scholarly journals Unclassified drug overdose deaths in the opioid crisis: emerging patterns of inequity

2019 ◽  
Vol 26 (8-9) ◽  
pp. 767-777 ◽  
Author(s):  
Andrew J Boslett ◽  
Alina Denham ◽  
Elaine L Hill ◽  
Meredith C B Adams
Keyword(s):  
Regression Models ◽  
Mortality Data ◽  
Specific Drug ◽  
Opioid Epidemic ◽  
Multivariate Logistic Regression ◽  
Economic Disparities ◽  
Logistic Regression Models ◽  
Opioid Crisis ◽  
Overdose Mortality ◽  
Overdose Deaths

Abstract Objective Examine whether individual, geographic, and economic phenotypes predict missing data on specific drug involvement in overdose deaths, manifesting inequities in overdose mortality data, which is a key data source used in measuring the opioid epidemic. Materials and Methods We combined national data sources (mortality, demographic, economic, and geographic) from 2014–2016 in a multi-method analysis of missing drug classification in the overdose mortality records (as defined by the use of ICD-10 T50.9 on death certificates). We examined individual disparities in decedent-level multivariate logistic regression models, geographic disparities in spatial analysis (heat maps), and economic disparities in a combination of temporal trend analyses (descriptive statistics) and both decedent- and county-level multivariate logistic regression models. Results Our analyses consistently found higher rates of unclassified overdoses in decedents of female gender, White race, non-Hispanic ethnicity, with college education, aged 30–59 and those from poorer counties. Despite the fact that unclassified drug overdose death rates have reduced over time, gaps persist between the richest and poorest counties. There are also striking geographic differences both across and within states. Discussion Given the essential role of mortality data in measuring the scale of the opioid epidemic, it is important to understand the individual and community inequities underlying the missing data on specific drug involvements. Knowledge of these inequities could enhance our understanding of the opioid crisis and inform data-driven interventions and policies with more equitable resource allocations. Conclusion Multiple individual, geographic, and economic disparities underlie unclassified overdose deaths, with important implications for public health informatics and addressing the opioid crisis.

scholarly journals Trends in Covid-19 hospital mortality in women and men

2021 ◽  
Author(s):  
Luis Ayerbe ◽  
Carlos Risco-Risco ◽  
Diego Martinez-Urbistondo ◽  
Maria Elena Caro-Tinoco ◽  
Salma Ayis
Keyword(s):  
Regression Models ◽  
Scientific Evidence ◽  
Future Research ◽  
Mortality Data ◽  
First Year ◽  
Multivariate Logistic Regression ◽  
Medical Outcomes ◽  
Logistic Regression Models ◽  
Time Of Admission

Introduction: It remains unclear if the development of health services, clinical management, and scientific evidence, during the pandemic is associated with better medical outcomes, sustained in the long term, for Covid-19 patients of each gender. This study presents the trends in mortality associated with Covid-19 for women and men during the first year of the pandemic. Methods: This study was based in 17 Spanish hospitals. Sociodemographic, clinical, and mortality data from all patients with Covid-19, who had been discharged alive, or had died after being admitted, between March 2020 and February 2021, were used. The association between time of admission and mortality was examined with multivariate logistic regression models. Results: 3390 Covid-19 patients were included in the study, of which 1330 were women, the age was M(SD): 66.55(16.55) Death was reported for 451 patients. There was a significant decreasing trend in mortality by time of admission for the whole year with an OR: 0.86(0.77-0.96) p=0.005. No significant trend in mortality for women was observed OR: 1.00(0.85-1.19) p=0.959, while there was a significant decreasing trend for men OR: 0.78 (0.68-0.90) p=0.001 Discussion: The health policies put in place, the scientific evidence developed by researchers, and the experienced acquired by clinicians, are likely to explain this improvement in mortality. More epidemiological and clinical studies addressing trends of mortality in patients with different sociodemographic and clinical profile and the improvement of clinical outcomes are required. Future research may address the safety and efficacy of interventions specifically in female patients.

scholarly journals Confronting Two Crises: The COVID-19 Pandemic, the Opioid Epidemic, and the Industrial Hygienist

2021 ◽  
pp. 104829112110295
Author(s):  
Jonathan Rosen ◽  
Peter Harnett
Keyword(s):  
Disease Control ◽  
Drug Overdose ◽  
Industrial Hygiene ◽  
Prevention Programs ◽  
Opioid Epidemic ◽  
Opioid Misuse ◽  
Opioid Crisis ◽  
The Impact ◽  
Overdose Deaths ◽  
Industrial Hygienist

