American journal of preventive medicine
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Health insurance status affects access to preventive services. Effective use of preventive services is a key factor in the reduction of important health concerns and has the potential to enable adults to live longer, healthier lives. ⋯ Generally, uninsured African American and Hispanic populations fare better than uninsured whites in preventive service utilization. Future research should examine reasons behind these racial/ethnic differences to inform policy interventions aiming to increase preventive service utilization among the uninsured.
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The prevalence of smokeless tobacco use in the U.S. is increasing and its use is a risk factor for a number of adverse health outcomes. Currently, there is limited evidence on the effectiveness of quitlines for tobacco cessation among smokeless tobacco users. ⋯ Tobacco quitlines offer an effective intervention to increase smokeless tobacco abstinence.
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Experiences of discrimination are associated with tobacco and alcohol use, and work is a common setting where individuals experience racial/ethnic discrimination. Few studies have evaluated the association between workplace discrimination and these behaviors, and none have described associations across race/ethnicity. ⋯ Workplace discrimination is common, associated with smoking and alcohol use, and merits further policy attention, given the impact of these behaviors on morbidity and mortality.
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There are substantial disparities in breast and cervical cancer screening that stem from lack of health insurance. Although the Affordable Care Act (ACA) expands insurance coverage to many Americans, there are differences in availability of Medicaid coverage across states. ⋯ As women in nonexpansion states remain uninsured and others gain coverage, existing disparities in cancer screening by race and socioeconomic status are likely to widen. Health risks and associated costs to underserved populations must be taken into account in ongoing debates over expansion.
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American Indians in Oklahoma have higher rates of tobacco use (29.2%) than any other racial group in the state. The Oklahoma Tobacco Helpline provides free cessation services to all Oklahomans and implements strategies specifically aimed at increasing the utilization and effectiveness of cessation services for American Indians. ⋯ The Oklahoma Tobacco Helpline is equally effective for American Indian and white tobacco users who register for Helpline services.