Influenza Vaccination Coverage Among Medicare Fee-for-Service BeneficiariesInfluenza vaccination is the best prevention strategy to protect against influenza infection. Determining accurate influenza vaccination coverage is critical. This study assesses the concordance between self-reported and claimed-based influenza vaccination coverage and examines vaccination disparities in the U.S.
Concordance in Adolescent and Caregiver Report of Social Determinants of HealthScreening youth for negative social determinants of health is a widespread practice across healthcare settings in the U.S., with such systems almost exclusively relying on caregiver reports. Little work has sought to identify the social determinants of health adolescents identify as having the largest influence on their health and well-being or the extent to which adolescents agree with their caregiver. This study sought to (1) identify the most prevalent and influential negative social determinants of health, according to adolescent reports, and (2) assess concordance between adolescent and caregiver reports of social determinants of health.
Impacts of Medicaid Expansion on Stage at Cancer Diagnosis by Patient Insurance TypeThe expansion of Medicaid under the Affordable Care Act increased access to health care for millions of low-income Americans. However, the longer-term impacts of the policy on cancer outcomes remain unknown. This study examined the impact of Medicaid expansion on early- and late-stage diagnosis for 4 common cancers (breast, cervical, colorectal, and lung) using 4 full years of postpolicy data.
Adjusting for Patient Economic/Access Issues in a Hypertension Quality MeasureThe American Heart Association and American College of Cardiology have proposed adjusting hypertension-related care quality measures by excluding patients with economic/access issues from the denominator of rate calculations. No research to date has explored the methods to operationalize this recommendation or how to measure economic/access issues. This study applied and compared different approaches to populating these denominator exceptions.
Health Institutions and the Political Determinants of HealthHealth institutions, such as hospitals and hospital systems, are investing in programs to address upstream drivers of health. These drivers include the macrolevel forces that comprise social-structural influences on health institutions; government policies; and the social, physical, economic, and environmental factors that affect health. Historically, health institutions have mostly invested in mitigating the harmful aspects of social determinants of health—the most publicized upstream driver of health—for their patients.
Medicaid Hepatitis C Virus Treatment Policies: Impact on Testing and Treatment in the Commercially InsuredA total of 23 state Medicaid programs continue to restrict hepatitis C virus (HCV) medication access by liver disease or substance-use criteria, creating obstacles to HCV elimination and significant care disparities. Because public insurers often set precedents for private insurer coverage and clinician practice patterns, this study sought to analyze whether spillover occurs from state Medicaid HCV treatment restrictions to HCV screening and treatment rates in commercially insured individuals.
Medicaid Expansion and Contraceptive Use Among Female High-School StudentsAccess to effective contraception prevents unintended pregnancies among sexually active female youth. Potentially impacted by the Affordable Care Act's Medicaid-related policies, contraception use increased among sexually active high-school students from 2013 to 2019.
Association Between Fatal Occupational Injuries and State Minimum-Wage Laws, 2003–2017Low wages are associated with an increased risk of occupational injuries. Increasing the minimum wage is one way to increase workers’ wages; however, a previous study found that higher state minimum wage was associated with an increase in nonfatal occupational injuries and illnesses. This study aims to examine the association between state minimum-wage laws and fatal occupational injuries.
Obesity and Eligibility for Obesity Treatments Among Adults With Disabilities in the U.S.Obesity has been associated with disability; yet, the proportion who meet clinical criteria for obesity treatment among adults with disabilities remains poorly defined. Characterization of obesity and treatment eligibility by disability type may prioritize high-need groups. This study assessed the prevalence of obesity and eligibility for antiobesity pharmacotherapy and/or bariatric surgery in adults with disability.
Medication Nonuse and Hospital Utilization: Medicaid Participants With Type 2 Diabetes in New York CityThis study assesses the proportion of New York City Medicaid participants diagnosed with type 2 diabetes who did not have any claims for diabetes medication for an entire year and the association between nonuse of diabetes medication and subsequent hospitalizations.
Cross-Sectional Associations: Social Risks and Diabetes Care Quality, OutcomesSocial risks (e.g., food/transportation insecurity) can hamper type 2 diabetes mellitus (T2DM) self-management, leading to poor outcomes. To determine the extent to which high-quality care can overcome social risks’ health impacts, this study assessed the associations between reported social risks, receipt of guideline-based T2DM care, and T2DM outcomes when care is up to date among community health center patients.
State-Level Social Vulnerability Index and Healthcare Access: The Behavioral Risk Factor Surveillance System SurveyAccess to health care is affected by social determinants of health. The social vulnerability index encompasses multiple social determinants of health simultaneously and may therefore be associated with healthcare access.
