Socioeconomic and Demographic Factors for Spousal Resemblance in Obesity Status and Habitual Physical Activity in the United States

Studies suggested that the married population has an increased risk of obesity and assimilation between spouses’ body weight. We examined what factors may affect married spouses’ resemblance in weight status and habitual physical activity (HPA) and the association of obesity/HPA with spouses’ sociodemoeconomic characteristics and lifestyles. Medical Expenditure Panel Survey data of 11,403 adult married couples in the US during years 2006–2008 were used. Absolute-scale difference and relative-scale resemblance indices (correlation and kappa coefficients) in body mass index (BMI) and HPA were estimated by couples’ socioeconomic and demographic characteristics. We found that spousal difference in BMI was smaller for couples with a lower household income, for who were both unemployed, and for older spouses. Correlation coefficient between spouses’ BMI was 0.24, differing by race/ethnicity and family size. Kappa coefficient for weight status (obesity: BMI ≥ 30, overweight: 30 > BMI ≥ 25) was 0.11 and 0.35 for HPA. Never-working women’s husbands had lower odds of obesity than employed women’s husbands (OR = 0.69 (95% CI = 0.53–0.89)). Men’s unemployment status was associated with wives’ greater odds of obesity (OR = 1.31 (95% CI = 1.01–1.71)). HPA was associated with men’s employment status and income level, but not with women’s. The population representative survey showed that spousal resemblance in weight status and HPA varied with socioeconomic and demographic factors.

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Abstract 254: Persistent SES Disparities in Cardiovascular Risk Factors and Health in the United States: MEPS 2002-2013

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.10.suppl_3.254 ◽

2017 ◽

Vol 10 (suppl_3) ◽

Author(s):

Javier Valero-Elizondo ◽

Erica S Spatz ◽

Joseph A Salami ◽

Chukwuemeka U Osondu ◽

Nihar R Desai ◽

...

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Medical Expenditure Panel Survey ◽

The United States ◽

Pooled Analysis ◽

High Income ◽

Self Report ◽

Medical Expenditure ◽

Poverty Level ◽

Logistic Regression Models

Background: Given the health and cost burden of cardiovascular (CV) disease, we aimed to describe the trends in CV risk factors (CRF) in the US over the last twelve years, and quantify the disparities in healthcare by socioeconomic status (SES). Methods: The 2002-2013 Medical Expenditure Panel Survey (MEPS), a nationally representative sample was the basis for our study. CRFs (hypertension, diabetes mellitus, hypercholesterolemia, smoking, lack of physical activity and obesity) were identified by ICD9CM codes and/or self-report. Individuals were stratified by income level (per the federal poverty level), and proportions and logistic regression models were used to study trends and relationships for each CRF in two-year intervals. All analyses took into consideration the survey’s complex design. Inclusion criteria: age ≥ 18, BMI ≥ 18.5 and a positive sampling weight. Results: The study sample consisted of 250,371 MEPS participants (46 ± 14 years of age, 49% male), translating into 1.3 billion US adults. During the study period, the proportion of individuals with obesity increased overall, though moreso among people of low SES (Table). Trends in diabetes prevalence increased (from 9.6% to 12.8% in “Poor/Near Poor” and 5.6% to 8.3% in “High Income”, both p trend < 0.001) and hypertension (from 28.5% to 36.3% in “Poor/Near Poor” and 24.2% to 33.4% in “High Income”, both p trend < 0.001), though the greatest relative change was observed among the Middle/High Income SES group. Prevalence of inadequate physical activity increased in all SES categories, with the “Poor/Near Poor” group having the most drastic change (32.4% vs. 55.4%, p trend < 0.001), and a relative percent change of 71.1% increase in this category. Smoking declined across time in all SES categories, and hypercholesterolemia showed no significant changes. In pooled analysis, the odds of having a “Poor CRF Profile” (≥ 4 CRFs) for “Poor/Near Poor” SES were 36% higher when compared to “High Income” SES (OR 1.36, 95% CI [1.30, 1.44]) (Table). Conclusion: Disparities in the prevalence of CRFs have increased over the past 12 years, and have worsened for some conditions, including obesity, diabetes, hypertension and physical inactivity. There is a need for healthcare initiatives and policies to target the groups most in need.

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2163 Polypharmacy and patterns of prescription medication use among cancer survivors

Journal of Clinical and Translational Science ◽

10.1017/cts.2018.297 ◽

2018 ◽

Vol 2 (S1) ◽

pp. 85-86

Author(s):

Caitlin Murphy ◽

Hannah Fullington ◽

Carlos Alvarez ◽

Simon C. Lee ◽

Andrea Betts ◽

...

