1
|
Serrano N, Beck A, Salvo D, Eyler A, Reis R, Steensma JT, Gilbert A, Brownson RC. Examining the Associations of and Interactions Between Intrapersonal and Perceived Environmental Factors With Objectively Assessed Physical Activity Among Rural Midwestern Adults, USA. Am J Health Promot 2022; 37:511-515. [PMID: 36268648 PMCID: PMC10119329 DOI: 10.1177/08901171221134797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE We investigated associations of intrapersonal and environmental factors with objectively assessed weekly moderate to vigorous physical activity (MVPA) minutes, and their interactions in rural adults. DESIGN Cross-sectional. SETTING 14 rural towns participating in a multilevel intervention to promote physical activity. SAMPLE Baseline data from 241 rural community members (19% losses due to missing data). MEASURES Self-reported demographics, behavioral factors, and neighborhood environment perceptions. Weekly MVPA minutes were assessed using accelerometry data. ANALYSIS Generalized linear models using a negative binomial distribution examined associations of and interactions between intrapersonal and environmental correlates with weekly MVPA. RESULTS Older age (β = -1.37; P= .025) and identifying as a woman (β = -.71; p= <.001) were inversely associated with MVPA. Self-efficacy (β = .34; p = <.001) and trail use (β = .44; P-value = .003) were directly associated with MVPA. Further, among women, perceived safety from traffic was inversely associated with MVPA (β = -.37; P = .003), while indoor recreational facility access was directly associated with MVPA (β = .24; P = .045). CONCLUSIONS Rural residents, especially women, face disproportionately lower MVPA levels. Improving recreational access and self-efficacy may be effective strategies for increasing MVPA.
Collapse
Affiliation(s)
- Natalicio Serrano
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Alan Beck
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, St. Louis, MO, USA
| | - Deborah Salvo
- Department of Kinesiology and Health Education, College of Education, University of Texas at Austin, Austin, TX, USA
| | - Amy Eyler
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, St. Louis, MO, USA
| | - Rodrigo Reis
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, St. Louis, MO, USA
| | - Joseph T Steensma
- Health Communication Research Laboratory, Brown School at Washington University in St. Louis, St. Louis, MO, USA
| | - Amanda Gilbert
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, St. Louis, MO, USA
| | - Ross C Brownson
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, St. Louis, MO, USA.,Division of Public Health Sciences and Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
| |
Collapse
|
2
|
Joynt Maddox KE, Reidhead M, Grotzinger J, McBride T, Mody A, Nagasako E, Ross W, Steensma JT, Barker AR. Understanding contributors to racial and ethnic inequities in COVID-19 incidence and mortality rates. PLoS One 2022; 17:e0260262. [PMID: 35089919 PMCID: PMC8797246 DOI: 10.1371/journal.pone.0260262] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 11/07/2021] [Indexed: 11/18/2022] Open
Abstract
Background
Racial inequities in Coronavirus 2019 (COVID-19) have been reported over the course of the pandemic, with Black, Hispanic/Latinx, and Native American individuals suffering higher case rates and more fatalities than their White counterparts.
Methods
We used a unique statewide dataset of confirmed COVID-19 cases across Missouri, linked with historical statewide hospital data. We examined differences by race and ethnicity in raw population-based case and mortality rates. We used patient-level regression analyses to calculate the odds of mortality based on race and ethnicity, controlling for comorbidities and other risk factors.
