Use Of Preventive Health Care Research Articles

Migration background and use of preventive healthcare services: Findings of the German Ageing Survey

BackgroundThis study aimed to investigate the relationship between migration background and the utilization of preventive healthcare services.MethodsCross-sectional data from wave 5 in the year 2014, with a sample size of 7,684 individuals, were extracted from the nationally representative German Ageing Survey. The survey included community-dwelling individuals aged 40 years and above, with migration background serving as the primary independent variable. The outcomes measured included participation in cancer screenings, flu vaccinations, and routine health check-ups. Multiple logistic regressions were used to examine the association between migration background and preventive healthcare services.ResultsRegressions showed that the presence of a migration background with personal migration experience (compared with not having a migration background) was associated with a lower likelihood of using preventive healthcare services. More precisely, compared to individuals not having a migration background, individuals with a migration background and personal migration experience had a lower likelihood of routine health check-ups (OR = 0.76, 95% CI: 0.61 to 0.95), flu vaccinations (OR = 0.75, 95% CI: 0.59 to 0.95) and cancer screenings (OR = 0.71, 95% CI: 0.57 to 0.89). In contrast, there was no significant association between the presence of a migration background without personal migration experience (compared with not having a migration background) and the use of preventive healthcare services.ConclusionIn conclusion, results showed differences between individuals without migration background and individuals with migration background (and with personal migration experience) in terms of using preventive healthcare services. It may be helpful to specifically address individuals with migration background (and with migration experience) in terms of using preventive healthcare services.

Evaluating the Connection Between Rural Travel Time and Health: A Cross-Sectional Analysis of Older Adults Living in the Northeast United States.

To characterize the impact of rural patients' travel time to obtain healthcare on their reported utilization of preventive healthcare services and personal health outcomes. Online survey data from rural adults ages 50+ years living in the Northeastern United States were collected from February to August 2021. Study measures included self-reported travel time to obtain healthcare, use of preventive healthcare, and health outcomes. The associations between travel time with use of preventive care and health outcomes were assessed using linear, Poisson, and logistic regression analyses controlling for demographic variables. Our study population included 1052 rural adults, with a mean travel time of 18.5 min (range: 0-60). Travel time was greater for racial/ethnic minority participants and for higher-income participants (both P < .05), but it was not associated with use of preventive healthcare. Greater travel time was associated with poorer mental health and more comorbidities, including cancer and diabetes (all P < .05). Travel time varied by patient demographic factors, and it was associated with mental health and comorbidities. There was no association between travel time and preventive care use, suggesting that other barriers likely contribute to suboptimal use of these services within rural communities. Further research is needed to elucidate the causal pathways linking travel time to mental health and comorbidities within rural communities, as increased travel may exacerbate intrarural health disparities.

Health Care Support Worker Status, Health Behaviors, Mental Health, and Preventive Health Care Use

This cross-sectional study compares the health behaviors, mental health status, and preventive health care usage of health care support workers (HSWs) with clinicians and the general population.

Structural Sexism and Preventive Health Care Use in the United States.

Preventive health care use can reduce the risk of disease, disability, and death. Thus, it is critical to understand factors that shape preventive care use. A growing body of research identifies structural sexism as a driver of population health, but it remains unknown if structural sexism is linked to preventive care use and, if so, whether the relationship differs for women and men. Gender performance and gendered power and resource allocation perspectives lead to competing hypotheses regarding these questions. This study explores the relationship between structural sexism and preventive care in gender-stratified, multilevel models that combine data from the Behavioral Risk Factor Surveillance System with state-level data (N = 425,454). We find that in states with more structural sexism, both men and women were less likely to seek preventive care. These findings support the gender performance hypothesis for men and the gendered power and resource allocation hypothesis for men and women.

