National Health Interview Survey Research Articles

Nationally Representative Rates of Incident Prescription Opioid Use Among United States Adults and Selected Subpopulations: Longitudinal Cohort Study From the National Health Interview Survey, 2019 to 2020

Nationally representative rates of incident prescription opioid use in the United States adult population and selected subpopulations are unknown. Using the National Health Interview Survey (2019–2020) longitudinal cohort, a cohort with 1-year follow-up created using random cluster probability sampling of noninstitutionalized civilian U.S. adults, we estimated rates and predictors of incident opioid use. Of 21,161 baseline (2019) participants randomly chosen for follow-up, the final analytic sample included 10,415 who also participated in 2020. Exposure variables were selected per the socio-behavioral model of health care utilization: predisposing characteristics (sex, age, race, etc), enabling characteristics (socioeconomic status, insurance status), health status (pain, disability, comorbidities, etc), and health care use (office visits, emergency room visits, and hospitalizations). Among adults who did not use prescription opioids in 2019, a 1-year cumulative incidence of 4.1% (95% confidence interval [CI]: 3.5–4.6) was seen in 2020, with an incidence rate (IR) of 32.6 cases of new prescription opioid use per 1,000 person-years (PYs). Cumulative incidence, IR, and adjusted relative risk (RR) varied by participant characteristics. We observed the highest IR in those with ineffective pain treatment (81.6 cases per 1,000 PY) and those who visited the emergency room ≥3 times (93.8 cases per 1,000 PY). Participants reporting ≥4 painful conditions had an adjusted RR of 2.9 (95% CI: 2.0–4.1), while the RR for those with sleep problems was 2.3 (95% CI: 1.7–3.1). Overall, this study presents nationally representative rates of incident prescription opioid use and suggests that some participants are using prescription opioids as an early-resort analgesic contrary to best-practice guidelines. PerspectiveThis longitudinal cohort study presents nationally representative rates of incident prescription opioid use in U.S. adults and selected subpopulations. Our data suggest that some participants are using prescription opioids as a first-line or early-resort analgesic, contrary to best-practice guidelines.

Frailty as a sequela of burn injury: a post hoc analysis of the “RE-ENERGIZE” multicenter randomized-controlled trial and the National Health Interview Survey

BackgroundWith advancements in burn treatment and intensive care leading to decreased mortality rates, a growing cohort of burn survivors is emerging. These individuals may be susceptible to frailty, characterized by reduced physiological reserve and increased vulnerability to stressors commonly associated with aging, which significantly complicates their recovery process. To date, no study has investigated burns as a potential risk factor for frailty. This study aimed to determine the short-term prevalence of frailty among burn survivors’ months after injury and compare it with that of the general population.MethodsA post hoc analysis was conducted on the Randomized Trial of Enteral Glutamine to Minimize the Effects of Burn Injury (RE-ENERGIZE) trial, an international randomized-controlled trial involving 1200 burn injury patients with partial- or full-thickness burns. Participants who did not complete the 36-Item Short Form Health Survey (SF-36) questionnaire were excluded. Data for the general population were obtained from the 2022 National Health Interview Survey (NHIS). Frailty was assessed using the FRAIL (Fatigue, Resistance, Ambulation, Illness, Loss of weight) scale. Due to lack of data on loss of weight, for the purposes of this study, malnutrition was used as the fifth variable. Illness and malnutrition were based on admission data, while fatigue, resistance, and ambulation were determined from post-discharge responses to the SF-36. The burn cohort and general population groups were matched using propensity score matching and compared in terms of frailty status. Within the burn group, patients were divided into different subgroups based on their frailty status, and the differences in their (instrumental) activities of daily living (iADL and ADL) were compared. A multivariable analysis was performed within the burn cohort to identify factors predisposing to frailty as well as compromised iADL and ADL.ResultsOut of the 1200 burn patients involved in the study, 600 completed the required questionnaires [follow-up time: (5.5 ± 2.3) months] and were matched to 1200 adults from the general population in the U.S. In comparison to the general population, burn patients exhibited a significantly higher likelihood of being pre-frail (42.3% vs. 19.8%, P < 0.0001), or frail (13.0% vs. 1.0%, P < 0.0001). When focusing on specific components, burn patients were more prone to experiencing fatigue (25.8% vs. 13.5%, P < 0.0001), limited resistance (34.0% vs. 2.7%, P < 0.0001), and restricted ambulation (41.8% vs. 3.8%, P < 0.0001). Conversely, the incidence rate of illness was observed to be higher in the general population (1.2% vs. 2.8%, P = 0.03), while no significant difference was detected regarding malnutrition (2.3% vs. 2.6%, P = 0.75). Furthermore, in comparison with robust burn patients, it was significantly more likely for pre-frail and frail patients to disclose compromise in ADL and iADL. The frail cohort reported the most pronounced limitation.ConclusionsOur findings suggest a higher incidence of post-discharge frailty among burn survivors in the short-term following injury. Burn survivors experience compromised fatigue, resistance, and ambulation, while rates of illness and malnutrition were lower or unchanged, respectively. These results underscore the critical need for early identification of frailty after a burn injury, with timely and comprehensive involvement of a multidisciplinary team including burn and pain specialists, community physicians, physiotherapists, nutritionists, and social workers. This collaborative effort can ensure holistic care to address and mitigate frailty in this patient population.

