scholarly journals Prevalence of Hepatitis C Testing Among Non-Institutionalized Individuals in the US, NHIS 2013-2017

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Jae Eui Soh ◽  
Mohammed A. Khan ◽  
William W. Thompson ◽  
Lauren Canary ◽  
Claudia J. Vellozzi ◽  
...  
Keyword(s):  
United States ◽  
Hepatitis C ◽  
Baby Boomers ◽  
Baby Boomer ◽  
Private Insurance ◽  
Preventive Services ◽  
The United States ◽  
The Us ◽  
Nationally Representative ◽  
Baby Boomer Cohort

ObjectiveUsing a large nationally representative dataset, we estimated the prevalence of self-reported hepatitis C testing among individuals who were recommended to be tested (i.e., baby boomer cohort born between 1945 and 1965) by the CDC and United States Preventive Services Task Force.IntroductionHepatitis C virus (HCV) infection is the most common blood-borne disease in the US and the leading cause of liver-related morbidity and mortality. Approximately 3.5 million individuals in the US were estimated to have been living with hepatitis C in 2010 and approximately half of them were unaware that they were infected. Among HCV infected individuals, those born between 1945 and 1965 (usually referred to as the baby boomer cohort) represents approximately 75% of current cases. Because of the substantial burden of disease among this age group, CDC expanded its existing hepatitis C risk-based testing recommendations to include a one-time HCV antibody test for all persons born between 1945 and 1965. The United States Preventive Services Task Force (USPSTF) subsequently made the same recommendation in June 2013.DescriptionMethodsThe following question "Have you ever had a blood test for hepatitis C?" has been administered annually from 2013 through 2017 on the National Health Interview Survey (NHIS). The NHIS is a nationally representative cross-sectional face-to-face household interview of civilian noninstitutionalized individuals in the U.S. The NHIS survey uses a complex multistage probability design that includes stratification, clustering, and oversampling. We estimated the prevalence of hepatitis C testing for adults in the US during the study period from 2013 to 2017. In addition, we carried out stratified analyses comparing those with private insurance to those who did not have private insurance. We reported weighted estimates taking into account the NHIS survey design. The R statistical software (R Core Team, 2018) was used to estimate weighted prevalence estimates for hepatitis C testing.ResultsDuring the study period from 2013-2017, there were 148,674 adults who responded to the ever tested for hepatitis C question. In addition, 33.56% of these individuals were born between 1945 and 1965; among all adults, the weighted percentage of individuals that responded yes they had received a hepatitis C screening test was 12.82% (95% CI: 12.54-13.10%) while for baby boomers the estimate was 13.93% (95% CI: 13.51-14.35%).Figure 1 presents the annual trend in the hepatitis C test prevalence over the study period by birth cohorts. For both cohorts, there were significant increases over time in hepatitis C testing prevalence. The two trend lines began to diverge in 2015 with the baby boomer cohort reporting higher rates of hepatitis C testing. For the baby boomer cohort, there was also a substantial increase in reported hepatitis C testing in 2017 relative to 2016. Similar trends were found for the samples when we restricted the sample to only those with private insurance. Compared to the people with private insurance, the baby boomers with 'Non-private’ insurance, including Medicaid, Medicare, or military- government sponsored insurances, reported higher rates of testing.ConclusionAcross the five-year period from 2013 through 2017, we found increasing rates of self-reported hepatitis C testing among non-institutionalized U.S. adults. For the baby boomer cohort, we saw a substantial increase in testing in 2017, which was likely due in part, to increased awareness among both physicians and patients of the CDC and USPSTF recommendation to have all baby boomers tested. Efforts to increase the awareness of these recommendations should continue. Additional targeted promotions among hard to reach populations should also be considered.How the Moderator Intends to Engage the Audience in Discussions on the TopicThis panel will discuss strengths and weaknesses for monitoring hepatitis C testing using alternative data sources including self-reported data, insurance claims data, and laboratory testing data. 

scholarly journals Rising Trends in Emergency Department Visits Associated With Hepatitis C Virus Infection in the United States, 2006-2014

2019 ◽  
Vol 134 (6) ◽  
pp. 685-694
Author(s):  
Shaoman Yin ◽  
Laurie Barker ◽  
Eyasu H. Teshale ◽  
Ruth B. Jiles
Keyword(s):  
United States ◽  
Emergency Department ◽  
Hepatitis C ◽  
Baby Boomers ◽  
The United States ◽  
Emergency Department Visits ◽  
Medicare Beneficiaries ◽  
Compensated Cirrhosis ◽  
Ed Visits ◽  
Medicaid Beneficiaries

