American journal of public health
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We assessed cancer care disparities within the Veterans Affairs (VA) health care system and whether between-hospital differences explained disparities. ⋯ Disparities in VA cancer care were observed for 7 of 20 measures and were primarily attributable to within-hospital differences.
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Noncommunicable diseases result from consuming unhealthy products, including tobacco, which are promoted by transnational corporations. The tobacco industry uses preemption to block or reverse tobacco control policies. Preemption removes authority from jurisdictions where tobacco companies' influence is weak and transfers it to jurisdictions where they have an advantage. ⋯ Tobacco companies are using these agreements to preempt domestic authority over tobacco policy. Other transnational corporations that profit by promoting unhealthy foods could do the same. "Fast-track authority," in which Congress cedes ongoing oversight authority to the President, further distances the public from the debate. With international agreements binding governments to prioritize trade over health, transparency and public oversight of the trade negotiation process is necessary to safeguard public health interests.
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We review evidence of determinants contributing to increased opioid-related mortality in the United States and Canada between 1990 and 2013. We identified 17 determinants of opioid-related mortality and mortality increases that we classified into 3 categories: prescriber behavior, user behavior and characteristics, and environmental and systemic determinants. ⋯ Researchers in this area face significant methodological difficulties; most of the studies in our review were ecological or observational and lacked control groups or adjustment for confounding factors; thus, causal inferences are difficult. Preventing additional opioid-related mortality will likely require interventions that address multiple determinants and are tailored to specific locations and populations.
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Evaluating the effect of state regulation of federally licensed firearm dealers on firearm homicide.
Effective federal regulation of firearm dealers has proven difficult. Consequently, many states choose to implement their own regulations. ⋯ We found that lower homicide rates were associated with states that required licensing and inspections. We concluded that firearm dealer regulations might be an effective harm reduction strategy for firearm homicide.