Clinical Epidemiology Commons^™

Surveillance Of The Incidence And Mortality Of Oral And Pharyngeal, Esophageal, And Lung Cancer In Nevada: Potential Implications Of The Nevada Indoor Clean Air Act, Kevin Foote, David Foote, Karl Kingsley

Dental Medicine Faculty Publications

Reviews of national and state-specific cancer registries have revealed differences in rates of oral, esophageal, and lung cancer incidence and mortality that have implications for public health research and policy. Many significant associations between these types of cancers and major risk factors, such as cigarette usage, may be influenced by public health policy such as smoking restrictions and bans—including the Nevada Clean Indoor Air Act (NCIAA) of 2006 (and subsequent modification in 2011). Although evaluation of general and regional advances in public policy have been previously evaluated, no recent studies have focused specifically on the changes to the epidemiology of …

Prevalence Trend And Disparities In Rheumatoid Arthritis Among Us Adults, 2005–2018, Yingke Xu, Qing Wu

Public Health Faculty Publications

Rheumatoid arthritis (RA) trends among US adults and disparities in RA patients in recent years have not been well described. We aimed to examine the trend of RA prevalence and disparities among US adults. Data from the National Health and Nutrition Examination Survey (NHANES) of the years 2005–2018 were analyzed to examine the self-reported RA prevalence trend. Age-adjusted RA prevalence stratified by race/ethnicity and socioeconomic status (SES), as well as associated linear trends, were calculated for both genders. The multivariable adjustment was used to evaluate the association between race, SES, and RA. During 2005–2018, there was no significant linear trend …

Lagged Meteorological Impacts On Covid-19 Incidence Among High-Risk Counties In The United States—A Spatiotemporal Analysis, Lung-Chang Chien, Lung-Wen Antony Chen, Ro-Ting Lin

Public Health Faculty Publications

Background: The associations between meteorological factors and coronavirus disease 2019 (COVID-19) have been discussed globally; however, because of short study periods, the lack of considering lagged effects, and different study areas, results from the literature were diverse and even contradictory. Objective: The primary purpose of this study is to conduct more reliable research to evaluate the lagged meteorological impacts on COVID-19 incidence by considering a relatively long study period and diversified high-risk areas in the United States. Methods: This study adopted the distributed lagged nonlinear model with a spatial function to analyze COVID-19 incidence predicted by multiple meteorological measures from …

Incidence Of Neonatal Abstinence Syndrome Epidemic And Associated Predictors In Nevada: A Statewide Audit, 2016–2018, Kavita Batra, Patricia Cruz, Chad L. Cross, Neeraj Bhandari, Farooq Abdulla, Jennifer R. Pharr, Mark P. Buttner

Environmental & Occupational Health Faculty Publications

Neonatal abstinence syndrome (NAS) is a postnatal withdrawal syndrome among neonates born to mothers with drug dependence disorders. NAS poses a significant public health challenge nationally, with a six-fold increase in incidence (1.2 to 6.7 per 1000 hospital births/year) from 2000–2016. Besides national data, it is critical to quantify NAS at the state-level to identify target areas for prevention. The objectives of this study were to ascertain statewide burden, including county and regional distribution of NAS in Nevada during 2016–2018, and to investigate potential factors associated with NAS. This study utilized hospital administrative data, and a total of 100,845 inpatient …

Effect Of Poverty Level On The Relationship Between Hyperlipidemia And Cardiorenal Syndrome, Sri K. Banerjee Md, Phd, Raymond Panas, James Diegel, Karen Banerjee

Journal of Health Disparities Research and Practice

Purpose. Elevated cholesterol is known to be associated with chronic kidney disease (CKD) and cardiovascular disease (CVD) independently. Cardiorenal syndrome (CRS), a recently defined syndrome, is characterized by renal failure that is closely interrelated to cardiac dysfunction. The effect of socioeconomic status on cardiorenal syndrome has not been explored in a multi-ethnic population. In this retrospective secondary analysis, the hypothesis was tested if socioeconomic status modifies the effect of hyperlipidemia on CRS.