This article was originally written for and published in the January 2021 issue of The Synergist, a monthly publication of the American Industrial Hygiene Association. The article addresses the convergence of the COVID-19 and opioid crises, the impact of the opioid crisis on the workplace and workers, and the role that industrial hygienists can play in developing workplace programs to prevent and respond to opioid misuse. While the article is specifically written for industrial hygienists, the review and recommendations will be useful to others who are developing workplace opioid prevention programs. Note that the data presented in this article were current as of January 2021. Centers for Disease Control and Prevention’s latest available data are for the twelve-month period ending October 2020 and include 88,990 total overdose deaths and 91,862 predicted, when reporting is completed. Source: https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm (accessed on 15 June 2021).

Child awareness of and access to cigarettes: impacts of the point-of-sale display ban in England

2018 ◽  
Vol 28 (5) ◽  
pp. 526-531 ◽  
Author(s):  
Anthony A Laverty ◽  
Eszter Panna Vamos ◽  
Christopher Millett ◽  
Kiara C-M Chang ◽  
Filippos T Filippidis ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Drug Use ◽  
Regression Models ◽  
Multivariate Logistic Regression ◽  
Tobacco Advertising ◽  
Point Of Sale ◽  
Logistic Regression Models ◽  
Annual Survey ◽  
Perceived Difficulty ◽  
Ease Of Access

IntroductionEngland introduced a tobacco display ban for shops with >280 m2 floor area (‘partial ban’) in 2012, then a total ban in 2015. This study assessed whether these were linked to child awareness of and access to cigarettes.MethodsData come from the Smoking, Drinking and Drug Use survey, an annual survey of children aged 11–15 years for 2010–2014 and 2016. Multivariate logistic regression models assessed changes in having seen cigarettes on display, usual sources and ease of access to cigarettes in shopsResultsDuring the partial display ban in 2012, 89.9% of children reported seeing cigarettes on display in the last year, which was reduced to 86.0% in 2016 after the total ban (adjusted OR 0.58, 95% CI 0.50 to 0.66). Reductions were similar in small shops (84.1% to 79.3%)%) and supermarkets (62.6% to 57.3%)%). Although the ban was associated with a reduction in the proportion of regular child smokers reporting that they bought cigarettes in shops (57.0% in 2010 to 39.8% in 2016), we did not find evidence of changes in perceived difficulty or being refused sale among those who still did.DiscussionTobacco point-of-sale display bans in England reduced the exposure of children to cigarettes in shops and coincided with a decrease in buying cigarettes in shops. However, children do not report increased difficulty in obtaining cigarettes from shops, highlighting the need for additional measures to tackle tobacco advertising, stronger enforcement of existing laws and measures such as licencing for tobacco retailers.

Abstract TP321: Is Weekend Admission Associated With Increased 30-day Stroke Mortality? The Effect of Adjustment Using a Claims-Based Stroke Severity Index

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Cheng-Yang Hsieh ◽  
Sheng-Feng Sung
Keyword(s):  
Logistic Regression ◽  
Regression Models ◽  
Severity Index ◽  
Case Mix ◽  
Stroke Severity ◽  
Stroke Mortality ◽  
Multivariate Logistic Regression ◽  
Stroke Patients ◽  
Logistic Regression Models ◽  
Case Mix Adjustment

Introduction: Whether weekend admission is associated with increased stroke mortality in Taiwan remains uncertain, partly because of an inadequate case-mix adjustment in other studies using an insurance claims databases. Hypothesis: Adding the 7-item claims-based stroke severity index (SSI) to a multivariate logistic regression model might alter the analysis of the effect of weekend admission on 30-day stroke mortality. Methods: We identified, in the Taiwan Longitudinal Health Insurance Database, which is linked with the National Death Registry, patients hospitalized for acute ischemic stroke between 2001 and 2013. The primary outcome was mortality 30 days post-admission. In base logistic regression models with and without the SSI, we tested the odds ratio (OR) of 30-day mortality in patient admitted on weekends using the covariates of age, sex, year of admission, Charlson’s comorbidity index, brain surgery, physician specialty and surgical volume, hospital ownership, accreditation, and patient volume. Results: We analyzed 46,007 consecutive hospitalized stroke patients (mean age: 68.8 ± 12.0 years; male: 59%), with an SSI of 7.5 ± 5.3 (range: 4.1-27.1), 23.0% were admitted on the weekend, and 4.2% died within 30 days. Patients who died within 30 days were more likely to have been admitted on a weekend (4.9% vs. 4.0%, p < 0.001). Nevertheless, patients admitted on a weekend had a higher SSI than those admitted on a weekday (7.8 vs. 7.4, p < 0.001). In multivariate logistic regression models, weekend admission was associated with 30-day mortality (OR: 1.22, 95% CI: 1.10-1.35) in the base model but not in the base model plus SSI (OR: 1.07, 95% CI: 0.95-1.20). Conclusions: We confirmed that, after stroke severity had been adjust by adding the SSI, weekend admission did not increase the 30-day mortality of stroke patients in Taiwan. A case-mix adjustment in comparative outcome studies of stroke patients is important when using an insurance claims database.

