Affordability, negative experiences, perceived racism, and health care system distrust among black American women aged 45 and over.

Black Americans (AA) face a confluence of challenges when seeking care including unaffordable costs, negative experiences with providers, racism, and distrust in the healthcare system. This study utilized linear regressions and mediation analysis to explore the interconnectedness of these challenges within a community-based sample of 313 AA women aged 45 and older. Approximately 23% of participants reported affordability problems, while 44% had a negative experience with a provider.

A Study of the Connection Between Health Insurance Literacy and Health Status: Evidence from the US Healthcare Reform Monitoring Survey.

This study examines the relationship between health insurance literacy, as indicated by confidence in comprehending health insurance terms, and health status using cross-sectional data from 8 waves of the Health Reform Monitoring Survey (HRMS), covering 61,895 individuals from 2013 to 2017. An ordered logistic regression model was employed with self-rated health status on a five-point Likert scale as the dependent variable and the score of confidence in understanding health insurance terms as the primary independent variable. The model adjusts for variables such as access to care, insurance status, concerns about affordability leading to missed care, household size, family income, employment, education, race, marital status, and gender.

PM chemical components are associated with in-hospital case fatality among acute myocardial infarction patients in China.

Recent studies have linked the cardiovascular events with the exposure to ambient fine particulate matter (PM); however, the impact of PM chemical components on acute myocardial infarction (AMI) case fatality remains poorly understood. To address this gap, we included 178,340 hospitalised patients with AMI utilising the inpatient discharge database from Sichuan, Shanxi, Guangxi, and Guangdong, China spanning 2014-2019. We evaluated exposure to PM and its components (black carbon (BC), organic matter (OM), sulphate (SO), nitrate (NO), and ammonium (NH)) using bilinear interpolation based on the patient's residential address.

Ambient particulate matter and in-hospital case fatality of acute myocardial infarction: A multi-province cross-sectional study in China.

The acute myocardial infarction (AMI) outcomes have been extensively linked with ambient particulate matter (PM). However, whether a smaller particle has greater impact and the consequent attributable burden associated with PM of different sizes remain unclear. We conducted a multi-province cross-sectional study among AMI patients using the inpatient discharge datasets from four Chinese provinces (Shanxi, Sichuan, Guangxi, and Guangdong) from 2014 to 2019.

Health Insurance Literacy and Medical Care Avoidance Among International Students: A Case Study.

This research examines the health insurance literacy and healthcare utilization of international students attending a university in the US Midwest. One hundred and forty-three undergraduate and graduate students attending a midsize metropolitan university in the Midwest completed an online survey in early 2022. Many students surveyed could not identify the definitions of basic terms, such as copay.

The impact of healthcare industry convergence on the performance of the public health system: a geospatial modeling study of provincial panel data from China.

Objective: This paper examines the impact of healthcare industry convergence on the performance of the public health system in the eastern, central, and western regions of China.

Methods: Public health performance was measured by a composite index of three standards: average life expectancy at birth, perinatal mortality, and maternal mortality. The healthcare industry convergence was measured using a coupling coordination degree method.

Factors associated with food insecurity among the chronically ill population during the COVID-19 pandemic in the United States.

Introduction: Little is known about food insecurity among Americans with chronic diseases, one of the vulnerable groups in health care. Factors influencing food insecurity among this population group are especially poorly understood.

Methods: Using data from the COVID Impact Survey, this cross-sectional study sought to examine food insecurity among adults with chronic diseases in the United States and to identify factors associated with their risks for food insecurity during the COVID-19 pandemic.

Short-term air pollution exposure associated with death from kidney diseases: a nationwide time-stratified case-crossover study in China from 2015 to 2019.

Background: Long-term exposure to air pollution has been associated with the onset and progression of kidney diseases, but the association between short-term exposure to air pollution and mortality of kidney diseases has not yet been reported.

