Abstract 15131: National Rates and Trends of Tobacco and Substance Use Disorders Among Atrial Fibrillation Hospitalizations in the United States

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
devina adalja ◽  
Rajkumar P Doshi ◽  
Mihir Dave ◽  
Monil Majmundar ◽  
Ashish Kumar ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Substance Abuse ◽  
Socioeconomic Status ◽  
Substance Use ◽  
Substance Use Disorder ◽  
The United States ◽  
P Value ◽  
Lower Socioeconomic Status ◽  
Lower Socioeconomic ◽  
Increased Risk

Introduction: Atrial Fibrillation (AF) has been associated with various behavioral risk factors such as tobacco, alcohol, and/or substance abuse. Hypothesis: The main objective is to describe the national trends and burden of tobacco and substance abuse in AF hospitalizations. Methods: The National Inpatient Sample database from 2007 to 2015 was utilized and the hospitalizations with AF were identified using the international classification of disease, Ninth Revision, Clinical Modification (ICD-9-CM) code 427.31 in the primary diagnosis column. They were stratified into without abuse, tobacco use disorder (TUD), substance use disorder (SUD), alcohol use disorder (AUD), and drug use disorder (DUD). We used the Jonckheere-Terpstra trend test to analyze the trend in this study. Results: Out of 3,631,507 AF hospitalizations, 852,110 (23.46%) had TUD, 1851,170 (5.1%) had SUD, 155,681 (4.29%) had AUD and 42,667 (1.17%) had DUD. The trends of all increased substantially during the study period (Figure) . The prevalence of TUD, SUD, AUD, and DUD was substantially increased across all age groups, races, and gender during the study period. Female sex was associated with lower odds TUD (0.57 (0.56-0.57), P-value <0.001), SUD (0.27 (0.26-0.27), P-value <0.001), AUD (0.22 (0.22-0.22), P-value <0.001), and DUD (0.51 (0.5-0.52), P-value <0.001). Among AF hospitalizations, the black race was associated with higher odds of SUD (1.12 (1.1-1.14), P-value <0.001), and DUD(1.42 (1.38-1.47), P-value <0.001). The younger age group (18-35 years), male, Medicare/Medicaid as primary insurance, and lower socioeconomic status were associated with increased risk of both TUD and SUDs. Conclusions: Tobacco and substance use disorder among hospitalized AF patients in the US mainly affects males, younger individuals, white more than black, and those of lower socioeconomic status which demands the development of preventive strategies to address multilevel influences.

scholarly journals Why Is Infant Mortality Higher in the United States than in Europe?

2016 ◽  
Vol 8 (2) ◽  
pp. 89-124 ◽  
Author(s):  
Alice Chen ◽  
Emily Oster ◽  
Heidi Williams
Keyword(s):  
United States ◽  
Socioeconomic Status ◽  
Infant Mortality ◽  
Birth Outcomes ◽  
The United States ◽  
Similar Data ◽  
Lower Socioeconomic Status ◽  
Lower Socioeconomic ◽  
The Us ◽  
Differential Reporting

The United States has higher infant mortality than peer countries. In this paper, we combine microdata from the United States with similar data from four European countries to investigate this US infant mortality disadvantage. The US disadvantage persists after adjusting for potential differential reporting of births near the threshold of viability. While the importance of birth weight varies across comparison countries, relative to all comparison countries the United States has similar neonatal (<1 month) mortality but higher postneonatal (1–12 months) mortality. We document similar patterns across census divisions within the United States. The postneonatal mortality disadvantage is driven by poor birth outcomes among lower socioeconomic status individuals. (JEL I12, I14, I32, J14)

First Comes Cohabitation and then Comes Marriage?

