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Singh SR. Estimating the Cost of the COVID-19 Response for Local Health Departments: Evidence From Ohio. J Public Health Manag Pract 2024; 30:416-419. [PMID: 38603748 DOI: 10.1097/phh.0000000000001907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
This study assessed the staffing allocations and associated costs incurred by Ohio local health departments (LHDs) in response to the challenges posed by the COVID-19 pandemic. Data were extracted from the annual financial reports of Ohio LHDs for 2020 and 2021, encompassing a sample of 38 LHDs in 2020 and 60 LHDs in 2021. Descriptive analysis showed that Ohio LHDs committed substantial resources to responding to the COVID-19 pandemic. Although there was considerable variability across LHDs, median staffing and compensation collectively constituted 22% of total staffing and compensation. Multivariate regression analysis found minimal associations between the examined agency and community-level variables and the differences in staffing allocations and associated costs incurred by LHDs in response to the COVID-19 pandemic. After decades of underfunding and understaffing, securing sustainable funding will be crucial to equip LHDs across the country with the necessary resources to deliver comprehensive public health services in their communities.
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Affiliation(s)
- Simone R Singh
- Author Affiliations: Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, Michigan
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Murnan AW, Keim SA, Klebanoff MA. Exploration of Differences between Women Who Do and Do Not Disclose Their Marijuana Use during Pregnancy. Am J Perinatol 2024; 41:902-908. [PMID: 35240705 PMCID: PMC10008515 DOI: 10.1055/a-1787-6889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE This study aimed to explore demographic and health-related factors that may differentiate women who do and do not disclose their marijuana use during pregnancy. STUDY DESIGN The current study is a secondary analysis of data from a prospective cohort of pregnant women identified as using marijuana during pregnancy via a variety of assessment tools including self-report, urine screen, and obstetrics record abstraction. The cohort included a convenience sample of women recruited from several antenatal clinics at The Ohio State University Wexner Medical Center (OSUWMC). To be eligible, women needed to be within the first or second trimester of their pregnancy, 16 to 50 years of age, able to communicate in English, and intended to deliver at OSUWMC. Chi-square, independent samples t-tests, and logistic regression analyses were used to explore differences between those who did and did not disclose their use in relation to physical and mental health diagnoses, adverse experiences, use of other substances, and demographics. RESULTS Women who used marijuana during their pregnancy and had mental/physical health data available comprised the current sample (n = 109). Women who attended college were more likely to disclose their marijuana use compared with women who did not attend college (p < 0.001). Women who experienced homelessness (p < 0.01) or self-reported alcohol use during pregnancy (p < 0.001) were significantly more likely to disclose their marijuana use. CONCLUSION Findings, suggesting disclosure of other substance use and adverse experiences, such as homelessness, may increase the likelihood that pregnant women will voluntarily disclose their marijuana use to providers. Findings did not reflect racial differences nor significant differences in mental/physical health status among women based on their disclosure. Future research with larger datasets is needed to build on these findings by confirming results, as well as exploring additional factors, that may more effectively differentiate women who are unlikely to disclose their prenatal marijuana use from those who do disclose their use. KEY POINTS · Women with higher education were more likely to self-disclose their prenatal marijuana use.. · Women who experienced homelessness were more likely to self-disclose their prenatal marijuana use.. · Self-disclosure of prenatal alcohol use was related to self-disclosure of prenatal marijuana use.
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Affiliation(s)
- Aaron W Murnan
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Sarah A Keim
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio
- Division of Epidemiology, The Ohio State University College of Public Health, Columbus, Ohio
| | - Mark A Klebanoff
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio
- Center for Perinatal Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio
- Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio
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Shen YF, Arruda AG, Koscielny MP, Cheng TY. Contrasting PRRSV temporal lineage patterns at the individual farm, production system, and regional levels in Ohio and neighboring states from 2017 to 2021. Prev Vet Med 2024; 226:106186. [PMID: 38518657 DOI: 10.1016/j.prevetmed.2024.106186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 02/13/2024] [Accepted: 03/13/2024] [Indexed: 03/24/2024]
Abstract
Porcine reproductive and respiratory virus (PRRSV), one of the most significant viruses in the swine industry, has been challenging to control due to its high mutation and recombination rates and complexity. This retrospective study aimed to describe and compare the distribution of PRRSV lineages obtained at the individual farm, production system, and regional levels. PRRSV-2 (type 2) sequences (n = 482) identified between 2017 - 2021 were provided by a regional state laboratory (Ohio Department of Agriculture, Animal Disease Diagnostic Center (ODA-ADDL)) collected from swine farms in Ohio and neighboring states, including Indiana, Michigan, Pennsylvania, and West Virginia. Additional sequences (n = 138) were provided by one collaborating swine production system. The MUSCLE algorithm on Geneious Prime® was used to align the ORF5 region of PRRSV-2 sequences along with PRRSV live attenuated vaccine strains (n = 6) and lineage anchors (n = 169). Sequenced PRRSV-2 were assigned to the most identical lineage anchors/vaccine strains. Among all sequences (n = 620), 29.8% (185/620) were ≥ 98.0% identity with the vaccine strains, where 93.5% (173/185) and 6.5% (12/185) were identical with the L5 Ingelvac PRRS® MLV and L8 Fostera® PRRS vaccine strains, respectively, and excluded from the analysis. At the regional level across five years, the top five most identified lineages included L1A, L5, L1H, L1C, and L8. Among non-vaccine sequences with production system known, L1A sequences were mostly identified (64.3% - 100.0%) in five systems, followed by L1H (0.0% - 28.6%), L1C (0.0% - 10.5%), L5 (0.0% - 14.4%), L8 (0.0% - 1.3%), and L1F (0.0% - 0.5%). Furthermore, among non-vaccine sequences with the premise identification available (n = 262), the majority of sequences from five individual farms were either classified into L1A or L5. L1A and L5 sequences coexisted in three farms, while samples submitted by one farm contained L1A, L1H, and L5 sequences. Additionally, the lineage classification results of non-vaccine sequences were associated with their restriction fragment length polymorphism (RFLP) patterns (Fisher's exact test, p < 0.05). Overall, our results show that individual farm and production system-level PRRSV-2 lineage patterns do not necessarily correspond to regional-level patterns, highlighting the influence of individual farms and systems in shaping PRRSV occurrence within those levels, and highlighting the crucial goal of within-farm and system monitoring and early detection for accurate knowledge on PRRSV-2 lineage occurrence and emergence.
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Affiliation(s)
- Yi-Fan Shen
- Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - Andréia G Arruda
- Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | | | - Ting-Yu Cheng
- Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA.
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Kirkpatrick DR, Kobayashi H, Walker HM, Tuttle RM. Initiation of Breast Cancer Screening at a Later Age May Disproportionately Impact Minority Groups: Review of Ohio Data (1996-2022). Am Surg 2024; 90:897-901. [PMID: 37993112 DOI: 10.1177/00031348231216487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Among women with breast cancer, delays in diagnosis and earlier presentation have been documented among minority women. Consequently, initiation of breast cancer screening at a later age may disproportionately harm minority groups. This study seeks to determine whether minority women face a higher proportional risk of younger age breast cancer than their White peers. Using publicly available data from the Ohio Department of Public Health Data Warehouse, we constructed a database allowing for retrospective evaluation of all breast cancer patients in the state of Ohio from 1996 to 2020. White women represented the bulk of total breast cancer cases in each age group and overall; however, the proportion of cancers attributable to White women increased in each successively older cohort group: 80.7% of cases under age 40 up to 91.3% of the 80 or older group. By a significant margin, the opposite is true in minority groups with African American women accounting for 15% of cases under the age of 40, trending down to 7.8% of the 80 and older group. Comparison of the proportions of these groups demonstrates statistically significant proportional decreases among minority groups and statistically significant increases among White women. Our findings suggest that women of color in the Ohio population face a disproportionately high risk of being diagnosed with younger age breast cancer and support the findings of other authors who recommend tailoring breast cancer screening by racial cohort. Efforts should be made to promote younger-age screening for minority women to prevent disproportionate harm.
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Affiliation(s)
| | | | - Hannah M Walker
- Department of Surgery, Wright State University Boonschoft School of Medicine, Dayton, OH, USA
| | - Rebecca M Tuttle
- Department of Surgery, Wright State University Boonschoft School of Medicine, Dayton, OH, USA
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Abstract
BACKGROUND Agriculture is a hazardous industry with undocumented injury events. Credible surveillance measures are critical for this industry, especially to guide injury prevention programs with targeted recommendations for specific commodity groups and populations. This multi-phase study explored the feasibility for two state agency databases, the Ohio Bureau of Workers' Compensation (BWC) Program and the Emergency Medical Services Incident Reporting System (EMSIRS), to augment the state's Bureau of Labor Statistics (BLS) annual reports. METHODS BWC data described injury claims in agricultural workplaces from 1999 to 2008. State EMSIRS data described the types of medical emergencies for which EMS services were requested to Ohio farms in 2013-2014. Descriptive analyses were performed on each distinctive source. RESULTS Over 14,000 BWC claims were analyzed, with primary nature of injury identified as sprains and strains of bodily extremities; falls were the most common cause of injury. The EMSIRS data provided 1,376 cases, where EMS services were requested to Ohio farms at injury onset. Some cases had possibility to be excluded in CFOI or employment claims data, with 24% patients 65 years and older and 6% children 13 years and younger. The primary cause of injury was falls, and the highest reported injury type was blunt trauma. CONCLUSIONS Both BWC and EMSIRS databases showed the potential to enhance Ohio's agricultural surveillance data with viable information not found in previously used systems. Each agency database had its own merits to further clarify and quantify morbidity. When used together, these sources enrich surveillance statistics to describe Ohio's agricultural injury incidents.
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Affiliation(s)
- S Dee Jepsen
- Department of Food, Agricultural, and Biological Engineering, College of Food, Agricultural and Environmental Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Andrea Costin
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Jed Bookman
- Department of Food, Agricultural, and Biological Engineering, College of Food, Agricultural and Environmental Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Gail Kaye
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, Ohio, USA
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Kopczynski K, Casamassimo P, Amini H, Peng J, Gorham T, Meyer BD. Evaluating the type of pediatric dental care use in the context of neighborhood opportunity. J Am Dent Assoc 2024; 155:294-303.e4. [PMID: 38340112 DOI: 10.1016/j.adaj.2023.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/26/2023] [Accepted: 11/16/2023] [Indexed: 02/12/2024]
Abstract
BACKGROUND Increasing evidence supports the influence of neighborhood factors on health care use and outcomes. This study measured the association between area-level social determinants of health (SDH) and type of dental care use among Ohio pediatric Medicaid beneficiaries. METHODS A retrospective dental claims analysis was completed for children aged 1 through 5 years enrolled in Ohio Medicaid with a dental visit in 2017. Dental care use was measured from 2017 through 2021 as 1 of 4 visit types: (1) preventive, (2) caries treatment, (3) dental general anesthesia (GA), and (4) dental emergency department. The Ohio Children's Opportunity Index defined area-level SDH at the census tract level. Exploratory analysis included descriptive statistics of area-level SDH for each outcome. Poisson regression models were developed to examine the associations between the number of each dental care use outcome and Ohio Children's Opportunity Index quintiles. Visualizations were facilitated with geospatial mapping. RESULTS Fifty-six percent of children (10,008/17,675) had caries treatment visits. Overall area-level SDH were positively associated with preventive (fifth vs first quintile incidence rate ratio [IRR], 1.09; 95% CI, 1.07 to 1.12), caries treatment (fifth vs first quintile IRR, 1.16; 95% CI, 1.08 to 1.24), and dental GA visits (fifth vs first quintile IRR, 2.13; 95% CI, 1.13 to 4.01). CONCLUSIONS Children with preventive, caries treatment, and dental GA visits were more likely to live in neighborhoods with better SDH. Future efforts should investigate the mechanisms by which area-level factors influence dental access and use. PRACTICAL IMPLICATIONS Neighborhood factors influence pediatric dental care use. Patient home addresses might add value to caries risk assessment tools and efforts by care networks to optimize efficient care use.
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Davis AJ, Chipman RB, Nelson KM, Haley BS, Kirby JD, Ma X, Wallace RM, Gilbert AT. Evaluation of contingency actions to control the spread of raccoon rabies in Ohio and Virginia. Prev Vet Med 2024; 225:106145. [PMID: 38354432 DOI: 10.1016/j.prevetmed.2024.106145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 01/31/2024] [Accepted: 02/05/2024] [Indexed: 02/16/2024]
Abstract
The raccoon (Procyon lotor) variant of the rabies virus (RRV) is enzootic in the eastern United States and oral rabies vaccination (ORV) is the primary strategy to prevent and control landscape spread. Breaches of ORV management zones occasionally occur, and emergency "contingency" actions may be implemented to enhance local control. Contingency actions are an integral part of landscape-scale wildlife rabies management but can be very costly and routinely involve enhanced rabies surveillance (ERS) around the index case. We investigated two contingency actions in Ohio (2017-2019 and 2018-2021) and one in Virginia (2017-2019) using a dynamic, multi-method occupancy approach to examine relationships between specific management actions and RRV occurrence, including whether ERS was sufficient around the index case. The RRV occupancy was assessed seasonally at 100-km2 grids and we examined relationships across three spatial scales (regional management zone, RRV free regions, and local contingency areas). The location of a grid relative to the ORV management zone was the strongest predictor of RRV occupancy at the regional scale. In RRV free regions, the neighbor effect and temporal variability were most important in influencing RRV occupancy. Parenteral (hand) vaccination of raccoons was important across all three contingency action areas, but more influential in the Ohio contingency action areas where more raccoons were hand vaccinated. In the Virginia contingency action area, ORV strategies were as important in reducing RRV occupancy as a hand vaccination strategy. The management action to trap, euthanize, and test (TET) raccoons was an important method to increase ERS, yet the impacts of TET on RRV occupancy are not clear. The probability of detecting additional cases of RRV was exceptionally high (>0.95) during the season the index case occurred. The probability of detecting RRV through ERS declined in the seasons following initial TET efforts but remained higher after the contingency action compared to the ERS detection probabilities prior to index case incidence. Local RRV cases were contained within one year and eliminated within 2-3 years of each contingency action.
