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Life's Simple 7 (LS7; nutrition, physical activity, cigarette use, body mass index, blood pressure, cholesterol, glucose) predicts cardiovascular health. The principal objective of our study was to define demographic and socioeconomic factors associated with LS7 to better inform programs addressing cardiovascular health and health equity.
National Health and Nutrition Examination Surveys 1999-2016 data were analyzed on non-Hispanic White [NHW], NH Black [NHB], and Hispanic adults aged ≥20 years without cardiovascular disease. Each LS7 variable was assigned 0, 1, or 2 points for poor, intermediate, and ideal levels, respectively. Composite LS7 scores were grouped as poor (0-4 points), intermediate (5-9), and ideal (10-14).
32,803 adults were included. Mean composite LS7 scores were below ideal across race/ethnicity groups. After adjusting for confounders, NHBs were less likely to have optimal LS7 scores than NHW (multivariable odds ratios (OR .44; 95% CI .37-.53), whereas Hispanics tended to have better and reducing poverty are also important.Obesity rates increase as household income increases among Black men, yet only a few studies have sought to understand this unique association. Scholars have posited that gendered stressors like role strain that are work-related could play a role in obesity among Black men. Work-life interference is a concept that captures the conflict between work life and family/personal life. Work-life interference is associated with obesity-related behaviors but has been understudied in Black men. The aim of this study was to determine the interrelationship between work-life interference, income, and obesity among Black men. Using data from the 2015 National Health Interview Survey, the associations between household income and odds of overweight and obesity (measured by body mass index) were assessed using ordinal logit regressions. Multiplicative interaction terms were used to assess the potential moderation of the association between income and log-odds of overweight/obesity by work-life interference. The results of our study demonstrate that work-life interference interacts with income ≥400% federal poverty level (FPL) on the log-odds of overweight/obesity (beta=2.10, standard error [se]=.87). Among those who reported work-life interference, Black men who had household income ≥400% FPL had higher log-odds of overweight/obesity (beta=1.51, se=.74) compared with those with income less then 100% FPL. There was no association between income and obesity among Black men who did not report work-life interference. The results suggest that work-life interference plays an important role in the positive association between income and obesity in Black men. Future studies should explicate the obesogenic ways in which work and family/personal life combine among high-income Black men.
Diabetes results in $327 billion in medical expenditures annually, while obesity, a risk factor for type 2 diabetes, leads to more than $147 billion in expenditure annually. The aims of this study were 1) to evaluate racial/ethnic trends in obesity and medical expenditures; and 2) to assess incremental medical expenditures among a nationally representative sample of women with diabetes.
Nine years of data (2008-2016) from the Medical Expenditure Panel Survey Full Year Consolidated File (unweighted = 11,755; weighted = 10,685,090) were used. The outcome variable was medical expenditure. The primary independent variable was race/ethnicity defined as non-Hispanic Black (NHB), Hispanic, or non-Hispanic White (NHW). Covariates included age, education, marital status, income, insurance, employment, region, comorbidity, and year. Cochran-Armitage tests determined statistical significance of trends in obesity and mean expenditure. Two-part modeling using Probit and gamma distribution was used to assess incremental medical expenditure. Data were clustered to 2008-2010, 2011-2013, 2014-2016.
Trends in medical expenditures differed significantly between NHB and NHW women between 2008-2016 (P<.001). Hispanic women paid $1,291 less compared with NHW women, after adjusting for relevant covariates. There were no significant differences in obesity trends from 2008-2016 between NHB (P=.989) or Hispanic women with diabetes (P=.938) compared with NHW women with diabetes.
These findings suggest the need to further understand the factors associated with differences in trends for medical expenditures between NHB and NHW women with diabetes and incremental medical expenditures in Hispanic women with diabetes compared with NHW women with diabetes.
These findings suggest the need to further understand the factors associated with differences in trends for medical expenditures between NHB and NHW women with diabetes and incremental medical expenditures in Hispanic women with diabetes compared with NHW women with diabetes.
People living with lupus may experience poor access to primary care and delayed specialty care.
To identify characteristics that lead to increased odds of poor access to primary care for minorities hospitalized with lupus.
Cross-sectional design with 2011-2012 hospitalization data from South Carolina, North Carolina, and Florida. We used ICD-9 codes to identify lupus hospitalizations. Ambulatory care sensitive conditions were used to identify preventable lupus hospitalizations and measure access to primary care. Logistic regression was used to estimate the odds ratio for the association between predictors and having poor access to primary care. TWS119 in vivo Sensitivity analysis excluded patients aged >65 years.