Methods: A nationally representative sample of 101,919 deaths from kidney diseases was collected from the Chinese Center for Disease Control and Prevention from 2015 to 2019. A time-stratified case-crossover study was applied to determine the associations.

Self-esteem and weight status of young adults: Findings from a pilot study.

Background: Researchers have examined the association between self-esteem and obesity in past studies. However, most studies have focused on pediatric or adolescent populations. In this pilot study, we aim to explore the association of self-esteem with weight status in young adults, a group of individuals in a significant and pivotal period of their lives whose needs and challenges have received little attention in previous studies.

Association between maternal family history of hypertension and preterm birth: modification by noise exposure and multivitamin intake.

Objective: To measure the effect of maternal family history of hypertension on preterm birth (PTB) and to identify factors that modified this association.

Methods: A case-control study was nested in a prospective cohort of the entire pregnant population in Wuhan, China, from 2011 to 2013. Home-visit interviews were scheduled for all PTBs and their controls, to collect extensive information on maternal exposures to behavioral, environmental, and intergenerational risk factors of PTB.

The Chasm in Percutaneous Coronary Intervention and In-Hospital Mortality Rates Among Acute Myocardial Infarction Patients in Rural and Urban Hospitals in China: A Mediation Analysis.

To determine to what extent the inequality in the ability to provide percutaneous coronary intervention (PCI) translates into outcomes for AMI patients in China. We identified 82,677 patients who had primary diagnoses of AMI and were hospitalized in Shanxi Province, China, between 2013 and 2017. We applied logistic regressions with inverse probability weighting based on propensity scores and mediation analyses to examine the association of hospital rurality with in-hospital mortality and the potential mediating effects of PCI.

Population attributable fraction of lung cancer due to genetic variants, modifiable risk factors, and their interactions: a nationwide prospective cohort study.

Background: Genetic variants and modifiable risk factors (including environmental exposure and lifestyle) greatly contribute to the development of lung cancer. The population attributable fraction (PAF) of these risk factors, especially their interactive effects, has not been well quantified.

Methods: A total of 398,577 participants were included in this analysis.

Underlying Factors of Health Insurance Use Among Blacks and Hispanics With Ambulatory Care-Sensitive Conditions.

This study examined satisfaction with and confidence in understanding health insurance use among Blacks and Hispanic Americans with ambulatory care-sensitive conditions. Using the 2013-2016 Health Reform Monitoring Survey data sets, descriptive statistics and ordinary least-square regressions estimated the association between satisfaction and confidence scores and racial or ethnic groups with ambulatory care-sensitive conditions. Compared with their White counterparts, Black (β = -.

Health Insurance Literacy and Medical Debt in Middle-Age Americans.

Background: Health insurance literacy (HIL) may influence medical financial burden among people who are sick and the most vulnerable.

Objective: This study examined the relationships between HIL, health insurance factors, and medical debt among middle-age Americans, a population with an increasing prevalence of illnesses.

Methods: Linear and generalized linear regression analyses were conducted on data drawn from the 2015-2016 waves of the Health Reform Monitoring Survey, a national, internet-based sample of Americans age 18 to 64 years.

Maternal PM exposure associated with stillbirth: A large birth cohort study in seven Chinese cities.

Background: Maternal exposure to fine particulate matter (PM) has been associated with a few adverse birth outcomes. However, its effect on stillbirth remains unknown in China, especially the susceptible windows and potential modifiers.

Objective: This study aimed to evaluate the associations between maternal PM exposure and stillbirth in seven Chinese cities.

Association between socioeconomic welfare and depression among older adults: Evidence from the China health and Retirement Longitudinal Study.

This study aims to examine the association between province-level socioeconomic welfare factors and depression symptoms among older adults in China. Province-level socioeconomic characteristics were merged with microdata for respondents over 65 years from the 2018 China Health and Retirement Longitudinal Study (CHARLS) Wave 4 (N = 6657). Principal component analysis (PCA) was used to extract three socioeconomic welfare factors constructed from 14 province-level variables.