Disparities in utilization of preventive health services among Asian young adults in the United States

Despite the favorable health impacts of preventive services use, young adults remain at a higher risk of not using these services compared with older adults. This study seeks to identify barriers to receiving recommended preventive services among Asian young adults compared to other racial/ethnic young adults.Using 2016–2018 National Health Interview Survey data, this study examined barriers to recommended preventive services among non-Hispanic (NH) Asian young adults aged 18–39 years compared with other racial/ethnic groups in the United States (Total = 25,430; NH Asians = 6.3%). General prevention included fasting blood sugar, cholesterol, blood pressure, and Human Immunodeficiency Virus checkups. We documented information on vaccinations for influenza, pneumonia, tetanus, hepatitis A/B, and female-specific preventive care measures.NH Asian young adults reported blood pressure checkups less often than NH Whites (72.88% vs. 79.92%, p < 0.001). NH Asian young adults were also less likely to report HIV testing than all other racial/ethnic groups (p < 0.001). After controlling for covariates, NH Whites (odds ratio [OR] = 2.00, 95% confidence interval [CI] = 1.60, 2.50), NH Blacks (OR = 1.55, 95% CI = 1.18, 2.02), and other races (OR = 2.40, 95% CI = 1.60, 3.58) were more likely to receive any preventive services than NH Asians. Among those receiving any preventive services, there were no differences between NH Asians and all other racial/ethnic groups in whether they reported receiving relatively more preventive services.Our findings demonstrate that the rates of certain recommended preventive services use were lower among NH Asian young adults. Targeted public health strategies are needed to increase the use of preventive healthcare for racial/ethnic minority young adults.

Morbidity and healthcare use among mothers of children with cancer: A population-based study.

The impact of a child's cancer diagnosis on subsequent maternal physical health is unclear. We identified all Ontario children diagnosed less than 18years with cancer between 1992 and 2017. Linkage to administrative databases identified mothers who were matched to population controls. We identified physical health conditions, acute healthcare use, and preventive healthcare use through validated algorithms using healthcare data, and compared them between exposed (child with cancer) and unexposed mothers. Predictors of health outcomes were assessed among exposed mothers. We identified 5311 exposed mothers and 19,516 matched unexposed mothers. For exposed mothers, median age at last follow-up was 48years, (interquartile range: 42-53). Exposed mothers had an increased risk of cancer (hazard ratio [HR] 1.2, 95% confidence interval [95% CI]: 1.0-1.5, p=.03), but not of any other adverse physical outcomes or of increased acute healthcare use. Exposed mothers were more likely to receive influenza vaccinations (odds ratio 1.4, 95% CI: 1.3-1.5, p<.0001), and underwent cancer screening at the same rate as unexposed mothers. Among exposed mothers, bereavement was associated with a subsequent increased risk of cancer (HR 1.7, 95% CI: 1.2-2.5, p=.004) and death (HR 2.2, 95% CI: 1.2-4.1, p=.01). Mothers of children with cancer are at increased risk of developing cancer, but not of other adverse physical health outcomes, and were equally or more likely to be adherent to preventive healthcare practices. Bereaved mothers were at increased risk of subsequent cancer and death. Interventions targeting specific subpopulations of mothers of children with cancer or focused on screening for specific cancers may be warranted.

The Use of Preventive Health Care in Asian Americans: The Cross-level Interactions between Individual and Neighborhood Factors in the United States.

The present study explored how individual- and neighborhood-level factors contribute to predicting the use of preventive health care in a sample of Asian Americans. The cross-level interaction between individual- and neighborhood-level factors was also examined. We found a significant interaction between individual-level health insurance coverage and neighborhood health care providers' availability. Those who were uninsured and living in areas with limited health care provider availability (bottom 20%) were the most disadvantaged. This study adds to the growing literature on the effect of neighborhood-level factors on health care as sources of disparities. For health care policy, identifying individuals without health insurance coverage and living in a neighborhood with limited health care providers should be a priority to diminish disparities in access to care.

