The Associations Between Access to Recreational Facilities and Adherence to the American Heart Association's Physical Activity Guidelines in US Adults

Physical activity decreases the risk of long-term health consequences including cardiac diseases. According to the American Health Association (AHA), adults should perform at least 75 min of vigorous physical activity (PA) or 150 min of moderate PA per week to impact long-term health. Results of previous studies are varied and have yet to integrate perceived access to facilities with AHA PA guidelines. We investigated whether access to free or low-cost recreational facilities was associated with meeting the AHA PA guidelines.Methodology: This cross-sectional study utilized data extracted from the Family Life, Activity, Sun, Health, and Eating (FLASHE) database collected in 2017 (n = 1,750). The main exposure variable was access to free or low-cost recreational facilities. The main outcome variable was meeting the AHA guidelines of 150 min moderate PA or 75 min vigorous PA per week. Covariates included age, sex, level of education, overall health, BMI, ethnicity, hours of work per week, income, and time living at current address. Unadjusted and adjusted logistic regression analysis were used to calculate measures of odds ratio (OR) and corresponding 95% confidence interval (CI).Results: Of the 1,750 included participants, 61.7% (n = 1,079) reported to have access to recreational facilities. Of those with access to facilities, 69.9% met AHA PA guidelines while 30.4% did not. After adjusting for covariates, participants who reported access to recreational facilities were 42% more likely to meet AHA PA guidelines compared with participants who did not (adjusted OR 1.42; 95% CI 1.14-1.76). Secondary results suggest that healthier individuals were more likely to have met AHA PA guidelines.Conclusions: Having access to free or low-cost recreational facilities such as parks, walking trails, bike paths and courts was associated with meeting the AHA PA guidelines. Increasing prevalence and awareness of neighborhood recreational facilities could assist in access to these facilities and increase the ability of individuals to meet AHA PA guidelines. Future research should determine which types of recreational facilities impact physical activity strongest and discover methods of increasing their awareness.Peer reviewe

Editorial : Physical Activity, Health Equity and Health Related Outcomes

Non peer reviewe

Smoking and cancer, cardiovascular and total mortality among older adults: The Finrisk Study

Little information is available about the deleterious effect of smoking in older adults The objective of this study was to assess the relationship of smoking habits with cancer, CVD and all-cause mortality in late middle-age (45–64 years) and older (65–74) people. This cohort study of 6516 men and 6514 women studied the relationship of smoking habits with cancer, cardiovascular disease (CVD) and all-cause mortality among middle-aged and older Finnish men and women during 1997–2013. The study cohort was followed up until the end of 2013 (median follow-up time was 11.8 years). Mortality data were obtained from the National Causes of Death Register and data on incident stroke events from the National Hospital Discharge Register. Adjusted Hazard ratios (HR) for total mortality were 2.61 (95% Confidence interval 2.15–3.18) among 45–64 years-old men and 2.59 (2.03–3.29) in 65–74 years-old men. The corresponding HRs for women 45–64 years-of-age were 3.21 (2.47–4.19) and 3.12 (2.09–4.68) for those 65–74 years-old, respectively. Adjusted HRs for CVD mortality in the 45–64 years-old and 65–74 years-old groups were 2.67 (1.92–2.67) and 1.95 (1.33–2.86) in men, and 4.28 (2.29–7.99) and 2.67 (1.28–5.58) in women, respectively. Among men, the risk difference between never and current smokers was 108/100.000 in the age-group 45–64 years, and 324/100.000 in the age group 65–74 years. Among women the differences were 52/100.000 and 196/100.000, respectively. In conclusion, absolute risk difference between never and current smokers are larger among the older age group. Smoking cessation counseling should routinely target also older adults in primary health-care.Peer reviewe

The Association Between Race and Diagnostic Delay of Retinoblastoma in US Children