Intakes of Lean Proteins and Processed Meats and Differences in Mental Health between Rural and Metro Adults 50 Years and Older.

Mental health disparities exist between rural and metro areas of the United States. Differences in dietary intake may contribute to these disparities. We examined differences in dietary intake and mental health between those 50 years and older (n = 637) living in rural counties to those living in metro counties in North Dakota and the relationship between dietary intake to days with depression or anxiety. A survey was conducted throughout North Dakota. Items were modified from other surveys, such as the Behavioral Risk Factor Surveillance System questionnaires and the National Health Interview Survey Cancer Control Supplement Dietary Screener Questionnaire. Comparing medians, individuals more likely to be unable to perform normal daily activities due to mental health (p = 0.009) resided in rural areas instead of metro areas. Those living rurally also ate more processed meats (p = 0.005), while trending toward less lean protein intake (p = 0.056). Multinomial regression analyses controlling for covariates revealed that lean protein intake and fruit intake were inversely associated with days with depression and anxiety (all p < 0.05), whereas processed meat intake was positively associated with anxiety (p = 0.005). Clinicians working with older adults residing in rural areas should emphasize substituting lean proteins for processed meats.

Edukasi Penanganan Nonfarmakologi Nyeri Otot Kronis

Chronic pain can result from various clinical conditions and may persist for more than three months. The symptoms can range from mild to severe. While chronic pain can be associated with various diseases, its exact cause sometimes remains unclear. In 2019, data from the National Health Interview Survey in the United States indicated that approximately 1 in 5 adults experienced chronic pain, with over 7% frequently limiting their activities due to this condition. However, there is no comparable data available for Indonesia. Chronic pain restricts activities and can decrease a person’s quality of life. Various options are available for pain management, one of which is non-pharmacological therapy, including hot-cold compresses, massage and stretching techniques, music therapy, and aromatherapy. These therapies aim to improve bodily function, regulate emotions, reduce weakness, stress, and anxiety, and decrease the need for pain medication. Gout is among the most common causes of chronic pain, with a prevalence of 3.9% in the US, 2.5% in Europe, and 7.3% in Indonesia, according to Riskesdas (2018). Based on this, local citizens were provided with education about pain management. This community service activity involved educating citizens on non-pharmacological treatments for chronic pain management and offering health services to residents of Angke. The purpose was to increase knowledge about non-pharmacological treatments for managing chronic pain. This activity was conducted on April 27th, 2024, from 07.00 to 12.00 at the Dhammasavana School in the Angke sub-district area, West Jakarta. The activities proceeded smoothly and in an orderly manner. A comparison of citizens’ knowledge before and after the education revealed a 58.18% increase in knowledge, contributing to improved welfare among the local residents.