There were 23,154 total lupus hospitalizations, and 2,094 (9.04%) were preventable. An adjusted model showed minorities aged ≥65 years (OR 2.501, CI 1.501, 4.169), minorities aged 40-64 years (OR 2.248, CI 1.394, 3.627), minorities with Medicare insurance (OR 1.669, CI1.353,2.059) and minorities with Medicaid (OR 1.662,CI1.321, 2.092) had the highest odds for a preventable lupus hospitalization. Minorities with Medicare had significantly higher odds for ≥3 hospital days (OR 1.275, CI 1.149, 1.415). Whites with Medicare (OR 1.291, CI 1.164, 1.432) had the highest odds for ≥3 days.
Our data show that middle-aged minorities living with lupus and on public health insurance have a higher likelihood of poor access to primary care. Health care workers and policymakers should develop plans to identify patients, explore issues affecting access, and place patients with a community health worker or social worker to promote better access to primary care.
Our data show that middle-aged minorities living with lupus and on public health insurance have a higher likelihood of poor access to primary care. Health care workers and policymakers should develop plans to identify patients, explore issues affecting access, and place patients with a community health worker or social worker to promote better access to primary care.
Almost 40% of the 63 million Americans who speak a language other than English have limited English proficiency (LEP). This communication barrier can result in poor quality care and potentially adverse health outcomes. link2 Of particular interest is that the greatest proportion of LEP adults are aged >65 years and will face barriers and delays in accessing high-quality care. Age cohort variation of LEP burden has not been widely addressed. Culturally and linguistically appropriate hospital care delivery can mitigate these barriers.
In order to test whether culturally competent services reduced length-of-stay (LOS), we linked organizational cultural competence surveys across two-states (CA+FL) for comparison across Medicare acute care LOS. Using the 2013 American Hospital Association Database, and Hospital Compare Data from CMS (N=184), we compared hospital structure with culturally and linguistically appropriate services related to improved care delivery for LEP populations and aging LEP populations. We uti care in hospitals is lacking. A larger and multi-level sample across the United States could yield a greater understanding of the role of culturally and linguistically appropriate care for a rapidly growing population of diverse older adults.
Our findings demonstrate that patient outcomes are responsive to culturally and linguistically appropriate services. Further, our findings suggest understanding of culturally competent care in hospitals is lacking. A larger and multi-level sample across the United States could yield a greater understanding of the role of culturally and linguistically appropriate care for a rapidly growing population of diverse older adults.
To communicate research to the public, the National Cancer Institute developed the Health Information National Trends Survey (HINTS). link3 However, as with most national health surveillance, including the Behavioral Risk Factor Surveillance System, HINTS data are not sufficient to address unique demographic subpopulations such as US Pacific Islanders (PIs). National sampling methods do not adequately reach participants from small, medically underserved populations.
This study aims to document the cancer-relevant knowledge, attitudes, behaviors, and information-seeking practices of PIs in Hawaii (HI).
We conducted a cross-sectional survey during 2017-2018 of Native Hawaiians, Chuukese, and Marshallese in HI using Respondent Driven Sampling (RDS) to recruit these geographically diffuse groups. The modified HINTS survey included questions about cancer knowledge, attitudes and behaviors, health communications, and cultural practices.
A total of 515 Native Hawaiians, 305 Chuukese, and 180 Marshallese completed e role of culture in communications influencing cancer risk behaviors, which may be generalizable to migrant PIs in the United States.
To adapt and apply the Nutrition Environment Measures Survey for Restaurants (NEMS-R) to Hispanic Caribbean (HC) restaurants and examine associations between restaurant characteristics and nutrition environment measures.
We adapted the NEMS-R for HC cuisines (Cuban, Puerto Rican, Dominican) and cardiovascular health-promoting factors, and applied the instrument (NEMS-HCR) to a random sample of HC restaurants in New York City (NYC) (N=89). Multivariable linear regression was used to assess independent associations between NEMS-HCR score and restaurant characteristics (cuisine, size, type [counter-style vs sit-down] and price).
None of the menus in the restaurants studied listed any main dishes as "healthy" or "light." More than half (52%) offered mostly (>75%) nonfried main dishes, and 76% offered at least one vegetarian option. The most common facilitator to healthy eating was offering reduced portion sizes (21%) and the most common barrier was having salt shakers on tables (40%). NEMS-HCR scores (100-point scale) ranged from 24.1-55.2 (mean=39.7). In multivariable analyses, scores were significantly related to cuisine (with Puerto Rican cuisine scoring lower than Cuban and Dominican cuisines), and size (with small [<22 seats] restaurants scoring lower than larger restaurants). We found a significant quadratic association with midpoint price, suggesting that scores increased with increasing price in the lowest price range, did not vary in the middle range, and decreased with increasing price in the highest range.
Our application of the NEMS-R to HC restaurants in NYC revealed areas for potential future interventions to improve food offerings and environmental cues to encourage healthful choices.
Our application of the NEMS-R to HC restaurants in NYC revealed areas for potential future interventions to improve food offerings and environmental cues to encourage healthful choices.
Website: https://www.selleckchem.com/products/TWS119.html
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