2002 ◽  
Vol 23 (8) ◽  
pp. 1065-1087 ◽  
Author(s):  
WENDY D. MANNING ◽  
PAMELA J. SMOCK
Keyword(s):  
Socioeconomic Status ◽  
Initial Step ◽  
The United States ◽  
Lower Socioeconomic Status ◽  
Lower Odds ◽  
Factors Associated ◽  
Family Growth ◽  
Lower Socioeconomic ◽  
Cohabiting Couples ◽  
Race Ethnicity

Recent evidence indicates an overall retreat from marriage. Cohabitation has contributed to this trend as cohabiting unions are increasingly not resulting in marriage. As an initial step in understanding why some cohabiting couples do not marry, the authors examine factors associated with cohabitors' marriage expectations. The authors focus particularly on the effects of socioeconomic status and race/ethnicity because prior research has suggested that the retreat from marriage in the United States has been more marked among Blacks than among non-Hispanic Whites or Hispanics and also for those of lower socioeconomic status. Using the 1995 National Survey of Family Growth, we find Black cohabiting women have lower odds of expecting marriage. However, for all race and ethnic groups the probability of expecting to marry depends on men's socioeconomic position.

Mortality and injury following the 2007 Ica earthquake in Peru

2009 ◽  
Vol 4 (1) ◽  
pp. 15-22 ◽  
Author(s):  
Shannon Doocy, PhD ◽  
Amy Daniels, MHS ◽  
Inppares-JHSPH-CUNY Study Team ◽  
Daniel Aspilcueta, MD, MPH
Keyword(s):  
Socioeconomic Status ◽  
Rural Areas ◽  
Urban Areas ◽  
Survey Design ◽  
Lower Socioeconomic Status ◽  
Injury Rates ◽  
Cluster Survey ◽  
Risk Of Injury ◽  
Lower Socioeconomic ◽  
Increased Risk

Objective. To quantify earthquake injury and mortality from the 2007 Ica earthquake in Peru and to assess earthquake-related risk and vulnerability.Design. A population-based cluster survey of households in the region most affected by the earthquake. A stratified cluster survey design was used to allow for comparison between urban, periurban, and rural areas, where different outcomes were anticipated as a result of variation in building practices and access to post-earthquake assistance. A total of 42 clusters of 16 households were planned to allow for comparison between the location types and to ensure adequate spatial coverage.Setting. The four affected provinces in Southern Peru: Ica, Pisco, Chincha, and Canete.Participants. A total of 672 randomly selected households with a combined population of 3,608 individuals, of which 3,484 (97 percent) were reported as household members on the day of the earthquake.Results. Mortality and injury rates in the four most affected provinces were estimated at 1.4 deaths/ 1,000 exposed (95 CI: 0.5-3.3) and 29 injuries/1,000 exposed (95 CI: 6-52). Older adults and members of households of lower socioeconomic status faced increased risk of injury. No significant differences in injury rates were observed between rural, urban, and peri-urban residence areas.Conclusions. Populations of lower socioeconomic status faced increased risk of injury; however, no differences in injury rates were observed between rural, urban, and peri-urban communities. Study findings suggest that earthquake preparedness and mitigation efforts should focus on population subgroups of lower socioeconomic in both rural and urban areas of earthquake- prone regions.

scholarly journals Assessment of Screening, Brief Intervention, and Referral to Treatment Training to Interprofessional Health-Care Students

2019 ◽  
Vol 5 ◽  
pp. 237796081983413 ◽  
Author(s):  
Helen C. Pervanas ◽  
Eric Landry ◽  
Douglas R. Southard ◽  
Pamela P. DiNapoli ◽  
Paula Smith ◽  
...  
Keyword(s):  
Health Care ◽  
At Risk ◽  
Substance Abuse ◽  
Substance Use ◽  
Substance Use Disorder ◽  
Brief Intervention ◽  
Health Care Professionals ◽  
Interprofessional Education ◽  
The United States ◽  
Health Care Students

Substance abuse and addiction are responsible for an assortment of health and financial concerns in the United States. Tools to identify and assist at-risk persons before they develop a substance use disorder are necessary. Screening, brief intervention, and referral to treatment (SBIRT) can be utilized by health-care professionals to identify those at risk to minimize health-related complications and the potential of developing a substance use disorder. The primary objective of this study was to provide educational training sessions on SBIRT to health-care students utilizing interprofessional education activities and assess perceptions of the training sessions and activities with regard to confidence to utilize SBIRT in at-risk patients and overall student satisfaction with SBIRT instruction. The research protocol enrolled students of pharmacy, nursing, medicine, behavioral health, and physician assistant studies who received interprofessional SBIRT training. Students completed an anonymous posttraining online survey, measuring student perceptions of knowledge gained and confidence to utilize training. A total of 303 students completed the SBIRT training. Approximately 70% of students were satisfied with the training materials, instruction, quality, and experience. After training, 78% were confident that they could perform screening for substance abuse, conduct a brief intervention (80%), and when to refer to treatment (71%). A total 73% of students reported that the asynchronous online-based activity was extremely effective in increasing knowledge of the roles and responsibilities of other disciplines and providing opportunities to interact with students from other health professions. Interprofessional education-trained students from multiple health-care disciplines feel comfortable performing SBIRT to identify persons at risk for substance misuse in practice.