Keyword(s):

Cancer Survivors ◽

Adverse Drug Events ◽

Medical Expenditure Panel Survey ◽

Medication Use ◽

Prescription Medication ◽

The United States ◽

Abuse Potential ◽

Medical Expenditure ◽

Adolescent And Young Adult ◽

Increased Risk

OBJECTIVES/SPECIFIC AIMS: The population of cancer survivors is rapidly growing in the United States. Long term and late effects of cancer, combined with ongoing management of other chronic conditions, make cancer survivors particularly vulnerable to polypharmacy and its adverse effects. We examined patterns of prescription medication use and polypharmacy in a population-based sample of cancer survivors. METHODS/STUDY POPULATION: Using data from the Medical Expenditure Panel Survey (MEPS), we matched cancer survivors (n=5216) to noncancer controls (n=19,588) by age, sex, and survey year. We defined polypharmacy as using 5 or more unique medications. We also estimated proportion of respondents prescribed specific medications within therapeutic classes and total prescription expenditures. RESULTS/ANTICIPATED RESULTS: A higher proportion of cancer survivors were prescribed 5 or more unique medications (64.0%, 95% CI 62.3%–65.8%) compared with noncancer controls (51.5%, 95% CI 50.4%–52.6%), including drugs with abuse potential. Across all therapeutic classes, a higher proportion of newly (≤1 year since diagnosis) and previously (>1 years since diagnosis) diagnosed survivors were prescribed medications compared to controls, with large differences in central nervous system agents (65.8% vs. 57.4% vs. 46.2%), psychotherapeutic agents (25.4% vs. 26.8% vs. 18.3%), and gastrointestinal agents (31.9% vs. 29.6% vs. 22.0%). Specifically, nearly 10% of cancer survivors were prescribed benzodiazepines and/or opioids compared to about 5% of controls. Survivors had more than double prescription expenditures (median $1633 vs. $784 among noncancer controls). Findings persisted similarly across categories of age and comorbidity. DISCUSSION/SIGNIFICANCE OF IMPACT: Cancer survivors were frequently prescribed a higher number of unique medications and inappropriate medications or drugs with abuse potential, increasing risk of adverse drug events, financial toxicity, poor adherence, and drug-drug interactions. Adolescent and young adult survivors appear at increased risk of polypharmacy.

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The Effect of Massachusetts' Health Reform on Employer-Sponsored Insurance Premiums

Forum for Health Economics & Policy ◽

10.2202/1558-9544.1204 ◽

2010 ◽

Vol 13 (2) ◽

Cited By ~ 6

Author(s):

John F Cogan ◽

R. Glenn Hubbard ◽

Daniel Kessler

Keyword(s):

United States ◽

Health Reform ◽

Medical Expenditure Panel Survey ◽

Private Insurance ◽

The United States ◽

Medical Expenditure ◽

Insurance Premiums ◽

Reform Plan ◽

The Difference ◽

The Cost

In this paper, we use publicly available data from the Medical Expenditure Panel Survey - Insurance Component (MEPS-IC) to investigate the effect of Massachusetts' health reform plan on employer-sponsored insurance premiums. We tabulate premium growth for private-sector employers in Massachusetts and the United States as a whole for 2004 - 2008. We estimate the effect of the plan as the difference in premium growth between Massachusetts and the United States between 2006 and 2008that is, before versus after the planover and above the difference in premium growth for 2004 to 2006. We find that health reform in Massachusetts increased single-coverage employer-sponsored insurance premiums by about 6 percent, or $262. Although our research design has important limitations, it does suggest that policy makers should be concerned about the consequences of health reform for the cost of private insurance.

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Are There Racial Disparities in Psychotropic Drug Use and Expenditures in a Nationally Representative Sample of Men in the United States? Evidence From the Medical Expenditure Panel Survey

American Journal of Men s Health ◽

10.1177/1557988313496564 ◽

2013 ◽

Vol 8 (1) ◽

pp. 82-90 ◽

Cited By ~ 6

Author(s):

Geraldine Pierre ◽

Roland J. Thorpe ◽

Gniesha Y. Dinwiddie ◽

Darrell J. Gaskin

Keyword(s):