Results
As of September 10, 2020 there were 73,635 confirmed COVID-19 cases in the State of Missouri. Among the 64,526 case records (87.7% of all cases) that merged with prior demographic and health care utilization data, 12,946 (20.1%) were Non-Hispanic (NH) Black, 44,550 (69.0%) were NH White, 3,822 (5.9%) were NH Other/Unknown race, and 3,208 (5.0%) were Hispanic. Raw cumulative case rates for NH Black individuals were 1,713 per 100,000 population, compared with 2,095 for NH Other/Unknown, 903 for NH White, and 1,218 for Hispanic. Cumulative COVID-19-related death rates for NH Black individuals were 58.3 per 100,000 population, compared with 38.9 for NH Other/Unknown, 19.4 for NH White, and 14.8 for Hispanic. In a model that included insurance source, history of a social determinant billing code in the patient’s claims, census block travel change, population density, Area Deprivation Index, and clinical comorbidities, NH Black race (OR 1.75, 1.51–2.04, p<0.001) and NH Other/Unknown race (OR 1.83, 1.36–2.46, p<0.001) remained strongly associated with mortality.
Conclusions
In Missouri, COVID-19 case rates and mortality rates were markedly higher among NH Black and NH Other/Unknown race than among NH White residents, even after accounting for social and clinical risk, population density, and travel patterns during COVID-19.
Collapse
Affiliation(s)
- Karen E. Joynt Maddox
- Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri, United States of America
- Center for Health Economics and Policy, Institute for Public Health at Washington University, St. Louis, Missouri, United States of America
- Washington University Brown School, St. Louis, Missouri, United States of America
- * E-mail:
| | - Mat Reidhead
- Washington University Brown School, St. Louis, Missouri, United States of America
| | - Joshua Grotzinger
- Washington University Brown School, St. Louis, Missouri, United States of America
| | - Timothy McBride
- Center for Health Economics and Policy, Institute for Public Health at Washington University, St. Louis, Missouri, United States of America
- Missouri Hospital Association, Jefferson City, Missouri, United States of America
| | - Aaloke Mody
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | | | - Will Ross
- Division of Nephrology, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Joseph T. Steensma
- Missouri Hospital Association, Jefferson City, Missouri, United States of America
| | - Abigail R. Barker
- Center for Health Economics and Policy, Institute for Public Health at Washington University, St. Louis, Missouri, United States of America
- Missouri Hospital Association, Jefferson City, Missouri, United States of America
| |
Collapse
|
3
|
Garg R, Steensma JT, Luke AA, Huang K, Golla B, Greer R, Joynt Maddox KE. Helpline Calls Associated With Preventable Emergency Department Utilization. Am J Prev Med 2021; 61:729-732. [PMID: 34210582 DOI: 10.1016/j.amepre.2021.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/29/2021] [Accepted: 04/16/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Unmet social needs are linked with greater healthcare utilization, but most studies lack timely and granular data on these needs. The 2-1-1 helpline is a telephone helpline focused on social needs. The objective of the study is to determine whether the number of 2-1-1 requests per 1,000 people is associated with preventable emergency department visits and compare the strength of the association with another commonly used predictor, Area Deprivation Index. METHODS This cross-sectional study linked 2-1-1 requests to emergency department visits from uninsured and Medicaid-insured patients by ZIP code for a large urban hospital system from January 1, 2016 to August 31, 2019. Negative binomial regression analysis was used to estimate the association of 2-1-1 service requests and Area Deprivation Index with preventable emergency department visits. RESULTS A total of 233,146 preventable emergency department visits and 520,308 2-1-1 requests were analyzed. For every 1-SD increase in 2-1-1 requests per 1,000 population, preventable emergency department visits increased by a factor of 3.05, even after controlling for local area deprivation and other population characteristics (p<0.001). CONCLUSIONS Requests to 2-1-1 helplines are strongly associated with preventable emergency department visits. This information may help hospital leaders and policymakers target social needs interventions to the neighborhoods with the greatest need.
