American journal of preventive medicine
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In 2016, Oregon developed an innovative policy to improve care for Medicaid patients with back pain. The objective of this study was to identify the factors associated with dose reduction and discontinuation among Medicaid patients using chronic opioid therapy after implementation of this policy. ⋯ Most Medicaid beneficiaries had a dose reduction after implementation of Oregon's back pain policy. Opioid discontinuation was associated with factors that suggest that providers pursue this strategy for patients at higher overdose risk.
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Chain restaurants are ubiquitous in the U.S. While restaurants are increasingly promoting health- and climate-conscious menu options, few studies have examined whether restaurants are increasing availability of menu items with lower climate impact and whether these offerings are healthier. This study examines trends in the availability and nutritional profile of food items featuring different meat sources on menus at 75 large chain restaurants in the U.S. from 2013 to 2021. ⋯ While meat-free items had fewer calories and some aspects of nutritional profile were more favorable, the availability of meat-free menu items has not increased in large chain restaurants, suggesting limited improvement on reducing climate impact.
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The purpose of this study was to simulate potential changes in dietary intake and food costs by replacing juice with whole fruit among children ages 1-5 years attending U.S. early care and education settings between 2008 and 2020. ⋯ Replacing juice with whole fruit in early care and education would result in increased fiber intake and decreased sugar and calories. A policy to replace juice with whole fruit in early care and education would likely cause an increased daily food cost and given the potential broad benefit of this dietary intervention, there may be reason to expand funding within nutrition assistance programs in early care and education.
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High tobacco smoking prevalence in people with low SES or serious psychological distress in the U.S. may increase cardiovascular disease risk among these marginalized subpopulations. The authors estimate how smoking disparities contribute to cardiovascular disease disparities. ⋯ Interventions focused on reducing smoking disparities could substantially reduce cardiovascular disease in marginalized subpopulations.