Reported skin cancer screening of US adult workers

Early detection of skin cancer by skin examination may reduce its associated morbidity and mortality, in particular for workers routinely exposed to sun

Prevalence of Undetected High Risk for Type 2 Diabetes Mellitus in Primary Care: A South Florida Primary Care Practice- Based Research Network Study

Background: The 2004 National Health Interview Survey suggests that 7.0% of adults in the US population have diabetes mellitus (DM). Minority populations in the United States are disproportionately burdened with this disease. Objective: The purpose of this study was to determine the prevalence of DM risk in a cross-section of primary care practices in a large urban area that has considerable proportions of Latino and Caribbean populations and to examine the extent to which primary prevention of DM is provided to this ethnically and economically diverse population. Methods: This was a cross-sectional study of primary care patients presenting to physicians participating in the South Florida Primary Care Practice-Based Research Network and 2 physicians from central and northern Florida. We used a validated instrument to calculate DM risk based on body mass index, family history of DM, age-appropriate physical activity, and obstetric history. We excluded people who self-reported DM, and classified undiagnosed patients into 2 groups: those who recalled receiving information about their high risk for DM and those who did not recall receiving such information. Results: A total of 2836 patients were surveyed; data from 2486 were analyzed. The mean (SD) age of the study sample (N = 2486) was 50.22 (16.38) years, and the majority of the patients were female (n = 1685 [67.8%]). Of the 2018 patients without DM, 1013 (50.2%) were at high risk for the disease. Among high-risk patients, 839 (82.8%) reported not having been informed by their physician that they were at risk. Significant differences in DM risk were observed among ethnic groups (P = 0.01), but patient demographics were not associated with informed status in high-risk patients. High body mass index was strongly associated with informed status (P < 0.001). Conclusions: Fewer than I in 5 patients at high risk reported having been informed of their elevated risk. This low rate of patient education may delay preventive measures and may contribute to the disproportionate effect of DM on ethnic groups in whom this disease is more common

Dental care access and unmet dental care needs among U.S. workers: the National Health Interview Survey, 1997 to 2003

Healthy People 2010 oral health objectives call for an increase in the proportion of adults who use the oral health care system annually. To assess progress toward this goal, the authors evaluated dental care utilization and the extent of unmet dental care needs of U.S. workers and their families. The authors conducted sex-specific analyses by occupation of 135,004 U.S. worker participants in the nationally representative National Health Interview Surveys (NHIS) conducted from 1997 to 2003. The reported lack of oral health care within the preceding year ranged from 18.9 to 57.8 percent among male workers and from 17.6 to 50.0 percent among female workers. Sex-specific occupational groups with the highest rates of reported unmet dental care needs included male health service occupations (17.1 percent) and female construction and extractive trade workers (26.8 percent). There are significant oral health care underutilization and high rates of unmet dental care needs among many U.S. worker groups. Strategies to increase regular dental visits for U.S. worker groups reporting low dental care access and high dental need are paramount. Targeting strategic dental care access programs to identified U.S. worker groups reporting dental care access deficits can improve oral health

Untreated substance use disorder affects glycemic control: Results in patients with type 2 diabetes served within a network of community-based healthcare centers in Florida

Patients with diabetes and comorbid substance use disorders (SUD) experience poor diabetes management, increased medical complications and mortality. However, research has documented that patients engaged in substance abuse treatment have better management of their comorbid conditions. The current study examines diabetes management among patients with type 2 diabetes, with and without comorbid SUD, receiving care at Florida-based Federally Qualified Health Centers (FQHC) of Health Choice Network (HCN). A retrospective analysis was conducted using deidentified electronic health records of 37,452 patients with type 2 diabetes who received care at a HCN site in Florida between 2016 and 2019. A longitudinal logistic regression analysis examined the impact of SUD diagnosis on achievement of diabetes management [HbA1c < 7.0% (53 mmol/mol)] over time. A secondary analysis evaluated, within those with an SUD diagnosis, the likelihood of HbA1c control between those with and without SUD treatment. The longitudinal assessment of the relationship between SUD status and HbA1c control revealed that those with SUD (N = 6,878, 18.4%) were less likely to control HbA1c over time (OR = 0.56; 95% CI = 0.49-0.63). Among those with SUD, patients engaged in SUD treatment were more likely to control HbA1c (OR = 5.91; 95% CI = 5.05-6.91). Findings highlight that untreated SUD could adversely affect diabetes control and sheds light on the opportunity to enhance care delivery for patients with diabetes and co-occurring SUD