Collapse
Affiliation(s)
- Rachel Garg
- Health Communication Research Laboratory, Brown School, Washington University in St. Louis, St. Louis, Missouri.
| | - Joseph T Steensma
- Health Communication Research Laboratory, Brown School, Washington University in St. Louis, St. Louis, Missouri
| | - Alina A Luke
- Cardiovascular Division, John T. Milliken Department of Internal Medicine, School of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Kristine Huang
- Cardiovascular Division, John T. Milliken Department of Internal Medicine, School of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Balaji Golla
- Health Communication Research Laboratory, Brown School, Washington University in St. Louis, St. Louis, Missouri
| | - Regina Greer
- United Way 2-1-1, United Way of Greater St. Louis, St. Louis, Missouri
| | - Karen E Joynt Maddox
- Cardiovascular Division, John T. Milliken Department of Internal Medicine, School of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| |
Collapse
|
4
|
Wang X, Steensma JT, Bailey MH, Feng Q, Padda H, Johnson KJ. Characteristics of The Cancer Genome Atlas cases relative to U.S. general population cancer cases. Br J Cancer 2018; 119:885-892. [PMID: 30131556 PMCID: PMC6189215 DOI: 10.1038/s41416-018-0140-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 05/15/2018] [Accepted: 05/16/2018] [Indexed: 12/17/2022] Open
Abstract
Background Despite anecdotal reports of differences in clinical and demographic
characteristics of The Cancer Genome Atlas (TCGA) relative to general population
cancer cases, differences have not been systematically evaluated. Methods Data from 11,160 cases with 33 cancer types were ascertained from
TCGA data portal. Corresponding data from the Surveillance, Epidemiology, and End
Results (SEER) 18 and North American Association of Central Cancer Registries
databases were obtained. Differences in characteristics were compared using
Student’s t, Chi-square, and Fisher’s exact
tests. Differences in mean survival months were assessed using restricted mean
survival time analysis and generalised linear model. Results TCGA cases were 3.9 years (95% CI 1.7–6.2) younger on average than
SEER cases, with a significantly younger mean age for 20/33 cancer types. Although
most cancer types had a similar sex distribution, race and stage at diagnosis
distributions were disproportional for 13/18 and 25/26 assessed cancer types,
respectively. Using 12 months as an end point, the observed mean survival months
were longer for 27 of 33 TCGA cancer types. Conclusions Differences exist in the characteristics of TCGA vs. general
population cancer cases. Our study highlights population subgroups where increased
sample collection is warranted to increase the applicability of cancer
genomic research results to all individuals.
Collapse
Affiliation(s)
- Xiaoyan Wang
- Brown School, Washington University in St. Louis, St. Louis MO, USA
| | | | - Matthew H Bailey
- Division of Oncology, Department of Medicine, Washington University in St. Louis, St. Louis MO, USA.,McDonnell Genome Institute, Washington University in St. Louis, St. Louis MO, USA
| | - Qianxi Feng
- Brown School, Washington University in St. Louis, St. Louis MO, USA
| | - Hannah Padda
- Brown School, Washington University in St. Louis, St. Louis MO, USA
| | - Kimberly J Johnson
- Brown School, Washington University in St. Louis, St. Louis MO, USA. .,Siteman Cancer Center, Washington University in St. Louis, St. Louis MO, USA.
| |
Collapse
|
5
|
Heslinga HT, Hazenberg BP, Peters FT, Elema JD, Steensma JT, van Rijswijk MH. [Amyloidosis as cause of severe abdominal symptoms in a young Somali immigrant?]. Ned Tijdschr Geneeskd 1993; 137:667-72. [PMID: 8469300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Extensive deposition of amyloid was detected in the digestive tract of a Somali woman aged 20 yr with abdominal pain, diarrhoea and cachexia. Immunohistochemical characterisation showed that the amyloid protein involved was of the AA type. Elevated levels were also found for serum amyloid A (SAA), an acute-phase protein which is the precursor of AA amyloid. The underlying inflammatory disease was peritoneal tuberculosis. The normalisation of the SAA levels and the recovery of the small intestine during tuberculostatic therapy showed that the tuberculosis was the cause of the enteropathy. This case report highlights the importance of early detection and effective treatment of the underlying inflammatory disease in case of AA amyloidosis.