Influence of gender inequalities in curative and preventive health care use among children between 2 months to 5 years of age and its impact on changing sex ratio of the community

Background: Male preferring mentality of the society has created a discrimination against females in seeking curative and preventive health care and their overall nutritional status. Methods: Prospective observational study that included all the children between the age of 2 months to 5 years. The data collection started from January 2020 from registers in a monthly fashion till December 2020 and were analysed and categorized based on sex difference in admissions, leave against medical advice, mortality, immunisation, and follow-up. Results: The basic descriptive statistics shows that there is gross difference in the frequency of admissions in Inpatient (males- 58.33%, females- 41.67%), follow-up care (males- 56.33%, females- 43.67%) and immunization (males-53.06%, females-46.94%). The number of females children who left against medical advice (10.49%) were more than male children (6.45%) and is also statistically significant. In our study a greater number of female deaths (11.02%) occurred compared to males (10.15%) despite of their survival advantage. The number of female children (48.30%) who were admitted in nutritional rehabilitation centre were less compared to the number of males (51.70%). The hospital sex ratio at birth was 114 males per 100 females which is worse than the national average. Conclusions: Male biased community has put females at risk starting from the time of conception. Gender difference is experienced throughout and in all aspects of social, cultural, healthcare fields and nutritional needs.

Access and Use of Preventive Health Care by Adolescents in Immigrant Families: An Integrative Review

More than 25% of American adolescents live in immigrant families. This cohort of adolescents is a minority group with amplified health challenges. The purpose of this study was to provide an integrative review of quantitative research on the access and use of primary and preventive health care by adolescents in immigrant families. Searches yielded 460 reports, 54 of them satisfied criteria for full-text review, and four publications met inclusion criteria. Research, albeit very limited, revealed that adolescents in immigrant families have poor access to and use of preventive health care. Lack of primary health care may prevent identification of health risks in immigrant adolescents and lead them to perceive that preventive health care is unnecessary. Researchers are challenged to develop and test health promotion interventions tailored for these adolescents. Study recruitment outside of high schools, the typical setting, is critical to advance knowledge and improve access for this vulnerable population.

EXAMINING AGE, RACE, AND COMMUNITY ON PREVENTIVE HEALTH AND COVID-19 VACCINATION AMONG ADULTS 65+

Abstract During the ongoing spread of COVID-19 and its variants, older adults remain an age group particularly at-risk for poorer health outcomes, not only related to infection with COVID-19, but also due to disruptions in access to preventive health services, including routine vaccination. In the U.S., older adults have generally had high uptake of the COVID-19 vaccines, but differences persist regionally and between older adults from minority racial backgrounds. The purpose of the following study was to better understand how groups of Black and white-identifying adults ages 65+ described the impact of the COVID-19 pandemic on their preventive health behavior and healthcare use, including what contributed to their decision to receive or not receive a primary COVID-19 vaccination series. Seventy-five participants were purposively sampled and stratified into virtual focus groups based on their age, racial identity, vaccination status, and relationship to a local community. Findings leverage data from a pre-group questionnaire and focus groups conducted in November 2021. Analyses revealed differences among sub-groups about how the pandemic has impacted their relationship to their local community. Participants described the extent of the pandemic’s disruption to their healthcare access, including modifications to in-person care, use of telehealth, and engagement in new health behaviors. Decision-making related to the COVID-19 vaccine differed among the vaccinated and unvaccinated and white and Black-identifying groups, including factors related to interpersonal and systemic trust, independent research, and bodily autonomy. Implications of this research for public health and practitioners working with older adults will be discussed.

Association of meaning in life with preventive healthcare use among Chinese adults: are there age and gender differences?