The Association Between Race and Diagnostic Delay of Retinoblastoma in US Children Alexander K. Black1, Amanda E. Kahn2, Roberto Warman3, Noël C. Barengo4 1 Florida International University Herbert Wertheim College of Medicine, [email protected], ORCID: 0000-0003-1688-5109 2 Florida International University Herbert Wertheim College of Medicine, [email protected], ORICD: 0000-0002-8045-4576 3 Florida International University Herbert Wertheim College of Medicine, [email protected]. 4 Florida International University Herbert Wertheim College of Medicine, [email protected], ORCID: 0000-0003-0660-3091 Objective: Explore associations between race and age at diagnosis of retinoblastoma in children in the United States between 1988-2018. Methods: An analytical non-concurrent cohort study was conducted using the Surveillance, Epidemiology, and End Results (SEER) database from 1988-2018. The cohort includes children ages 0-17 diagnosed with retinoblastoma. The exposure was race and the outcome was age at diagnosis. Primary diagnosis after two years old was considered diagnostic delay. Covariates include sex, rural-urban continuum, ethnicity, decade of diagnosis, and disease laterality. Unadjusted and adjusted logistic regression analysis were performed to calculate odds ratios (OR) and 95% confidence intervals (CI). Results: In total, 747 participants met inclusion criteria. By racial group, 70.15% of participants were white, 16.33% black, 10.98% Asian/Pacific Islander and 2.54% American Indian/Alaska native. By ethnicity, 84.34% were non-Hispanic. No statistically significant associations between racial or ethnic groups and age at diagnosis compared to the non-Hispanic white control group (black OR 0.92; 95% CI 0.58-1.54, Asian/Pacific Islander OR 1.15; 95% CI 0.50-19.95, American Indian/Alaska native OR 0.61; 95% CI 0.20-1.85, Hispanic OR 0.86; 95% CI 0.52 -1.41) were found. Females were significantly more likely to be diagnosed under age two compared to males (OR 0.62; 95% CI 0.44-0.88). Conclusion: While many variables affect development of retinoblastoma, this nationwide study of US children suggests that timely identification of retinoblastoma does not differ based on race or ethnicity. Keywords: retinoblastoma, race/ethnicity, epidemiolog

Is Being Single a Risk Factor for Previously Undetected Abnormal Glucose Tolerance?

Background: Type II diabetes represents a chronic disease with costly consequences. It is important to identify all risk factors to allow patients the opportunity to counter its progression. The aim of this study was to evaluate the association between marital status and previously undiagnosed abnormal glucose tolerance (AGT) in a northern Colombian population. Methods: Secondary data analysis of a cross-sectional screening study in a northern Colombian adult population ages 18-74 using healthcare insurance company data from 2014-2015. The main exposure was marital status, while the outcome was AGT. A descriptive analysis of the variables in the database was conducted, and chi-square analysis of categorical covariates and a t-test of continuous covariates were performed. Unadjusted and adjusted linear regression models were used to evaluate the association between marital status and AGT. Results: Single individuals had a 20% decreased odds of having AGT compared to married individuals (odds ratio (OR) 0.80, 95% confidence interval (CI) 0.7 - 1.0), but this association disappeared after adjusting for covariates (OR 1.0, 95% CI 0.7 - 1.2). There was a 40% increased odds of AGT in women compared to men (OR 1.40, 95% CI 1.1 - 1.8). Hypertension increased the risk of AGT by about 60% (OR 1.60, 95% CI 1.2 - 2.1), while obesity was associated with an 80% increased odds of developing AGT (OR 1.80, 95% CI 1.3 - 2.4). Conclusion: Our study suggests that screening for abnormal glucose tolerance may not be necessary in specific marital status groups

Factors related to good asthma control using different medical adherence scales in Latvian asthma patients : An observational study

Publisher Copyright: © 2017 The Author(s). Copyright: Copyright 2018 Elsevier B.V., All rights reserved.One of the main challenges in asthma control is adherence to pharmaceutical treatment. The aim of this study was to test the association between adherence to asthma medication, control and medical beliefs, cognitive and emotional perceptions using three different validated questionnaires. Beliefs about asthma medicine, cognitive and emotional factors were determined in a cross-sectional survey of patients attending outpatient pulmonologist practices in Latvia (n = 352). The validated Beliefs about Medicines Questionnaire and the Brief Illness Perception Questionnaire were used. Adherence to asthma medication was assessed using the Morisky Medication Adherence Scale and two different versions of the Medication Adherence Reporting Scale. Several questions about necessity or concerns related to pharmaceutical treatment were able to predict poor adherence according to the Morisky scale. If the patient felt that without the asthma medication his life would be impossible, his risk to have poor treatment adherence was 46% reduced (odds ratio 0.54; 95% confidence interval 0.33-0.89). Furthermore, asthma patients who were convinced that their health depends on the asthma treatment were less likely to have poor treatment adherence (odds ratio 0.56: 95% confidence interval 0.32-0.97). In case the patient was concerned by the need to constantly use asthma medication or sometimes concerned by long-term effects of asthma medication the odds of poor treatment adherence were 1.96 (95% confidence interval 1.19-3.24) and 2.43 (95% confidence interval 1.45-4.08), respectively. In conclusion, medication beliefs, particularly concerns and necessity of asthma treatment were associated with poor treatment adherence when assessed with the Morisky or 5-item Medication Adherence Reporting Scale.publishersversionPeer reviewe

