Preventive medicine
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Preventive medicine · Dec 2021
Factors associated with participation in the organized cervical cancer screening program in the greater Paris area (France): An analysis among more than 200,000 women.
We aimed to identify the contextual factors associated with participation in the organized Cervical Cancer Screening (CCS) pilot program, which includes specific interventions to reach vulnerable women, in the Greater Paris region. Study population consisted of 231,712 women aged 25-65 years, who were not up to date to their smear test and had been invited to take part in the program from July 2014 to September 2017. Using a multilevel mixed logistic regression with random effects, we investigated the effect of grassroots interventions targeting vulnerable women, healthcare provider accessibility, social environment and municipal policy-related factors. ⋯ In both populations, there were no significant trends in participation with regards to the type of grassroots interventions, level of accessibility of healthcare services or municipal commitment to healthcare. Among women invited previously and aged above 35 increased participation was seen in neighborhoods with low proportion of single women or in less deprived neighborhoods. Our results identified groups of women who participated less in the organized CCS program and suggested that additional interventions targeting the barriers faced by vulnerable women, especially those aged 35-45 years old, are needed.
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Preventive medicine · Dec 2021
Impact of geographic access to primary care providers on pediatric behavioral health screening.
Behavioral Health (BH) screening is critical for early diagnosis and treatment of pediatric mental disorders. The objective of this study was to assess the impact of geographic access to primary care providers (PCP) on pediatric BH screening in children with different race/ethnicity. A retrospective cohort study was conducted using the 2013-2016 administrative claims data from a large pediatric Medicaid Managed Care Plan that have been linked to 2010 US Census data and the 2017 National Provider Identifier (NPI) Registry. ⋯ Multivariable analysis stratified by individual race/ethnicity revealed that Hispanic and Black children were more vulnerable to the geographic access barriers than their non-Hispanic White counterparts. The increase in travel distance to the nearest PCP was negatively associated with screening uptake only among Hispanics (10-20 miles vs. 0-10 miles: OR = 0.78, 95% CI [0.71-0.86]; 20-30 miles vs. 0-10 miles: OR = 0.35, 95% CI [0.23-0.54]). In a subgroup that had access to at least one PCP within 10 miles of travel distance, the variation in PCP density had a greater impact on the screening uptake among Hispanics and Blacks than that in non-Hispanic Whites.
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Preventive medicine · Dec 2021
Should physical activity calorie equivalent (PACE) labelling be introduced on food labels and menus to reduce excessive calorie consumption? Issues and opportunities.
PACE food labelling seeks to provide kilocalorie information with an interpretation of what the kilocalorie content of the food item or meal means for energy expenditure. For example, "the kilocalories in this pizza require 110 minutes of walking to expend". ⋯ However, several criticisms of this labelling system have been raised. This commentary explores both the issues and opportunities related to PACE food labelling, arguing that the benefits of implementation outweigh potential unintended consequences.
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Preventive medicine · Dec 2021
Changes in parental smoking behavior and children's health status in Chile.
Studies on parental smoking behavior have mostly been conducted for developed countries and show that current parental smoking is negatively associated with children's current health. Using four waves of a Chilean longitudinal survey (Encuesta de Protección Social), we estimate probit and ordinary least squares models relating parents' self-report of their children's current health status to several covariates, including current parental smoking status and change (transitions) in parental smoking status across the waves of the survey. The data were collected in the years 2004, 2006, 2009, and 2015. ⋯ Cessation among mothers who are unemployed or inactive is also associated with a more positive assessment of their children's health status. The findings suggest that cessation programs may have health benefits not only for smoking parents, but also for their children. Improving coverage or establishing a national cessation program may have important present and future effects on population health and well-being.
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We overcome a lack of frontline worker status information in most COVID-19 data repositories to document the extent to which occupation has contributed to COVID-19 disparities in the United States. Using national data from over a million U. S. respondents to a Facebook-Carnegie Mellon University survey administered from September 2020 to March 2021, we estimated the likelihoods of frontline workers, compared to non-frontline workers, 1) to ever test positive for SARs-Cov-2 and 2) to test positive for SARs-Cov-2 within the past two weeks. ⋯ In particular, non-healthcare frontline workers have experienced sustained higher risk of testing positive for SARs-Cov-2 compared to non-frontline workers. Alongside more worker protections, future COVID-19 and other highly infectious disease response strategies must be augmented by a more robust recognition of the role that structural factors, such as the highly stratified U. S. occupational landscape, have played in the uneven toll of the COVID-19 pandemic.