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Affiliation(s)
- Amy J Davis
- United States Department of Agriculture, Animal and Plant Health Inspection Service, Wildlife Services, National Wildlife Research Center, Fort Collins, CO, 80521, USA.
| | - Richard B Chipman
- United States Department of Agriculture, Animal and Plant Health Inspection Service, Wildlife Services, National Rabies Management Program, Concord, NH, 03301, USA
| | - Kathleen M Nelson
- United States Department of Agriculture, Animal and Plant Health Inspection Service, Wildlife Services, National Rabies Management Program, Concord, NH, 03301, USA
| | - Betsy S Haley
- United States Department of Agriculture, Animal and Plant Health Inspection Service, Wildlife Services, National Rabies Management Program, Concord, NH, 03301, USA
| | - Jordona D Kirby
- United States Department of Agriculture, Animal and Plant Health Inspection Service, Wildlife Services, National Rabies Management Program, Concord, NH, 03301, USA
| | - Xiaoyue Ma
- Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Ryan M Wallace
- Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Amy T Gilbert
- United States Department of Agriculture, Animal and Plant Health Inspection Service, Wildlife Services, National Wildlife Research Center, Fort Collins, CO, 80521, USA
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Rezaeitavabe F, Rezaie M, Modayil M, Pham T, Ice G, Riefler G, Coschigano KT. Beyond linear regression: Modeling COVID-19 clinical cases with wastewater surveillance of SARS-CoV-2 for the city of Athens and Ohio University campus. Sci Total Environ 2024; 912:169028. [PMID: 38061656 DOI: 10.1016/j.scitotenv.2023.169028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 11/20/2023] [Accepted: 11/29/2023] [Indexed: 01/18/2024]
Abstract
Wastewater-based surveillance has emerged as a detection tool for population-wide infectious diseases, including coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Infected individuals shed the virus, which can be detected in wastewater using molecular techniques such as reverse transcription-digital polymerase chain reaction (RT-dPCR). This study examined the association between the number of clinical cases and the concentration of SARS-CoV-2 in wastewater beyond linear regression and for various normalizations of viral loads. Viral loads were measured in a total of 446 wastewater samples during the period from August 2021 to April 2022. These samples were collected from nine different locations, with 220 samples taken from four specific sites within the city of Athens and 226 samples from five sites within Ohio University. The correlation between COVID-19 cases and wastewater viral concentrations, which was estimated using the Pearson correlation coefficient, was statistically significant and ranged from 0.6 to 0.9. In addition, time-lagged cross correlation was applied to identify the lag time between clinical and wastewater data, estimated 4 to 7 days. While we also explored the effect on the correlation coefficients of various normalizations of viral loads accounting for procedural loss or amount of fecal material and of estimated lag times, these alternative specifications did not change our substantive conclusions. Additionally, several linear and non-linear regression models were applied to predict the COVID-19 cases given wastewater data as input. The non-linear approach was found to yield the highest R-squared and Pearson correlation and lowest Mean Absolute Error values between the predicted and actual number of COVID-19 cases for both aggregated OHIO Campus and city data. Our results provide support for previous studies on correlation and time lag and new evidence that non-linear models, approximated with artificial neural networks, should be implemented for WBS of contagious diseases.
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Affiliation(s)
- Fatemeh Rezaeitavabe
- Ohio University, Russ College of Engineering, Department of Civil and Environmental Engineering, Athens, OH 45701, USA
| | - Mehdi Rezaie
- Kansas State University, Department of Physics, Manhattan, KS 66506, USA
| | - Maria Modayil
- Ohio University, Division of Diversity and Inclusion, Athens, OH 45701, USA; Ohio University, College of Health Sciences and Professions, Department of Interdisciplinary Health Studies, Athens, OH 45701, USA
| | - Tuyen Pham
- Ohio University, Voinovich School of Leadership and Public Service, Athens, OH 45701, USA
| | - Gillian Ice
- Ohio University, College of Health Sciences and Professions, Department of Interdisciplinary Health Studies, Athens, OH 45701, USA; Ohio University, Heritage College of Osteopathic Medicine, Department of Social Medicine, Athens, OH 45701, USA
| | - Guy Riefler
- Ohio University, Russ College of Engineering, Department of Civil and Environmental Engineering, Athens, OH 45701, USA
| | - Karen T Coschigano
- Ohio University, Heritage College of Osteopathic Medicine, Department of Biomedical Sciences, Athens, OH 45701, USA.
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DiPietro Mager N, Menegay M, Bish C, Oza-Frank R. Geographic Differences in Preconception Health Indicators Among Ohio Women Who Delivered Live Births, 2019-2021. Prev Chronic Dis 2024; 21:E08. [PMID: 38329922 PMCID: PMC10870995 DOI: 10.5888/pcd21.230244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024] Open
Abstract
To determine whether geographic differences in preconception health indicators exist among Ohio women with live births, we analyzed 9 indicators from the 2019-2021 Ohio Pregnancy Assessment Survey (N = 14,377) by county type. Appalachian women reported lower rates of folic acid intake and higher rates of depression than women in other counties. Appalachian and rural non-Appalachian women most often reported cigarette use. Suburban women reported lower rates of diabetes, hypertension, and unwanted pregnancy than women in other counties. Preconception health differences by residence location suggest a need to customize prevention efforts by region to improve health outcomes, particularly in regions with persistent health disparities.
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Affiliation(s)
- Natalie DiPietro Mager
- Ohio Northern University Raabe College of Pharmacy, Ada, Ohio
- Ohio Northern University Raabe College of Pharmacy, 525 S Main St, Ada, OH 45810
| | - Michelle Menegay
- Ohio Colleges of Medicine Government Resource Center, The Ohio State University Wexner Medical Center, Columbus
| | - Connie Bish
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Reena Oza-Frank
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Estadt AT, White BN, Ricks JM, Lancaster KE, Hepler S, Miller WC, Kline D. The impact of fentanyl on state- and county-level psychostimulant and cocaine overdose death rates by race in Ohio from 2010 to 2020: a time series and spatiotemporal analysis. Harm Reduct J 2024; 21:13. [PMID: 38233924 PMCID: PMC10792830 DOI: 10.1186/s12954-024-00936-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 01/10/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Over the past decade in the USA, increases in overdose rates of cocaine and psychostimulants with opioids were highest among Black, compared to White, populations. Whether fentanyl has contributed to the rise in cocaine and psychostimulant overdoses in Ohio is unknown. We sought to measure the impact of fentanyl on cocaine and psychostimulant overdose death rates by race in Ohio. METHODS We conducted time series and spatiotemporal analyses using data from the Ohio Public Health Information Warehouse. Primary outcomes were state- and county-level overdose death rates from 2010 to 2020 for Black and White populations. Measures of interest were overdoses consisting of four drug involvement classes: (1) all cocaine overdoses, (2) cocaine overdoses not involving fentanyl, (3) all psychostimulant overdoses, and (4) psychostimulant overdoses not involving fentanyl. We fit a time series model of log standardized mortality ratios (SMRs) using a Bayesian generalized linear mixed model to estimate posterior median rate ratios (RR). We conducted a spatiotemporal analysis by modeling the SMR for each drug class at the county level to characterize county-level variation over time. RESULTS In 2020, the greatest overdose rates involved cocaine among Black (24.8 deaths/100,000 people) and psychostimulants among White (10.1 deaths/100,000 people) populations. Annual mortality rate ratios were highest for psychostimulant-involved overdoses among Black (aRR = 1.71; 95% CI (1.43, 2.02)) and White (aRR = 1.60, 95% CI (1.39, 1.80)) populations. For cocaine not involving fentanyl, annual mortality rate ratios were similar among Black (aRR = 1.04; 95% CI (0.96,1.16)) and White (aRR = 1.02; 95% CI (0.87, 1.20)) populations. Within each drug category, change over time was similar for both racial groups. The spatial models highlighted county-level variation for all drug categories. CONCLUSIONS Without the involvement of fentanyl, cocaine overdoses remained constant while psychostimulant overdoses increased. Tailored harm reduction approaches, such as distribution of fentanyl test strips and the removal of punitive laws that influence decisions to contact emergency services, are the first steps to reduce cocaine overdose rates involving fentanyl among urban populations in Ohio. In parallel, harm reduction policies to address the increase in psychostimulant overdoses are warranted.
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Affiliation(s)
- Angela T Estadt
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, USA.
| | - Brian N White
- Division of Public Health Sciences, Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, USA
| | - JaNelle M Ricks
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, USA
| | - Kathryn E Lancaster
- Division of Public Health Sciences, Department of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, USA
| | - Staci Hepler
- Department of Statistical Sciences, Wake Forest University, Winston-Salem, USA
| | - William C Miller
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - David Kline
- Division of Public Health Sciences, Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, USA
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Gelberg KH, Chase R, Lindstrom M, Hochstatter KR, Larochelle L, Hunt T. Need for Improved Timeliness of Reporting on Drug Overdose Fatalities: The HEALing Communities Study. Public Health Rep 2024; 139:72-78. [PMID: 36951207 PMCID: PMC10905759 DOI: 10.1177/00333549231161339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023] Open
Abstract
OBJECTIVE Timely data on drug overdose deaths can help identify community needs, evaluate the effectiveness of interventions, and allocate resources. We identified variations in death investigation and reporting systems within and between states that affect the timeliness and accuracy of death certificate information. METHODS The HEALing Communities Study (HCS) is a community-engaged, data-driven approach to combating the opioid crisis in 67 communities in 4 states: Kentucky, Massachusetts, New York, and Ohio. HCS conducted a survey of coroners and medical examiners to understand variability in drug overdose death data. We compared survey results in Massachusetts, New York, and Ohio with national data to investigate the completeness of provisional death counts by type of death investigation system. RESULTS Communities in each HCS state had different ways of collecting and reporting mortality data. Completion of death certificates for drug overdoses ranged from <2 weeks in 23% (7 of 31) of those surveyed to more than 3 months in 10% (3 of 31) of those surveyed. Variabilities in the timeliness of reporting drug overdose deaths were not associated with type of coroner or medical examiner office in each state, urban versus rural setting, or specificity of drug information on the death certificate. CONCLUSION Having specific drug information on the death certificate may increase death certificate quality, comparability, and accuracy. We recommend the following: (1) all coroners and medical examiners should be trained on conducting death investigations, interpreting toxicology reports, and completing death certificates; (2) 1 office in each state should oversee all coroners and medical examiners to increase data consistency; and (3) communities should identify and address barriers to timely death certification.
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Affiliation(s)
| | - Rachel Chase
- HEALing Communities Study, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Megan Lindstrom
- HEALing Communities Study, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | | | - Lauren Larochelle
- Injury Surveillance Program, Massachusetts Department of Public Health, Boston, MA, USA
| | - Timothy Hunt
- Social Intervention Group, Columbia University School of Social Work, New York, NY, USA
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Larwin KH, Larwin DA. Maternal and Infant Pathways HUB in NE Ohio: Influence on Birth Outcomes. Matern Child Health J 2024; 28:83-92. [PMID: 37902918 DOI: 10.1007/s10995-023-03799-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2023] [Indexed: 11/01/2023]
Abstract
INTRODUCTION This investigation examines the outcomes of the Pathways HUB Community Action, a Maternal and Infant Mortality HUB in NE Ohio. The purpose of a HUB is to provide a one-stop point of contact for primarily minority pregnant women who are low-income and are at high risk for pregnancy complications. As a HUB client, each mother is assigned a community health worker who provides wrap-around support across 20 identified areas of potential need. METHODS The focus of this evaluation is on the women who were enrolled in the PHCA and gave birth between 2016 and 2020. Pre-existing data was used to examine the association between mother variables and birth outcomes using odds ratio and correlation analysis. RESULTS Using a within-subjects design, results indicate that there is no significant association between preterm rates for women who have previously experienced one or more preterm deliveries. Likewise, results indicate that there is no significant association on the birth weight of infants of enrolled women who have previously given birth to a low-birth-weight infant. Results indicate that there is a strong significant association between 1st and 2nd-trimester enrollee's dosage of PHCA services and supports and positive birth outcomes. DISCUSSION These findings suggest that the PHCA is providing needed support and assistance to at-risk pregnant women who are mitigating the likelihood of repeated preterm and low-weight births, therefore lowering the likelihood of infant mortality for their clients in Summit County.
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Kalley A, Halcomb M, Hoet A, Summers D, Skorupski S, Day C, Berrian AM. A multisectoral approach to developing a state-level foreign animal disease response plan: the Ohio African Swine Fever Response Plan Workshop. J Am Vet Med Assoc 2024; 262:109-116. [PMID: 38103389 DOI: 10.2460/javma.23.08.0489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 09/18/2023] [Indexed: 12/19/2023]
Abstract
Foreign animal disease (FAD) preparedness is a high priority for state and federal governments to ensure the protection of the nation's livestock industry. Highly contagious diseases such as African swine fever (ASF) have been the focus of recent advancements in FAD preparedness, including the development of disease-specific response plans. At the state level, FAD response plans provide a framework to help ensure a rapid and coordinated response that considers the resources and realities of that state; however, preparing a comprehensive plan requires collaboration across multiple agencies and sectors that can be difficult to operationalize. To initiate systematic state-level ASF response plan writing and identify gaps in preparedness, university and industry stakeholders partnered with the Ohio Department of Agriculture and USDA to develop the Ohio African Swine Fever Response Plan Workshop. A linear planning model was used to implement the workshop in May 2021. All planning and workshop activities were conducted fully virtually, prompted by public health restrictions in response to COVID-19. Sixty-four participants, representing multiple sectors and stakeholder groups including state/federal/industry animal health officials, emergency management, environmental protection, and academia, contributed to the workshop. Spanning 3 days, participants identified current response capabilities and areas requiring additional planning for an effective state-level response. The workshop generated recommendations from a multisectoral perspective for subcommittees tasked with developing standard operating procedures for the Ohio ASF Response Plan. The methodology and resources used to plan, implement, and evaluate the workshop are described to provide a model for state-level response planning.