Methods. The National Health and Nutrition Examination Survey (NHANES) is a cross sectional survey done on the non-institutionalized population of the United States. All patients from the NHANES …

Trends And Disparities In Self-Reported And Measured Osteoporosis Among Us Adults, 2007-2014., Qing Wu, Yingke Xu, Ge Lin

Environmental & Occupational Health Faculty Publications

(1) Background: Studies examining osteoporosis trends among US adults by different socioeconomic status (SES) are limited. The prevalence of self-reported osteoporosis in the US is rarely reported. (2) Methods: Data from the National Health and Nutritional Examination Survey (NHANES) between 2007–2008 and 2013–2014 cycles were analyzed. Age-adjusted prevalence of self-reported and that of measured osteoporosis were calculated overall and by sex, race/ethnicity, education attainment, and SES. (3) Results: The prevalence of self-reported osteoporosis was higher than that of measured osteoporosis in all three survey cycles for women, and in 2007–2008 and 2009–2010 for men. Participants with high school/GED or higher …

Risk Of Cancer Death Among White, Black, And Hispanic Populations In South Florida, Paulo S. Pinheiro, Karen E. Callahan, Tulay Koru-Sengul, Justine Ransdell, Layla Bouzoubaa, Clyde P. Brown, Erin Kobetz

Environmental & Occupational Health Faculty Publications

Background: The cancer burden in South Florida, with a population of more than 6 million with a heavily Hispanic and large Afro-Caribbean population, has not been quantified. Methods: We analyzed 2012–2016 cancer mortality data from South Florida for white, Hispanic, and black populations with disaggregation for Cuban, Puerto Rican, South American, African American, and Afro-Caribbean groups. We calculated cancer site-specific and all-sites combined age-adjusted mortality rates, and we used negative binomial regression to determine mortality rate ratios to compare South Florida’s cancer mortality rates with those of the rest of the nation. Results: We analyzed 53,837 cancer deaths. Per 100,000 …

Disparities In Access To Primary Care And Emergency Department Utilization In A Large Medicaid Program, Natasha Parekh, Marian Jarlenski, David Kelley

Journal of Health Disparities Research and Practice

Identifying and eliminating disparities are priorities for State Medicaid programs, especially in the context of increased enrollment through Medicaid expansion. We assessed racial, ethnic, regional, and managed care organization (MCO) differences, as well as time trends before and after Medicaid expansion, in primary care and emergency department (ED) utilization in a large Medicaid program. We performed a cross-sectional evaluation of data from Pennsylvania Medicaid from 2011-2015. Three primary care outcomes included: 1) adult access to primary care; 2) adolescent access to primary care; and 3) pediatric access to dental care. Our fourth outcome reflected ED utilization. We observed significant racial …

Lagged Influence Of Fine Particulate Matter And Geographic Disparities On Clinic Visits For Children’S Asthma In Taiwan, Lung-Chang Chien, Yu-An Chen, Hwa-Lung Yu

Public Health Faculty Publications

Recent studies have revealed the influence of fine particulate matter (PM2.5) on increased medication use, hospital admission, and emergency room visits for asthma attack in children, but the lagged influence of PM2.5 on children’s asthma and geographic disparities of children’s asthma have rarely been discussed simultaneously. This study investigated the documented diagnosis of children’s asthma in clinic visits for children aged less than 15 years old that were associated with PM2.5 in two counties located in west-central Taiwan during 2005–2010. The result shows that PM2.5 had a significant lagged effect on children’s asthma for up to 6 days. A significantly …

Demographic Differences And Annual Trends In Childhood And Adolescent Cancer Incidence And Mortality In Michigan During The Period 1999-2012, Gergana Kodjebacheva, Jeremy Blankenship, Lenwood Hayman, Shan Parker

Journal of Health Disparities Research and Practice

Background. Michigan has declining economic conditions and factories that release pollutants. During the period 1999-2012, only 10 out of 50 states had an overall cancer incidence rate that was higher than that in Michigan. It is not known how children’s cancer rates in Michigan vary by age, gender, race/ethnicity, and year as well as how these rates compare to those in the U.S.

