An examination of early colorectal cancer screening guidelines for African Americans: Hints from the HINTS data

Background: Despite the overall gains in reducing colorectal cancer (CRC) deaths due to the increase in screening, minority racial/ethnic groups who have disparately higher rates of death compared to Whites, also have disproportionately lower screening rates. Patient-provider communication about screening has a strong influence on the uptake of screening. In much the same way that gradual impact was made after the 1996 implementation of guidelines recommending screening starting at age 50 for those at average risk, it may be expected that the American College of Gastroenterology (ACG) guidelines suggesting screening start at 45 for Blacks combined with a recent trend toward increasing incidence of cancer in persons below the age of 50 might influence practitioners to offer screening with greater frequency to those younger minority groups. Methods: This study examines HINTS Cycle 4 data to examine the nationally representative rates at which providers offer patients the option to be screened for CRC, with emphasis on Blacks ages 45-49. We looked for a trend in these rates over time, compared the pooled proportion estimates across racial/ethnic groups aged 45-49, and compared the proportion of Black individuals in this age group to those between ages 50 and 75 who had been told they could choose to have a CRC screening. Results: Approximately 27.14% of Black individuals aged 45-49 had been offered the option of CRC screening by a healthcare provider compared to 32.57% of White individuals of the same age group and 43.53% of Black individuals age 50-75. Discussion: There is not yet any evidence of an increase in adherence to the ACG guidelines for the Black population aged 45-49 and there remains a significant racial disparity in discussion of the CRC screening option. Earlier information regarding the option to be screened may have the potential to reduce disparities CRC screening and mortality, as well as potentially halt a disturbing trend toward early cancers

Medical Marijuana Policy Reform Reaches Florida: A Scoping Review

Background: Florida became the first state in the U.S. South to legalize the use of medical marijuana to treat a variety of health conditions including chronic pain, epilepsy, and spasticity symptoms from multiple sclerosis. While there are over 200,000 medical marijuana patients in Florida, there remain financial, psychological, and insurance coverage barriers which reduce access for many patients. Purpose: This scoping review, with a focus on state health policy, first describes some clinical studies examining the therapeutic benefits of medical marijuana. Next, there is a discussion of the Florida regulatory environment and major legislation. Also, the review describes how the current Florida policy landscape presents challenges for physicians and patients. Methods: A scoping review of the literature was conducted in PubMed and Google Scholar using the search terms, “medical marijuana” and “medical cannabis” to identify research articles, newspaper reports, and government documents. The purpose of the review was to identify research investigating the therapeutic efficacy of medical marijuana and state policies affecting physician practice. Results: The review concluded there was general scientific consensus of therapeutic benefits for patients, especially for chronic pain, from the use of medical marijuana. The review also identified several barriers for physicians and patients around cost, stigma, and lack of insurance coverage which constrains use and access. Discussion: The review discusses several directions for future medical marijuana policy and research with the aim to improve therapeutic benefits for Florida patients

After Implementation of the ACA – Coverage Gaps among Rural Latinos Still Remain

In this study, we assessed health needs and insurance coverage among a rural Latino population. A health needs survey was conducted in 2015 with approximately 100 Latino residents living in a rural Florida county. The survey included questions on socio-economic characteristics, type of insurance coverage, lapses in coverage, delays in care and satisfaction with health services. Only 15% of respondents had insurance through their employer, and 11% had Medicaid. Over 45% of participants had no health insurance, and 20% had no insurance for more than three years. One in ten had a medication delay due to lack of coverage/money, and 17% expressed they had medical bills they were paying off. Gaps in coverage highlight the need for targeted outreach efforts, while gaps in access and affordability highlight the need for new strategies to address barriers to care and out of pocket expenses for those with health insurance