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Affiliation(s)
- Aminata Kalley
- 1Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, OH
| | - Megan Halcomb
- 1Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, OH
| | - Armando Hoet
- 1Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, OH
- 2Veterinary Public Health Program, Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH
| | - Dennis Summers
- 3Division of Animal Health, Ohio Department of Agriculture, Reynoldsburg, OH
| | | | | | - Amanda M Berrian
- 1Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, OH
- 2Veterinary Public Health Program, Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH
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Hernandez E, Griggs S. Substance Use, Sleep Duration, and Health Among Adults in Ohio. Prev Chronic Dis 2023; 20:E117. [PMID: 38154118 PMCID: PMC10756651 DOI: 10.5888/pcd20.230198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2023] Open
Abstract
Introduction Substance use affects approximately 46.3 million people aged 12 years or older (16.5% of the US population) and is associated with poor sleep health overall. Methods We conducted a cross-sectional secondary analysis of data from the 2020 Behavioral Risk Factor Surveillance System survey in Ohio. The sample comprised 14,676 adults. We examined associations between the use of 2 types of substances (marijuana and nonprescribed prescription pain medication) and short sleep duration (<6 hours per night) and overall health (mental, physical, and general). We used linear and logistic regression modeling while adjusting for individual-level (age, sex, race and ethnicity, education, income, and body mass index) and area-level (socioeconomic deprivation) covariates. Results Of survey respondents who answered questions, 9.2% (1,140 of 12,362) reported using marijuana, and 1.4% (111 of 8,203) used nonprescribed prescription pain medication. Respondents who used marijuana used it an average 17.3 days per month. In adjusted logistic regression models, the odds of reporting short sleep duration were 2.4 times greater among respondents who used nonprescribed prescription pain medication (vs those who did not). The odds of reporting short sleep duration, poor mental health, poor physical health, and poor general health were 1.5, 1.3, 2.1, and 1.9 times greater, respectively, among respondents who reported marijuana use (vs those who did not). In the linear regression models (adjusted), more days of marijuana use were associated with longer sleep duration, worse mental health, and worse general health. Conclusion Understanding the connection between substance use and health outcomes is needed to improve trajectories of substance use and recovery. Sleep duration is often underassessed among people who use substances. Expanding diagnostics and treatment options for those who use substances may result in lower levels of substance use and improved overall health.
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Affiliation(s)
- Estefania Hernandez
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio
- Case Western Reserve University, Frances Payne Bolton School of Nursing, 10900 Euclid Ave, Cleveland, OH 44106
| | - Stephanie Griggs
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio
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15
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Eom KY, Koroukian SM, Dong W, Kim U, Rose J, Albert JM, Zanotti KM, Owusu C, Cooper G, Tsui J. Accounting for Medicaid expansion and regional policy and programs to advance equity in cancer prevention in the United States. Cancer 2023; 129:3915-3927. [PMID: 37489821 DOI: 10.1002/cncr.34956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 05/02/2023] [Accepted: 06/07/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND Many studies compare state-level outcomes to estimate changes attributable to Medicaid expansion. However, it is imperative to conduct more granular, demographic-level analyses to inform current efforts on cancer prevention among low-income adults. Therefore, the authors compared the volume of patients with cancer and disease stage at diagnosis in Ohio, which expanded its Medicaid coverage in 2014, with those in Georgia, a nonexpansion state, by cancer site and health insurance status. METHODS The authors used state cancer registries from 2010 to 2017 to identify adults younger than 64 years who had incident female breast cancer, cervical cancer, or colorectal cancer. Multivariable Poisson regression was conducted by cancer type, health insurance, and state to examine the risk of late-stage disease, adjusting for individual-level and area-level covariates. A difference-in-differences framework was then used to estimate the differences in risks of late-stage diagnosis in Ohio versus Georgia. RESULTS In Ohio, the largest increase in all three cancer types was observed in the Medicaid group after Medicaid expansion. In addition, significantly reduced risks of late-stage disease were observed among patients with breast cancer on Medicaid in Ohio by approximately 7% and among patients with colorectal cancer on Medicaid in Ohio and Georgia after expansion by approximately 6%. Notably, the authors observed significantly reduced risks of late-stage diagnosis among all patients with colorectal cancer in Georgia after expansion. CONCLUSIONS More early stage cancers in the Medicaid-insured and/or uninsured groups after expansion suggest that the reduced cancer burden in these vulnerable population subgroups may be attributed to Medicaid expansion. Heterogeneous risks of late-stage disease by cancer type highlight the need for comprehensive evaluation frameworks, including local cancer prevention efforts and federal health policy reforms. PLAIN LANGUAGE SUMMARY This study looked at how Medicaid expansion affected cancer diagnosis and treatment in two states, Ohio and Georgia. The researchers found that, after Ohio expanded their Medicaid program, there were more patients with cancer among low-income adults on Medicaid. The study also found that, among people on Medicaid, there were lower rates of advanced cancer at the time of diagnosis for breast cancer and colon cancer in Ohio and for colon cancer in Georgia. These findings suggest that Medicaid expansion may be effective in reducing the cancer burden among low-income adults.
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Affiliation(s)
- Kirsten Y Eom
- MetroHealth Population Health Research Institute, Cleveland, Ohio, USA
- MetroHealth Cancer Center, Cleveland, Ohio, USA
| | - Siran M Koroukian
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- Case Comprehensive Cancer Center, Cleveland, Ohio, USA
| | - Weichuan Dong
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Uriel Kim
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Johnie Rose
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- Case Comprehensive Cancer Center, Cleveland, Ohio, USA
| | - Jeffrey M Albert
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- Case Comprehensive Cancer Center, Cleveland, Ohio, USA
| | - Kristine M Zanotti
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- Case Comprehensive Cancer Center, Cleveland, Ohio, USA
| | - Cynthia Owusu
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- Case Comprehensive Cancer Center, Cleveland, Ohio, USA
| | - Gregory Cooper
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- Case Comprehensive Cancer Center, Cleveland, Ohio, USA
- University Hospital of Cleveland, Cleveland, Ohio, USA
| | - Jennifer Tsui
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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Chien RC, Mingqun L, Yan Q, Randolph N, Huang W, Wellman M, Toribio R, Rikihisa Y. Strains of Anaplasma phagocytophilum from horses in Ohio are related to isolates from humans in the northeastern USA. Microbiol Spectr 2023; 11:e0263223. [PMID: 37882777 PMCID: PMC10715102 DOI: 10.1128/spectrum.02632-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 09/15/2023] [Indexed: 10/27/2023] Open
Abstract
IMPORTANCE The tick-borne obligatory intracellular bacterium Anaplasma phagocytophilum infects humans as well as domesticated and wild animals, causing a febrile disease collectively called granulocytic anaplasmosis. The epidemiology and the host species specificity and zoonotic potential of A. phagocytophilum strains remain unclear. In this study, ankA (encoding ankyrin A) and p44 gene sequences of A. phagocytophilum were determined in clinical specimens from horses in Ohio and compared with those found in A. phagocytophilum strains from various hosts and geographic regions. With increasing numbers of seropositive horses, the study points out the unrecognized prevalence and uncharacterized strains of A. phagocytophilum infection in horses and the importance of A. phagocytophilum molecular testing for the prevention of equine and human granulocytic anaplasmosis.
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Affiliation(s)
- Rory C Chien
- Laboratory of Molecular, Cellular, and Environmental Rickettsiology, Infectious Diseases Institute, The Ohio State University , Columbus, Ohio, USA
- Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University , Columbus, Ohio, USA
| | - Lin Mingqun
- Laboratory of Molecular, Cellular, and Environmental Rickettsiology, Infectious Diseases Institute, The Ohio State University , Columbus, Ohio, USA
- Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University , Columbus, Ohio, USA
| | - Qi Yan
- Laboratory of Molecular, Cellular, and Environmental Rickettsiology, Infectious Diseases Institute, The Ohio State University , Columbus, Ohio, USA
- Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University , Columbus, Ohio, USA
| | - Nina Randolph
- Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University , Columbus, Ohio, USA
| | - Weiyan Huang
- Laboratory of Molecular, Cellular, and Environmental Rickettsiology, Infectious Diseases Institute, The Ohio State University , Columbus, Ohio, USA
- Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University , Columbus, Ohio, USA
| | - Maxey Wellman
- Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University , Columbus, Ohio, USA
| | - Ramiro Toribio
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University , Columbus, Ohio, USA
| | - Yasuko Rikihisa
- Laboratory of Molecular, Cellular, and Environmental Rickettsiology, Infectious Diseases Institute, The Ohio State University , Columbus, Ohio, USA
- Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University , Columbus, Ohio, USA
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Tiesman HM, Konda S, Wurzelbacher SJ, Naber SJ, Attwood WR. Occupational injuries and illnesses among law enforcement officers, 2001-2019: Findings from the Ohio Bureau of Workers' Compensation. Am J Ind Med 2023; 66:1079-1089. [PMID: 37749916 DOI: 10.1002/ajim.23541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/06/2023] [Accepted: 09/14/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND Occupational injuries are common among law enforcement officers (LEOs) and can impact an agency's ability to serve communities. Workers' compensation (WC) data are an underutilized source for occupational injury surveillance in the law enforcement field. METHODS LEOs WC claims from the Ohio Bureau of Workers' Compensation (OHBWC) from 2001 to 2019 were identified based on manual review of the occupation title and injury description. Worker, employer, incident, and injury characteristics were described by claim type-medical-only (MO) and lost-time (8 or more days away from work). Data are presented using injury claim counts. RESULTS From 2001 to 2019, 50,793 WC claims were identified among Ohio LEOs. Of these, 68% were MO claims (n = 34,622). WC claims significantly decreased over the 19-year period (p < 0.001). Seventy-five percent of WC claims were from a LEO with more than one claim and of these, 34% were from a LEO with five or more claims during the study period. Male officers and those aged 25-54 years incurred the highest proportion of total claims (87.8% & 91.8%, respectively). Violence (n = 17,247; 34%), falls/slips/trips (n = 9079; 17.9%), and transportation events (n = 7977; 15.7%) were the leading events. Among the 50,793 claims, there were 79,637 unique clinical diagnosis groups. The most common injury diagnoses were sprains (n = 32,796; 41.2%) followed by contusions (n = 13,529; 17%). CONCLUSIONS Results can guide the development or improvement of workplace injury prevention strategies for LEOs. Efforts should be focused on better understanding and preventing violent injury events and sprains among LEOs, as well as preventing multiple injury events.
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Affiliation(s)
- Hope M Tiesman
- Division of Safety Research, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Srinivas Konda
- Division of Safety Research, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Steven J Wurzelbacher
- Center for Workers' Compensation Studies, Division of Field Studies and Engineering, Cincinnati, Ohio, USA
| | - Steven J Naber
- Information Technology Division, Ohio Bureau of Workers' Compensation, Columbus, Ohio, USA
| | - Wesley R Attwood
- National Personal Protective Technology Laboratory, National Institute for Occupational Safety and Health, Pittsburgh, Pennsylvania, USA
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Wing JJ, Rajczyk JI, Burke JF. Geographic Distribution of Social Service Resources for Stroke Survivors in Ohio Varies by Rurality. Stroke 2023; 54:3128-3137. [PMID: 37942643 DOI: 10.1161/strokeaha.123.043929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 09/21/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Both social service resources and stroke prevalence vary by geography, and health care resources are scarcer in rural areas. We assessed whether distributions of resources relevant to stroke survivors were clustered around areas of the highest stroke prevalence in Ohio and whether this is varied by rurality using an ecological study design. METHODS Census tract (CT)-level self-reported stroke prevalence estimates (Centers for Disease Control and Prevention PLACES-2019 Behavioral Risk Factor Surveillance System) were linked with sociodemographic and rurality data (2019 American Community Survey) and geographic density of resources in Ohio (2020 findhelp data). Resources were grouped into categories: housing, in-home, financial, transportation, education, and therapy. Negative binomial regression models estimated the mean number of resources within 25 miles and 30 minutes of a CT centroid and quartiles of stroke prevalence for each resource group by rurality status (rural, urban, and suburban). Models were sequentially adjusted for total population and CT demographics. RESULTS In Ohio, stroke prevalence was 3.9% (0.4%-14.2%). The highest stroke prevalence quartile (versus lowest) was associated with fewer resources within 25 miles overall (resource ratio [RR], 0.57-0.98). The most pronounced disparities were in rural CT; rural CTs with the highest quartile stroke prevalence had fewer housing (RR, 0.49 [95% CI, 0.32-0.75]), in-home (RR, 0.31 [95% CI, 0.20-0.49]), and therapy (RR, 0.23 [95% CI, 0.13-0.43]) resources compared with those with the lowest quartile stroke prevalence (reference: mean, 1.2 housing, 5.1 in-home, and 4.9 therapy resources, respectively). Rural disparities no longer persisted after adjustment for federal poverty limit (rural: housing [RR, 0.69 (95% CI, 0.40-1.20)], in-home [RR, 0.65 (95% CI, 0.34-1.23)], and therapy [RR, 0.66 (95% CI, 0.33-1.32)]). CONCLUSIONS Stroke social service resources are inversely distributed relative to stroke prevalence in Ohio, particularly in rural areas. This inverse link in rural Ohio is likely explained by geographic differences in poverty. Stroke-specific resource-related interventions may be needed and should consider the roles of rurality and poverty.
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Affiliation(s)
- Jeffrey J Wing
- Division of Epidemiology, College of Public Health (J.J.W., J.I.R.), The Ohio State University, Columbus
| | - Jenna I Rajczyk
- Division of Epidemiology, College of Public Health (J.J.W., J.I.R.), The Ohio State University, Columbus
| | - James F Burke
- Department of Neurology, Wexner Medical Center (J.F.B.), The Ohio State University, Columbus
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Cao RG, Mejias A, Leber AL, Wang H. Clinical and molecular characteristics of the 2022 Enterovirus-D68 outbreak among hospitalized children, Ohio, USA. J Clin Virol 2023; 169:105618. [PMID: 37977074 DOI: 10.1016/j.jcv.2023.105618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/17/2023] [Accepted: 11/01/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Enterovirus-D68 (EV-D68) has appeared biennially in the United States following the 2014 outbreak. It has gained epidemiologic and clinical relevance and was identified as an important pathogen associated with severe respiratory and central nervous system diseases. We aim to describe the clinical and molecular characteristics of the post-pandemic 2022 Enterovirus-D68 outbreak in children evaluated in a tertiary pediatric hospital in Columbus, Ohio. METHODS EV-D68 RT-PCR was performed on nasopharyngeal specimens collected during Jun-Nov 2022 from children (<18 years), identified by 1) physician-order or 2) random selection of 10-15 specimens weekly that were Rhinovirus/Enterovirus-positive by physician-ordered respiratory virus panel. Patients who tested positive for EV-D68 were identified and clinical data and outcomes were analyzed. Partial viral VP1 region was sequenced and characterized. RESULTS Forty-four children positive for EV-D68 were identified, among which 88.6 % of patients presented with respiratory symptoms and 61.4 % required PICU admission. Two patients presented with AFM that was attributed to EV-D68. EV-D68 sequences from 2022 clustered within the B3 subclade. CONCLUSIONS A significant proportion of children identified with EV-D68 during the 2022 outbreak had respiratory compromise requiring PICU admission. As the virus continues evolving, it is important to monitor the activity of EV-D68, characterizing these strains clinically and genetically, which will help to understand the viral pathogenicity and virulence.