Association between maternal outdoor physical exercise and the risk of preterm birth: a case-control study in Wuhan, China.

Background: China had the second largest proportion of preterm birth (PTB) internationally. However, only 11% of pregnant women in China meet international guidelines for maternal physical activity, a significantly lower proportion than that in Western countries. This study aims to examine the association between outdoor physical exercise during pregnancy and PTB among Chinese women in Wuhan, China.

Investigation of simple, objective, and effective indicators for predicting acute paraquat poisoning outcomes.

Initial symptoms of paraquat (PQ) toxicity are often not obvious, and the lack of advanced testing equipment and medical conditions in the primary hospital make it difficult to provide early diagnosis and timely treatment. To explore simple, objective, and effective indicators of prognosis for primary clinicians, we retrospectively analyzed acute PQ poisoning in 190 patients admitted to our hospital from 2008 to 2017. Based on their condition at the time of discharge, patients were categorized into either the survival group ( = 71) or the mortality group ( = 119).

Confidence in Understanding Health Insurance and Challenges Paying Medical Bills Among Men in the United States.

Although the number of men with health insurance has increased, men are less likely to utilize health services than females, and experience difficulty in paying medical bills. Understanding the details of health insurance can be challenging and the lack of understanding can have financial consequences. This study, guided by Andersen's model of health-care utilization, assessed the relationship between confidence level in understanding health insurance terms and difficulty in paying medical bills among American men.

Comparing the Performance of Charlson and Elixhauser Comorbidity Indices to Predict In-Hospital Mortality Among a Chinese Population.

Objective: Earlier comorbidity measures have been developed or validated using the North American population. This study aims to compare five Charlson or Elixhauser comorbidity indices to predict in-hospital mortality using a large electronic medical record database from Shanxi, China.

Methods: Using the primary diagnosis code and surgery procedure codes, we identified four hospitalized patient cohorts, hospitalized between 2013 and 2017, in Shanxi, China, as follows: congestive heart failure (CHF, n=41,577), chronic renal failure (CRF, n=40,419), diabetes (n=171,355), and percutaneous coronary intervention (PCI, n=39,097).

Association between depressive symptoms and poor sleep quality among Han and Manchu ethnicities in a large, rural, Chinese population.

Objectives: To estimate the relationship between sleep quality and depression, among Han and Manchu ethnicities, in a rural Chinese population.

Methods: A sample of 8,888 adults was selected using a multistage cluster and random sampling method. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI).

Short-term and long-term effects of PM on acute nasopharyngitis in 10 communities of Guangdong, China.

Objectives: We aimed to assess the effects of short-term and long-term exposure to ambient fine particle matter (PM) on acute nasopharyngitis.

Methods: A total of 9468 participants aged 18 years and above were recruited from 10 communities in four cities of Guangdong, China during the baseline survey in 2014, and they were followed-up from January 2015 to December 2016. Air pollution exposure was assessed based on the daily concentrations (short-term) and annual concentrations (long-term) of the nearby air monitoring station and the survey date.

Association between ambient air pollution and hyperuricemia in traffic police officers in China: a cohort study.

To evaluate the association between ambient air pollution and hyperuricemia, we prospectively followed 1748 traffic police officers without hyperuricemia at baseline (2009-2014) from 11 districts in Guangzhou, China. We calculated six-year average PM, SO and NO concentrations using data collected from air monitoring stations. The hazard ratios for hyperuricemia per 10 µg/m increase in air pollutants were 1.

Ambient PM air pollution, blood pressure, and hypertension: Insights from the 33 Communities Chinese Health Study.

No evidence exists concerning the association between blood pressure and ambient particles with aerodynamic diameter ≤ 1.0 µm (PM), a major component of PM (≤ 2.5 µm) particles, and potentially causing more hazardous health effects than PM.