American journal of preventive medicine
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Understanding the joint effects of insurance type and primary care physician density on stage at diagnosis is essential to elucidating the healthcare access and late-stage cancer relationship. ⋯ As primary care physician density increases, those with private insurance consistently benefit the most in terms of late-stage cancer diagnosis, whereas those with several other insurance types experience flatter decreases or significantly higher odds of late-stage cancer diagnosis.
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Skin cancer, the most common cancer in the U.S., is a major public health problem. The incidence of nonmelanoma and melanoma skin cancer is increasing; however, little is known about the economic burden of treatment. ⋯ These findings demonstrate that the health and economic burden of skin cancer treatment is substantial and increasing. Such findings highlight the importance of skin cancer prevention efforts, which may result in future savings to the healthcare system.
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Lack of insurance is associated with suboptimal receipt of diabetes preventive care. One known reason for this is an access barrier to obtaining healthcare visits; however, little is known about whether insurance status is associated with differential rates of receipt of diabetes care during visits. ⋯ Lack of insurance is associated with a lower probability of receiving recommended services that are due during a clinic visit. Thus, the association between being uninsured and receiving fewer preventive services may not be completely mediated by access to clinic visits.
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Childhood obesity remains a public health concern, and tracking local progress may require local surveillance systems. Electronic health record data may provide a cost-effective solution. ⋯ Electronic health records that are weighted and adjusted to account for intrinsic bias may create an opportunity for comparing regional disparities with precision. In PHINEX patients, childhood obesity disparities were measurable from a young age, highlighting the need for early intervention for at-risk children. The electronic health record is a cost-effective, promising tool for local obesity prevention efforts.
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The U.S. population has shown increasing rates of overweight and obesity in recent years, but similar analyses do not exist for U.S. military personnel. It is important to understand these patterns in the military because of their impact on fitness and readiness. ⋯ Combined overweight and obesity in active duty personnel rose to more than 60% between 1995 and 2008, primarily because of increased obesity. The high prevalence of overweight and obesity needs attention and has implications for Department of Defense efforts to improve the health, fitness, readiness, and quality of life of the Active Forces.