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Affiliation(s)
- Raquel Giacomelli Cao
- Department of Pediatrics, Division of Infectious Diseases, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, United States of America
| | - Asuncion Mejias
- Department of Infectious Diseases, St Jude Children's Research Hospital, Memphis, TN, United States of America
| | - Amy L Leber
- Department of Pediatrics, Division of Infectious Diseases, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, United States of America; Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio, United States of America; Department of Pathology, The Ohio State University, Columbus, Ohio, United States of America
| | - Huanyu Wang
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio, United States of America; Department of Pathology, The Ohio State University, Columbus, Ohio, United States of America.
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Dong W, Kucmanic M, Winter J, Pronovost P, Rose J, Kim U, Koroukian SM, Hoehn R. Understanding Disparities in Receipt of Complex Gastrointestinal Cancer Surgery at a Small Geographic Scale. Ann Surg 2023; 278:e1103-e1109. [PMID: 36804445 PMCID: PMC10440364 DOI: 10.1097/sla.0000000000005828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
OBJECTIVE To define neighborhood-level disparities in the receipt of complex cancer surgery. BACKGROUND Little is known about the geographic variation of receipt of surgery among patients with complex gastrointestinal (GI) cancers, especially at a small geographic scale. METHODS This study included individuals diagnosed with 5 invasive, nonmetastatic, complex GI cancers (esophagus, stomach, pancreas, bile ducts, liver) from the Ohio Cancer Incidence Surveillance System during 2009 and 2018. To preserve patient privacy, we combined US census tracts into the smallest geographic areas that included a minimum number of surgery cases (n=11) using the Max-p-regions method and called these new areas "MaxTracts." Age-adjusted surgery rates were calculated for MaxTracts, and the Hot Spot analysis identified clusters of high and low surgery rates. US Census and CDC PLACES were used to compare neighborhood characteristics between the high- and low-surgery clusters. RESULTS This study included 33,091 individuals with complex GI cancers located in 1006 MaxTracts throughout Ohio. The proportion in each MaxTract receiving surgery ranged from 20.7% to 92.3% with a median (interquartile range) of 48.9% (42.4-56.3). Low-surgery clusters were mostly in urban cores and the Appalachian region, whereas high-surgery clusters were mostly in suburbs. Low-surgery clusters differed from high-surgery clusters in several ways, including higher rates of poverty (23% vs. 12%), fewer married households (40% vs. 50%), and more tobacco use (25% vs. 19%; all P <0.01). CONCLUSIONS This improved understanding of neighborhood-level variation in receipt of potentially curative surgery will guide future outreach and community-based interventions to reduce treatment disparities. Similar methods can be used to target other treatment phases and other cancers.
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Affiliation(s)
- Weichuan Dong
- Population Cancer Analytics Shared Resource, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Matthew Kucmanic
- Population Cancer Analytics Shared Resource, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
- Department of Geographical and Sustainability Sciences, University of Iowa, Iowa City, IA
| | - Jordan Winter
- Division of Surgical Oncology, University Hospitals, Cleveland, OH
| | - Peter Pronovost
- Department of Anesthesia and Critical Care Medicine, University Hospitals, Cleveland, OH
| | - Johnie Rose
- Population Cancer Analytics Shared Resource, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH
- Center for Community Health Integration, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Uriel Kim
- Population Cancer Analytics Shared Resource, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH
- Center for Community Health Integration, Case Western Reserve University School of Medicine, Cleveland, OH
- Kellogg School of Management, Northwestern University, Evanston, IL
| | - Siran M Koroukian
- Population Cancer Analytics Shared Resource, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH
- Center for Community Health Integration, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Richard Hoehn
- Division of Surgical Oncology, University Hospitals, Cleveland, OH
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Menchaca AD, Style CC, Wang L, Cooper JN, Minneci PC, Olutoye OO. An Accountable Care Organization Maintains Access for Appendicitis During the COVID-19 Pandemic. J Surg Res 2023; 291:336-341. [PMID: 37506433 PMCID: PMC10285208 DOI: 10.1016/j.jss.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 05/15/2023] [Accepted: 06/12/2023] [Indexed: 07/30/2023]
Abstract
INTRODUCTION It has been reported that pediatric patients experienced a delay in treatment for acute appendicitis during the pandemic, resulting in increased rates of complicated appendicitis. We investigated the association of the COVID-19 pandemic and the incidence and severity of acute appendicitis among pediatric Medicaid patients using a population-based approach. METHODS The claims database of Partners For Kids, a pediatric Medicaid accountable care organization (ACO) in Ohio, was queried for cases of acute appendicitis from April to August 2017-2020. The monthly rate of acute appendicitis/100,000 covered lives was calculated each year and compared over time. Rates of complicated appendicitis were also compared. Diagnosis code validation for classification as complicated or uncomplicated appendicitis was performed for patients treated at our hospital. RESULTS During the study period, 465 unique cases of acute appendicitis were identified. Forty percent (186/465) were coded as complicated. No significant difference in the incidence of acute appendicitis cases was observed across the 4 y, either in an overall comparison or in pairwise comparisons (P > 0.15 for all). The proportion of acute appendicitis cases that were coded as complicated did vary significantly over the 4-year study period (P = 0.005); this was due to this proportion being significantly higher in 2018 than in either 2019 (P = 0.005 versus 2018) or 2020 (P = 0.03 versus 2018). CONCLUSIONS The COVID-19 pandemic was not associated with reduced access to treatment for acute appendicitis among patients in a pediatric Medicaid ACO. This suggests that an ACO may promote continued healthcare access for their covered population during an unexpected crisis.
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Affiliation(s)
- Alicia D Menchaca
- Center for Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio; Department of General Surgery, Indiana University, Indianapolis, Indiana
| | - Candace C Style
- Center for Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio
| | - Ling Wang
- Nationwide Children's Hospital, Columbus, Ohio
| | - Jennifer N Cooper
- Center for Surgical Outcomes Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio
| | - Peter C Minneci
- Center for Surgical Outcomes Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio; Department of Surgery, Nationwide Children's Hospital, Columbus, Ohio; Department of Surgery, The Ohio State University College of Medicine, Columbus, Ohio
| | - Oluyinka O Olutoye
- Center for Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio; Department of Surgery, Nationwide Children's Hospital, Columbus, Ohio; Department of Surgery, The Ohio State University College of Medicine, Columbus, Ohio.
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Socias-Morales C, Konda S, Bell JL, Wurzelbacher SJ, Naber SJ, Scott Earnest G, Garza EP, Meyers AR, Scharf T. Construction industry workers' compensation injury claims due to slips, trips, and falls - Ohio, 2010-2017. J Safety Res 2023; 86:80-91. [PMID: 37718072 PMCID: PMC10772999 DOI: 10.1016/j.jsr.2023.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 04/20/2023] [Accepted: 06/29/2023] [Indexed: 09/19/2023]
Abstract
PROBLEM Compared to other industries, construction workers have higher risks for serious fall injuries. This study describes the burden and circumstances surrounding injuries related to compensable slip, trip, and fall (STF) claims from private construction industries covered by the Ohio Bureau of Workers' Compensation. METHODS STF injury claims in the Ohio construction industry from 2010-2017 were manually reviewed. Claims were classified as: slips or trips without a fall (STWOF), falls on the same level (FSL), falls to a lower level (FLL), and other. Claim narratives were categorized by work-related risk and contributing factors. Demographic, employer, and injury characteristics were examined by fall type and claim type (medical-only (MO, 0-7 days away from work, DAFW) or lost-time (LT, ≥8 DAFW)). Claim rates per 10,000 estimated full-time equivalent employees (FTEs) were calculated. RESULTS 9,517 Ohio construction industry STF claims occurred during the 8-year period, with an average annual rate of 75 claims per 10,000 FTEs. The rate of STFs decreased by 37% from 2010 to 2017. About half of the claims were FLL (51%), 29% were FSL, 17% were STWOF, and 3% were "other." Nearly 40% of all STF claims were LT; mostly among males (96%). The top three contributing factors for STWOF and FSL were: slip/trip hazards, floor irregularities, and ice/snow; and ladders, vehicles, and stairs/steps for FLL. FLL injury rates per 10,000 FTE were highest in these industries: Foundation, Structure, and Building Exterior Contractors (52); Building Finishing Contractors (45); and Residential Building Construction (45). The highest rate of FLL LT claims occurred in the smallest firms, and the FLL rate decreased as construction firm size increased. Discussion and Practical Applications: STF rates declined over time, yet remain common, requiring prevention activities. Safety professionals should focus on contributing factors when developing prevention strategies, especially high-risk subsectors and small firms.
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Affiliation(s)
| | | | | | - Steven J Wurzelbacher
- NIOSH, Division of Field Studies and Engineering, Center for Workers' Compensation Studies, United States
| | | | - G Scott Earnest
- NIOSH, Office of Construction Safety and Health, United States
| | | | - Alysha R Meyers
- NIOSH, Division of Field Studies and Engineering, Center for Workers' Compensation Studies, United States
| | - Ted Scharf
- NIOSH, Division of Science Integration, United States
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Padamsee TJ, Stover DG, Tarver WL, Washington CM, Baltic RD, DeGraffinreid CR, Whiting CRB, Rumano R, Lee CN, Nolan T, Oppong B, Obeng-Gyasi S, Toland AE, Bernardo B, Hampel H, Paskett ED. Turning the Page on Breast Cancer in Ohio: Lessons learned from implementing a multilevel intervention to reduce breast cancer mortality among Black women. Cancer 2023; 129:3114-3127. [PMID: 37691524 PMCID: PMC10881116 DOI: 10.1002/cncr.34845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 03/14/2023] [Accepted: 04/11/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Turning the Page on Breast Cancer (TPBC) uses a multilevel approach to reduce breast cancer (BC) mortality among Black women. TPBC intervenes by (1) improving health care facilities' ability to conduct effective BC screening, follow-up, and treatment; (2) involving community-based organizations; and (3) providing education and personal risk information through a culturally relevant website. Ohio has among the worst BC mortality rates in the United States for Black women. TPBC is in its third year of providing targeted interventions in 12 Ohio counties with particularly high BC rates among Black women. METHODS TPBC enrolls health care facilities, collects organizational and patient data, and conducts key informant interviews to inform the provision of appropriate evidence-based interventions. TPBC engages Black communities through community-based organizations and social media advertising. The TPBC website offers BC information, connects Black women to community BC resources, and provides access to a risk-assessment tool. RESULTS TPBC has provided tailored information packets, evidence-based interventions, and systematic support for improving the tracking and follow-up of breast health care among patients in 10 clinical partnerships. The project has provided education at community events monthly since mid-2021. The TPBC website (http://endbreastcancerohio.org) is promoted through social media (primarily Facebook) and community events to reach Black women aged 25-70 years. To date, 4108 unique users have visited the website, of whom 15.9% completed the risk assessment. CONCLUSIONS Novel strategies are needed to address persistent disparities in BC outcomes among Black women. TPBC demonstrates the potential effectiveness of multiple methods of community-based, clinic-based, and web-based engagement. PLAIN LANGUAGE SUMMARY Turning the Page on Breast Cancer (TPBC) aims to reduce breast cancer mortality among Black women in Ohio by conducting multilevel, community-engaged interventions in 12 counties. Women are provided risk information and education at virtual and in-person community events and through a community-friendly website that was launched in November 2020. Almost 4000 women have visited the website, which offers community-targeted information, urges screening for individuals at elevated risk, and offers access to patient navigation services; 655 users have used a breast cancer risk-assessment tool on the site. Community-based organizations conduct educational efforts. TPBC partners with health care facilities, which are taught to improve their ability to conduct effective breast cancer screening, follow-up, and treatment. So far, TPBC has provided educational information, evidence-based intervention lists, tailored information packets, and ongoing quarterly support to partners in 10 counties. Evaluation will focus on aggregated data for screening and genetic testing referral at the clinic level.
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Affiliation(s)
- Tasleem J. Padamsee
- The Ohio State University James Comprehensive Cancer Center, Columbus, Ohio, USA
- The Ohio State University College of Public Health, Columbus, Ohio, USA
| | - Daniel G. Stover
- The Ohio State University James Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Willi L. Tarver
- The Ohio State University James Comprehensive Cancer Center, Columbus, Ohio, USA
- The Ohio State University College of Medicine, Columbus, Ohio, USA
| | | | - Ryan D. Baltic
- The Ohio State University James Comprehensive Cancer Center, Columbus, Ohio, USA
| | | | | | - Ruvarashe Rumano
- The Ohio State University James Comprehensive Cancer Center, Columbus, Ohio, USA
- The Ohio State University College of Public Health, Columbus, Ohio, USA
| | - Clara N. Lee
- The Ohio State University James Comprehensive Cancer Center, Columbus, Ohio, USA
- The Ohio State University College of Public Health, Columbus, Ohio, USA
| | - Timiya Nolan
- The Ohio State University College of Nursing, Columbus, Ohio, USA
| | - Bridget Oppong
- The Ohio State University James Comprehensive Cancer Center, Columbus, Ohio, USA
- The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Samilia Obeng-Gyasi
- The Ohio State University James Comprehensive Cancer Center, Columbus, Ohio, USA
- The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Amanda E. Toland
- The Ohio State University James Comprehensive Cancer Center, Columbus, Ohio, USA
- The Ohio State University College of Medicine, Columbus, Ohio, USA
| | | | - Heather Hampel
- Department of Medical Oncology, City of Hope National Medical Center, Duarte, California, USA
| | - Electra D. Paskett
- The Ohio State University James Comprehensive Cancer Center, Columbus, Ohio, USA
- The Ohio State University College of Medicine, Columbus, Ohio, USA
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24
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Wallace J, Goldsmith-Pinkham P, Schwartz JL. Excess Death Rates for Republican and Democratic Registered Voters in Florida and Ohio During the COVID-19 Pandemic. JAMA Intern Med 2023; 183:916-923. [PMID: 37486680 PMCID: PMC10366951 DOI: 10.1001/jamainternmed.2023.1154] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 03/04/2023] [Indexed: 07/25/2023]
Abstract
Importance There is evidence that Republican-leaning counties have had higher COVID-19 death rates than Democratic-leaning counties and similar evidence of an association between political party affiliation and attitudes regarding COVID-19 vaccination; further data on these rates may be useful. Objective To assess political party affiliation and mortality rates for individuals during the initial 22 months of the COVID-19 pandemic. Design, Setting, and Participants A cross-sectional comparison of excess mortality between registered Republican and Democratic voters between March 2020 and December 2021 adjusted for age and state of voter registration was conducted. Voter and mortality data from Florida and Ohio in 2017 linked to mortality records for January 1, 2018, to December 31, 2021, were used in data analysis. Exposures Political party affiliation. Main Outcomes and Measures Excess weekly deaths during the COVID-19 pandemic adjusted for age, county, party affiliation, and seasonality. Results Between January 1, 2018, and December 31, 2021, there were 538 159 individuals in Ohio and Florida who died at age 25 years or older in the study sample. The median age at death was 78 years (IQR, 71-89 years). Overall, the excess death rate for Republican voters was 2.8 percentage points, or 15%, higher than the excess death rate for Democratic voters (95% prediction interval [PI], 1.6-3.7 percentage points). After May 1, 2021, when vaccines were available to all adults, the excess death rate gap between Republican and Democratic voters widened from -0.9 percentage point (95% PI, -2.5 to 0.3 percentage points) to 7.7 percentage points (95% PI, 6.0-9.3 percentage points) in the adjusted analysis; the excess death rate among Republican voters was 43% higher than the excess death rate among Democratic voters. The gap in excess death rates between Republican and Democratic voters was larger in counties with lower vaccination rates and was primarily noted in voters residing in Ohio. Conclusions and Relevance In this cross-sectional study, an association was observed between political party affiliation and excess deaths in Ohio and Florida after COVID-19 vaccines were available to all adults. These findings suggest that differences in vaccination attitudes and reported uptake between Republican and Democratic voters may have been factors in the severity and trajectory of the pandemic in the US.
