American journal of preventive medicine
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Observational Study
Community Health Centers' Performance in Cancer Screening and Prevention.
Little is known about what clinic-level factors differentiate community health centers that achieve high performance on cancer-preventive care metrics. This study aims to describe the longitudinal trends in the delivery of 3 cancer-preventive care metrics (cervical and colorectal cancer screenings and tobacco-cessation intervention) and define and compare community health centers with high cancer-preventive care performance with those with low cancer-preventive care performance. ⋯ Very few community health centers meet all Healthy People 2020 goals in cancer screenings and may struggle to achieve the 2030 goals. Very few indicators differentiated high performers from low performers.
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Routine HIV testing is expected to facilitate early diagnosis and treatment. Nevertheless, to date, limited data are available on the presumed benefit of early detection with improved outcomes through routine HIV testing. ⋯ Routine HIV testing was associated with highly favorable outcomes, including decreased late diagnosis, lower HIV-related mortality, and lower all-cause mortality, among people diagnosed with HIV infection. Under universal health coverage, expanding routine HIV testing in well-targeted settings may improve both HIV epidemic control for society and clinical outcomes for people living with HIV.
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A total of 21 states have enacted laws that extend the types of firearm transfers that require the prospective purchaser to undergo a background check, often referred to as comprehensive background check laws. Utilizing a national representative survey of gun owners, this study estimates the proportion of firearm transfers that occur without background checks in states with and without these laws. ⋯ Fewer gun owners acquired their most recent firearm without a background check when the transfer occurred in a state with, relative to without, comprehensive background check laws. Private firearm sales that do not occur at traditional retail locations continue to be the type of sale least likely to have a background check.
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Although growing evidence links residential evictions to health, little work has examined connections between eviction and healthcare utilization or access. In this study, eviction records are linked to Medicaid claims to estimate short-term associations between eviction and healthcare utilization, as well as Medicaid disenrollment. ⋯ Results suggest that eviction drives increased healthcare spending while disrupting healthcare access. Given previous research that Medicaid expansion lowered eviction rates, eviction and Medicaid disenrollment may operate cyclically, accumulating disadvantage. Preventing evictions may improve access to care and lower Medicaid costs.
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A better understanding of how menthol cigarette flavoring and ENDS impact smoking initiation, cessation, and transitions between tobacco products could help elucidate the potential impact of a U.S. menthol ban on combustible tobacco products. ⋯ Sociodemographic differences in product transitions should be accounted for when estimating the potential impact of a menthol ban.