Objective: Emergency departments (EDs) are critical settings for hepatitis C care in the United States. We assessed trends and characteristics of hepatitis C–associated ED visits during 2006-2014. Methods: We used data from the 2006-2014 Nationwide Emergency Department Sample to estimate numbers, rates, and costs of hepatitis C–associated ED visits, defined by either first-listed diagnosis of hepatitis C or all-listed diagnosis of hepatitis C. We assessed trends by demographic characteristics, liver disease severity, and patients’ disposition by using joinpoint analysis, and we calculated the average annual percentage change (AAPC) from 2006 to 2014. Results: During 2006-2014, the rate per 100 000 visits of first-listed and all-listed hepatitis C–associated ED visits increased significantly from 10.1 to 25.4 (AAPC = 13.0%; P < .001) and from 484.4 to 631.6 (AAPC = 3.4%; P < .001), respectively. Approximately 70% of these visits were made by persons born during 1945-1965 (baby boomers); 30% of visits were made by Medicare beneficiaries and 40% by Medicaid beneficiaries. Significant rate increases were among visits by baby boomers (first-listed: AAPC = 13.8%; all-listed: AAPC = 2.6%), persons born after 1965 (first-listed: AAPC = 14.3%; all-listed: AAPC = 9.2%), Medicare beneficiaries (first-listed: AAPC = 18.0%; all-listed: AAPC = 3.9%), and persons hospitalized after ED visits (first-listed: AAPC = 20.0%; all-listed: AAPC = 2.3%; all P < .001). Increasing proportions of compensated cirrhosis were among visits by baby boomers (first-listed: AAPC = 11.5%; all-listed: AAPC = 6.3%). Annual hepatitis C–associated total ED costs increased by 400.0% (first-listed) and 192.0% (all-listed) during 2006-2014. Conclusion: Public health efforts are needed to address the growing burden of hepatitis C care in the ED.

Hepatitis C Virus in Children: Trying to Overcome the Domestic and Global Challenges of Cases and Cost

2019 ◽  
Author(s):  
Chase Perfect ◽  
Ravi Jhaveri
Keyword(s):  
United States ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Global Health ◽  
The United States ◽  
Cost Of Treatment ◽  
Global Challenges ◽  
The Us ◽  
Adults And Children ◽  
Global Health Challenge

Abstract Over the last decade, Hepatitis C virus has persisted and evolved as a domestic and global health challenge for adults and children. The challenges involve both increased cases in the United States and cost of treatment both in the US and globally.

scholarly journals Trends and Risk Factors for Leishmaniasis among Reproductive Aged Women in the United States

2021 ◽  
Vol 10 (2) ◽  
pp. 166-173
Author(s):  
Chioma Ikedionwu ◽  
Deepa Dongarwar ◽  
Courtney Williams ◽  
Evelyn Odeh ◽  
Maylis Nkeng Peh ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Global Health ◽  
Protective Factor ◽  
Private Insurance ◽  
The United States ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
The Us ◽  
Clinical Awareness

Background and Objective: Leishmaniasis, a neglected tropical disease, is endemic in several regions globally, but commonly regarded as a disease of travelers in the United States (US). The literature on leishmaniasis among hospitalized women in the US is very limited. The aim of this study was to explore trends and risk factors for leishmaniasis among hospitalized women of reproductive age within the US. Methods: We analyzed hospital admissions data from the 2002-2017 Nationwide Inpatient Sample among women aged 15-49 years. We conducted descriptive statistics and bivariate analyses for factors associated with leishmaniasis. Utilizing logistic regression, we assessed the association between sociodemographic and hospital characteristics with leishmaniasis disease among hospitalized women of reproductive age in the US. Joinpoint regression was used to examine trends over time. Results: We analyzed 131,529,239 hospitalizations; among these, 207 cases of leishmaniasis hospitalizations were identified, equivalent to an overall prevalence of 1.57 cases per million during the study period. The prevalence of leishmaniasis was greatest among older women of reproductive age (35-49 years), Hispanics, those with Medicare, and inpatient stay in large teaching hospitals in the Northeast of the US. Hispanic women experienced a statistically significant increased odds of leishmaniasis diagnosis (OR, 1.80; 95% CI, 1.19-4.06), compared to Non-Hispanic (NH) White women. Medicaid and Private Insurance appeared to serve as a protective factor in both unadjusted and adjusted models. We did not observe a statistically significant change in leishmaniasis rates over the study period. Conclusion and Global Health Implications: Although the prevalence of leishmaniasis among women of reproductive age appears to be low in the US, some risk remains. Thus, appropriate educational, public health and policy initiatives are needed to increase clinical awareness and timely diagnosis/treatment of the disease.   Copyright © 2021 Ikedionwu, et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.