Leveraging publicly available data to evaluate health reform: establishing a methodology to assess the future impact of over-the-counter hearing aids

Health systems are complex and health reform is uncertain. With an aging global population, chronic health conditions are increasing and have become a priority for policymakers. Hearing loss is the third most common chronic condition among older adults and if left untreated, is associated with poor health and social outcomes. In the US, accessibility and affordability have been significant barriers to hearing aid utilization. Through new reform, over-the-counter (OTC) hearing aids are now available. This study demonstrates how publicly available health data was used to establish a methodology to define, characterize, and analyze the target population of this reform. In this retrospective cross-sectional cohort analysis, data from the National Health Interview Survey (NHIS) was utilized, with a sample that included respondents from the 2021 NHIS Sample Adult Interview. Three hearing aid groups (Active, Potential, General) were defined using questions from the NHIS annual core questionnaire and a baseline population health framework was developed. Binary logistic regression confirmed that the framework sufficiently described two group comparisons (Active-Potential, Active General) and also identified the key determinants of hearing aid utilization. Classification and regression tree (CART) classification amply predicted active hearing aid users and verified the key determinants as important predictors. These findings aligned nicely with literature published before OTC hearing aids were made available, confirming the NHIS to be consistent and representative. Our methodology can be repeated to examine the impact of OTC hearing aids in the post-implementation period and similar approaches should be taken to examine other emerging health reforms.

Correlates and patterns of using complementary health approaches among individuals with recent and longer-term cancer diagnoses: a US national cross-sectional study.

To (1) describe and compare the prevalence of using of complementary health approaches, focusing on mind and body practices, and reasons for use among cancer survivors, and (2) examine characteristics associated with use among those with a recent and non-recent diagnosis of cancer compared to those without a previous cancer diagnosis. Using data from the 2022 US National Health Interview Survey, prevalence estimates were derived for using any complementary health approach, by category (manipulative body-based [chiropractor, acupuncture, massage], creative [music therapy, art therapy], and mind-body [meditation, guided imagery, yoga]), and reasons for use. Regression models identified correlates of use among all participants and within cancer diagnosis subgroups. Among 26,523 adult participants, overall prevalence of using any complementary approach was similar amongst individuals with recent cancer (40.17%), non-recent cancer (37.75%), and no cancer diagnosis (37.93%). However, odds of use were higher amongst recent (OR = 1.37) and relatively long term(OR = 1.14) cancer survivors compared to those without a history of cancer in adjusted models (both p < 0.05). In cancer survivors, mind-body approaches were mostly used for general health purposes, whereas manipulative approaches were used for general health and pain management. Female sex, younger age, higher education and income were among the prominent variables associated with using complementary approaches. We present an important snapshot of the landscape of using complementary approaches, specifically mind and body practices, in adult cancer survivors in the US. Inequalities in access to these therapies may exist, as use remains highest amongst those with higher socioeconomic conditions. Given the prevalence and potential benefits of complementary approaches among cancer survivors, there is a need to better understand their effectiveness, optimal use, and integration into cancer care. Further research is needed to understand and address access barriers that might exist amongst some cancer survivors.

The Impact of Physical Activity on Memory Loss and Concentration in Adults Aged 18 or Older in the U.S. in 2020.

This cross-sectional study used secondary data from the USA 2020 National Health Interview Survey database. The goal of this study is to outline the impact physical activity has on cognition and mental ability. The reason we chose to pursue this research was a result of the exponentially growing weight of economic and emotional burden caused by cognitive impairments and diseases. The main outcome was whether individuals experienced dementia symptoms such as memory loss and difficulty concentrating. The main exposure was following physical activity guidelines (none, strength only, aerobic only, both). The confounders included age, sex, region, heart disease status, smoking status, drinking status, and depression status. The sample is composed of 30,119 USA adults aged 18 or older. Of those participants, 46% were male and 54% were female. By age, 96% were 18-84 years old, and approximately 4% were 85 and older. Logistic regression analysis was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). There was a statistically significant association between difficulty following physical activity guidelines and cognitive difficulties. Those who met aerobic only increased the odds of cognitive difficulty by 52% (OR 1.52; 95% CI: 1.34-1.74) compared with those who met both criteria. Those who met the strength criteria had 1.7 greater odds of cognitive difficulties (OR 1.70; 95% CI: 1.42-2.02) than those who met both criteria. Those who met neither of these guidelines had almost threefold greater odds of having cognitive difficulties (OR 2.64; 95% CI: 2.36-2.96) than those who met both guidelines. Researchers and healthcare providers should collaborate to encourage meeting these guidelines and addressing barriers preventing people from being physically active, such as physical limitations and access to safe recreational spaces. Future studies should address the health disparities regarding physical activity.

Disparities in adherence to physical activity guidelines among US adults: A population-based study.