United States ◽

Drug Use ◽

Racial Disparities ◽

Psychotropic Drug ◽

Medical Expenditure Panel Survey ◽

The United States ◽

Medical Expenditure ◽

Panel Survey ◽

Psychotropic Drug Use ◽

Nationally Representative

This article sought to determine whether racial disparities exist in psychotropic drug use and expenditures in a nationally representative sample of men in the United States. Data were extracted from the 2000-2009 Medical Expenditure Panel Survey, a longitudinal survey that covers the U.S. civilian noninstitutionalized population. Full-Year Consolidated, Medical Conditions, and Prescribed Medicines data files were merged across 10 years of data. The sample of interest was limited to adult males aged 18 to 64 years, who reported their race as White, Black, Hispanic, or Asian. This study employed a pooled cross-sectional design and a two-part probit generalized linear model for analyses. Minority men reported a lower probability of psychotropic drug use (Black = −4.3%, 95% confidence interval [CI] = [−5.5, −3.0]; Hispanic = −3.8%, 95% CI = [−5.1, −2.6]; Asian = −4.5%, 95% CI = [−6.2, −2.7]) compared with White men. After controlling for demographic, socioeconomic, and health status variables, there were no statistically significant race differences in drug expenditures. Consistent with previous literature, racial and ethnic disparities in the use of psychotropic drugs present problems of access to mental health care and services.

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The Ecology of Antihypertensives in the United States, 1997-2017

10.1101/2020.04.01.20050146 ◽

2020 ◽

Author(s):

Michael E. Johansen ◽

Joshua D. Niforatos ◽

Jeremey B. Sussman

Keyword(s):

United States ◽

Beta Blocker ◽

Medical Expenditure Panel Survey ◽

The United States ◽

Medical Expenditure ◽

Future Research ◽

Channel Blockers ◽

Converting Enzyme Inhibitors ◽

Cross Sectional ◽

Medication Class

AbstractBackgroundAntihypertensives are the most used medication type in the United States, yet there remains uncertainty about the use of different antihypertensives. We sought to characterize use of antihypertensives by and within medication class(es) between 1997-2017.MethodsA repeated cross-sectional study of 493,596 adult individuals using the 1997-2017 Medical Expenditure Panel Survey (MEPS). The Orange Book and published research were used for adjunctive information. The primary outcome was the estimated use by and within anti-hypertensive medication class(es).ResultsThe proportion of individuals taking any antihypertensive during a year increased from 1997 to the early 2010’s and then remained stable. The proportion of the population taking 2 or more medications declined from 2015-2017. The proportion of adults using angiotensin II receptor-blockers (ARBs) and dihydropyridine calcium channel-blockers (CCBs) increased during the study period, while angiotensin-converting enzyme inhibitors (ACE-Is) increased until 2010 after which rates remained stable. Beta-blocker use was similar to ACE-Is with an earlier decline starting in 2012. Thiazide diuretic use increased from 1997-2007, leveled off until 2014, and declined from 2015-2017. Non-dihydropyridine CCBs use declined throughout the study. ACE-Is, ARBs, CCBs, thiazide diuretics, and loop diuretics all had one dominant in-class medication. There was a clear increase in the use of losartan within ARBs, lisinopril within ACE-Is, and amlodipine within CCBs following generic conversion. Furosemide and hydrochlorothiazide started with and maintained a dominant position in their classes. Metoprolol use increased throughout the study and became the dominant beta-blocker, while atenolol peaked around 2005 and then declined thereafter.ConclusionsAntihypertensive classes appear to have a propensity to equilibrate to an individual medication, despite a lack of outcomes based research to compare medications within a class. Future research could focus on comparative effectiveness for within-class medications early in the life cycle of therapeutics that are probable to have wide spread use.

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Union, Premium Cost, and the Provision of Employment-based Health Insurance

Socius Sociological Research for a Dynamic World ◽

10.1177/2378023118798502 ◽

2018 ◽

Vol 4 ◽

pp. 237802311879850

Author(s):

Ken-Hou Lin ◽

Samuel Bondurant ◽

Andrew Messamore

Keyword(s):

Medical Expenditure Panel Survey ◽

Health Benefits ◽

State Level ◽

The United States ◽

Critical Force ◽

First Century ◽

Medical Expenditure ◽

Health Plans ◽

Panel Survey ◽

Employment Relationships

The decline of employment-based health plans is commonly attributed to rising premium costs. Using restricted data and a matched sample from the Medical Expenditure Panel Survey–Insurance Component, the authors extend previous studies by testing the relationships among premium costs, employment relationships, and the provision of health benefits between 1999 and 2012. The authors report that both establishment- and state-level union densities are associated with a higher likelihood of employers’ providing health plans, whereas right-to-work legislation is associated with lower provision. These factors combined rival rising premium cost in predicting offering. This finding indicates that the declining provision of health benefits could be in part driven by the transformation of the employment relationship in the United States and that labor unions may remain a critical force in sustaining employment-based coverage in the twenty-first century.