A Decade of Nutrition and Health Disparities Research at NIH, 2010–2019Nutrition health disparities include differences in incidence, prevalence, morbidity, and mortality of diet-related diseases and conditions. Often, race, ethnicity, and the social determinants of health are associated with dietary intake and related health disparities. This report describes the nutrition health disparities research supported by NIH over the past decade and offers future research opportunities relevant to NIH's mission as described in the Strategic Plan for NIH Nutrition Research.
National Heart, Lung, and Blood Institute: Social Determinants of Health Research, Fiscal Year 2008–2020Social determinants of health influence the prevention, treatment, and progression of chronic diseases, including heart, lung, blood, and sleep diseases and conditions. Healthy People 2020 classifies Social Determinants of Health into 5 subcategories: (1) Neighborhood and Built Environment, (2) Education, (3) Economic Stability, (4) Social and Community Context, and (5) Health and Health Care. This study's goal is to characterize the National Heart, Lung, and Blood Institute's Fiscal Year 2008–2020 funding in overall Social Determinants of Health research and in the Healthy People 2020 subcategories.
Farmers’ Market Incentives for Low-Income Families: Who Uses, How Much, and WhyFocusing on participation and utilization, this research helps to assess the potential impact and contributions of farmers’ market incentive programs, often seen as means for improving nutrition and preventing disease among low-income families.
Friendship and Loneliness: A Prototype Roadmap for Health System ActionLoneliness, the subjective perception of social disconnectedness, is emerging as a public health crisis. In 2018, approximately 50 million U.S. adults aged ≥45 years reported feeling lonely, an increase from approximately 43 million in 2010.1 The high rate of loneliness is particularly worrisome because loneliness negatively impacts psychological and physical health and is associated with a 50%, 29%, and 26% increased risk of developing Alzheimer's disease, coronary heart disease, and premature mortality, respectively.
Substance Use Disorders Among Medicare Beneficiaries: Prevalence, Mental and Physical Comorbidities, and Treatment BarriersThis study aimed to determine the prevalence of treated and untreated substance use disorders among Medicare beneficiaries, the characteristics of Medicare beneficiaries with substance use disorders, and reasons for their unmet needs.
Vaccination Coverage of Privately Insured Children: Comparing U.S. Survey and Administrative DataNational Immunization Survey-Child data are used widely to assess childhood vaccination coverage in the U.S. This study compares National Immunization Survey-Child coverage estimates with estimates using other supplementary data sources.
Telemedicine Familiarity and Post-Disaster Utilization of Emergency and Hospital Services for Ambulatory Care Sensitive ConditionsIn this study, we examined the association between telemedicine use before a disaster and utilization of emergency or hospital services for ambulatory care sensitive conditions post-disaster.
Young Adult Healthcare Exposure and Future Opioid Misuse: A Prospective Cohort StudyOutpatient opioid prescribing is associated with opioid misuse in young adults, but the longitudinal association between general healthcare exposure and opioid misuse has not been explored. The objective of this study is to examine the association between healthcare exposure in young adulthood and future opioid misuse.
Community Health Needs Assessment Data and Community Recovery From COVID-19The COVID-19 pandemic has had a significant impact beyond physical morbidity and mortality. A mid-cycle Community Health Needs Assessment survey was administered in 1 community to generate data to evaluate change in community well-being since the beginning of the pandemic.
Sexual Orientation and Gender Identity Data Reporting Among U.S. Health CentersSexual orientation and gender identity data collection is necessary to address health inequities. This study examines sexual orientation and gender identity data reporting among community health centers.
Healthcare Utilization and Costs Associated With Perinatal Depression Among Medicaid EnrolleesDifferences in healthcare utilization and medical expenditures associated with perinatal depression are estimated.
Sustained Impact of the Philadelphia Beverage Tax on Beverage Prices and Sales Over 2 YearsIt is unclear whether changes in beverage price and sales after beverage tax implementation can be sustained long term. This study aims to quantify the changes in beverage prices and sales in large retailers 2 years after the implementation of the 1.5 cents per ounce Philadelphia beverage tax.
Predictors of Public Support for Social Safety Net Policy During the COVID-19 PandemicU.S. residents had varying experiences of the COVID-19 pandemic and social safety net policy in 2020. Past research has suggested that partisanship, ideology, racial attitudes, and personal experience may each influence policy attitudes. In this study, we explore whether variation in support for social safety net policy in 2020 is predicted by negative experiences of the pandemic when controlling for racial attitudes, partisanship, and ideology.