Collapse
|
6
|
Links TP, Karrenbeld A, Steensma JT, Weits J, van der Jagt EJ, Postmus PE. Fatal respiratory failure caused by pulmonary infiltration by pseudo-Gaucher cells. Chest 1992; 101:265-6. [PMID: 1729081 DOI: 10.1378/chest.101.1.265] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Pseudo-Gaucher cells are reticuloendothelial cells that are found in several diseases. We report a case of pulmonary tuberculosis in which extensive pulmonary involvement with these cells resulted in fatal respiratory failure.
Collapse
Affiliation(s)
- T P Links
- Department of Internal Medicine, University Hospital, Groningen, The Netherlands
| | | | | | | | | | | |
Collapse
|
7
|
Weits J, Sprenger HG, Ilic P, van Klingeren B, Elema JD, Steensma JT. [Mycobacterium avium disease in AIDS patients; diagnosis and therapy]. Ned Tijdschr Geneeskd 1991; 135:2485-9. [PMID: 1758516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
In eight (25%) of 32 consecutive AIDS patients between 1986 and 1989, Mycobacterium avium infection was diagnosed: in seven disseminated, in one as a local lymph node process. Six patients were treated as consistently as possible with a combination of ethambutol, rifabutine, clofazimine and protionamide (or cycloserine) in relatively large dosages. Median survival of treated patients was 15.5 (4-22) months. Protionamide inhibited most M. avium strains (7 of 8) in vitro, but often caused intolerance (nausea). Treatment of disseminated cytomegalovirus infection in our opinion was necessary in 5 of 6 patients during longterm M. avium therapy. HIV therapy (Zidovudine) during M. avium treatment was not possible due to bone marrow depression. A low maintenance dose of corticosteroids was necessary in 3 of 6 patients (one with adrenal insufficiency) to suppress symptoms such as fever and malaise.
Collapse
Affiliation(s)
- J Weits
- Interne Kliniek, Academisch Ziekenhuis, Groningen
| | | | | | | | | | | |
Collapse
|
8
|
Weits J, Sprenger HG, Ilic P, van Klingeren B, Steensma JT. Clarithromycin monotherapy of MAC-mycobacteriosis in AIDS patients. Neth J Med 1991; 39:126-7. [PMID: 1835763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
|
9
|
Veen J, Steensma JT. [Tuberculosis, a continuing challenge]. Ned Tijdschr Geneeskd 1989; 133:61-5. [PMID: 2492642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
|
10
|
Steensma JT, Knol K, Veen J. [Primary pulmonary tuberculosis: more than a 'little flu']. Ned Tijdschr Geneeskd 1989; 133:52-3. [PMID: 2915725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
|
11
|
Steensma JT, Sluiter HJ, Veen J. [Open pulmonary tuberculosis in the 80s]. Ned Tijdschr Geneeskd 1989; 133:49-51. [PMID: 2915724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
|
12
|
Steensma JT. [Tuberculostatic agents]. Ned Tijdschr Geneeskd 1988; 132:460. [PMID: 3347288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
|
13
|
Steensma JT. [The sense of prophylactic treatment of tuberculosis]. Ned Tijdschr Geneeskd 1988; 132:65-7. [PMID: 3340219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
|
14
|
Steensma JT. [Tuberculosis of the skeleton]. Ned Tijdschr Geneeskd 1986; 130:558-9. [PMID: 3960174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
|
15
|
Steensma JT. [Tuberculosis, does it always come out right?]. Ned Tijdschr Geneeskd 1986; 130:145-7. [PMID: 3513030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
|
16
|
Steensma JT, Dallinga OT, Leenstra-Borsje H, Meijer S, Snoek WJ. [Artificial respiration and hemodialysis in a patient with fulminant dermatomyositis]. Ned Tijdschr Geneeskd 1977; 121:1883-8. [PMID: 411050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|
17
|
Steensma JT, Mulder RJ, Rookmaker AE, Sluiter HJ. [Assisted ventilation in 2 patients with severe respiratory insufficiency due to tuberculosis]. Ned Tijdschr Geneeskd 1977; 121:572-8. [PMID: 854095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|