scholarly journals Nowhere to Go: Parents' Descriptions of Children's Physical Activity During a Global Pandemic

2021 ◽  
Vol 9 ◽  
Author(s):  
Deanna Perez ◽  
Janelle K. Thalken ◽  
Nzubechukwu E. Ughelu ◽  
Camilla J. Knight ◽  
William V. Massey
Keyword(s):  
Physical Activity ◽  
Socioeconomic Status ◽  
The United States ◽  
Lower Socioeconomic Status ◽  
Physically Active ◽  
Global Pandemic ◽  
Outdoor Spaces ◽  
Lower Socioeconomic ◽  
Exact Effect ◽  
Children’S Physical Activity

Background: Schools and outdoor public spaces play a substantial role in children's physical activity. Yet, the COVID-19 shelter-in-place mandates bound many children to their available home spaces for learning, movement, and development. The exact effect this mandate had on children's physical activity may vary among families.Objective: To understand, from the perspective of parents, how the COVID-19 shelter-in-place mandates affected children's physical activity, while also considering families' socioeconomic status.Design: Open-ended survey.Setting: Online.Method: Data were collected from 321 parents living in the United States of America. Parents answered an open-ended prompt to describe their children's physical activity during COVID-19 shelter-in-place mandates. Following data collection, inductive and deductive content analysis examined patterns in the data.Results: Analyses indicated that shelter-in-place mandates restricted children's opportunities for physical activity. However, if families had access to outdoor spaces or equipment, they could encourage and support more physical activity opportunities than those without. Families in the lower-income bracket had less access to outdoor space and subsequently those children had fewer opportunities to be physically active. Parents supported their children's physical activity through their involvement and encouragement.Conclusion: These findings underscore the importance of access to outdoor spaces and equipment for increasing children's physical activity. Findings can be used by educators and policymakers to equitably support families of lower socioeconomic status who reported less access to outdoor spaces.

scholarly journals Substance Use Disorder: A Model for Integration in Undergraduate Medical Education

2021 ◽  
Vol 8 ◽  
pp. 238212052110258
Author(s):  
Haritha Pavuluri ◽  
Nicolas Poupore ◽  
William Michael Schmidt ◽  
Samantha Gabrielle Boniface ◽  
Meenu Jindal ◽  
...  
Keyword(s):  
Medical Education ◽  
Substance Use ◽  
South Carolina ◽  
Substance Use Disorder ◽  
The United States ◽  
University Of South Carolina ◽  
Community Recovery ◽  
School Of Medicine ◽  
Treatment Gaps ◽  
The University

Substance Use Disorder (SUD) is a debilitating chronic illness with significant morbidity and mortality across the United States. The AAMC and LCME have supported the efforts for more effective medical education of SUD to address the existing stigma, knowledge, and treatment gaps. The Coronavirus 2019 (COVID-19) pandemic and associated social, economic, and behavioral impacts have added to this urgency. The University of South Carolina School of Medicine Greenville (USCSOMG), in collaboration with community organizations, has successfully implemented an integrated SUD education curriculum for medical students. Students learn about SUD in basic sciences, receive case-based education during clinical exercises, and are provided the opportunity to become a recovery coach and participate in the patient and family recovery meetings through this curriculum during preclinical years. During the clinical years, SUD education is enhanced with exposure to Medication for Addition Treatment (MAT). Students also partake in the care coordination of patients with SUD between the hospital and community recovery organizations. All students receive MAT waiver training in their final year and are prepared to prescribe treatment for SUD upon graduation. The experiences in this integrated curriculum integration can perhaps assist other organizations to implement similar components and empower the next generation of physicians to be competent and effective in treating patients with SUD.

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