Impact of Social Determinants of Health on Healthcare Disparities in Florida

Objective Healthcare disparities disproportionately affect underserved and marginalized communities due to social determinants of health (SDoH), contributing to significant differences in health outcomes and life expectancy within different communities in Florida. This observational study aimed to understand the impact of SDoH, such as race/ethnicity, income level, and education attainment on healthcare access in Florida. Methods Self-reported data from the 2020 Behavioral Risk Factor Surveillance System were pooled to evaluate disparities in healthcare access by race/ethnicity, income, and education level in Florida. Results Health status and healthcare access vary based on characteristics related to SDoH, including race/ethnicity, income level, and educational attainment. Health status and healthcare access increased with income and education attainment. There were no significant disparities in health status and healthcare access among racial and ethnic groups. Conclusion While race and ethnicity were not significant predictors of health status nor healthcare access, income level and education were positively correlated which may be related to policy including Florida\u27s lack of Medicaid expansion or population characteristics such as health-seeking behaviors. Understanding the prevalence of healthcare disparities based on SDoH can inform and support the implementation of evidence-based strategies for improving the accessibility and affordability of culturally competent care for underserved populations

A demonstration area for type 2 diabetes prevention in Barranquilla and Juan Mina (Colombia) Baseline characteristics of the study participants

Type 2 diabetes (T2D) imposes a heavy public health burden in both developed and developing countries. It is necessary to understand the effect of T2D in different settings and population groups. This report aimed to present baseline characteristics of study participants in the demonstration area for the Type 2 Diabetes Prevention in Barranquilla and Juan Mina (DEMOJUAN) project after randomization and to compare their fasting and 2-hour glucose levels according to lifestyle and T2D risk factor levels. The DEMOJUAN project is a randomized controlled field trial. Study participants were recruited from study sites using population-wide screening using the Finnish Diabetes Risk Score (FINDRISC) questionnaire. All volunteers with FINDRISC of >= 13 points were invited to undergo an oral glucose tolerance test (OGTT). Participant inclusion criteria for the upcoming field trial were either FINDRISC of >= 13 points and 2-hour post-challenge glucose level of 7.0 to 11.0mmol/L or FINDRISC of >= 13 points and fasting plasma glucose level of 6.1 to 6.9mmol/L. Lifestyle habits and risk factors for T2D were assessed by trained interviewers using a validated questionnaire. Among the 14,193 participants who completed the FINDRISC questionnaire, 35% (n=4915) had a FINDRISC score of >= 13 points and 47% (n=2306) agreed to undergo the OGTT. Approximately, 33% (n=772) of participants underwent the OGTT and met the entry criteria; these participants were randomized into 3 groups. There were no statistically significant differences found in anthropometric or lifestyle risk factors, distribution of the glucose metabolism categories, or other diabetes risk factors between the 3 groups (P>.05). Women with a past history of hyperglycaemia had significantly higher fasting glucose levels than those without previous hyperglycaemia (103 vs 99mg/dL; P Lifestyle habits and risk factors were evenly distributed among the 3 study groups. No differences were found in fasting or 2-hour glucose levels among different lifestyle or risk factor categories with the exception of body mass index, past history of hyperglycaemia, and age of 64 years in women.Peer reviewe

Association of insurance disparities and survival in adults with multiple myeloma: A non-concurrent cohort study

Background: Multiple myeloma (MM) accounts for 10 % of all hematological malignancies. As recent advances in MM treatment continue to improve survival rates, socioeconomic barriers need to be identified to ensure equal treatment. This study evaluates the association between insurance status and survival in patients with MM. Methods: This study analyzed patients with MM from the 2007?2016 Surveillance, Epidemiology, and End Results (SEER) Program database. Insurance status was categorized as uninsured, Medicaid, private insurance, and other insurance. Cancer-specific survival was measured at one- and five-years post diagnosis. Results: From 2007?2016, there were 41,846 patients with MM extracted from the SEER database. Those with private insurance had a higher proportion of participants that identified as married (65.5 %), resided in metropolitan cities (90.1 %), and identified as white (76 %) and non-Hispanic (90.8 %). The uninsured group had the highest proportion of Black participants compared to other insurance groups (37.4 %). After adjustment for age, sex, race, ethnicity, marital status, and residence, the likelihood of five-year survival was significantly lower in those respondents with Medicaid (adjusted (adj) Hazard Ratio (HR): 1.44; 95 % Confidence Interval (CI): 1.36-1.53), when compared with private insurance holders. Those who were uninsured had a 26 % increased mortality hazard than those with private insurance (95 % CI 1.04-1.53). Conclusion: After adjustment, insurance status can influence the survival of adults with MM. As treatment modalities for MM continue to advance, the insurance status of a patient should not hinder their ability to receive the most effective and timely therapies.Peer reviewe