Meaning in life could be of clinical importance in stimulating healthy and preventive behaviors. The study aimed to investigate the association between meaning in life and preventive healthcare use among Chinese adults, and to assess their age and gender differences in the association. A cross-sectional online survey was conducted among 1444 adults aged 18-64 years in February 2020 in China. Logistic regression models were employed to examine the association of meaning in life with preventive healthcheckups and assess their age and gender differences. The mean score of meaning in life was 5.801 (Standard Deviation = 1.349) out of 7. Each unit increase on the level of meaning in life was associated with 12.2% higher likelihood of using preventive health checkups (any type) (adjusted odds ratio 1.122, 95% confidence interval 1.015-1.241) after adjustment for sociodemographic factors, comorbidity and other psychological health factors. Meaning in life was significantly associated with the uses of X-ray (1.125, 1.010-1.253), B-ultrasound (1.176, 1.058-1.306), and blood testing (1.152, 1.042-1.274). The associations between meaning in life and these types of preventive healthcare increased with age, but there were no gender differences in these associations. Higher meaning in life was independently related to more preventive healthcheckups. Strategies to strengthen health education and interventions to improve experience of meaning in life might be an important component to increase preventive healthcare use in China.

Utilization of the emergency department as a routine source of care among children with asthma

Objective: To describe characteristics of children with persistent asthma in the ED who receive most of their healthcare in emergency settings; and determine whether recent asthma experiences or historic patterns of care are associated with identifying the ED as a typical location for care. Methods: We conducted a sub-analysis of baseline data from Telemedicine Enhanced Asthma Management through the Emergency Department (TEAM-ED), an RCT of children (3-12 years) presenting to the ED with persistent asthma (2016-2020). Caregivers identified reasons for seeking emergency care, including if their child received most overall healthcare in the ED (‘ED Care’; primary outcome) or not (‘Other Care’). Independent variables included demographics, recent symptoms and quality of life (QOL), and historic preventive care and healthcare use. We compared responses between ED Care and Other Care groups using bivariate and multivariate analyses. Results: We analyzed data for 355 children (31% ED Care, 69% Other Care). Compared with Other Care, ED Care respondents were more likely to identify the ED as the closest source of healthcare; report fewer symptom nights but a poorer quality of life; and describe the ED as a usual place for sick care, despite most having a PCP. Conclusions: Many children with asthma use the ED as a typical source of healthcare, and are distinguished by need for proximity, poorer caregiver QOL, and historic patterns of care-seeking. Efforts to improve timely access to outpatient care and reinforce the role of PCP-directed asthma management, such as through telemedicine, may reduce preventable morbidity including ED visits.

Adverse childhood experiences and utilization of preventive healthcare among Generation Z sexual and gender minorities

Historically, sexual and gender minority populations may have faced multiple Adverse Childhood Experiences (ACEs) and their utilization of preventive healthcare is low. However, sociocultural changes in attitudes and policies affecting sexual and gender minority populations signal their broader societal acceptance. We examined the prevalence of ACEs among sexual and gender minority populations belonging to Generation Z (those born between 1990-early 2000s) and their utilization of preventive healthcare to identify areas for health promotion. We used the Philadelphia Expanded ACEs questionnaire as well as questions about demographics and preventive healthcare use in a cross-sectional online survey design. The participants (n = 160) were chiefly female (n = 105, 65.6%) and bisexual (n = 51, 31.9%), while gender non-binary comprised 10.6% (n = 17). Most (93.75%, n = 150) participants reported three or more ACEs. ACEs were significantly associated with preventive healthcare use (p = 0.02). Higher prevalence of ACEs was associated with a 0.05 reduction in preventive healthcare utilization. Despite protective factors such as a comparatively advantaged background (based on their annual household income), health insurance, and college education, high ACEs, sexual orientation, and gender identity remained significantly associated with low utilization of preventive healthcare.

How has physical distancing impacted on health and well-being during the COVID-19 pandemic? A Scottish longitudinal qualitative study

ObjectivesThis study provides an in-depth understanding of the impact of physical distancing restrictions and other quarantining measures during the first 6 months of the COVID-19 pandemic on physical and mental...

