American journal of preventive medicine
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The objective of this study is to better understand cervical cancer screening and follow-up practices in U.S. prisons. ⋯ This study found relatively high rates of screening with a perceived lack of patient interest as the most reported barrier. Follow-up care was also often affected by reported lack of patient interest, delays in community referral for diagnostic procedures, and patient release before follow-up. There is room for further optimization of screening and surveillance among incarcerated women by understanding and addressing systems-based challenges. By understanding patient barriers to primary screening, expanding access to onsite testing and community referral for abnormal results, and streamlining post-release follow-up, disparities in care among incarcerated women can be reduced.
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The purpose of this study is to examine nationwide disparities in drug, alcohol, and suicide mortality; evaluate the association between county-level characteristics and these mortality rates; and illustrate spatial patterns of mortality risk to identify areas with elevated risk. ⋯ Spatial disparities in drug, alcohol, and suicide mortality exist at the county level across the U.S. social determinants of health; educational attainment, degree of rurality, ethnicity, disability, unemployment, and health insurance status are important factors associated with these mortality rates. A comprehensive strategy that includes downstream interventions providing equitable access to healthcare services and upstream efforts in addressing socioeconomic conditions is warranted to effectively reduce these mortality burdens.