scholarly journals Prevalence of Cognitive Frailty, Do Psychosocial-Related Factors Matter?

2020 ◽  
Vol 10 (12) ◽  
pp. 968
Author(s):  
Esperanza Navarro-Pardo ◽  
David Facal ◽  
María Campos-Magdaleno ◽  
Arturo X. Pereiro ◽  
Onésimo Juncos-Rabadán
Keyword(s):  
Regression Models ◽  
Well Being ◽  
Preventive Interventions ◽  
Psychosocial Variables ◽  
Multivariate Logistic Regression ◽  
Related Factors ◽  
Cognitive Frailty ◽  
Logistic Regression Models ◽  
Affective Factors ◽  
High Prevalence

Cognitive frailty (CF) is a topic of growing interest with implications for the study of preventive interventions in aging. Nevertheless, little research has been done to assess the influence of psychosocial variables on the risk of CF. Our objectives were to estimate the prevalence of CF in a Spanish sample and to explore the influence of psychosocial variables in this prevalence. Physical frailty and cognitive, functional, psychosocial, and socio-demographic aspects were assessed in a sample of 285 participants over 60 years. Univariate and multivariate logistic regression models were carried out. A prevalence of 21.8% (95% CI 17.4–26.9) was established when both frail and pre-frail conditions were included, and a prevalence of 3.2% (95% CI 1.7–5.9) if only frail individuals were considered. Age, educational level, profession and psychological well-being variables significantly predicted CF. Frailty and pre-frailty are high-prevalence health conditions in older adults influenced by socio-demographic, socio-educative and affective factors.

Forced Sexual Victimization Among Youth in Custody: Do Risk Factors Vary by Gender and Perpetrator?

2019 ◽  
Vol 100 (2) ◽  
pp. 151-172
Author(s):  
Eileen M. Ahlin
Keyword(s):  
Risk Factors ◽  
Gender Differences ◽  
Logistic Regression ◽  
National Survey ◽  
Regression Models ◽  
Sexual Victimization ◽  
Multivariate Logistic Regression ◽  
Logistic Regression Models ◽  
Factors Associated ◽  
Using Data

There is relatively little literature examining risk factors associated with sexual victimization among youth in custody. The current study explored whether risk of forced sexual victimization among youth in custody differs by gender or perpetrator. Using data from a sample of 8,659 youth who participated in the National Survey of Youth in Custody, multivariate logistic regression models were employed to investigate gender differences in risk factors associated with overall forced sexual victimization and staff-on-inmate and inmate-on-inmate forced sexual victimization. Findings suggest that gender differences are more pronounced when perpetrator type is considered.

E-cigarette use among US adolescents: Perceptions of relative addiction and harm

2016 ◽  
Vol 76 (3) ◽  
pp. 293-301 ◽  
Author(s):  
Page Daniel Dobbs ◽  
Bart Hammig ◽  
Leah Jean Henry
Keyword(s):  
High School Students ◽  
Grade Level ◽  
Regression Models ◽  
Cigarette Use ◽  
Multivariate Logistic Regression ◽  
School Students ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Cross Sectional Design ◽  
People’S Perceptions