The objective of this study was to determine adherence to national guidelines for aerobic and muscle-strengthening physical activity among United States (US) adults and identify factors associated with guideline nonadherence. The 2022 National Health Interview Survey data were analyzed to evaluate self-reported physical activity among 26,494 US adults. Adherence to national guidelines was defined as engaging in ≥150 minutes moderate-intensity or ≥75 minutes vigorous-intensity aerobic activity/week, and muscle-strengthening activity ≥2 days/week. A multivariable logistic regression model evaluated associations between 24 sociodemographic and health variables with nonadherence to physical activity guidelines. Shapley Additive Explanations were used to assess the relative importance of each factor in the model. The population-weighted analysis revealed that only 24.3% of US adults met both the aerobic and muscle-strengthening activity guidelines. The regression model identified 17 factors significantly associated with nonadherence. When evaluating the relative importance of these variables, older age, lower educational attainment, and lower household income emerged as the primary determinants of nonadherence. Guideline adherence was lowest among subgroups with multiple risk factors, with only 6.5% of older adults with lower income and education meeting the guidelines. In contrast, adherence was 42.7% in younger respondents with higher incomes and educational attainment. In conclusion, physical activity rates among US adults remain below public health targets, with significant disparities among sociodemographic groups. Expanded outreach efforts targeting higher-risk populations are urgently needed to address barriers, promote physical activity engagement, and achieve health equity.

Medical financial hardship in the Southern United States: the struggle continues across generations pre- and post- the Affordable Care Act

IntroductionMedical financial hardship in the United States is a growing public health concern. This study aims to assess the south vs. non-south disparities in medical financial hardship among US adults of different generations – Boomers (born between 1946 and 1964), Generation X (born between 1965 and 1980), and the Millennials (born between 1981 and 1996) across periods pre- and post- Affordable Care Act (ACA).MethodsThis observational study utilizes data from multiple waves of the National Health Interview Survey (NHIS) split into three periods: pre–ACA (2011–2013), ii) post ACA (2015–2018), and iii) COVID-19 pandemic (2021–2022). Multivariable logistic regressions were fitted, separately for each generation in each period, to compare the extent of medical financial hardship among those from South to rest of the US, and Karlson-Holm-Breen (KHB) decomposition was applied to analyze whether there was a mediating impact of health insurance coverage.ResultsAdults living in the South were more likely to experience medical financial hardship in all three periods. Residing in the South was associated with 1.7 to 2.6% points (pp) higher probability of medical financial hardship among boomers, 1.8 to 4.0 pp among generation Xers, and 1.7 to 2.8 pp among millennials. The relationship was robust after accounting for chronic comorbidities, sociodemographic and socioeconomic attributes and was partially mediated through differences in health insurance coverage.ConclusionsThe problem of medical financial hardship has been deeply rooted in the South across generations, which was partly attributable to the regional differences in health insurance coverage.

Association of sleep duration and all-cause and cancer-specific mortality: results of 2004 national health interview survey (NHIS)

Association of sleep duration and all-cause and cancer-specific mortality: results of 2004 national health interview survey (NHIS)

A Comparison of Working Conditions Between Immigrant and Non-immigrant Healthcare Workers in the United States: Evidence From the National Health Interview Survey

Immigrants in the United States (U.S.) healthcare workforce face challenging working conditions. This study aimed to compare the working conditions of healthcare workers based on immigration status. Using National Health Interview Survey (NHIS) 2015 data, we compared the sociodemographic characteristics and working conditions between 374 non-U.S. born and 1,986 U.S. born healthcare workers. Multivariable logistic regression was used to examine associations between immigration status and selected working conditions. It was found that non-U.S. born and U.S. born healthcare workers differed in sociodemographic and occupational characteristics. After adjusting for sociodemographic covariates, non-U.S. born healthcare workers had higher odds of non-permanent contract work (aOR: 1.87, 95% CI [1.25, 2.79], p < 0.01) and lower odds of workplace harassment (aOR: 0.51, 95% CI [0.31, 0.83], p < 0.01), compared to U.S. born healthcare workers. Immigrant healthcare workers' occupational experiences should be further explored to improve organizational and psychosocial working conditions.

Cancer in people who identify as lesbian, gay, bisexual, transgender, queer, or gender-nonconforming.