scholarly journals The January 6 Insurrection and America's Standing Abroad: Natural Experimental Evidence from Five Unexpectedly Interrupted Public Opinion Surveys

2022 ◽  
Author(s):  
Sam van Noort
Keyword(s):  
United States ◽  
Public Opinion ◽  
Experimental Test ◽  
Public Support ◽  
The United States ◽  
Random Digit Dialing ◽  
Random Digit ◽  
Public Opinion Surveys ◽  
The Us ◽  
Nationally Representative

American geopolitical power partly relies on foreign public support for its leadership. Pundits worry that this support is evaporating now that the United States—which claims to be the world’s beacon of democracy—has itself experienced democratic back- sliding. I provide the first natural experimental test of this hypothesis by exploiting that the January 6 insurrection of the US Capitol unexpectedly occurred while Gallup was conducting nationally-representative surveys in India, Indonesia, Malaysia, Romania, and Vietnam. Because Gallup uses random digit dialing I can identify the effect by comparing US leadership approval among respondents that were interviewed just before, and just after, January 6, 2021. I find that the insurrection had no effect on US approval. If even a violent attempt to overturn a free and fair election does not affect US approval abroad it is unlikely that any other domestic anti-democratic event will.

US Vicarious Identity with Israel, 1967–2020

2021 ◽  
pp. 89-120
Author(s):  
Christopher S. Browning ◽  
Pertti Joenniemi ◽  
Brent J. Steele
Keyword(s):  
United States ◽  
Baby Boomer ◽  
The United States ◽  
Positive Identity ◽  
The Us ◽  
Formative Experience ◽  
Six Day War ◽  
1960S And 1970S ◽  
The 1960S

The chapter explores the United States’ vicarious identification with Israel, arguing that since the 1967 Six-Day War, Israel has served as a positive identity proxy. Two features of Israeli military might have proven attractive for the United States’ vicarious identification with it: its preemptive military actions and its resounding military successes. Using generational analysis the chapter surmises that the increased connections made to Israel in the 1990s and 2000s by the United States are a result of the US Baby Boomer generation’s admiration of Israel as heroic, right, and assertive and where this image served as a formative experience for that generation at the same time as the United States was at its military, moral, and cultural nadir in Vietnam amid the broader tumult of the 1960s and 1970s. This generational take may also explain the increased tensions between the two countries and even the unraveling of the United States’ vicarious identification with Israel hereafter.

scholarly journals Prostate Cancer Incidence 5 Years After US Preventive Services Task Force Recommendations Against Screening

2020 ◽  
Vol 113 (1) ◽  
pp. 64-71 ◽  
Author(s):  
Ahmedin Jemal ◽  
MaryBeth B Culp ◽  
Jiemin Ma ◽  
Farhad Islami ◽  
Stacey A Fedewa
Keyword(s):  
Prostate Cancer ◽  
United States ◽  
Cancer Incidence ◽  
Task Force ◽  
Preventive Services ◽  
The United States ◽  
Research Database ◽  
Prostate Cancer Incidence ◽  
Stage Disease ◽  
The Us

Abstract Background Previous studies reported that prostate cancer incidence rates in the United States declined for local-stage disease and increased for regional- and distant-stage disease following the US Preventive Services Task Force recommendations against prostate-specific antigen-based screening for men aged 75 years and older in 2008 and for all men in 2012. It is unknown, however, whether these patterns persisted through 2016. Methods Based on the US Cancer Statistics Public Use Research Database, we examined temporal trends in invasive prostate cancer incidence from 2005 to 2016 in men aged 50 years and older stratified by stage (local, regional, and distant), age group (50-74 years and 75 years and older), and race and ethnicity (all races and ethnicities, non-Hispanic Whites, and non-Hispanic Blacks) with joinpoint regression models to estimate annual percent changes. Tests of statistical significance are 2-sided (P &lt; .05). Results For all races and ethnicities combined, incidence for local-stage disease declined beginning in 2007 in men aged 50-74 years and 75 years and older, although the decline stabilized during 2013-2016 in men aged 75 years and older. Incidence decreased by 6.4% (95% CI = 4.9%-9% to 7.9%) per year from 2007 to 2016 in men aged 50-74 years and by 10.7% (95% CI = 6.2% to 15.0%) per year from 2007 to 2013 in men aged 75 years and older. In contrast, incidence for regional- and distant-stage disease increased in both age groups during the study period. For example, distant-stage incidence in men aged 75 years and older increased by 5.2% (95% CI = 4.2% to 6.1%) per year from 2010 to 2016. Conclusions Regional- and distant-stage prostate cancer incidence continue to increase in the United States in men aged 50 years and older, and future studies are needed to identify reasons for the rising trends.

