Journal of epidemiology and community health
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J Epidemiol Community Health · Feb 2010
Comparative StudySurvival disparities in Indigenous and non-Indigenous New Zealanders with colon cancer: the role of patient comorbidity, treatment and health service factors.
Ethnic disparities in cancer survival have been documented in many populations and cancer types. The causes of these inequalities are not well understood but may include disease and patient characteristics, treatment differences and health service factors. Survival was compared in a cohort of Maori (Indigenous) and non-Maori New Zealanders with colon cancer, and the contribution of demographics, disease characteristics, patient comorbidity, treatment and healthcare factors to survival disparities was assessed. ⋯ Higher patient comorbidity and poorer access and quality of cancer care are both important explanations for worse survival in Maori compared with non-Maori New Zealanders with colon cancer.
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J Epidemiol Community Health · Feb 2010
Adherence and chemoprevention in major cardiovascular disease: a simulation study of the benefits of additional use of statins.
In everyday practice, adherence to preventive medication for cardiovascular disease (CVD) is lower than in clinical trials and appears to decline to approximately 50% by about 5 years. The UK body for the evaluation of health technologies, NICE, currently recommends that persons with a >20% 10-year risk of incident cardiovascular disease receive statins. ⋯ The benefits from increased spending on statin medication will be much greater if they result from enhanced adherence rather than from lowering the medication threshold.
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J Epidemiol Community Health · Nov 2009
Prevalence of chronic medical conditions among jail and prison inmates in the USA compared with the general population.
Despite growing inmate populations in the USA, inmates are excluded from most national health surveys and little is known about whether the prevalence of chronic disease differs between inmates and the non-institutionalised population. ⋯ Jail and prison inmates had a higher burden of most chronic medical conditions than the general population even with adjustment for important sociodemographic differences and alcohol consumption.
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J Epidemiol Community Health · Nov 2009
Solid fuel use and cooking practices as a major risk factor for ALRI mortality among African children.
Almost half of global child deaths due to acute lower respiratory infections (ALRIs) occur in sub-Saharan Africa, where three-quarters of the population cook with solid fuels. This study aims to quantify the impact of fuel type and cooking practices on childhood ALRI mortality in Africa, and to explore implications for public health interventions. ⋯ This study shows substantial differences in ALRI mortality risk among African children in relation to cooking practices, and suggests that stove ventilation may be an important means of reducing indoor air pollution.