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Affiliation(s)
- Jacob Wallace
- Yale School of Public Health, New Haven, Connecticut
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25
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Smith MH, Broscoe M, Chakraborty P, Hill J, Hood R, McGowan M, Bessett D, Norris AH. COVID-19 and abortion in the Ohio River Valley: A case study of Kentucky, Ohio, and West Virginia. Perspect Sex Reprod Health 2023; 55:178-191. [PMID: 37571959 DOI: 10.1363/psrh.12244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/13/2023]
Abstract
INTRODUCTION During early stages of COVID-19 in the United States, government representatives in Kentucky, Ohio, and West Virginia restricted or threatened to restrict abortion care under elective surgery bans. We examined how abortion utilization changed in these states. METHODOLOGY We examined COVID-19 abortion-related state policies implemented in March and April 2020 using publicly available sources. We analyzed data on abortions by method and gestation and experiences of facility staff, using a survey of 14 facilities. We assessed abortions that took place in February-June 2020 and February-June 2021. RESULTS In February-June 2020 the monthly average abortion count was 1916; 863 (45%) were medication abortions and 229 (12%) were ≥14 weeks gestation. Of 1959 abortions performed across all three states in April 2020, 1319 (67%) were medication abortions and 231 (12%) were ≥14 weeks gestation. The shift toward medication abortion that took place in April 2020 was not observed in April 2021. Although the total abortion count in the three-state region remained steady, West Virginia had the greatest decline in total abortions, Ohio experienced a shift from instrumentation to medication abortions, and Kentucky saw little change. Staff reported increased stress from concerns over health and safety and increased scrutiny by the state and anti-abortion protesters. DISCUSSION Although abortion provision continued in this region, policy changes restricting abortion in Ohio and West Virginia resulted in a decrease in first trimester instrumentation abortions, an overall shift toward medication abortion care, and an increase in stress among facility staff during the early phase of COVID-19.
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Affiliation(s)
- Mikaela H Smith
- Division of Epidemiology, College of Public Health, Ohio State University, Columbus, Ohio, USA
| | - Molly Broscoe
- Department of Sociology, University of Cincinnati, Cincinnati, Ohio, USA
| | - Payal Chakraborty
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Jessie Hill
- Case Western Reserve University School of Law, Cleveland, Ohio, USA
| | - Robert Hood
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Michelle McGowan
- Biomedical Ethics Research Program, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
- Department of Women's, Gender & Sexuality Studies, University of Cincinnati, Cincinnati, Ohio, USA
| | - Danielle Bessett
- Department of Sociology, University of Cincinnati, Cincinnati, Ohio, USA
| | - Alison H Norris
- Division of Epidemiology, College of Public Health, Ohio State University, Columbus, Ohio, USA
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26
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Clevenger LM, Wrenn JD, Bena J, Sodhi G, Tullio K, Singh AD. Clustering of uveal melanoma: County wide analysis within Ohio. PLoS One 2023; 18:e0290284. [PMID: 37594976 PMCID: PMC10437964 DOI: 10.1371/journal.pone.0290284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 07/19/2023] [Indexed: 08/20/2023] Open
Abstract
PURPOSE To determine if a greater than expected number of cases (clustering) of uveal melanoma occurred within Ohio for any specific region or time period as compared to others. DESIGN Analysis of population database. METHODS Ohio Cancer Incidence Surveillance System (OCISS) database (2000-2019) was accessed for the diagnosis of uveal melanoma using the International Classification of Disease for Oncology codes: C69.3 (choroid), C69.4 (ciliary body and iris). Counties within Ohio were grouped by geographic regions (7) and socioeconomic variables. Age- and race-standardized incidence ratios (SIR) were calculated to determine temporal or geographic clustering. RESULTS Over the twenty-year period, the total number of uveal melanoma cases reported within Ohio were 1,617 with the overall age-adjusted annual incidence of 6.72 cases per million population (95% CI 6.30-7.16). There was an increase in the incidence of uveal melanoma over 20 years (p<0.001) across seven geographic regions, but no significant difference in incidence rates between the regions. There was no difference in incidence based on county classification by age composition (p = 0.14) or education level (p = 0.11). Counties with a low median household income (p<0.001), those classified as urban (p = 0.004), and those with a greater minority population (p = 0.004) had lower incidence. Less populated counties had a higher incidence of uveal melanoma (p<0.001). CONCLUSIONS There is no evidence of geographic or temporal clustering of uveal melanoma within Ohio from 2000 to 2019.
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Affiliation(s)
- Leanne M. Clevenger
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Jacquelyn D. Wrenn
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - James Bena
- Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Guneet Sodhi
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Katherine Tullio
- Cancer Health Analytics, Taussig Cancer Institute, Cleveland Clinic and Health Equity (Ohio), CareSource, Columbus, Ohio, United States of America
| | - Arun D. Singh
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
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Tiller EC, Masters NB, Raines KL, Mathis AD, Crooke SN, Zwickl RC, French GK, Alexy ER, Koch EM, Tucker NE, Wilson EM, Krauss TS, Leasure E, Budd J, Billing LM, Dewart C, Tarter K, Dickerson K, Iyer R, Jones AN, Halabi KC, Washam MC, Sugerman DE, Roberts MW. Notes from the Field: Measles Outbreak - Central Ohio, 2022-2023. MMWR Morb Mortal Wkly Rep 2023; 72:847-849. [PMID: 37535476 PMCID: PMC10414998 DOI: 10.15585/mmwr.mm7231a3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
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28
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Gaughan C, Sorrentino KM, Liew Z, Johnson NP, Clark CJ, Soriano M, Plano J, Plata DL, Saiers JE, Deziel NC. Residential proximity to unconventional oil and gas development and birth defects in Ohio. Environ Res 2023; 229:115937. [PMID: 37076028 PMCID: PMC10198955 DOI: 10.1016/j.envres.2023.115937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 03/30/2023] [Accepted: 04/16/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Chemicals used or emitted by unconventional oil and gas development (UOGD) include reproductive/developmental toxicants. Associations between UOGD and certain birth defects were reported in a few studies, with none conducted in Ohio, which experienced a thirty-fold increase in natural gas production between 2010 and 2020. METHODS We conducted a registry-based cohort study of 965,236 live births in Ohio from 2010 to 2017. Birth defects were identified in 4653 individuals using state birth records and a state surveillance system. We assigned UOGD exposure based on maternal residential proximity at birth to active UOG wells and a metric specific to the drinking-water exposure pathway that identified UOG wells hydrologically connected to a residence ("upgradient UOG wells"). We estimated odds ratios (ORs) and 95% confidence intervals (CIs) for all structural birth defects combined and specific birth defect types using binary exposure metrics (presence/absence of any UOG well and presence/absence of an upgradient UOG well within 10 km), adjusting for confounders. Additionally, we conducted analyses stratified by urbanicity, infant sex, and social vulnerability. RESULTS The odds of any structural defect were 1.13 times higher in children born to mothers living within 10 km of UOGD than those born to unexposed mothers (95%CI: 0.98-1.30). Odds were elevated for neural tube defects (OR: 1.57, 95%CI: 1.12-2.19), limb reduction defects (OR: 1.99, 95%CI: 1.18-3.35), and spina bifida (OR 1.93; 95%CI 1.25-2.98). Hypospadias (males only) was inversely related to UOGD exposure (OR: 0.62, 95%CI: 0.43-0.91). Odds of any structural defect were greater in magnitude but less precise in analyses using the hydrological-specific metric (OR: 1.30; 95%CI: 0.85-1.90), in areas with high social vulnerability (OR: 1.27, 95%CI: 0.99-1.60), and among female offspring (OR: 1.28, 95%CI: 1.06-1.53). CONCLUSIONS Our results suggest a positive association between UOGD and certain birth defects, and findings for neural tube defects corroborate results from prior studies.
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Affiliation(s)
- Casey Gaughan
- Department of Ecology and Evolutionary Biology, Yale College, New Haven, CT, USA; Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Keli M Sorrentino
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Zeyan Liew
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Nicholaus P Johnson
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Cassandra J Clark
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Mario Soriano
- Yale School of the Environment, Yale University, New Haven, CT, USA; High Meadows Environmental Institute, Princeton University, Princeton, NJ, USA
| | - Julie Plano
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Desiree L Plata
- Civil and Environmental Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - James E Saiers
- Yale School of the Environment, Yale University, New Haven, CT, USA
| | - Nicole C Deziel
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA.
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Kline D, Waller LA, McKnight E, Bonny A, Miller WC, Hepler SA. A Dynamic Spatial Factor Model to Describe the Opioid Syndemic in Ohio. Epidemiology 2023; 34:487-494. [PMID: 37155617 PMCID: PMC10591492 DOI: 10.1097/ede.0000000000001617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
BACKGROUND The opioid epidemic has been ongoing for over 20 years in the United States. As opioid misuse has shifted increasingly toward injection of illicitly produced opioids, it has been associated with HIV and hepatitis C transmission. These epidemics interact to form the opioid syndemic. METHODS We obtain annual county-level counts of opioid overdose deaths, treatment admissions for opioid misuse, and newly diagnosed cases of acute and chronic hepatitis C and newly diagnosed HIV from 2014 to 2019. Aligned with the conceptual framework of syndemics, we develop a dynamic spatial factor model to describe the opioid syndemic for counties in Ohio and estimate the complex synergies between each of the epidemics. RESULTS We estimate three latent factors characterizing variation of the syndemic across space and time. The first factor reflects overall burden and is greatest in southern Ohio. The second factor describes harms and is greatest in urban counties. The third factor highlights counties with higher than expected hepatitis C rates and lower than expected HIV rates, which suggests elevated localized risk for future HIV outbreaks. CONCLUSIONS Through the estimation of dynamic spatial factors, we are able to estimate the complex dependencies and characterize the synergy across outcomes that underlie the syndemic. The latent factors summarize shared variation across multiple spatial time series and provide new insights into the relationships between the epidemics within the syndemic. Our framework provides a coherent approach for synthesizing complex interactions and estimating underlying sources of variation that can be applied to other syndemics.
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Affiliation(s)
- David Kline
- From the Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - Lance A Waller
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Erin McKnight
- Division of Adolescent Medicine, Nationwide Children's Hospital, Columbus, OH
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH
| | - Andrea Bonny
- Division of Adolescent Medicine, Nationwide Children's Hospital, Columbus, OH
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH
| | - William C Miller
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH
| | - Staci A Hepler
- Department of Statistical Sciences, College of Arts and Sciences, Wake Forest University, Winston-Salem, NC
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Rempe G, Petranovich C, Narad ME, Yeates KO, Taylor HG, Stancin T, Wade S. Trajectories of Executive Functions After Early Childhood Traumatic Brain Injury: Teacher Ratings in the Initial 81 Months Postinjury. J Head Trauma Rehabil 2023; 38:E203-E211. [PMID: 36730995 PMCID: PMC10102250 DOI: 10.1097/htr.0000000000000833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To explore teacher-rated trajectories of executive functioning (EF) after early childhood traumatic brain injury (TBI) and to identify injury-related, academic, and family factors associated with growth trajectories using latent class growth analysis. PARTICIPANTS A total of 121 children who sustained a TBI or orthopedic injury (OI) between the ages of 3 and 7 years were recruited from 3 tertiary care children's hospitals and a general hospital in Ohio, including 57 with moderate or severe TBI and 64 with OI. DESIGN Assessments were completed at baseline (0-3 months postinjury) and an average of 6, 12, 18, and 81 months postinjury. Changes in teacher-rated EF were modeled across time and heterogeneity in recovery and moderating factors was examined. MEASURES Study variables included participant demographics, teacher-rated EF (Behavior Rating Inventory of Executive Function), family functioning (McMaster Family Assessment Device), and parenting style (Parenting Practices Questionnaire). RESULTS Analysis of teacher-rated EF yielded 2 trajectories: Normative (64.71%) and At-Risk (35.29%). Traumatic brain injury was a weak predictor of membership in the At-Risk trajectory ( P = .05). Membership in the At-Risk trajectory (compared with Normative category) was associated with a higher incidence of Individualized Education Programs, higher baseline EF concerns, increased endorsement of authoritarian parenting, lower socioeconomic status, and non-White race. CONCLUSION Teacher-rated EF after pediatric TBI differs from OI. Increased EF concerns over time were associated with increased baseline EF and characteristics of the home and school environment. These findings extend previous research on recovery of EF to educational settings and outline potentially modifiable risk factors that can maximize success in the school settings for children who experience early-childhood traumatic injury.