Method: The Center for Disease Control and Prevention WONDER database obtained cancer incidence and mortality data from cancer registries and death certificates. We compared age-adjusted incidence and mortality cancer rates by gender, race/ethnicity, and year for children …

Unique Breast Cancer Features Within The Vietnamese Population, Polly Niravath, Melissa Bondy, Susan G. Hilsenbeck

Journal of Health Disparities Research and Practice

BACKGROUND: Breast cancer is known to be a heterogeneous disease across women, and even within individual tumors. However, relatively little is known about heterogeneity across cultures. There has been some evidence to suggest that Asian women are more likely to have HER2+ breast cancer than their Caucasian counterparts.

PURPOSE: The aim of this study was to further investigate the unique pattern of breast cancer incidence and subtype in the Vietnamese population.

METHODS: We retrospectively collected data on all Vietnamese women diagnosed with invasive breast cancer at the Lester & Sue Smith Breast Center in Houston, Texas over a four year …

Hispanic Ethnicity Is Associated With Increased Hospital Charges After Radical Cystectomy In The United States, Mark D. Tyson, Erik P. Castle

Journal of Health Disparities Research and Practice

Objective: To examine the impact of race and ethnicity on financial charges associated with radical cystectomy (RC).

Data Sources/Study Setting: The Nationwide Inpatient Sample was used to identify patients who underwent RC for bladder cancer between 1998 and 2010.

Study Design: The primary outcome was total hospital charges adjusted for inflation. Multivariate analysis was performed using a generalized linear model on the logarithmically transformed outcome variable (total hospital charges) after adjusting for age, sex, race, Elixhauser comorbidities, surgical approach, year, primary payer, hospital and surgeon annual RC volume, hospital characteristics, and postoperative complications.

Principle findings: A total of 14,873 patients …

Research Brief: An Examination Of The Social And Clinical Influences In Prostate Cancer Treatment In African American And White Men, Keith Elder, Bettina F. Drake, Sara Wagner, James Hebert

Journal of Health Disparities Research and Practice

BACKGROUND: The death rate for prostate cancer (PrCA), the most commonly diagnosed cancer in African-American (AA) men, is twice the rate of European-American (EA) men. AA men in South Carolina have the highest age-adjusted death rate in the nation. Studies have shown that treatment offered to AA men with PrCA is systematically different from that offered to EA men. METHODS: Surveys were mailed to 1,866 men in South Carolina with a diagnosis of PrCA. South Carolina men diagnosed with PrCA between 1996 and 2002 were eligible to participate. We performed a descriptive assessment of the factors that influenced …

Race And Hepatitis C Management Within The Veterans Administration, Joahd Toure, Joshua Metlay, Sandford Schwartz, Knashawn Morales, David Kaplan, Peter Groeneveld

Journal of Health Disparities Research and Practice

Objective: To examine black-white differences in hepatitis C treatment within the Veterans Administration (VA) and determine whether racial variation in specialty consultation explains differences in hepatitis C treatment between blacks and whites.

Methods: We performed a retrospective cohort study of 1040 veterans meeting VA eligibility criteria for hepatitis C treatment. We used multiple imputation to handle missing race data. Specialty consultation was determined from the VA outpatient medical dataset and hepatitis C treatment was determined from the VA decision support system. Conditional logistic regression was used to examine the association between race and hepatitis C treatment as well as race …

Results Of Universal Prenatal Screening For Hepatitis C Infection In A Remote American Indian Primary Care Population, Christine Dubray, John T. Redd, Cecile M. Town, Kathy K. Byrd, Supriya Janakiraman, Anindya K. De, James E. Cheek

Journal of Health Disparities Research and Practice

BACKGROUND: Although chronic liver disease remains a major area of health disparity for American Indian (AI) people, the epidemiology of hepatitis C virus (HCV) infection among AI people is poorly documented. Because of suspected high local prevalence, two remote AI clinics in the Northern Plains implemented universal prenatal HCV screening in 2005. When this screening program reported an unexpectedly high prenatal anti-HCV (anti-HCV antibody) positivity rate, we conducted a case-control study to determine risks for infection and opportunities for community intervention.

MAIN FINDINGS: The clinics screened a total of 205 pregnant women (median age, 22 years). Of these 205 women, …