Individuals who identify as lesbian, gay, bisexual, transgender, queer, intersex, or gender-nonconforming (LGBTQ+) experience discrimination and minority stress that may lead to elevated cancer risk. In the absence of population-based cancer occurrence information for this population, this article comprehensively examines contemporary, age-adjusted cancer risk factor and screening prevalence using data from the National Health Interview Survey, Behavioral Risk Factor Surveillance System, and National Youth Tobacco Survey, and provides a literature review of cancer incidence and barriers to care. Lesbian, gay, and bisexual adults are more likely to smoke cigarettes than heterosexual adults (16% compared to 12% in 2021-2022), with the largest disparity among bisexual women. For example, 34% of bisexual women aged 40-49 years and 24% of those 50 and older smoke compared to 12% and 11%, respectively, of heterosexual women. Smoking is also elevated among youth who identify as lesbian, gay, or bisexual (4%) or transgender (5%) compared to heterosexual or cisgender (1%). Excess body weight is elevated among lesbian and bisexual women (68% vs. 61% among heterosexual women), largely due to higher obesity prevalence among bisexual women (43% vs. 38% among lesbian women and 33% among heterosexual women). Bisexual women also have a higher prevalence of no leisure-time physical activity (35% vs. 28% among heterosexual women), as do transgender individuals (30%-31% vs. 21%-25% among cisgender individuals). Heavier alcohol intake among lesbian, gay, and bisexual individuals is confined to bisexual women, with 14% consuming more than 7 drinks/week versus 6% of heterosexual women. Incontrast, prevalence of cancer screening and risk reducing vaccinations in LGBTQ+ individuals is similar to or higher than their heterosexual/cisgender counterparts except for lower cervical and colorectal cancer screening among transgender men. People within the LGBTQ+ population have a higher prevalence of smoking, obesity, and alcohol consumption compared to heterosexual and cisgender people, suggesting a higher cancer burden. Health systems have an opportunity to help inform these disparities through the routine collection of information on sexual orientation and gender identity to facilitate cancer surveillance and to mitigate them through education to increase awareness of LGBTQ+ health needs.

Association of aerobic and muscle-strengthening activity with chronic low back pain: population-based study

BACKGROUND CONTEXTChronic low back pain (CLBP) is a significant global health burden, primarily affecting the middle-aged and older; However, there is a lack of clear, evidence-based guidelines for leisure-time physical activity aimed at preventing CLBP. PURPOSEThis study sought to delineate the association between aerobic physical activity (APA) and muscle strengthening activities (MSA) and the prevalence of CLBP. STUDY DESIGNThis was a population-based study conducted across the United States. PATIENT SAMPLEThis nationwide study utilizes deidentified data from 22 consecutive rounds of the National Health Interview Survey (NHIS) from 1997 to 2018. OUTCOME MEASURESThe primary outcome was self-reported CLBP. METHODSWe analyzed the prevalence of CLBP in a representative sample of 324,793 middle-aged and older people. Among 263,871 individuals, we used multiple logistic regression to investigate individual and joint association between the amount of APA and MSA with CLBP. RESULTSIn total, 263,871 participants (mean age, 59.0 years; SD, 9.7) were included in the final analysis. From 1997 to 2018, the prevalence of CLBP was approximately 32%, with an annual increase. Engaging in APA for 75 to 150 minutes weekly was associated with a modest reduction in CLBP risk (OR [95% CI] = 0.97 [0.97–0.98]). Similar benefits were seen with 150 to 225, 225 to 300, and >300 minutes. Engaging in MSA 2 to 3 times and 4 to 5 times weekly also reduced CLBP risk (0.98 [0.98–0.99] and 0.98 [0.97–0.99], respectively). Optimal reductions of CLBP risk may be associated with balanced levels of APA and MSA, with recommended amounts being 225 to 300 min/w of APA and 4 to 5 times/w of MSA (0.92 [0.89–0.95]). CONCLUSIONSThe study found engaging in over 75 minutes of APA and 2 to 5 weekly MSA sessions is associated with a reduced risk of CLBP. Furthermore, a balanced combination of APA and MSA may correspond to the greatest reduction in CLBP risk.