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Affiliation(s)
- Gary Rempe
- Neuropsychological Services of New Mexico, Albuquerque, New Mexico (Dr Rempe); Children's Hospital Colorado and the University of Colorado School of Medicine, Department of Rehabilitation Medicine, Aurora, Colorado (Dr Petranovich); Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio (Dr Narad); Department of Psychology, Alberta Children's Hospital Research Institute and Hotchkiss Brain Institute, University of Calgary, Alberta, Calgary (Dr Yeates); Abigail Wexner Research Institute, Nationwide Children's Hospital and Department of Pediatrics, The Ohio State University, Columbus, Ohio (Dr Taylor); MetroHealth Medical Center, Cleveland, Ohio (Dr Stancin); Department of Rehabilitation, Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, Cincinnati, Ohio (Dr Wade)
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Farrington M, Elenz J, Ginsberg M, Chiu CY, Miller S, Pangonis SF. Powassan Virus Infection Detected by Metagenomic Next-Generation Sequencing, Ohio, USA. Emerg Infect Dis 2023; 29:838-841. [PMID: 36958034 PMCID: PMC10045675 DOI: 10.3201/eid2904.221005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023] Open
Abstract
We describe a 4-year-old male patient in Ohio, USA, who had encephalitis caused by Powassan virus lineage 2. Virus was detected by using metagenomic next-generation sequencing and confirmed with IgM and plaque reduction neutralization assays. Clinicians should recognize changing epidemiology of tickborne viruses to enhance encephalitis diagnosis and management.
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32
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Eom KY, Berg KA, Joseph NE, Runner K, Tarabichi Y, Khiyami A, Perzynski AT, Sossey-Alaoui K. Neighborhood and racial influences on triple negative breast cancer: evidence from Northeast Ohio. Breast Cancer Res Treat 2023; 198:369-381. [PMID: 36781520 PMCID: PMC10716786 DOI: 10.1007/s10549-023-06883-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 02/02/2023] [Indexed: 02/15/2023]
Abstract
PURPOSE Triple negative breast cancer (TNBC) is an aggressive subtype of breast cancer (BC) with higher recurrence rates and poorer prognoses and most prevalent among non-Hispanic Black women. Studies of multiple health conditions and care processes suggest that neighborhood socioeconomic position is a key driver of health disparities. We examined roles of patients' neighborhood-level characteristics and race on prevalence, stage at diagnosis, and mortality among patients diagnosed with BC at a large safety-net healthcare system in Northeast Ohio. METHODS We used tumor registry to identify BC cases from 2007 to 2020 and electronic health records and American Community Survey for individual- and area-level factors. We performed multivariable regression analyses to estimate associations between neighborhood-level characteristics, measured by the Area Deprivation Index (ADI), race and comparative TNBC prevalence, stage at diagnosis, and total mortality. RESULTS TNBC was more common among non-Hispanic Black (53.7%) vs. non-Hispanic white patients (46.4%). Race and ADI were individually significant predictors of TNBC prevalence, stage at diagnosis, and total mortality. Race remained significantly associated with TNBC subtype, adjusting for covariates. Accounting for TNBC status, a more disadvantaged neighborhood was significantly associated with a worse stage at diagnosis and higher death rates. CONCLUSION Our findings suggest that both neighborhood socioeconomic position and race are strongly associated with TNBC vs. other BC subtypes. The burden of TNBC appears to be highest among Black women in the most socioeconomically disadvantaged neighborhoods. Our study suggests a complex interplay of social conditions and biological disease characteristics contributing to racial disparities in BC outcomes.
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Affiliation(s)
- Kirsten Y Eom
- Center for Health Care Research and Policy, The MetroHealth System and Case Western Reserve University, 2500 MetroHealth Dr. Rammelkamp Building R225, Cleveland, OH, 44109, USA.
| | - Kristen A Berg
- Center for Health Care Research and Policy, The MetroHealth System and Case Western Reserve University, 2500 MetroHealth Dr. Rammelkamp Building R225, Cleveland, OH, 44109, USA
| | - Natalie E Joseph
- Division of Surgical Oncology, MetroHealth Medical Center and Case Western Reserve University, Cleveland, OH, USA
| | - Kristen Runner
- Division of Surgical Oncology, MetroHealth Medical Center and Case Western Reserve University, Cleveland, OH, USA
| | - Yasir Tarabichi
- Division of Pulmonary, Critical Care, and Sleep Medicine, MetroHealth Medical Center of Case Western Reserve University, Cleveland, OH, USA
| | - Amer Khiyami
- Department of Pathology, MetroHealth Medical Center, Cleveland, OH, USA
| | - Adam T Perzynski
- Center for Health Care Research and Policy, The MetroHealth System and Case Western Reserve University, 2500 MetroHealth Dr. Rammelkamp Building R225, Cleveland, OH, 44109, USA
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KhudaBukhsh WR, Khalsa SK, Kenah E, Rempała GA, Tien JH. COVID-19 dynamics in an Ohio prison. Front Public Health 2023; 11:1087698. [PMID: 37064663 PMCID: PMC10098107 DOI: 10.3389/fpubh.2023.1087698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 02/20/2023] [Indexed: 03/31/2023] Open
Abstract
Incarcerated individuals are a highly vulnerable population for infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Understanding the transmission of respiratory infections within prisons and between prisons and surrounding communities is a crucial component of pandemic preparedness and response. Here, we use mathematical and statistical models to analyze publicly available data on the spread of SARS-CoV-2 reported by the Ohio Department of Rehabilitation and Corrections (ODRC). Results from mass testing conducted on April 16, 2020 were analyzed together with time of first reported SARS-CoV-2 infection among Marion Correctional Institution (MCI) inmates. Extremely rapid, widespread infection of MCI inmates was reported, with nearly 80% of inmates infected within 3 weeks of the first reported inmate case. The dynamical survival analysis (DSA) framework that we use allows the derivation of explicit likelihoods based on mathematical models of transmission. We find that these data are consistent with three non-exclusive possibilities: (i) a basic reproduction number >14 with a single initially infected inmate, (ii) an initial superspreading event resulting in several hundred initially infected inmates with a reproduction number of approximately three, or (iii) earlier undetected circulation of virus among inmates prior to April. All three scenarios attest to the vulnerabilities of prisoners to COVID-19, and the inability to distinguish among these possibilities highlights the need for improved infection surveillance and reporting in prisons.
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Affiliation(s)
- Wasiur R. KhudaBukhsh
- School of Mathematical Sciences, The University of Nottingham, Nottingham, United Kingdom
| | - Sat Kartar Khalsa
- Wexner Medical Center, The Ohio State University, Columbus, OH, United States
| | - Eben Kenah
- Division of Biostatistics, The Ohio State University, Columbus, OH, United States
| | - Gregorz A. Rempała
- Division of Biostatistics, Department of Mathematics, The Ohio State University, Columbus, OH, United States
| | - Joseph H. Tien
- Division of Epidemiology, Department of Mathematics, The Ohio State University, Columbus, OH, United States
- *Correspondence: Joseph H. Tien
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KhudaBukhsh WR, Bastian CD, Wascher M, Klaus C, Sahai SY, Weir MH, Kenah E, Root E, Tien JH, Rempała GA. Projecting COVID-19 cases and hospital burden in Ohio. J Theor Biol 2023; 561:111404. [PMID: 36627078 PMCID: PMC9824941 DOI: 10.1016/j.jtbi.2022.111404] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 12/13/2022] [Accepted: 12/26/2022] [Indexed: 01/09/2023]
Abstract
As the Coronavirus 2019 disease (COVID-19) started to spread rapidly in the state of Ohio, the Ecology, Epidemiology and Population Health (EEPH) program within the Infectious Diseases Institute (IDI) at The Ohio State University (OSU) took the initiative to offer epidemic modeling and decision analytics support to the Ohio Department of Health (ODH). This paper describes the methodology used by the OSU/IDI response modeling team to predict statewide cases of new infections as well as potential hospital burden in the state. The methodology has two components: (1) A Dynamical Survival Analysis (DSA)-based statistical method to perform parameter inference, statewide prediction and uncertainty quantification. (2) A geographic component that down-projects statewide predicted counts to potential hospital burden across the state. We demonstrate the overall methodology with publicly available data. A Python implementation of the methodology is also made publicly available. This manuscript was submitted as part of a theme issue on "Modelling COVID-19 and Preparedness for Future Pandemics".
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Affiliation(s)
- Wasiur R KhudaBukhsh
- School of Mathematical Sciences, University of Nottingham, University Park Nottingham NG7 2RD, United Kingdom.
| | - Caleb Deen Bastian
- Program in Applied and Computational Mathematics, Princeton University, Fine Hall, Washington Road, Princeton, NJ 08544, USA.
| | - Matthew Wascher
- Department of Mathematics, University of Dayton, 300 College Park, Dayton, OH 45469, USA.
| | - Colin Klaus
- Mathematical Biosciences Institute, The Ohio State University, 1735 Neil Avenue, Columbus, OH 43210, USA; College of Public Health, The Ohio State University, Cunz Hall, 1841 Neil Avenue, Columbus, OH 43210, USA; Infectious Diseases Institute, 208 Bricker Hall, 190 North Oval Mall, Columbus, OH 43210-1358, USA.
| | - Saumya Yashmohini Sahai
- Department of Computer Science and Engineering, The Ohio State University, 395 Dreese Laboratories, 2015 Neil Avenue, Columbus, OH 43210, USA.
| | - Mark H Weir
- College of Public Health, The Ohio State University, Cunz Hall, 1841 Neil Avenue, Columbus, OH 43210, USA; Infectious Diseases Institute, 208 Bricker Hall, 190 North Oval Mall, Columbus, OH 43210-1358, USA; The Sustainability Institute, The Ohio State University, 74 W. 18th Avenue, Columbus, OH 43210, USA.
| | - Eben Kenah
- College of Public Health, The Ohio State University, Cunz Hall, 1841 Neil Avenue, Columbus, OH 43210, USA; Infectious Diseases Institute, 208 Bricker Hall, 190 North Oval Mall, Columbus, OH 43210-1358, USA.
| | - Elisabeth Root
- Institute for Disease Modeling, The Bill & Melinda Gates Foundation, Seattle, WA, USA.
| | - Joseph H Tien
- Mathematical Biosciences Institute, The Ohio State University, 1735 Neil Avenue, Columbus, OH 43210, USA; College of Public Health, The Ohio State University, Cunz Hall, 1841 Neil Avenue, Columbus, OH 43210, USA; Infectious Diseases Institute, 208 Bricker Hall, 190 North Oval Mall, Columbus, OH 43210-1358, USA; Department of Mathematics, The Ohio State University, 231 West 18th Avenue, Columbus, OH 43210-1174, USA.
| | - Grzegorz A Rempała
- Mathematical Biosciences Institute, The Ohio State University, 1735 Neil Avenue, Columbus, OH 43210, USA; College of Public Health, The Ohio State University, Cunz Hall, 1841 Neil Avenue, Columbus, OH 43210, USA; Infectious Diseases Institute, 208 Bricker Hall, 190 North Oval Mall, Columbus, OH 43210-1358, USA; Department of Mathematics, The Ohio State University, 231 West 18th Avenue, Columbus, OH 43210-1174, USA.
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Sun W. The Devastating Health Consequences of the Ohio Derailment: A Closer Look at the Effects of Vinyl Chloride Spill. Int J Environ Res Public Health 2023; 20:5032. [PMID: 36981940 PMCID: PMC10049189 DOI: 10.3390/ijerph20065032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
On 3 February 2023, a train derailed in the village of East Palestine, Ohio, home to approximately 4700 residents [...].
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Affiliation(s)
- Wenjie Sun
- Center for Health Sciences, Oklahoma State University, 1111 W 17th Street, Tulsa, OK 74107, USA
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Tracy BM, Bergus KC, Hoover EJ, Young AJ, Sims CA, Wahl WL, Valdez CL. Fatal opioid overdoses geospatially cluster with level 1 trauma centers in Ohio. Surgery 2023; 173:788-793. [PMID: 36253312 DOI: 10.1016/j.surg.2022.08.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 08/01/2022] [Accepted: 08/05/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Ohio is consistently ranked as one of the worst states for opioid overdose deaths. Traumatic injury has been linked to opioid overdose deaths, yet the location of trauma centers has not been explored. We examined whether geospatial clustering occurred between county-level opioid overdose deaths (OODs) and trauma center levels. METHODS We obtained 2019 county-level data from the Ohio Department of Health for fatal overdoses from prescription opioids. We obtained the total number of opioid doses prescribed in 2019 per county from the Ohio Automated Rx Reporting System and American College of Surgeons designated trauma center locations within Ohio from their website. We used geospatial analysis to assess if clustering occurred between trauma center level and prescription opioid overdose deaths at a county level. RESULTS There were 42 trauma centers located within 21 counties: 7 counties had level 1, and 14 counties had only level 2/level 3. There was no difference in rates of opioid doses prescribed per 100,000 people between counties with level 1 trauma centers and only level 2/level 3. However, prescription OODs rates were significantly higher in counties with level 1 trauma centers (37.6 vs 20, P = .02). Geospatial clustering was observed between level 1 trauma centers and prescription opioid overdose deaths at the county level (P < .01). CONCLUSION Geospatial clustering exists between prescription OODs and level 1 trauma center locations in Ohio. Improved at-risk patient identification and targeted community outreach represent opportunities for trauma providers to tackle the opioid epidemic.
