scholarly journals The Financial Burden of Cancer on Families in the United States

Author(s):  
Patrick Richard ◽  
Nilam Patel ◽  
Yuan-Chiao Lu ◽  
Regine Walker ◽  
Mustafa Younis

This study examined the relationship between a diagnosis of cancer and the likelihood of having any out-of-pocket costs (OOPC) and medical debt, and the amounts of OOPC and medical debt, at the household level. We used the 2013 Panel Study of Income Dynamics, a continuous, representative panel survey that collects demographic, economic, and social data in the United States. The analytic sample included head of households and their spouse (if married), 18–64 years old. Two-part models were used. The first part consisted of logistic regression models and the second part consisted of generalized linear models with logarithmic link and a gamma distribution. Logistic regression results showed odds of 2.13 (CI: 1.27, 3.57, p < 0.01) for any OOPC and odds of 1.55 (CI: 0.93, 2.58, p < 0.1) for any medical debt for households in which either the head or spouse (if married) reported a diagnosis of cancer compared to those that did not report a diagnosis of cancer. Likewise, results from the second part of the model for households with a positive amount of OOPC showed an exponentiated coefficient of 1.73 (CI: 1.33, 2.25, p < 0.01) for households in which either the head or spouse (if married) reported a diagnosis of cancer compared to households without a diagnosis of cancer. This study shows that a diagnosis of cancer places a financial burden on families, particularly with all types of debt, in the United States even after controlling for differences between households with a diagnosis of cancer and those without a diagnosis of cancer.

2014 ◽  
Vol 10 (2) ◽  
pp. 90-99 ◽  
Author(s):  
Darcy White ◽  
Rob Stephenson

As the rate of HIV infection continues to rise among men who have sex with men (MSM) in the United States, a focus of current prevention efforts is to encourage frequent HIV testing. Although levels of lifetime testing are high, low levels of routine testing among MSM are concerning. Using data from an online sample of 768 MSM, this article explores how perceptions of HIV prevalence are associated with HIV testing behavior. Ordinal logistic regression models were fitted to examine correlates of perceived prevalence, and binary logistic regression models were fitted to assess associations between perceived prevalence and HIV testing. The results indicate that perceptions of higher prevalence among more proximal reference groups such as friends and sex partners are associated with greater odds of HIV testing. Perceptions of HIV prevalence were nonuniform across the sample; these variations point to groups to target with strategic messaging and interventions to increase HIV testing among MSM.


2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Khalid Alhussain ◽  
Abdulkarim M. Meraya ◽  
Usha Sambamoorthi

Objectives. (1) To examine the association between serious psychological distress (SPD) and emergency room (ER) use in the past 12 months among adults with multimorbidity in the United States (US) and (2) to investigate the association between SPD and the reasons for ER use. Methods. The current study used a cross-sectional design with retrospective data from the 2015 National Health Interview Survey. Logistic regression models were used to assess the association between SPD and ER use among adults with multimorbidity. Among ER users, adjusted logistic regression models were conducted to examine the association between SPD and the reasons for the ER use. Results. After controlling for other variables, adults with multimorbidity and SPD were more likely to use ER than those with multimorbidity and no SPD (AOR = 1.61, 95% CI = 1.26, 2.04). Among ER users, there were no significant associations between SPD and the reasons for ER use after controlling for other variables. Conclusion. Adults with multimorbidity and SPD were more likely to use ER as compared to those with multimorbidity and no SPD. Among adults with multimorbidity, routine screening for SPD may be needed to reduce the ER use.


2016 ◽  
Vol 32 (1) ◽  
pp. 84-88 ◽  
Author(s):  
Brenna K. VanFrank ◽  
Stephen Onufrak ◽  
Diane M. Harris

Purpose: To examine differences in students’ access to school salad bars across sociodemographic groups and changes in availability over time. Design: Nonexperimental. Setting: Nationally representative 2011 and 2014 YouthStyles surveys. Participants: A total of 833 (2011) and 994 (2014) US youth aged 12 to 17 years. Measures: Youth-reported availability of school salad bars. Analysis: Multivariable logistic regression models were used to assess differences in school salad bar availability by sociodemographics and changes in availability from 2011 to 2014. Results: Youth-reported salad bar availability differed by age in 2011 and race/ethnicity in 2014, but not by sex, income, metropolitan residence, or region in either year. Salad bars were reported by 62% of youth in 2011 and 67% in 2014; the increase was not statistically significant ( P = .07). Significant increases from 2011 to 2014 were noted among youth aged 12 to 14 years (56%-69%; P < .01), youth of non-Hispanic other races (60%-85%; P < .01), and youth in the Midwest (58%-72%; P = .01). Conclusion: These results suggest that youth-reported access to school salad bars does not differ significantly across most sociodemographic groups. Although overall salad bar availability did not increase significantly from 2011 to 2014, some increases were observed among subgroups. Continued efforts to promote school salad bars through initiatives such as Let’s Move Salad Bars to Schools could help increase access for the nearly one-third of US youth reporting no access.