Gender inequality and mammography screening: Does living with a partner improve women's mammography uptake?

Macrolevel gender inequality is defined as the unequal distribution of power and resources between men and women shaped by macrolevel social structures and institutions. An emerging line of health research is emphasising its negative consequences on women's health and healthcare access. The present study examines how gender inequality contexts affect women's mammography screening uptake. It adopts a macrosociological and institutionalist approach on preventive healthcare use and compares women who live with a partner with those who do not. This is the first study to test the effect of macrolevel gender inequality on mammography uptake across the 26 Swiss cantons (i.e. regions). The Swiss cantons' autonomy to manage their political and healthcare systems, as provided by the federal system, offers an ideal setting for the comparative analysis of macrolevel factors. Data on 9724 women aged 50–70 from the Swiss Health Interview Survey (waves 2007, 2012 and 2017) is analysed. Multilevel logistic models estimate two canton-level indicators of gender inequality, the gender gaps in time use and full-time employment, and their association with mammography uptake, controlling for women's socioeconomic and demographic characteristics, health status and healthcare use. Cross-level interactions assess how these indicators moderate the mammography uptake of women living with and without a partner. Results show that in cantons with higher gender inequality, women have a lower probability of mammography uptake. Women who live with a partner have a higher mammography uptake than those who do not. However, this advantage is moderated by canton-level gender inequality, namely, women who live with a partner in more gender unequal cantons have a lower mammography uptake than their counterparts who reside in more gender equal cantons. Results support the hypothesis that macrolevel gender inequality moderates women's preventive healthcare uptake, from an institutionalist approach.

Routine and preventive health care use in the community among women sentenced to probation

BackgroundWomen involved in the criminal legal (CL) system in the United States have much higher levels of chronic and infectious illness than women in the general population. Over 80% of women in the CL system are on community supervision, which means they receive health care in community settings. While the use of Emergency Department care among CL involved populations has been examined fairly extensively, less is known about engagement in routine and preventive medical care among people on community supervision.MethodsWe conducted a longitudinal study of health care utilization among women with Medicaid who were currently or previously sentenced to probation in Alameda County, CA (N = 328). At baseline, 6- and 12-months, we interviewed participants about every medical care visit in the six months prior, and about potential influences on health care utilization based on the Behavioral Model for Vulnerable Populations (BMVP). Associations between BMVP factors and utilization of routine or preventive care were estimated using Poisson regression models with robust standard errors. Generalized estimating equations (GEE) were used account for repeated measures over time.ResultsA diagnosis of one or more chronic illnesses was reported by 82% of participants. Two-thirds (62%) of women engaged in routine or preventive care in the six months prior to interview. A quarter of women engaging in routine or preventive care did not have a primary care provider (PCP). Having a PCP doubled the likelihood of using routine or preventive care (adjusted Relative Risk [adjRR] 2.27, p < 0.001). Subsistence difficulty (adjRR 0.74, p = 0.01) and unmet mental health care need (adjRR 0.83, p = 0.001) were associated with a lower likelihood of using routine or preventive care.ConclusionFindings underscore the importance of meeting the basic needs of women on community supervision and of connecting them with primary health care providers.

Health and Social Determinants Associated With Delay of Health Care Among Rural Older Adults

Delaying healthcare has the capacity to increase morbidity and mortality, especially among individuals with chronic and acute health conditions. Older adults in rural areas are more likely to have chronic health conditions and are more likely to delay care due to financial barriers than their urban counterparts. To further investigate these associations, we conducted descriptive, bivariate, and regression analyses using data from a needs assessment designed to identify health needs and service delivery gaps among an economically diverse eight-county region. A random sample of adults responded to the survey, with 1,226 respondents aged 60+ (mean age = 71). The majority of respondents were White, female, and had insurance coverage. Overall, 35% of respondents experienced a delay in healthcare. We used logistic regression to determine the associations of age, gender, number of health conditions, household income, distance from medical facility, and perceived quality of neighborhood with delay of healthcare. Individuals with younger age (p = .017), more chronic conditions (p < .001), lower income (p < .001), and lower perceived quality of neighborhood (p = .008) were more likely to experience a delay in healthcare. These findings highlight risk factors that were salient prior to the onset of the COVID-19 pandemic. However, the pandemic has contributed to an increasing trend of delaying healthcare and may have amplified existing challenges. Findings may inform efforts led by healthcare providers and policy makers to facilitate timely and preventive healthcare use. Future research is needed to investigate the compounding long-term health implications of delaying healthcare.