scholarly journals A State of Uncertainty: An Analysis of Recent State Legislative Proposals to Regulate Preventive Services in the United States

2019 ◽  
Vol 56 ◽  
pp. 004695801984151
Author(s):  
Maxim Gakh ◽  
Cody Cris ◽  
Prescott Cheong ◽  
Courtney Coughenour
Keyword(s):  
United States ◽  
Private Insurance ◽  
Preventive Services ◽  
State Level ◽  
The United States ◽  
Additional Patient ◽  
Evidence Based ◽  
State Legislation ◽  
Legislative Proposals ◽  
Patient Groups

This policy brief examines preventive services state legislation trends in the United States during uncertainty regarding the Affordable Care Act (ACA), which requires certain coverage of 4 evidence-based preventive services categories without additional patient costs under §2713. We used a legal mapping approach to search for and analyze state legislation related to preventive services proposed or enacted over a 25-month period of ACA uncertainty. We screened 1231 bills and coded the 76 screened-in bills. Next, we determined their characteristics and examined trends. Bills originated in 28 states, and 69.7% were not enacted. Only 3.9% contained requirements contingent on ACA modifications. About 56.6% referenced services covered by §2713, but usually not entire §2713 categories. Bills also mentioned preventive services in general (53.9%) and services outside §2713’s scope (21.1%). About 55.3% applied to private insurance, and 75.0% only to one patient group. Bills generally promoted access, and 51.3% specifically prohibited cost-sharing. But 26.3% of the bills limited access to preventive services. State-level legislation targets preventive services, usually expanding, but sometimes limiting, access. Most bills single out specific services without fully incorporating evidence-based recommendations. State legislation may therefore promote access to preventive services but can favor certain services, deviate from experts’ recommendations, and increase nationwide variability. State legislation can function as an important lever for access to preventive services across patient groups. This may be especially important during uncertainty about federal policy. However, the design of state-level proposals is critical for maximizing access to preventive services.

Icon and taboo: single-payer politics in Canada and the US

2019 ◽  
Vol 35 (1) ◽  
pp. 5-24 ◽  
Author(s):  
Carolyn Hughes Tuohy
Keyword(s):  
United States ◽  
Health Care ◽  
Medical Profession ◽  
Private Insurance ◽  
The United States ◽  
Hospital Services ◽  
Popular Support ◽  
Single Payer ◽  
The Us ◽  
Political Economies

AbstractIn 1965 and 1966, the United States and Canada adopted single-payer models of government insurance for physician and hospital services – universal in Canada, but restricted to certain population groups in the US. At the time, the American and Canadian political economies of health care and landscapes of public opinion were remarkably similar, and the different policy designs must be understood as products of the distinctive macro-level politics of the day. Subsequently, however, the different scopes of single-payer coverage would drive the two systems in different directions. In Canada, the single-payer system became entrenched in popular support and in the nexus of interest it created between the medical profession and the state. In the US, Medicare became similarly entrenched in popular support, but did so as part of the larger multi-payer private insurance system. In the process universal single-payer coverage became politically iconic in Canada and taboo in the US.

scholarly journals Intergenerational Occupational Mobility in Great Britain and the United States Since 1850

2013 ◽  
Vol 103 (4) ◽  
pp. 1109-1137 ◽  
Author(s):  
Jason Long ◽  
Joseph Ferrie
Keyword(s):  
United States ◽  
Nineteenth Century ◽  
Great Britain ◽  
Occupational Mobility ◽  
The United States ◽  
The Us ◽  
Late Twentieth ◽  
Nationally Representative ◽  
Fathers And Sons ◽  
Late Twentieth Century

The US tolerates more inequality than Europe and believes its economic mobility is greater than Europe's, though they had roughly equal rates of intergenerational occupational mobility in the late twentieth century. We extend this comparison into the nineteenth century using 10,000 nationally-representative British and US fathers and sons. The US was more mobile than Britain through 1900, so in the experience of those who created the US welfare state in the 1930s, the US had indeed been “exceptional.” The US mobility lead over Britain was erased by the 1950s, as US mobility fell from its nineteenth century levels. (JEL J62, N31, N32, N33, N34)

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