Mindfulness ◽  
2020 ◽  
Vol 11 (12) ◽  
pp. 2725-2729 ◽  
Author(s):  
Otto Simonsson ◽  
Maryanne Martin ◽  
Stephen Fisher

Abstract Objectives The aims of the present study are to provide population estimates for the prevalence of mindfulness use in the United States and to identify which groups are more likely to self-report mindfulness use. Methods Using data from the 2017 National Health Interview Survey (NHIS), the current study analyzed 26,742 responses from adults in the United States and estimated patterns in the likelihood of self-reported mindfulness use across groups using logistic regression models. Results The results suggest that 5% of adults in the United States in 2017 had used mindfulness over the prior year, which is significantly more than the finding that 2% of adults in the United States had used mindfulness during the 12 months prior to the 2012 NHIS interview. The logistic regression models show that self-reported mindfulness use was less likely among married adults and more likely among women, sexual minorities, young and middle-aged adults, white adults, employed adults, adults without minor children in the family, adults from the West of the United States, adults with access barriers to healthcare, adults with cost barriers to healthcare, adults with mental illness, and adults with physical pain. Most notably, mindfulness use was reported by substantial numbers of respondents with access barriers to healthcare (10%), cost barriers to healthcare (9%), mental illness (15%), or physical pain (7%). Conclusions The results of the present study suggest an unequal distribution of mindfulness use across groups in the United States.


2021 ◽  
Author(s):  
Dara H Sorkin ◽  
Emily A Janio ◽  
Elizabeth V Eikey ◽  
Margaret Schneider ◽  
Katelyn Davis ◽  
...  

BACKGROUND Accompanying the rising rates of reported mental distress during the COVID-19 pandemic has been a reported increase in the use of digital technologies to manage health generally, and mental health more specifically. OBJECTIVE The objective of this study was to systematically examine whether there was a COVID-19 pandemic–related increase in the self-reported use of digital mental health tools and other technologies to manage mental health. METHODS We analyzed results from a survey of 5907 individuals in the United States using Amazon Mechanical Turk (MTurk); the survey was administered during 4 week-long periods in 2020 and survey respondents were from all 50 states and Washington DC. The first set of analyses employed two different logistic regression models to estimate the likelihood of having symptoms indicative of clinical depression and anxiety, respectively, as a function of the rate of COVID-19 cases per 10 people and survey time point. The second set employed seven different logistic regression models to estimate the likelihood of using seven different types of digital mental health tools and other technologies to manage one’s mental health, as a function of symptoms indicative of clinical depression and anxiety, rate of COVID-19 cases per 10 people, and survey time point. These models also examined potential interactions between symptoms of clinical depression and anxiety, respectively, and rate of COVID-19 cases. All models controlled for respondent sociodemographic characteristics and state fixed effects. RESULTS Higher COVID-19 case rates were associated with a significantly greater likelihood of reporting symptoms of depression (odds ratio [OR] 2.06, 95% CI 1.27-3.35), but not anxiety (OR 1.21, 95% CI 0.77-1.88). Survey time point, a proxy for time, was associated with a greater likelihood of reporting clinically meaningful symptoms of depression and anxiety (OR 1.19, 95% CI 1.12-1.27 and OR 1.12, 95% CI 1.05-1.19, respectively). Reported symptoms of depression and anxiety were associated with a greater likelihood of using each type of technology. Higher COVID-19 case rates were associated with a significantly greater likelihood of using mental health forums, websites, or apps (OR 2.70, 95% CI 1.49-4.88), and other health forums, websites, or apps (OR 2.60, 95% CI 1.55-4.34). Time was associated with increased odds of reported use of mental health forums, websites, or apps (OR 1.20, 95% CI 1.11-1.30), phone-based or text-based crisis lines (OR 1.20, 95% CI 1.10-1.31), and online, computer, or console gaming/video gaming (OR 1.12, 95% CI 1.05-1.19). Interactions between COVID-19 case rate and mental health symptoms were not significantly associated with any of the technology types. CONCLUSIONS Findings suggested increased use of digital mental health tools and other technologies over time during the early stages of the COVID-19 pandemic. As such, additional effort is urgently needed to consider the quality of these products, either by ensuring users have access to evidence-based and evidence-informed technologies and/or by providing them with the skills to make informed decisions around their potential efficacy.


