Preventive medicine
-
Preventive medicine · Nov 2018
Correlations between population-levels of prescription opioid dispensing and related deaths in Ontario (Canada), 2005-2016.
Canada is experiencing an ongoing opioid-related public health crisis, including persistently rising opioid (e.g., poisoning) mortality. Previous research has documented marked correlations between population-levels of opioid dispensing and deaths. We examined possible correlations between annual population-level dispensing of specific opioid formulations and related poisoning deaths in Ontario (Canada), for the period 2005-2016. ⋯ Strong correlations between levels of dispensing and deaths for select opioid formulations were found. For select others, extrinsic factors - e.g., increasing involvement of non-medical opioid products (e.g., fentanyl) in overdose deaths - likely confounded underlying correlation effects. Opioid dispensing levels continue to influence population-level mortality levels, and need to be addressed by prevention strategies.
-
Very few studies have examined trends in multimorbidity over time and even fewer have examined trends over time across different body mass index (BMI) groups. Given a general decline in death rates but increased cardiovascular risk factors among individuals with obesity, the trend in the association between obesity and multimorbidity is hypothesized to be increasing over time. The data for our study came from the 1996-97 National Population Health Survey and the 2005 and 2012-13 Canadian Community Health Surveys (N = 277,366 across all 3 surveys). ⋯ Changes in multimorbidity levels were much greater among individuals with class II/III (OR = 1.48; p = 0.005) and class I obesity (OR = 1.38; p = 0.001) in 2012-13 relative to 1996-97. Much of the increase in multimorbidity among individuals living with obesity was due to increases in 3+ chronic conditions and conditions in combination with hypertension, and the greatest increase was found among seniors living with obesity. Our results highlight the need for interventions aimed at preventing obesity and the prevention of chronic conditions among individuals with obesity, especially among seniors.
-
Preventive medicine · Nov 2018
Patterns, trends and determinants of e-cigarette use in 28 European Union Member States 2014-2017.
There is a lack of nationally representative data on regular e-cigarette use, as well as on the transition from experimentation to regular use. This study examines changes in these in Europe between 2014 and 2017. Data come from the 2014 (n = 27,801) and 2017 (n = 27,901) adult Special Eurobarometer for Tobacco Survey, providing nationally representative surveys of 28 EU member states. ⋯ Among those who had ever used e-cigarettes, participants aged 15-24 years were less likely to be regular user than those aged ≥55 years (16.9% vs. 38.1%), as were never smokers compared with current and former smokers (12.8% vs. 27.0% vs. 41.3%). The proportion of adults who were regular e-cigarette users in 2017 ranged from 4.7% in the UK to 0.2% in Bulgaria. There have been slight rises in the proportion of people regularly using e-cigarettes in the EU, and this varies considerably between member states, indicating the role of the regional environment in supporting or deterring e-cigarette use.
-
Preventive medicine · Nov 2018
Trends in active transportation and associations with cardiovascular disease risk factors among U.S. adults, 2007-2016.
Active transportation (AT), or walking or bicycling for transportation, represents one way individuals can achieve recommended physical activity (PA) levels. This study describes AT prevalence and temporal trends, and examines associations between AT levels and measured CVD risk factors (hypertension, hypercholesterolemia, low high-density [HDL] cholesterol, diabetes, and obesity) among U. S. adults. ⋯ AT prevalence among adults has fluctuated from 2007 to 2016. Despite favorable associations between AT and CVD risk factors, most U. S. adults do not engage in any AT.
-
Preventive medicine · Nov 2018
Who owns guns and how do they keep them? The influence of household characteristics on firearms ownership and storage practices in the United States.
Our paper aims to describe firearm-related behavior among American households and to quantify the influence of household characteristics on the probability of firearms possession and storage practices. Applying logistic regression techniques to data from the 2004 Behavioral Risk Factor Surveillance Survey (BRFSS), we use separate models to estimate the effect of an array of respondent demographic characteristics factors on the likelihood that households will have a gun at home and, if so, whether they will keep it at either of two levels of risk. We find that rates of firearm ownership vary widely by household characteristics, including the state in which they reside. ⋯ Differing dynamics of ownership and storage reveal the existence of two regional gun cultures. From these findings, we conclude that to mitigate mortality risks associated with guns in the home, encouraging safer storage by owners may be as effective as controlling sales. States and localities should test a range of promising but largely unproven interventions.