Journal of Preventive Medicine and Public Health

COVID-19: Original Article

Social Determinants of COVID-19 in Massachusetts, United States: An Ecological Study: Devan Hawkins; J Prev Med Public Health. 2020;53(4):220-227. Published online June 24, 2020; DOI: https://doi.org/10.3961/jpmph.20.256

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Objectives
The aim of this study was to assess how different social determinants of health (SDoH) may be related to variability in coronavirus disease 2019 (COVID-19) rates in cities and towns in Massachusetts (MA).
Methods
Data about the total number of cases, tests, and rates of COVID-19 as of June 10, 2020 were obtained for cities and towns in MA. The data on COVID-19 were matched with data on various SDoH variables at the city and town level from the American Community Survey. These variables included information about income, poverty, employment, renting, and insurance coverage. We compared COVID-19 rates according to these SDoH variables.
Results
There were clear gradients in the rates of COVID-19 according to SDoH variables. Communities with more poverty, lower income, lower insurance coverage, more unemployment, and a higher percentage of the workforce employed in essential services, including healthcare, had higher rates of COVID-19. Most of these differences were not accounted for by different rates of testing in these cities and towns.
Conclusions
SDoH variables may explain some of the variability in the risk of COVID-19 across cities and towns in MA. Data about SDoH should be part of the standard surveillance for COVID-19. Efforts should be made to address social factors that may be putting communities at an elevated risk.

Summary

Citations

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Original Article

Comparison of Trends in Blood Pressure and the Prevalence of Obesity Among Korean and American Adolescents: A 12-Years Cross-sectional Study: Somi Heo, Seyoung Kwon, Yu-Mi Lee, Ji-Yeon Shin, Duk-Hee Lee; J Prev Med Public Health. 2020;53(1):45-55. Published online November 20, 2019; DOI: https://doi.org/10.3961/jpmph.19.198

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Abstract Summary PDF Supplementary Material

Objectives
This study was conducted to explore recent trends in the prevalence of pediatric elevated blood pressure and hypertension (HTN) in Korea and the United States, applying the new HTN reference values for adolescents.
Methods
This study analyzed 17 339 (8755 Korean and 8584 American) adolescents aged 10 to 17 who participated in the Korea National Health and Nutrition Examination Survey and the National Health and Nutrition Examination Survey, respectively, between 2005 and 2016. HTN was defined using percentile-based reference values for non-overweight adolescents from 7 nations, and obesity was defined by body mass index (BMI) based on country-specific growth charts. All analyses were stratified by sex and year-over-year changes were evaluated by calculating the p for trend.
Results
Systolic blood pressure showed a statistically meaningful upward trend in Korean boys and girls, while diastolic blood pressure did not show any significant changes. Both systolic and diastolic blood pressure levels declined among United States boys and girls. The prevalence of elevated blood pressure and HTN remained similar in Korean adolescents, but declined in both sexes among United States adolescents. BMI increased in both sexes among Korean adolescents, although the overweight and obesity rates stayed the same. No significant trends were found in any obesity indices among United States adolescents. The prevalence of elevated blood pressure and HTN by obesity level was higher among Korean adolescents than among their United States peers in both sexes, and the gap became higher at more severe levels of obesity.
Conclusions
Despite the strong correlation between obesity and HTN, recent trends in the prevalence of HTN and obesity among Korean and United States adolescents were strikingly different. Follow-up studies are necessary to determine why the prevalence of HTN was more than twice as high among Korean adolescents than among their United States counterparts.

Summary

Korean summary
본 연구에서는 새로운 소아청소년 고혈압 기준을 이용하여, 최근 한국과 미국 소아청소년들의 혈압 및 고혈압 유병률의 변화 추이를 비교하였다. 비만과 고혈압간의 높은 관련성에도 불구하고 한국과 미국 소아청소년의 고혈압 유병률과 비만율은 서로 다른 변화 추이를 나타내었으며, 고혈압 발생에 있어서 한국 소아청소년들이 미국 소아청소년들보다 비만에 더 취약할 가능성을 나타내고 있어 이에 관한 후속연구가 필요하다.

Citations

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Brief Report

A Cross-sectional Study of Cancer Knowledge and Beliefs Among Faith-based Chinese in the USA Versus Taiwan: Su-I Hou, Xian Cao; J Prev Med Public Health. 2019;52(1):60-65. Published online January 20, 2019; DOI: https://doi.org/10.3961/jpmph.17.051