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Injury Risk Associated With Sports Specialization and Activity Volume in Youth

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967119870124 ◽

2019 ◽

Vol 7 (9) ◽

pp. 232596711987012 ◽

Cited By ~ 5

Author(s):

Alison E. Field ◽

Frances A. Tepolt ◽

Daniel S. Yang ◽

Mininder S. Kocher

Keyword(s):

Physical Activity ◽

Cohort Study ◽

Injury Risk ◽

Cruciate Ligament ◽

The United States ◽

Level Of Evidence ◽

Sports Activity ◽

Risk Of Injury ◽

Increased Risk ◽

Anterior Cruciate

Background: Sports specialization has become increasingly common among youth. Purpose/Hypothesis: To investigate the relative importance of specialization vs volume of activity in increasing risk of injury. Hypotheses were that specialization increases the risk of injury and that risk varies by sport. Study Design: Cohort study; Level of evidence, 2. Methods: A prospective analysis was conducted with data collected from 10,138 youth in the Growing Up Today Study—a prospective cohort study of youth throughout the United States—and their mothers. Activity was assessed via questionnaires in 1997, 1998, 1999, and 2001. Sports specialization was defined as engaging in a single sport in the fall, winter, and spring. Injury history was provided by participants’ mothers via questionnaire in 2004. The outcome was incident stress fracture, tendinitis, chondromalacia patella, anterior cruciate ligament tear, or osteochondritis dissecans or osteochondral defect. Results: Females who engaged in sports specialization were at increased risk of injury (hazard ratio [HR], 1.31; 95% CI, 1.07-1.61), but risk varied by sport. Sports specialization was associated with greater volume of physical activity in both sexes ( P < .0001). Total hours per week of vigorous activity was predictive of developing injury, regardless of what other variables were included in the statistical model (males: HR, 1.04; 95% CI, 1.02-1.06; females: HR, 1.06; 95% CI, 1.05-1.08). Among females, even those engaging in 3 to 3.9 hours per week less than their age were at a significantly increased risk of injury (HR, 1.93; 95% CI, 1.34-2.77). In males, there was no clear pattern of risk. Conclusion: Sports specialization is associated with a greater volume of vigorous sports activity and increased risk of injury. Parents, coaches, and medical providers need to be made aware of the volume threshold above which physical activity is excessive.

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Prevalence of and Sociodemographic Disparities in Influenza Vaccination Among Adults With Diabetes in the United States

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa139 ◽

2020 ◽

Vol 4 (11) ◽

Cited By ~ 1

Author(s):

Priyanka Bhugra ◽

Reed Mszar ◽

Javier Valero-Elizondo ◽

Gowtham R Grandhi ◽

Salim S Virani ◽

...

Keyword(s):

United States ◽

Influenza Vaccination ◽

Medical Expenditure Panel Survey ◽

Vaccine Coverage ◽

The United States ◽

Sociodemographic Factors ◽

Medical Expenditure ◽

Sociodemographic Characteristics ◽

Black Race ◽

Patients With Diabetes

Abstract National estimates describing the overall prevalence of and disparities in influenza vaccination among patients with diabetes mellitus (DM) in United States are not well described. Therefore, we analyzed the prevalence of influenza vaccination among adults with DM, overall and by sociodemographic characteristics, using the Medical Expenditure Panel Survey database from 2008 to 2016. Associations between sociodemographic factors and lack of vaccination were examined using adjusted logistic regression. Among adults with DM, 36% lacked influenza vaccination. Independent predictors of lacking influenza vaccination included age 18 to 39 years (odds ratio [OR] 2.54; 95% confidence interval [CI], 2.14-3.00), Black race/ethnicity (OR 1.29; 95% CI, 1.14-1.46), uninsured status (OR 1.88; 95% CI, 1.59-2.21), and no usual source of care (OR 1.61; 95% CI, 1.39-1.85). Nearly 64% individuals with ≥ 4 higher-risk sociodemographic characteristics lacked influenza vaccination (OR 3.50; 95% CI 2.79-4.39). One-third of adults with DM in the United States lack influenza vaccination, with younger age, Black race, and lower socioeconomic status serving as strong predictors. These findings highlight the continued need for focused public health interventions to increase vaccine coverage and utilization among disadvantaged communities.

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