54016 Total-body skin examination rates among high-risk patients by insurance type: A National Health Interview Survey Study

54016 Total-body skin examination rates among high-risk patients by insurance type: A National Health Interview Survey Study

Use of complementary medicine among US adults with post-COVID-19: Results from the 2022 National Health Interview Survey

ObjectiveThe aim of this study was to investigate the prevalence and type of complementary medicine (CM) use as well as potential factors related to CM use in a representative sample of US adults with self-reported post-COVID-19. MethodsThis secondary data analysis was based on data from the 2022 National Health Interview Survey 2022 (NHIS) regarding presence of post-COVID-19 symptoms and CM use in a representative adult sample (weighted n = 89,437,918). ResultsOur estimates indicate that 19.7% of those who reported having a symptomatic SARS-CoV-2 infection experienced post-COVID-19 symptoms and 46.2% of those reported using any type of CM in the last 12 months. Specifically, post-COVID-19 respondents used most often mind-body medicine (32.0%), followed by massage (16.1%), chiropractic (14.4%), acupuncture (3.4%), naturopathy (2.2%) and art and/or music therapy (2.1%). Reporting post-COVID-19 was associated with an increased likelihood of using any CM in the last 12 months (AOR = 1.18, 95% CI [1.03, 1.34], p = 0.014) and specifically to visit an art and/or music therapist (AOR = 2.56, 95% CI [1.58, 4.41], p < 0.001). The overall use of any CM was more likely among post-COVID-19 respondents under 65 years old, females, those with an ethnical background other than Hispanic, African-American, Asian or Non-Hispanic Whites, having a higher educational level, living in large metropolitan areas and having a private health insurance. ConclusionsOur findings show a high prevalence of CM use among post-COVID-19 respondents which highlights the need for further investigations on effectiveness, safety and possible mechanisms of action.

Health Care Access Among Children in Latinx Families Across U.S. Destinations

Latinx children now live in a wider array of U.S. geographic areas than in the past, including both established and new areas of Latinx settlement. This geographic heterogeneity could be consequential for Latinx children’s health care access, with prior research suggesting increased health access barriers for Latinx children in new versus established areas of settlement. Merging public-use county-level data with restricted individual-level health data from the National Health Interview Survey (2010–2014), we quantitatively examine how three health access indicators—health insurance coverage, delayed care, and usual place of care—differ among children (ages 4–17) in Latinx immigrant, Latinx U.S.-born, White U.S.-born, and Black U.S.-born families (n = 89,994) across established, fast-growing hub, new, and minor Latinx destination counties. We also examine the potential roles of local immigrant hostilities and health care resources in contributing to health access differences across destinations. In fully adjusted models, children in new destinations are less likely to have health insurance than peers in established destinations, and this disparity is even wider for Latinx children of immigrants. Adjusted model results also show that children in new destinations are more likely to have delayed care than those in established destinations, and children in these four groups in new destinations, fast-growing hubs, and minor destinations are more likely to have no usual place of care than peers in established destinations. Our results are consistent with prior work suggesting that more health care access barriers exist for children, particularly Latinx children of immigrants, in new versus established Latinx destinations.

Changes in blood pressure measurement prevalence among United States adults with hypertension before and during the COVID-19 pandemic

BackgroundThe Coronavirus Disease 2019 (COVID-19) pandemic disrupted health care, with particularly profound effects on persons with chronic conditions like hypertension. ObjectivesIn this study, we examined changes in the prevalence of blood pressure (BP) measurements by a healthcare professional among adults aged ≥ 18 years with hypertension before and during the COVID-19 pandemic in the United States (US). MethodsThis study utilized the National Health Interview Survey data from April to December of the 2019 and 2021 modules of the survey. A total of 15,855 participants were included in the analytic sample. The prevalence of BP measurements taken by a health professional was calculated and the association between survey year and BP measurements was evaluated using adjusted and unadjusted logistic regression models. ResultsOverall, the prevalence of BP measurements by a health professional among US adults with hypertension decreased from 95.9 % in the pre-pandemic period to 94.7 % in the pandemic period. Adults with hypertension were less likely (OR: 0.76, 95 % CI: 0.63–0.91) to report having had a BP measurement taken by a health professional during the pandemic compared to before the pandemic. ConclusionSelf-measured BP monitoring with clinical support could ensure continuous and improved care of individuals with hypertension, especially when circumstances could interrupt healthcare access.

Differences in modifiable cancer risk behaviors by nativity (US-born v. Non-US-born) and length of time in the US.