Morbidity and health care use among siblings of children with cancer: A population-based study.

Childhood cancer impacts the entire family unit. We sought to investigate its impact on the long-term physical health outcomes of siblings of children with cancer. Pediatric cancer patients diagnosed in Ontario, Canada between 1988 and 2016 were linked to biological siblings. Sibling cases were matched to population controls based on sex, age, geographic location, and number of other children in the family. After individual linkage to health services data, we compared several outcomes between sibling cases and controls: (a) physical health conditions (such as diabetes, hypertension, and death); (b) acute health care use (hospitalization, low- and high-acuity emergency department [ED] visits); and (c) preventive health care use (periodic health checkups, influenza vaccinations). Cox proportional hazards, recurrent event, or logistic regression models were used as appropriate. We identified 8529 sibling cases and 30,364 matched controls (median age at index: 6years, median age at last follow-up 17years). Compared to controls, siblings were at increased risk of hypertension (hazard ratio [HR] 1.8; 95% confidence interval [CI] 1.1-2.9; p=.01), had higher rates of low- and high-acuity ED visits (rate ratio 1.1; 95% CI 1.1-1.2; p<.001), and increased risk of hospitalization (HR 1.1; 95% CI 1.1-1.2; p<.001). Sibling cases were also more likely to receive preventive health care (p<.05). Increased risk of hypertension, high-acuity ED visits, and hospitalizations suggest that siblings may experience poorer health compared to controls. Counseling families about this potential increased risk and long-term follow-up of siblings to monitor their physical health may be justified.

Children&amp;apos;s health status: examining the effect of mothers&amp;apos; preventive health care use

Children&amp;apos;s health status: examining the effect of mothers&amp;apos; preventive health care use

Preventive oral health care use for children with special health care needs aged 6 through 12 years enrolled in Medicaid: A mixed methods study

BackgroundThe authors aimed to assess preventive oral health care (POHC) use for children with special health care needs (CSHCN) aged 6 through 12 years enrolled in Medicaid and identify intervention strategies to improve oral health. MethodsIn this sequential mixed methods study, the authors analyzed 2012 Medicaid data for children aged 6 through 12 years in Washington state. They used eligibility and claims data to identify special health care needs status (independent variable) and POHC use (outcome variable). They ran modified Poisson regression models to generate prevalence rate ratios. They coded data from 21 key informant interviews deductively using content analytic techniques. ResultsOf the 208,648 children in the study, 18% were identified as CSHCN and 140,468 used POHC (67.3%). After adjusting for confounding variables, the authors found no difference in POHC use by special health care need status (prevalence rate ratio, 1.00; 95% CI, 0.99 to 1.01; P = .91). In the qualitative analysis, the authors identified 5 themes: caries risk depends on a child’s specific health condition, caries complicates overall health, having a special need creates a bigger barrier to care, legislation alone is “not going to make much of a dent,” and improvements across all fronts are needed to promote the oral health of CSHCN in Medicaid. ConclusionsCSHCN enrolled in Medicaid are just as likely as children without special health care needs to use POHC, although barriers to oral health care access persist for CSHCN. Practical ImplicationsFuture efforts should focus on comprehensive strategies that address the varying levels of dental disease risk and difficulties accessing oral health care within the diverse group of CSHCN.