Public health reports
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Public health reports · Nov 2018
Sociodemographic Factors Associated With Engagement in Diabetes Self-management Education Among People With Diabetes in the United States.
Research outside the United States shows that certain subgroups of patients (eg, those who are older, male, of low socioeconomic status, and uninsured) are less likely than others to report receiving diabetes self-management education (DSME); however, less is known about DSME uptake in the United States. We examined sociodemographic, patient, and behavioral characteristics associated with DSME in a nationally representative sample. ⋯ Increasing public health interventions aimed at educating people with diabetes about self-management could improve outcomes.
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Public health reports · Jul 2018
Disparities in Initiation of Direct-Acting Antiviral Agents for Hepatitis C Virus Infection in an Insured Population.
The cost of direct-acting antiviral agents (DAAs) for hepatitis C virus (HCV) infection may contribute to treatment disparities. However, few data exist on factors associated with DAA initiation. ⋯ Racial/ethnic and socioeconomic disparities exist in DAA initiation. Substance use may also influence patient or provider decision making about DAA initiation. Strategies are needed to ensure equitable access to DAAs, even in insured populations.
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Public health reports · Jul 2018
Anticipating Industry Arguments: The US Food and Drug Administration's Authority to Reduce Nicotine Levels in Cigarettes.
The US Food and Drug Administration has announced that it is considering lowering nicotine levels in cigarettes to "minimally addictive or nonaddictive levels." This could be a transformative public health measure, but the tobacco industry is likely to challenge such an action in court. This article reviews some of the key legal arguments that industry is likely to advance and considers possible responses. As we demonstrate, there are strong arguments that the US Food and Drug Administration has the authority to implement a policy to reduce nicotine in cigarettes to nonaddictive levels.
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Public health reports · May 2018
Improved Health and Insurance Status Among Cigarette Smokers After Medicaid Expansion, 2011-2016.
The high concentration of smokers among subgroups targeted by the Affordable Care Act and the historically worse health and lower access to health care among smokers warrants an evaluation of how Medicaid expansion affects smokers. We evaluated the impact of Medicaid expansion on smoking behavior, access to health care, and health of low-income adults, and we compared outcomes of all low-income people with outcomes of low-income current smokers by states' Medicaid expansion status. ⋯ Greater improvements among low-income smokers in Medicaid expansion states compared with nonexpansion states could influence future smoking behaviors and warrant longer-term monitoring. Additionally, health and insurance gains among low-income smokers in expansion states suggest the potential for Medicaid expansion to improve health among smokers compared with nonsmokers.