Previous studies have identified racial-ethnic disparities in modifiable risk factors for cancers. However, the impact of US nativity on these risks is understudied. Hence, we assessed the association between US nativity and length of time in the US on modifiable cancer risk factors. Utilizing the 2010 and 2015 National Health Interview Survey datasets, we analyzed 8,861 US-born and non-US-born adults. Key variables included age, sex, race-ethnicity, education, income, diet, body mass index, physical activity, alcohol consumption, and smoking. Statistical methods included descriptive statistics and regression. Most respondents were US-born (n = 7,370), followed by long-term (≥15 years, n = 928), and recent (<15 years, n = 563) immigrants. Moderate-to-vigorous physical activity was higher among US-born individuals (342.45 minutes/week), compared to recent (249.74 minutes/week) and long-term immigrants (255.19 minutes/week). Recent immigrants consumed more fruits (1.37 cups/day) and long-term immigrants more vegetables (1.78 cups/day) than US-born individuals. Multivariate analyses found recent immigrants had lower odds of consuming alcohol (AOR: 0.33, 95% CI: 0.21-0.50) and smoking (AOR: 0.30, 95% CI: 0.19-0.46), and higher odds of meeting fruit consumption guidelines (AOR: 2.80, 95% CI: 1.76-4.45) compared to US-born individuals. Long-term immigrants had lower odds of alcohol consumption (AOR: 0.56, 95% CI: 0.37-0.84) and smoking (AOR: 0.42, 95% CI: 0.30-0.59), and higher odds for meeting fruit (AOR: 1.87, 95% CI: 1.22-2.86) and fiber (AOR: 2.03, 95% CI: 1.02-4.05) consumption guidelines. Our findings illustrate the importance of considering the impact nativity and length of US residency has on health. Our findings underscore the need for culturally tailored public health strategies.

Does Pain Explain Trends in Disability? An Analysis of Middle-Aged and Older U.S. Adults, 2002-2018.

This article investigates the role of pain in disability trends in the United States, within the context of recent unfavorable disability trends and the concurrent rise in pain. We conducted a 2-part analysis using National Health Interview Survey data from 2002 to 2018 for U.S. adults aged 45-84. First, we assessed how changes in the prevalence of 5 site-specific types of pain (headaches/migraines, joint, low back, neck, and facial/jaw pain) associated with disability trends. Second, we used self-reported causes of disability and examined whether there has been a change in the proportion of individuals who attribute their disability to 1 of 5 chronic or acute painful conditions. The 5 site-specific types of pain, individually and collectively, were significantly associated with increases in disability. If site-specific chronic pain had not increased during the study period, the trend for functional limitations would have been 40% lower, and that for activity limitations would have shown a slight decline instead of an increase. Attributions of functional limitations to painful conditions increased by 23% during the 2002-2018 period, representing an additional 9.82 million Americans experiencing pain-attributable disability. Arthritis/rheumatism, back/neck problems, and other musculoskeletal/connective conditions were the primary sources of pain-related disability. Our research provides the first systematic, national examination of how pain is contributing to disability trends in the United States. The findings have implications for disability reduction policies and shed light on the far-reaching consequences of pain for overall population health.

Hysterectomy and medical financial hardship among U.S. women

ObjectiveHysterectomy is one of the common surgical procedures for women in the United States. Studies show that hysterectomy is associated with elevated risk of developing chronic conditions, whichmay cause financial toxicity in patients. This study aimed to assess whether women who underwent hysterectomy had a higher risk of experiencing medical financial hardship compared to women who didn’t. MethodsUsing data on 32,823 adult women from the 2019 and 2021 waves of the National Health Interview Survey, we estimated binomial and multinomial logistic regressions to assess the relationship between hysterectomy and financial hardship, defined as problems paying or unable to pay any medical bills. Further, we performed a Karlson-Holm-Breen (KHB) decomposition to examine whether the association could be explained by chronic comorbidity. ResultsWhile the prevalence of financial hardship was 13.6 % among all women, it was 16.2 % among women who underwent a hysterectomy. The adjusted odds of experiencing medical financial hardship among women with a hysterectomy were 1.36 (95 % CI: 1.22–1.52) times that of their counterparts who did not have a hysterectomy. The KHB decomposition suggested that 34.5 % of the size of the effect was attributable to chronic conditions. Women who had a hysterectomy were also 1.45 (95 % CI: 1.26–1.67) times more likely to have unpaid medical debts. ConclusionsOur results suggested that women, who underwent a hysterectomy in the US, were vulnerable to medical financial hardship. Policy makers and health professionals should be made aware of this issue to help women coping against this adversity.