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116 Download

Abstract PDF: Objectives
This study examined cancer knowledge, beliefs, and practice among faith-based Chinese in the USA versus Taiwan to gain better understandings on how environment and culture might play a role for tailored cancer education programs.
Methods
A self-administered survey included a validated 10-item Cancer Screening Belief Scale (CSBS), an 8-item Cancer Screening Knowledge Test (CSKT), and a 14-item cancer Warning Signs Test (CWST) was administered. Participants were recruited from 9 Chinese churches (5 in the USA and 4 in Taiwan).
Results
A total of 372 Chinese participated, 50% lived in the USA and 50% in Taiwan. Mean age was 44.31 (standard deviation, 14.74), 60% males, and majority had college education (85%). Taiwan participants scored higher on both CSKT (6.13 vs. 5.52; p<0.001) and CWST (6.80 vs. 5.38; p<0.001). Although perceived screening benefits and barriers were similar, Taiwan participants endorsed higher on screening norms (11.67 vs. 10.82; p<0.001). Taiwan participants also indicated more doctor recommending cancer screenings (42.1% vs. 29.6%; p=0.015), USA participants were more likely to have had annual health exams (65.4% vs. 48.9%; p=0.002). Regression results showed that those resided in the USA were 2.38 times more likely to report annual health exams. Married status (odds ratio [OR], 2.85), college education (OR, 2.38), doctor’s recommendation (OR, 2.87), no family cancer history (OR, 2.47), and those with lower barriers were significant factors on annual health exams.
Conclusions
Taiwan participants scored higher on cancer knowledge and screening norms, while more USA participants reported annual health exams. Taiwan’s universal healthcare might play a role on the different healthcare seeking patterns.; Summary

Original Article

Determinants of Potentially Unnecessary Cervical Cancer Screenings in American Women: Munseok Seo, James R. Langabeer II; J Prev Med Public Health. 2018;51(4):181-187. Published online June 7, 2018; DOI: https://doi.org/10.3961/jpmph.18.023

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Abstract PDF

Objectives
To identify factors responsible for potentially clinically unnecessary cervical cancer screenings in women with prior hysterectomy.
Methods
A retrospective cross-sectional study was conducted using the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System (BRFSS). This study targeted adult women and examined whether they received a both a Papanicolaou (Pap) test and undergone a hysterectomy in the last three years. We conducted multivariate analyses, including weighted proportions and odds ratios (ORs), based on the modified BRFSS weighting method (raking). The inclusion criteria were adult women (>18 years old) who reported having received a Pap test within the last 3 years.
Results
Of all women (n=252 391), 72 366 had received a Pap test, and 32 935 of those women (45%, or 12.5 million, weighted) had a prior hysterectomy. We found that age, race/ethnicity, marital status, family income, health status, time since last routine checkup, and health insurance coverage were all significant predictors. Black, non-Hispanic women were 2.23 times more likely to receive Pap testing after a hysterectomy than white women (OR, 2.23; 95% confidence interval [CI], 1.99 to 2.50). Similarly, the odds for Hispanic women were 2.34 times higher (OR, 2.34; 95% CI, 1.97 to 2.80). The odds were also higher for those who were married (OR, 1.17; 95% CI, 1.08 to 1.27), healthier (OR, 1.24; 95% CI, 1.14 to 1.35), and had health insurance (OR, 1.54; 95% CI, 1.28 to 1.84), after controlling for confounders.
Conclusions
We conclude that women may potentially receive Pap tests even if they are not at risk for cervical cancer, and may not be adequately informed about the need for screenings. We recommend strategies to disseminate recommendations and information to patients, their families, and care providers.

Summary

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Brief Report

Knowledge and Perceptions of Influenza Vaccinations Among College Students in Vietnam and the United States: Akiko Kamimura, Ha N. Trinh, Shannon Weaver, Alla Chernenko, Maziar M. Nourian, Nushean Assasnik, Hanh Nguyen; J Prev Med Public Health. 2017;50(4):268-273. Published online May 25, 2017; DOI: https://doi.org/10.3961/jpmph.17.061

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Abstract PDF

Objectives
Influenza is a significant worldwide public health issue. Knowledge and perceptions regarding the flu vaccination are associated with whether individuals obtain the vaccination. The purpose of this study was to examine how such perceptions were related to knowledge and self-efficacy regarding influenza and the flu vaccination in Vietnam and the US. Methods: College students (n=932) in Vietnam (n=495) and the US (n=437) completed a self-administered survey regarding knowledge and perceptions of influenza vaccinations in September and October 2016. Results: Vietnamese participants reported significantly lower levels of awareness about flu risk, higher levels of negative attitudes toward flu vaccination, lower levels of knowledge about the flu and vaccination, and lower levels of self-efficacy than US participants. Higher levels of flu and flu vaccination knowledge and self-efficacy regarding general responsible health practices were associated with lower levels of negative perceptions of flu risk and attitudes toward vaccination. At the same time, self-efficacy regarding responsible health practices was associated with higher levels of awareness of flu risk and lower levels of negative attitudes toward vaccination. Self-efficacy regarding exercise was associated with lower levels of perceptions of flu risk and higher levels of negative attitudes toward vaccination. Conclusions: Vietnam could benefit from influenza education based on this comparison with the US. In both countries, knowledge and self-efficacy were found to be important factors influencing perceptions of influenza risk and vaccination.

Summary

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