , Monisha Sharma PhD , Helen Y. Chu MD , Marita Zimmermann PhD","doi":"10.1016/j.focus.2024.100307","DOIUrl":"10.1016/j.focus.2024.100307","url":null,"abstract":"<div><h3>Introduction</h3><div>COVID-19 surveillance in congregate settings is important to mitigating disease, but the health and economic impact of testing remains unclear.</div></div><div><h3>Methods</h3><div>The authors developed a Markov model to project the cost-utility of COVID-19 testing strategies in homeless shelters from the healthcare payer and societal perspective over 1 year. Model inputs utilized data from residents aged ≥18 years across 23 Seattle shelters from January 1, 2020, to May 31, 2021. No in-shelter surveillance was compared with scenarios of 2 COVID-19 testing strategies implemented monthly: polymerase chain reaction (PCR) testing and rapid antigen testing; scenarios in which only PCR testing was available were also evaluated. The primary health outcome was quality-adjusted life years. Interventions were considered cost-effective if the incremental cost-effectiveness ratio was ≤$150,000 per quality-adjusted life year and dominant if they saved costs and provided health effects.</div></div><div><h3>Results</h3><div>When assuming the availability of both antigen and PCR tests, most rapid antigen testing strategies were cost-effective, whereas PCR testing was dominated by antigen testing. Compared with no in-shelter surveillance, antigen testing increased mean quality-adjusted life years by 0.0009 (0.03% infections averted) at an incremental cost of $97/resident from the healthcare perspective (incremental cost-effectiveness ratio=$112,352/quality-adjusted life year gained) and $8/resident from the societal perspective (incremental cost-effectiveness ratio=$9,627/quality-adjusted life year gained) at 75% vaccination coverage. PCR testing was not cost-effective when antigen testing was available but was cost-effective compared with no surveillance at low vaccination coverage levels (<30% coverage from the healthcare perspective and ≤48% coverage from the societal perspective). Probabilistic sensitivity analysis showed that antigen testing was cost-effective in 62% and 86% of simulations from the healthcare and societal perspectives, respectively.</div></div><div><h3>Conclusions</h3><div>Modeled findings show that COVID-19 testing in shelters can be a cost-effective pandemic response. Antigen testing remained cost-effective at high vaccination levels, whereas PCR testing was most effective at low vaccination levels if antigen testing was not available.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 2","pages":"Article 100307"},"PeriodicalIF":0.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cigarette Smoking Patterns Among Racial and Ethnic Groups With Chronic Lung Diseases During the COVID-19 Pandemic

AJPM focus

Pub Date : 2024-12-04 DOI: 10.1016/j.focus.2024.100310

Vijaya L. Seegulam MPH , Caretia J. Washington BS , Parvathy P. Surendran BPT , Alyssa M. Falise PhD, MSPH , Diana Gomez-Manjarres MD , Catalina Lopez-Quintero MD, MPH, PhD

<div><h3>Introduction</h3><div>Chronic obstructive pulmonary disease and asthma are significant respiratory conditions that contribute to substantial morbidity and mortality globally. Chronic obstructive pulmonary disease remains the third most prevalent cause of death worldwide, with 90% of chronic obstructive pulmonary disease deaths attributed to combustible cigarette smoking. Asthma, although often less fatal, leads to considerable health burdens, particularly among marginalized populations who are at higher risk for both more severe chronic obstructive pulmonary disease and asthma outcomes. This study investigates the association between race/ethnicity and current cigarette smoking among adults diagnosed with chronic obstructive pulmonary disease and/or asthma in the U.S. before, during, and after the COVID-19 pandemic.</div></div><div><h3>Methods</h3><div>The authors analyzed data from 10,763 adults (aged ≥40 years) with a history of chronic obstructive pulmonary disease and/or asthma surveyed in the 2019, 2021, and 2023 National Health Interview Survey. The authors estimated predicted probabilities derived from multiple logistic regression and negative binomial regression models to examine changes in (1) the prevalence of current cigarette smoking in the target population, (2) the mean number of days of cigarette smoking in the past 30 days, and (3) the mean number of cigarettes smoked in the past 30 days across racial/ethnic subgroups and prepandemic, pandemic, and postpandemic periods.</div></div><div><h3>Results</h3><div>Current cigarette smoking was reported by about one fifth (20%) of U.S. adults diagnosed with chronic obstructive pulmonary disease and asthma. Among them, the mean number of days of cigarette smoking in the past 30 days was 27 days, and the mean number of cigarettes smoked in the past 30 days was 14. Hispanic individuals had the lowest prepandemic rates of current cigarette smoking (10.5%); however, it was the only racial/ethnic group showing a significant change during the pandemic, with rates increasing to 14.9% during the pandemic. Non-Hispanic White individuals, who showed the highest rates of current cigarette smoking (21.1%) during the pandemic, were the only racial/ethnic group showing a significant decline in the postpandemic period (19.8%). No significant changes were observed in the mean number of days or cigarettes smoked in the past 30 days, except for a marginally significant increase in cigarette consumption among non-Hispanic Black individuals.</div></div><div><h3>Conclusions</h3><div>These analyses suggest that the pandemic had a differential impact on the rates of current smoking across racial/ethnic subgroups in adults with chronic obstructive pulmonary disease and/or asthma, with a detrimental effect in Hispanic individuals and an improvement among non-Hispanic White individuals. Given the dangers of smoking in chronic lung conditions, future research should investigate the factors behind these to de

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引用次数: 0

Heterogeneity of the Association Between Obesity and COVID-19 Mortality and the Roles of Policy Interventions: U.S. National-Level Analysis

AJPM focus

Pub Date : 2024-12-04 DOI: 10.1016/j.focus.2024.100312

Nabin Bhandari MS , Joel M. Cuffey PhD , Ruiqing Miao PhD , David Zilberman PhD

This article examines the heterogeneity of the association between obesity and COVID-19 mortality across various dimensions, including COVID-19 vaccination rates, mask mandates, gathering restrictions, and household income. Using multivariate regression analysis on U.S. county-level data over 2020–2021, the authors found that county-level adult obesity rates were positively associated with COVID-19 death rates. The results suggest that on average, a 10-percentage-point decrease in adult obesity rate is associated with a decrease in COVID-19 deaths by 4.79%–5.98% in the U.S. Considering that the average adult obesity rate in the U.S. is higher than the global average, this finding may explain why deaths due to COVID-19 were disproportionately large in the U.S. In addition, the authors found that association between obesity and the COVID-19 death rate is much more pronounced in groups with low vaccination rates, weak mask mandates, loose gathering restrictions, or low household incomes, indicating the importance of COVID-19 response policies and income to people with obesity facing a pandemic. The study results contribute to policy discussions surrounding preparation for COVID-19–like pandemics. Food policies and health promotion strategies that encourage physical well-being to reduce obesity prevalence may help reduce mortality in future pandemics.

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引用次数: 0

Editorial Board and Journal Information 编辑委员会和期刊信息

AJPM focus

Pub Date : 2024-12-01 DOI: 10.1016/S2773-0654(24)00116-0

引用次数: 0