Preventive medicine
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Preventive medicine · Dec 2019
Building evidence to reduce inequities in youth physical activity and obesity: Introduction to the Physical Activity Research Center (PARC) Special Section.
This guest editorial introduces the rationale and goals of the Physical Activity Research Center. It provides an overview of the five papers in this Special Section plus six commissioned studies intended to inform advocacy efforts.
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Preventive medicine · Dec 2019
Rural-urban disparities in colonoscopies after the elimination of patient cost-sharing by the Affordable Care Act.
Improving the prevention and early detection of colorectal cancer is a priority for reducing rural-urban disparities in colorectal cancer mortality. By eliminating out-of-pocket (OOP) costs for preventive colonoscopies, the Affordable Care Act (ACA) could have reduced rural-urban disparities in screening. ⋯ The ACA was associated with significant reductions in rural-urban disparities in colonoscopies in Maine, suggesting that OOP costs are an important barrier for rural residents. Further research is needed to determine whether increased uptake, particularly in rural areas, translated into better patient outcomes for colorectal cancer.
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Preventive medicine · Dec 2019
Money speaks: Reductions in severe food insecurity follow the Canada Child Benefit.
Food insecurity is a pervasive public health problem in high income countries, disproportionately affecting households with children. Though it has been strongly linked with socioeconomic status and investments in social protection programs, less is known about its sensitivity to specific policy interventions, particularly among families. We implemented a difference-in-difference (DID) design to assess whether Canadian households with children experienced reductions in food insecurity compared to those without following the roll-out of a new country-wide income transfer program: the Canada Child Benefit (CCB). ⋯ However, they also experienced significantly greater drops in the likelihood of experiencing severe food insecurity following CCB; most dramatically among those reporting the LIM or less (DID: -4.7%, 95% CI: -8.6, -0.7). These results suggest that CCB disproportionately benefited families most susceptible to food insecurity. Furthermore, our findings also indicate that food insecurity may be impacted by even modest changes to economic circumstance, speaking to the potential of income transfers to help people meet their basic needs.
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Preventive medicine · Dec 2019
Association between numeracy and self-rated poor health in 33 high- and upper middle- income countries.
The association between numeracy proficiency and health outcomes has been the subject of several studies. However, it is not known if this association is independent of educational attainment and literacy proficiency. In this study, we used logistic regression to model numeracy proficiency as a predictor of self-rated poor health after accounting for educational attainment and literacy proficiency. ⋯ Numeracy and literacy proficiencies show both independent and interdependent correlations with poor self-rated health. Further, these associations varied by sociodemographic characteristics and across countries. Policies aimed at improving numeracy and literacy may be beneficial in preventing adverse health outcomes.
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Preventive medicine · Dec 2019
The association of fatigue with dispositional mindfulness: relationships by levels of depressive symptoms, sleep quality, childhood adversity, and chronic medical conditions.
Although mindfulness-based interventions may be effective in addressing the common symptom of fatigue, no population-based studies have examined the relationship between mindfulness and fatigue. We determined whether higher levels of dispositional mindfulness were associated with lower levels of fatigue. Cross-sectional data were obtained through the Pennsylvania Head Start Staff Wellness Survey, a 2012 web-based survey in which 2199 of 3375 (65%) eligible staff participated. ⋯ The adjusted mean fatigue score decreased significantly and in a graded manner across higher quartiles of mindfulness, with the adjusted fatigue score 1.4 points lower (95% confidence interval: -1.5, -1.2) among those in the highest quartile of dispositional mindfulness compared to the lowest. This significant graded relationship was present within each subgroup examined, and there was not a statistically significant interaction between dispositional mindfulness and any subgroup variable. Future trials of mindfulness-based interventions should consider assessing the outcome of fatigue in both clinical and non-clinical populations.