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Affiliation(s)
- Brett M Tracy
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.
| | - Katherine C Bergus
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Erin J Hoover
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Andrew J Young
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Carrie A Sims
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Wendy L Wahl
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Carrie L Valdez
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
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Uwishema O, Anis H, El Kassem S, Hamitoglu AE, Essayli D, Nazir A. Recent measles outbreak in unvaccinated children in Ohio: cause and causality - a correspondence. Int J Surg 2023; 109:196-197. [PMID: 36799850 PMCID: PMC10389341 DOI: 10.1097/js9.0000000000000215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 01/05/2023] [Indexed: 02/18/2023]
Affiliation(s)
- Olivier Uwishema
- Oli Health Magazine Organization, Research, and Education, Kigali, Rwanda
- Clinton Global Initiative University, New York, USA
- Faculty of Medicine, Karadeniz Technical University, Trabzon
| | - Heeba Anis
- Oli Health Magazine Organization, Research, and Education, Kigali, Rwanda
- Deccan College of Medical Sciences, Hyderabad, Telangana, India
| | - Sarah El Kassem
- Oli Health Magazine Organization, Research, and Education, Kigali, Rwanda
- Faculty of Medicine, Beirut Arab University, Beirut
| | - Ali E. Hamitoglu
- Oli Health Magazine Organization, Research, and Education, Kigali, Rwanda
- Namik Kemal University Faculty of Medicine, Merkez/Tekirdag, Turkey
| | - Dina Essayli
- Oli Health Magazine Organization, Research, and Education, Kigali, Rwanda
- Lebanese University – Faculty of Medicine, Hadat Campus, Lebanon
| | - Abubakar Nazir
- Oli Health Magazine Organization, Research, and Education, Kigali, Rwanda
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
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Shadik JA, Perkins NH, Heller N. Child welfare workers satisfaction and wellbeing during the COVID-19 pandemic: Perspectives of agency staff in Ohio. Child Abuse Negl 2023; 136:106000. [PMID: 36565583 PMCID: PMC9767888 DOI: 10.1016/j.chiabu.2022.106000] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 12/10/2022] [Accepted: 12/15/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The COVID-19 pandemic has impacted the lives of children and families, created additional stressors, and increased risks for maltreatment. The pandemic has changed the way child welfare agencies operate, requiring changes to policies and practice. Minimal research has considered the effects of the COVID-19 pandemic on child welfare workers wellbeing and job satisfaction. OBJECTIVE This mixed-methods research study seeks to understand CPS staff satisfaction, variables impacting satisfaction, and challenges that increased since the pandemic began for child welfare workers in Ohio. PARTICIPANTS AND SETTING A sample of staff members (n = 267) from 50 CPS agencies across Ohio participated in the study. METHODS This mixed-methods study used logistic regression, chi square analyses, and thematic analysis to analyze the data from a survey sent to child welfare agencies in Ohio. RESULTS Caring for minor children, primary role at work, and years in child welfare were significantly associated with job satisfaction. Those working in foster care/placement, adoption/permanency, family support/visitation, kinship were 7.57 times more likely than those doing intake/investigation work to be satisfied with their job (p = .007). Thematic analysis of staff issues that increased during the pandemic resulted in six themes: Stress and Anxiety, Feeling Overwhelmed, Burnout, All, Motivation, and Isolation and Disconnection. CONCLUSIONS The COVID-19 pandemic has created additional stressors for child welfare staff. Practice implications are discussed to help increase job satisfaction, staff wellbeing, and mitigate turnover.
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Affiliation(s)
- Jennifer A Shadik
- Department of Social Work, Ohio University, Morton Hall 535, Athens, OH 45701, United States of America.
| | - Nathan H Perkins
- School of Social Work, Loyola University Chicago, 820 N Michigan Ave., Chicago, IL 60611, United States of America.
| | - Natalie Heller
- Communication Sciences and Disorders, Ohio University, Grover Center W218, Athens, OH 45701, United States of America.
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Ronis SD, Selvaraj D, Albert JM, Koroukian SM, Nelson S. Dental Caries in Medicaid-Insured Preschool Children With or Without Special Health Care Needs in Northeast Ohio. JAMA Netw Open 2023; 6:e230999. [PMID: 36853605 PMCID: PMC9975899 DOI: 10.1001/jamanetworkopen.2023.0999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
IMPORTANCE Children with special health care needs (CSHCN) are recognized to be at increased risk of developing dental caries (decay). Evidence is mixed regarding the association of preventive oral health care delivered by pediatric primary care clinicians with caries experience among CSHCN. OBJECTIVE To investigate caries experience, including untreated decay, among Medicaid-enrolled preschoolers with or without special health care needs. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used baseline data from the Pediatric Providers Against Cavities in Children's Teeth study, a cluster-randomized hybrid effectiveness-implementation trial conducted among 1022 Medicaid-enrolled preschoolers aged 3 to 6 years attending well-child visits at 18 participating community pediatric primary care practices in northeast Ohio. Baseline data were collected from November 1, 2017, to August 31, 2019, with statistical analyses conducted from April to August 2022. EXPOSURES Presence of special health care needs, as assessed by applying the Pediatric Medical Complexity Algorithm to International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes, was abstracted from electronic medical records. CSHCN were defined as having either noncomplex chronic disease (presence of only 1 nonprogressive chronic condition, or multiple nonprogressive chronic conditions in a single body system) or complex chronic disease (presence of any progressive chronic condition, malignant neoplasm, or significant chronic conditions involving multiple body systems). MAIN OUTCOMES AND MEASURES Untreated dental decay and caries experience as assessed through clinical dental examinations using International Caries Detection and Assessment System criteria. RESULTS A total of 1022 children aged 3 to 6 years from 18 practices were enrolled in the study. The mean (SD) age of the study population was 4.3 (1.1) years, 554 (54.2%) were boys, and of 988 with data on race and ethnicity, 451 (45.6%) were Black. Of these, 301 of 1019 (29.5%) had a likely special health care need (225 with noncomplex chronic conditions and 76 with complex chronic conditions). The most frequent chronic conditions included asthma (n = 209) and mental or behavioral health disorders (n = 146), including attention-deficit/hyperactivity disorder, autism, and developmental delays. Overall, 296 children (29.0%) had untreated decay, and 378 (37.0%) had caries experience (decayed and filled teeth). Accounting for sociodemographic characteristics, CSHCN had 34% reduced odds of untreated decay (adjusted odds ratio [AOR], 0.66 [95% CI, 0.48-0.92]) compared with those with without chronic disease. In addition, caries experience was lower among CSHCN (AOR, 0.79 [95% CI, 0.60-1.04]). CONCLUSIONS AND RELEVANCE In this cross-sectional study of Medicaid-enrolled children who attended well-child visits as preschoolers, untreated dental decay was lower among CSHCN compared with those without chronic conditions. This study suggests that CSHCN may have had better access to the various types of dental care facilitated in medical settings.
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Affiliation(s)
- Sarah D. Ronis
- UH Rainbow Center for Child Health & Policy, Cleveland, Ohio
- Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - David Selvaraj
- Department of Community Dentistry, Case Western Reserve University School of Dental Medicine, Cleveland, Ohio
| | - Jeffrey M. Albert
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Siran M. Koroukian
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Suchitra Nelson
- Department of Community Dentistry, Case Western Reserve University School of Dental Medicine, Cleveland, Ohio
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio
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Morgan E, Dyar C, Feinstein BA, Ricks J. PrEP use and stigma among a sample of older adults in Columbus, Ohio. Int J STD AIDS 2023; 34:122-129. [PMID: 36424190 PMCID: PMC10113038 DOI: 10.1177/09564624221140967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Despite older adults (age ≥50 years) continuing to account for 1 in 6 new HIV diagnoses, the majority of research has focused on young adults. Assessing PrEP use and stigma among this understudied population is key to achieving the U.S.'s goals of Ending the HIV Epidemic, a federal initiative focusing on reducing new HIV infections by at least 90% by 2030. METHODS Data for this analysis came from the Columbus Health Aging Project (N = 794). This study was designed to assess several domains of health among adults aged 50 years and older in Columbus, Ohio. Multiple logistic and linear regression models were used to examine the associations between sociodemographic factors and past 6-month PrEP use, PrEP stigma, and concurrent use of PrEP and other prevention methods, adjusting for known confounders. RESULTS Overall, 93 (11.7%) participants reported past 6-month PrEP use. Transgender women (aOR = 6.90; 95% CI: 2.19, 21.72), cisgender gay men (aOR = 5.58; 95% CI: 2.49, 12.50), cisgender lesbians (aOR = 2.24; 95% CI: 1.05, 4.80), and those living with family members or roommates (aOR = 6.59; 95% CI: 3.49, 12.45) were each more likely to report past 6-month PrEP use relative to cisgender women, heterosexuals, and those living with a spouse/partner, respectively. Relative to cisgender women, PrEP-related stigma was lower among transgender women (β = -5.05; 95% CI: -8.44, -1.66) and higher among cisgender men (β = 1.96; 95% CI: 0.46, 3.46). CONCLUSION Future research should aim to continue developing a firm understanding of PrEP use and stigma among older adults to reduce HIV risk among this population and to understand unique needs of sub-populations of older adults.
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Affiliation(s)
- Ethan Morgan
- College of Nursing, The Ohio State University, Columbus, OH
- Infectious Disease Institute, The Ohio State University, Columbus, OH
- College of Public Health, The Ohio State University, Columbus, OH
| | - Christina Dyar
- College of Nursing, The Ohio State University, Columbus, OH
| | - Brian A. Feinstein
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL
| | - JaNelle Ricks
- College of Public Health, The Ohio State University, Columbus, OH
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Park D, Lee M, Osborne K, Minnick D. Stress and Depression in Ohio Social Workers during the COVID-19 Pandemic: The Buffering Role of Social Connectedness. Health Soc Work 2023; 48:33-42. [PMID: 36535038 DOI: 10.1093/hsw/hlac033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 11/01/2021] [Accepted: 12/21/2021] [Indexed: 06/17/2023]
Abstract
Although social workers have an elevated risk of infection with COVID-19, no previous studies have investigated the virus's impact on practitioners. Using survey data (N = 441), this study identified associations between stress, depression, and COVID-related factors and explored the role of social connectedness as a moderator for mental health among Ohio social workers. The results of the study showed that among social workers with a positive COVID-19 diagnosis, 70 percent experienced moderate/high levels of stress, and 37 percent met the criteria for clinical depressive symptoms. Results from the multiple regression analyses showed that perceived stress was positively associated with a positive COVID-19 diagnosis for social workers, and depression was positively associated with working with a client with a positive COVID-19 diagnosis. An interaction effect was also identified between social connectedness and social workers' mental health. These findings suggest that the provision of individual or organizational interventions that emphasize social connectedness can help to protect social workers' mental health.
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Affiliation(s)
- Daejun Park
- is assistant professor, Department of Social Work, College of Health Sciences and Professions, Ohio University, Athens, OH 45701, USA
| | - Mingun Lee
- is associate professor, Department of Social Work, College of Health Sciences and Professions, Ohio University, Athens, OH, USA
| | | | - Dane Minnick
- is assistant professor, Department of Social Work, Ball State University, Muncie, IN, USA
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Abstract
This Medical News article discusses an annual report on measles from the World Health Organization and the US Centers for Disease Control and Prevention.
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Borgemenke S, Hughes AS. Social Determinants and Health Disparities Pertaining to Diabetes in Appalachia. J Prim Care Community Health 2023; 14:21501319231192327. [PMID: 37571832 PMCID: PMC10422881 DOI: 10.1177/21501319231192327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 08/13/2023] Open
Abstract
CONTEXT Diabetes poses a significant threat to public health in the United States, with an estimated total prevalence of 37.3 million individuals in 2019, of which 28.7 million were diagnosed and 8.5 million remained undiagnosed. The high prevalence of diabetes imposes a considerable economic burden on the U.S. healthcare system. Appalachian Ohio is disproportionately impacted with southeastern Ohio exhibiting a diabetes prevalence that exceeds the national average by more than twofold and a critical shortage of healthcare providers. OBJECTIVE To quantify the associations between diabetes prevalence and incidence in Ohio counties, considering various factors that impact health and quality-of-life outcomes. METHODS The data used in this study were obtained from the United States Diabetes Surveillance System (USDSS) on the 88 counties in Ohio. Pearson correlation tests were employed to investigate the relationship between diabetes (prevalence and incidence) and social determinants of health. A t-test and multivariate analysis of variance (MANOVA) test were performed to analyze the disparities in diabetes and social determinants between Appalachian and non-Appalachian counties. RESULTS The results of this study demonstrate notable disparities in diabetes prevalence between Appalachian and non-Appalachian counties (P < .001, α = .05). Furthermore, the MANOVA test revealed significant differences between these 2 groups regarding social determinants of health (P < .05). CONCLUSION These findings suggest that Appalachian counties may face a disproportionate impact from health-related factors and experience limited access to healthcare services. The data highlight the need for focused efforts to address the specific challenges faced by Appalachian counties. Improving access to healthcare services in the Appalachian region is paramount to ensure equitable healthcare and enhance the overall health outcomes of affected communities.
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Affiliation(s)
- Samuel Borgemenke
- Ohio University Heritage College of Osteopathic Medicine, Athens, OH, USA
| | - Allyson S. Hughes
- Ohio University Heritage College of Osteopathic Medicine, Athens, OH, USA
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Morgan E, Dyar C, Feinstein BA. Differences in infection and prevention of HIV and other sexually transmitted infections among older adults in Columbus, Ohio. PLoS One 2023; 18:e0282702. [PMID: 36877711 PMCID: PMC9987766 DOI: 10.1371/journal.pone.0282702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 02/21/2023] [Indexed: 03/07/2023] Open
Abstract
INTRODUCTION In the United States, rates of sexually transmitted infections (STIs) have increased year after year for the past six consecutive years. Even so, the majority of research has focused on younger populations with little work examining infections and prevention methods among older adults. METHODS Data come from the Columbus Health Aging Project (N = 794). This study was designed to assess several domains of health among adults aged 50 years and older in Columbus, Ohio with a particular focus on addressing disparities based on sexual and gender identity. Multivariable logistic regression models were used to examine the association between sociodemographic factors and risk of STI acquisition, HIV diagnosis, and several common prevention methods, adjusting for known confounders. RESULTS Key results suggest that cisgender women, intersex individuals, and transgender women are less likely to use condoms relative to cisgender men. Meanwhile, white individuals were least likely to use condoms while bisexual individuals were most likely. Transgender women and those living with family/roommates were most likely to use PrEP/PEP relative to cisgender men and those living with a spouse or partner. Cisgender women, compared to cisgender men, were most likely to report not using any prevention method. CONCLUSION This study highlights the need for better research among older adults in order to ascertain how interventions may be targeted to specific populations. Future research should aim to educate individuals differently based on their specific needs rather than treating older adults as a homogenous population or ignoring their sexually active nature entirely.