2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 30-30
Author(s):  
Ajay Kolli ◽  
Rebecca Mozaffarian ◽  
Erica Kenney

Abstract Objectives To test the hypotheses that poor diet and food insecurity are associated with both measured and self-reported vision impairment (VI). Methods We analyzed data from adults age ≥50 years in the National Health and Nutrition Examination Survey (NHANES) between 1999–2008 in the United States (US). To assess diet quality, Healthy Eating Index 2015 scores (HEI-2015) were applied to participants’ 24-hour recall dietary intake. Participants were categorized as having full, marginal, low, or very low food security using the US Food Security Survey Module. Presenting VI (PVI) was defined as presenting distance visual acuity worse than 20/40 in the better-seeing eye. Self-reported VI (SRVI) was defined as vision reported as fair, poor, or very poor. Accounting for NHANES’ complex survey design, separate logistic regression models were constructed to assess the associations between HEI-2015 quintile and PVI, HEI-2015 quintile and SRVI, food insecurity category and PVI, and food insecurity category and SRVI. Models were adjusted for age, gender, race, education, income, cigarette use, alcohol use, body mass index, and physical activity. Results Of the 10078 adults in this analysis, mean age was 63.4 years, 54% were women, and 80% were white. Mean HEI-2015 score (from 0–100) was 52.5. The prevalence of full food security was 89.9%, that of PVI was 7.2%, and that of SRVI was 20.1%. In adjusted logistic regression models, those with HEI-2015 scores in the lowest quintile (poor diet) had significantly higher odds of SRVI (OR: 1.29; 95% confidence interval [CI]: 1.04–1.61), but not PVI (OR: 1.13; CI: 0.86–1.49) compared to those in the fifth quintile. Compared to full food security, marginal (OR: 1.31; CI: 0.97–1.76), low (OR: 1.61; CI: 1.17–2.23), and very low (OR: 2.71; CI: 1.75, 4.20) food security was associated with increased odds of PVI. Similarly, marginal (OR: 1.58; CI: 1.23–2.02), low (OR: 1.46; CI: 1.11–2.92), and very low (OR: 1.85; CI: 1.41, 2.41) food security were associated with increased odds of SRVI compared to full security. Conclusions In this nationally representative sample of US adults age 50 years and older, poorer overall diet quality was associated with greater prevalence of SRVI. In a dose-response pattern, increasingly severe food insecurity was associated with greater prevalence of both PVI and SRVI. Funding Sources None


2002 ◽  
Vol 36 (1) ◽  
pp. 103-124 ◽  
Author(s):  
Benigno E. Aguirre ◽  
Rogelio Saenz

This study tests a hypothesis that Mexican foreign-born immigrants who came to the United States for economic reasons naturalize less often than Cubans who immigrate for political reasons. It uses information from the Panel Study of Income Dynamics, Latino Sample, a national sample of 7,453 respondents from the 1989 Latino National Political Survey (LNPS) and the 1990 Panel Study of Income Dynamics (PSID). Ordinal logistic regression is used to examine the hypothesis. The results indicate that while more Mexicans plan to apply or have applied for naturalization, proportionately more Cubans than Mexicans have naturalized. Cuban political immigrants who came to the United States during the first half of the 1960s naturalize more often than their Mexican counterparts. However, the effect of ethnic identity on naturalization is mediated by a number of other predictors of naturalization such as gender, race, urban residence, socioeconomic status and acculturation.


2017 ◽  
Vol 14 (3) ◽  
pp. 331-342 ◽  
Author(s):  
Thomas John Cooke ◽  
Ian Shuttleworth

It is widely presumed that information and communication technologies, or ICTs, enable migration in several ways; primarily by reducing the costs of migration. However, a reconsideration of the relationship between ICTs and migration suggests that ICTs may just as well hinder migration; primarily by reducing the costs of not moving.  Using data from the US Panel Study of Income Dynamics, models that control for sources of observed and unobserved heterogeneity indicate a strong negative effect of ICT use on inter-state migration within the United States. These results help to explain the long-term decline in internal migration within the United States.


Author(s):  
Kelly Cosgrove ◽  
Maricarmen Vizcaino ◽  
Christopher Wharton

Food waste contributes to adverse environmental and economic outcomes, and substantial food waste occurs at the household level in the US. This study explored perceived household food waste changes during the COVID-19 pandemic and related factors. A total of 946 survey responses from primary household food purchasers were analyzed. Demographic, COVID-19-related household change, and household food waste data were collected in October 2020. Wilcoxon signed-rank was used to assess differences in perceived food waste. A hierarchical binomial logistic regression analysis was conducted to examine whether COVID-19-related lifestyle disruptions and food-related behavior changes increased the likelihood of household food waste. A binomial logistic regression was conducted to explore the contribution of different food groups to the likelihood of increased food waste. Perceived food waste, assessed as the estimated percent of food wasted, decreased significantly during the pandemic (z = −7.47, p < 0.001). Food stockpiling was identified as a predictor of increased overall food waste during the pandemic, and wasting fresh vegetables and frozen foods increased the odds of increased food waste. The results indicate the need to provide education and resources related to food stockpiling and the management of specific food groups during periods of disruption to reduce food waste.


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