Objective: Between 2013 and 2014, past 30-day use of e-cigarettes increased from 4.5% to 13.4% among US high school students aged 9–19 years. We sought to examine the influence of perceived addiction and harm of e-cigarettes on e-cigarette use among adolescents. Design: Self-reported use and perception of harm of e-cigarettes were assessed using a cross-sectional design. Setting: Data were collected from the 2014 National Youth Tobacco Survey. Method: Multivariate logistic regression models were employed regressing lifetime e-cigarette use and past 30-day use on established covariate factors. Results: Perceiving e-cigarettes as less harmful than conventional cigarettes increased students’ odds of lifetime use (odds ratio [ OR] = 2.40, 95% confidence interval [ CI] = 1.98–2.90) and past 30-day use ( OR = 2.18, 95% CI = 1.63–2.92) of e-cigarettes. Perceiving e-cigarettes as less addictive than conventional cigarettes also increased students’ odds of lifetime use ( OR = 2.11, 95% CI = 1.82–2.45) and past 30-day use ( OR = 1.93, 95% CI = 1.57–2.38) of e-cigarettes; however, perceiving e-cigarettes as more addictive than conventional cigarettes also increased students’ odds of lifetime use ( OR = 1.85, 95% CI = 1.37–2.49) and past 30-day use ( OR = 2.68, 95% CI = 1.84–3.90) of e-cigarettes. Other influencing factors of e-cigarette use among youth included race, grade level, living with a smoker and lifetime use of regular cigarettes. Conclusion: The perception that e-cigarettes are less addictive and harmful than their conventional counterparts may be an important risk factor for the use of e-cigarettes. Factors influencing young people’s perceptions need to be examined further.

scholarly journals Consumers’ Consciousness of Health-Friendly Products and Services and Its Association with Sociodemographic Characteristics and Health Status

2019 ◽  
Author(s):  
Young Ho Yun ◽  
Jin-Ah Sim ◽  
Yaeji Kim ◽  
Sujee Lee
Keyword(s):  
Regression Models ◽  
Normal Weight ◽  
Spiritual Health ◽  
Social Responsiveness ◽  
Multivariate Logistic Regression ◽  
Urban Residence ◽  
Logistic Regression Models ◽  
Positive Attitudes ◽  
The Government ◽  
Perception Of Health

Although health policy resides mainly with the government, industry can play an important role in building a health ecosystem. From March to May, we administered questionnaires to 1,200 individuals from the general Korean population asking about their perception of health-friendly labels, and if they would purchase such labeled products (foods, pharmaceuticals, etc.) and services (purifying water, preventing air pollution, etc.) at extra cost. The participants placed a high value on the importance of mental, social, spiritual, and physical health factors in terms of company&rsquo;s products and services with a score of about 8 out of 10 (range, 7.74-8.33). Most respondents (72.4%) said they were interested in adopting health-friendly labels. When a health-friendly label is introduced (such as one by the Business for Social Responsiveness), 65.1% of the respondents said they intended to purchase the product or service, while 6.8% said they did not, and 75.0% said they were willing to pay extra for the health-friendly product or service. Multivariate logistic regression models showed urban residence, high education level, and good social health to be significantly associated with positive attitudes toward health-friendly labels. People with high income, no religion, or normal weight were more likely to say they intend to purchase products and services with health-friendly labels. They also had a more positive attitude toward paying more for such products and services, as did people with good spiritual health. This study provides data that illustrate the importance of health-friendly products and services to the general population and companies.

scholarly journals Examining the Association of Pain and Financial Hardship Among Older Men by Race in the United States

2021 ◽  
Vol 15 (5) ◽  
pp. 155798832110496
Author(s):  
Chiho Song ◽  
Gillian L. Marshall ◽  
Alyssa Reed ◽  
Tamara A. Baker ◽  
Roland J. Thorpe
Keyword(s):  
Regression Models ◽  
African American Men ◽  
White Men ◽  
Older Men ◽  
The United States ◽  
Financial Hardship ◽  
Composite Score ◽  
Multivariate Logistic Regression ◽  
Logistic Regression Models ◽  
Retirement Study

Pain associated with financial hardship among older men varies by race. The purpose of this study was to examine the association of financial hardship with the presence of pain in men 50 years and older by race. Using the Health and Retirement Study (HRS) 2010 wave, bivariate and multivariate logistic regression models were used to assess the association between four financial hardship indicators and total financial hardship as a composite score, and the presence of pain by race. Among White men, the association between the presence of pain and hardship controlling for demographic factors was statistically significant across four indicators and one composite score: ongoing financial hardship (OR = 1.29, 95% CI [1.02, 1.64]), food insecurity (OR = 2.55, 95% CI [1.51, 4.31]), taking less medication due to cost (OR = 2.12, 95% CI [1.40, 3.22]), difficulty paying bills (OR = 1.36, 95% CI [1.07, 1.73]), and total financial hardship (OR = 1.27, 95% CI [1.12, 1.44]). Among African American men, the association between the presence of pain and taking less medication due to cost (OR = 2.99, 95% CI [1.31, 6.85]) was significant. With increasing comorbidities among older adults, particularly African Americans, it is imperative to fully understand the mechanisms of this underexplored area in both the pain and financial hardship literature.

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