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Affiliation(s)
- Ethan Morgan
- College of Nursing, The Ohio State University, Columbus, OH, United States of America
- Infectious Disease Institute, The Ohio State University, Columbus, OH, United States of America
- * E-mail:
| | - Christina Dyar
- College of Nursing, The Ohio State University, Columbus, OH, United States of America
| | - Brian A. Feinstein
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States of America
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Freedman DA, Ciesielski TH, Yamoah O, Borawski EA, Ross KR, Nock NL, Lee EK, Dimitropoulos A, Minnes S, Burkhart K, Ogland-Hand C, Tisch DJ. Improving Surveillance and Epidemic Response in Ohio Childcare Settings. Int J Environ Res Public Health 2022; 19:ijerph192416927. [PMID: 36554817 PMCID: PMC9779310 DOI: 10.3390/ijerph192416927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/29/2022] [Accepted: 12/09/2022] [Indexed: 06/12/2023]
Abstract
At the start of the Coronavirus Disease of 2019 (COVID-19) pandemic, the risk of cases in childcare programs was unknown. Thus, a rapid-response research approach was launched in Ohio childcare settings. Passive surveillance data from a state-operated incident reporting system were evaluated to estimate the number of COVID-19 cases from 15 August 2020 to 1 January 2021. Additionally, active surveillance with self-administered reverse transcriptase-polymerase chain reaction (RT-PCR) tests were conducted among staff at 46 childcare programs. Finally, six zoom-based focus groups with program administrators were used to gain feedback. Staff and children in childcare settings contributed 0.38% and 0.15% of the COVID-19 cases in Ohio during this timeframe, respectively. RT-PCR testing identified 3 unrecognized cases (0.88% of tests), and all occurred when the statewide positivity rate was >5%. Focus groups revealed that access to affordable cleaning supplies, masks, and reliable staffing were critical. Perhaps most importantly, we conclude that expanding the incident reporting system to include a childcare census would allow for the tracking of future health problems with highly valuable incidence rate estimations.
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Affiliation(s)
- Darcy A. Freedman
- Mary Ann Swetland Center for Environmental Health, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
- Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
- Schubert Center for Child Studies, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Timothy H. Ciesielski
- Mary Ann Swetland Center for Environmental Health, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
- Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Owusua Yamoah
- Mary Ann Swetland Center for Environmental Health, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Elaine A. Borawski
- Department of Nutrition, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Kristie R. Ross
- Mary Ann Swetland Center for Environmental Health, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
- University Hospitals of Cleveland, Cleveland, OH 44106, USA
| | - Nora L. Nock
- Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Eun Kyung Lee
- Mary Ann Swetland Center for Environmental Health, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
- Department of Health Law, School of Public Health, Boston University, Policy and Management, Boston, MA 02118, USA
| | - Anastasia Dimitropoulos
- Schubert Center for Child Studies, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Sonia Minnes
- Schubert Center for Child Studies, Case Western Reserve University, Cleveland, OH 44106, USA
| | | | - Callie Ogland-Hand
- Mary Ann Swetland Center for Environmental Health, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
- Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Daniel J. Tisch
- Mary Ann Swetland Center for Environmental Health, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
- Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
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Ricks JM, Spahnie M, Matthews A, Copen CE, Rushmore J, Bernstein KT, Miller WC, Turner AN. Changes in Sexual Behavior Over the COVID-19 Pandemic Among a Community-Based Cohort of Men Who Have Sex With Men in Columbus, Ohio. Sex Transm Dis 2022; 49:844-850. [PMID: 36367583 PMCID: PMC9668357 DOI: 10.1097/olq.0000000000001719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 09/10/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND The purpose was to assess COVID-19 beliefs and attitudes and examine COVID-19-related changes in sexual behavior of men who have sex with men during 3 time periods: April-July 2020 (T1), August-December 2020 (T2), January-May 2021 (T3). METHODS Data were analyzed from 157 men who have sex with men in Ohio recruited to participate in a longitudinal multisite network study of syphilis epidemiology in 3 US cities: Columbus, Ohio; Baltimore, Maryland; and Chicago, Illinois. In April 2020, a COVID-19 module was appended to existing baseline and follow-up surveys to assess beliefs, attitudes, and changes in sexual behavior. Sample characteristics were summarized. Correlations between demographic variables (age, racial identity) and COVID-19 outcomes were examined. RESULTS In response to COVID-19 social distancing restrictions and self-reported anxiety, some men limited sexual activity at T1, but the majority (n = 105 [67%]) continued to engage in sex. The number of men engaging in sex increased over time (T2: n = 124 [79%]; T3: n = 121 [77%]). At T1, men not in a relationship more frequently reported having less sex compared with prepandemic (n = 39 [57%]). By T3, men in a relationship more frequently reported less sex (n = 32 [54%]). Increased anxiety about sex and condom use was positively correlated with identifying as a man of color (P < 0.001). Most of the sample reported either starting or increasing online sexual activity during each time period. CONCLUSIONS Future efforts to target sexual health during a pandemic or other health emergencies should prioritize men of color and address the unique perspective of both single and partnered men.
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Affiliation(s)
- JaNelle M. Ricks
- From the College of Public Health, Ohio State University, Columbus, OH
| | - Morgan Spahnie
- From the College of Public Health, Ohio State University, Columbus, OH
| | - Amiah Matthews
- From the College of Public Health, Ohio State University, Columbus, OH
| | - Casey E. Copen
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Julie Rushmore
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Kyle T. Bernstein
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - William C. Miller
- From the College of Public Health, Ohio State University, Columbus, OH
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Walker DM, Shiu-Yee K, Chen S, DePuccio MJ, Jackson RD, McAlearney AS. Community Coalitions' Perspectives on Engaging with Hospitals in Ohio to Address the Opioid Crisis. Popul Health Manag 2022; 25:729-737. [PMID: 36315182 PMCID: PMC10024063 DOI: 10.1089/pop.2022.0174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Community coalitions have been leading the multisector response to the opioid epidemic in the Unites States. However, with the medicalization of opioid use disorder and changing health care policies, hospitals have moved to the forefront, becoming more active in collaborating with community coalitions. Little is currently known about how community coalitions view and approach collaborating with hospitals despite its importance for understanding and advancing interorganizational approaches to combating the opioid epidemic. Using data from semistructured interviews (n = 119) conducted from November 2019 to January 2020 as part of the HEALing Communities Study (ClinicalTrials.gov: NCT04111939), the authors examined how community coalition members perceive hospital collaborations and explored the opportunities and challenges of these partnerships. They characterized 3 emergent themes: coalition approaches to collaborating with hospitals, barriers to collaboration, and opportunities for sustainable relationships. This new evidence highlights the value that coalitions place on hospital collaborations, as well as mechanisms that may help support ongoing partnerships.
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Affiliation(s)
- Daniel M. Walker
- Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, USA
- CATALYST, The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Karen Shiu-Yee
- CATALYST, The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Sadie Chen
- CATALYST, The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Matthew J. DePuccio
- CATALYST, The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Rebecca D. Jackson
- Center for Clinical and Translational Science and the Division of Endocrinology, Diabetes, and Metabolism, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Ann Scheck McAlearney
- Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, USA
- CATALYST, The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research, College of Medicine, The Ohio State University, Columbus, Ohio, USA
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Doogan NJ, Mack A, Wang J, Crane D, Jackson R, Applegate M, Villani J, Chandler R, Barocas JA. Opioid Use Disorder Among Ohio's Medicaid Population: Prevalence Estimates From 19 Counties Using a Multiplier Method. Am J Epidemiol 2022; 191:2098-2108. [PMID: 36004683 PMCID: PMC10144717 DOI: 10.1093/aje/kwac154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 06/21/2022] [Accepted: 08/19/2022] [Indexed: 02/01/2023] Open
Abstract
The decades-long overdose epidemic in the United States is driven by opioid misuse. Overdoses commonly, although not exclusively, occur in individuals with opioid use disorder (OUD). To allocate adequate resources and develop appropriately scaled public health responses, accurate estimation of the prevalence of OUD is needed. Indirect methods (e.g., a multiplier method) of estimating prevalence of problematic substance-use behavior circumvent some limitations of household surveys and use of administrative data. We used a multiplier method to estimate OUD prevalence among the adult Medicaid population (ages 18-64 years) in 19 Ohio counties that are highly affected by overdose. We used Medicaid claims data and the US National Vital Statistics System overdose death data, which were linked at the person level. A statistical model leveraged opioid-related death rate information from a group with known OUD to estimate prevalence among a group with unknown OUD status given recorded opioid-related deaths in that group. We estimated that 13.6% of the total study population had OUD in 2019. Men (16.7%) had a higher prevalence of OUD than women (11.4%), and persons aged 35-54 had the highest prevalence (16.7%). Our approach to prevalence estimation has important implications for OUD surveillance and treatment in the United States.
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Affiliation(s)
- Nathan J Doogan
- Correspondence to Dr. Nathan J. Doogan, Ohio Colleges of Medicine Government Resource Center, The Ohio State University, 150 Pressey Hall, 1070 Carmack Road, Columbus, OH 43210 (e-mail: )
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Trapl E, Pike Moore S, Osborn C, Gupta N, Love TE, Kinzy TG, Kinsella A, Frank S. Evaluation of Restrictions on Tobacco Sales to Youth Younger Than 21 Years in Cleveland, Ohio, Area. JAMA Netw Open 2022; 5:e2222987. [PMID: 35819781 PMCID: PMC9277498 DOI: 10.1001/jamanetworkopen.2022.22987] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 06/04/2022] [Indexed: 11/14/2022] Open
Abstract
Importance Tobacco 21 (T21) policies raise the minimum legal age to purchase tobacco from 18 to 21 years to curb youth access to tobacco products. While some studies have found that T21 is associated with reducing prevalence of youth tobacco use, little is known about the impact it may have on youth of different racial and ethnic identities. Objective To evaluate the association of T21 policy with the prevalence of high school youth tobacco use across sex, race, and ethnicity. Design, Setting, and Participants This survey study used representative survey data collected from the local biennial Youth Risk Behavior Survey from 2013 to 2017 comparing Cleveland, Ohio (which has a T21 policy), to proximal jurisdictions in the first-ring suburbs in Cuyahoga County (which do not have T21 policies). Within-Cleveland demographic information was also collected for 2013 to 2019. Overall high school youth tobacco use rates were compared between Cleveland and the first-ring suburbs and then examined within Cleveland among Hispanic, non-Hispanic Black, and non-Hispanic White high school students. Percentage data were adjusted to more closely align with local population demographics. Data were analyzed from January to June 2022. Exposures T21 was implemented in Cleveland in 2016 and not adopted in proximal jurisdictions or at the state and federal level until at least 1 year later. Main Outcomes and Measures The main outcomes were prevalence of past 30-day cigarette, cigar product, or e-cigarette use, measured using geographically representative high school youth survey data from 2013 to 2015 (prelegislation) and 2017 to 2019 (postlegislation) and compared using a difference-in-differences analysis. Results The unweighted sample included 12 616 high school students (27.0% [95% CI, 26.9%-28.0%] in 10th grade; 50.9% [95% CI, 50.3%-51.6%] females) participating in 1 or more Youth Risk Behavior Surveys from 2013 to 2019, including 7064 students in Cleveland and 5552 students in the first-ring suburbs. Compared with the first-ring suburbs, Cleveland had a greater proportion of younger students (1623 [28.5%] ninth grade students vs 2179 [34.0%] ninth grade students) and Hispanic students (436 students [1.1%] vs 1433 students [12.6%]) and non-Hispanic Black students (2000 students [53.1%] vs 3971 students [75.1%]). Cigars were the most commonly used tobacco product in Cleveland, with use reported by 6201 students (19.8%) in 2013, 5877 students (21.3%) in 2015, and 5784 students (16.8%) in 2019. Compared with the first-ring suburbs, there was a greater decline in prevalence of use of cigars in Cleveland (β = 0.18 [SE, 0.05]; P < .001). The disparity across race, ethnicity, and sex decreased for all current tobacco product use. For example, the maximum difference between demographic subpopulations in current cigarette use was 11.6 (95% CI, 9.5-13.7) percentage points in 2013 between White females (16.1% [95% CI, 11.3%-20.8%]) and Black males (4.5% [95% CI, 3.5%-5.4%]). This maximum difference in current cigarette use decreased significantly to 5.1 (95% CI, 3.5-6.7) percentage points in 2019 between White females (6.9% [95% CI, 3.4%-10.3%]) and Black females (1.8% [95% CI, 0.7%-2.8%]). Conclusions and Relevance This survey study found that there was a decline in youth-reported tobacco use across every tobacco product category from 2013 to 2019. This decline changed the trajectory of use among several demographic groups and brought the youth populations with the highest tobacco product use to similar rates of others.
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Affiliation(s)
- Erika Trapl
- Prevention Research Center for Healthy Neighborhoods, Case Western Reserve University, Cleveland, Ohio
| | - Stephanie Pike Moore
- Prevention Research Center for Healthy Neighborhoods, Case Western Reserve University, Cleveland, Ohio
| | - Catherine Osborn
- Prevention Research Center for Healthy Neighborhoods, Case Western Reserve University, Cleveland, Ohio
| | - Neha Gupta
- Case Western Reserve University, Cleveland, Ohio
| | - Thomas E. Love
- Case Western Reserve University, Cleveland, Ohio
- Population Health Research Institute, The MetroHealth System, Cleveland, Ohio
| | | | - Audrey Kinsella
- Prevention Research Center for Healthy Neighborhoods, Case Western Reserve University, Cleveland, Ohio
| | - Scott Frank
- Case Western Reserve University, Cleveland, Ohio
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50
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Hood RB, Moseson H, Smith M, Chakraborty P, Norris AH, Gallo MF. Comparison of abortion incidence estimates derived from direct survey questions versus the list experiment among women in Ohio. PLoS One 2022; 17:e0269476. [PMID: 35657985 PMCID: PMC9165909 DOI: 10.1371/journal.pone.0269476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 05/20/2022] [Indexed: 12/02/2022] Open
Abstract
Abortion is highly stigmatized in the United States which prevents its accurate measurement in surveys. The list experiment aims to improve the reporting of abortion history. We evaluated whether a list experiment resulted in higher reporting of abortion experiences than did two direct questions. Utilizing data from a representative survey of adult women of reproductive age in Ohio, we examined abortion history using two direct questions and a double list experiment. Through the double list experiment, we asked respondents to report how many of two lists of health items they had experienced; one list included abortion. We compared weighted history of abortion between these measures and by respondent demographic characteristics (age and socioeconomic status). Estimates of abortion history were similar between direct and list experiment questions. When measured with the two different direct question of abortion history, 8.4% and 8.0% of all respondents indicated ever having an abortion and with the list experiment, 8.5% indicated ever having an abortion. In a Midwestern state-level survey, the list experiment did not lead to increases in abortion reporting as compared to the direct questions. Subgroup analyses require larger samples, and future iterations should incorporate related but non-stigmatized control items to reduce misclassification and under-powering of such subgroup analyses.
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Affiliation(s)
- Robert B. Hood
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
| | - Heidi Moseson
- Ibis Reproductive Health, Oakland, CA, United States of America
| | - Mikaela Smith
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, United States of America
| | - Payal Chakraborty
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, United States of America
| | - Alison H. Norris
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, United States of America
| | - Maria F. Gallo
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, United States of America
- * E-mail:
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