Preventive medicine
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Preventive medicine · Jan 2023
Modeling cigarette smoking disparities between people with and without serious psychological distress in the US, 1997-2100.
Cigarette smoking rates are significantly higher among people with serious psychological distress (SPD) compared to the general population. US simulation models that project future smoking disparities by SPD status could inform policy interventions, but have not been developed. We calibrated two compartmental models to the National Health Interview Survey 1997-2018 for populations with and without SPD, calculating smoking prevalence, mortality, and life-years lost by SPD status under different scenarios from 2023 to 2100. ⋯ Preventing smoking initiation could avert up to 18% of these deaths, while improving smoking cessation could avert up to 82%. Smoking-related disparities for people with SPD will persist unless a shift in tobacco control substantially improves cessation and prevents initiation in this subpopulation. Smoking disparities by SPD may widen in relative but narrow in absolute terms, so both perspectives should be evaluated.
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Preventive medicine · Jan 2023
Sense of control as a mediator of the association between social capital and health inequality in China.
Social capital was shown to be associated with health. However, less is known about the pathways of the association and whether the mediating effect of the pathways varies across different income groups. Using adults (≥18 years) data from the 2010 Chinese General Social Survey (N = 3265), we examined the mediating effect of sense of control between social capital and health and whether income groups moderated the mediating effect in China. ⋯ Moderated mediation analysis further showed that sense of control mediated the association between frequency of socializing and health in all income groups, with the mediating effect decreasing when income increased (β (95% CI) from Q1 to Q5: 0.026 (0.015, 0.040); 0.022 (0.012, 0.036); 0.018 (0.009, 0.030); 0.013 (0.005, 0.024); 0.008 (0.000, 0.018)). Moderated mediation analysis also showed the same patterns for the mediating effect of sense of control on the association between trust and health and reciprocity and health. Our study suggested that employing social capital to promote sense of control could not only be beneficial for people's health but also be helpful to narrow the health gap on the income gradient.
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Nationally, between 2011 and 2019, suicide was the second leading cause of injury death, and about half of all suicides were firearm related. An overlooked factor connecting firearms and suicide is lead exposure. Lead bullets and primers are used throughout the US and pose danger to adults and children. ⋯ Lead was a predictor of all suicide types. Our study appears to be the first to show the established firearm suicide relationships holds within municipalities in a single state. We provide evidence concerning the link between lead exposure and suicide, particularly from firearms, and provide a glimpse into the relationship between firearm prevalence and elevated blood lead levels.
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Preventive medicine · Jan 2023
Long-term effects of the interruption of the Dutch breast cancer screening program due to COVID-19: A modelling study.
Due to COVID-19, the Dutch breast cancer screening program was interrupted for three months with uncertain long-term effects. The aim of this study was to estimate the long-term impact of this interruption on delay in detection, tumour size of screen-detected breast cancers, and interval cancer rate. After validation, the micro-simulation model SiMRiSc was used to calculate the effects of interruption of the breast cancer screening program for three months and for hypothetical interruptions of six and twelve months. ⋯ A 19% increase in interval cancer rate was found between last screening before and first screening after interruption compared to no interruption. Hypothetical interruptions of six and twelve months resulted in larger increases in interval cancer rate of 38% and 78% between last screening before and first screening after interruption, respectively, and an increase in middle-sized tumours in first screening after interruption of 26% and 47%, respectively. In conclusion, the interruption of the Dutch screening program is not expected to result in a long-term delay in detection or clinically relevant change in tumour size of screen-detected cancers, but only affects the interval cancer rate between last screening before and first screening after interruption.
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Preventive medicine · Jan 2023
Prevalence of and disparities in adolescents' susceptibility to novel oral nicotine products marketed as "tobacco-free".
Non-therapeutic, novel oral nicotine products are convenient, discreet to use, and flavored, with increasing sales in the United States. It is unclear whether these products appeal predominantly to adolescents already susceptible to inhalable nicotine products, or whether they attract adolescents who would not otherwise use nicotine. This study examined prevalence and correlates of susceptibility to inhalable and oral nicotine product use among adolescents. ⋯ Lower-socioeconomic status (SES) and sexual minority adolescents were more susceptible to oral (ORs = 1.76-1.87; ps < 0.05) and both products (ORs = 1.32-1.88; ps < 0.05), compared to higher-SES and heterosexual adolescents. Adolescents in Southern California may be more susceptible to e-cigarettes than other nicotine/tobacco products. However, appreciable numbers may be susceptible to oral nicotine products, including some youth who might not otherwise use nicotine and youth from populations historically impacted by tobacco-related health disparities.