358 research outputs found

    Health literacy and libraries: a literature review

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    Purpose The aim of this article is to assess the involvement of libraries in health literacy programs and initiatives based on a review of the literature.  Methodology Four databases were searched for articles that described health literacy programs and initiatives within libraries.  Findings Several themes of health literacy programs in libraries emerged: health literacy for older adults, underserved populations, the general public, healthcare professionals and medical students, and patients. Collaborations between libraries and community organizations were frequently utilized.  Practical implications Librarians may use this review to understand the history of health literacy efforts and libraries in order to inform future programming. This review will contextualize current research on health literacy and libraries.  Originality/value Despite the currency and relevance of this topic, there are no literature reviews on health literacy and librarianship

    Are Americans Feeling Less Healthy? The Puzzle of Trends in Self-rated Health

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    Although self-rated health is proposed for use in public health monitoring, previous reports on US levels and trends in self-rated health have shown ambiguous results. This study presents a comprehensive comparative analysis of responses to a common self-rated health question in 4 national surveys from 1971 to 2007: the National Health and Nutrition Examination Survey, Behavioral Risk Factor Surveillance System, National Health Interview Survey, and Current Population Survey. In addition to variation in the levels of self-rated health across surveys, striking discrepancies in time trends were observed. Whereas data from the Behavioral Risk Factor Surveillance System demonstrate that Americans were increasingly likely to report “fair” or “poor” health over the last decade, those from the Current Population Survey indicate the opposite trend. Subgroup analyses revealed that the greatest inconsistencies were among young respondents, Hispanics, and those without a high school education. Trends in “fair” or “poor” ratings were more inconsistent than trends in “excellent” ratings. The observed discrepancies elude simple explanations but suggest that self-rated health may be unsuitable for monitoring changes in population health over time. Analyses of socioeconomic disparities that use self-rated health may be particularly vulnerable to comparability problems, as inconsistencies are most pronounced among the lowest education group. More work is urgently needed on robust and comparable approaches to tracking population health

    Impact of intercensal population projections and error of closure on breast cancer surveillance: examples from 10 California counties

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    INTRODUCTION: In 2001, data from the California Cancer Registry suggested that breast cancer incidence rates among non-Hispanic white (nHW) women in Marin County, California, had increased almost 60% between 1991 and 1999. This analysis examines the extent to which these and other breast cancer incidence trends could have been impacted by bias in intercensal population projections. METHOD: We obtained population projections for the year 2000 projected from the 1990 census from the California Department of Finance (DOF) and population counts from the 2000 US Census for nHW women living in 10 California counties and quantified age-specific differences in counts. We also computed age-adjusted incidence rates of invasive breast cancer in order to examine and quantify the impact of differences between the population data sources. RESULTS: Differences between year 2000 DOF projections and year 2000 census counts varied by county and age and ranged from underestimates of 60% to overestimates of 64%. For Marin County, the DOF underestimated the number of nHW women aged 45 to 64 years by 32% compared to the 2000 US census. This difference produced a significant 22% discrepancy between breast cancer incidence rates calculated using the two population data sources. In Los Angeles and Santa Clara counties, DOF-based incidence rates were significantly lower than rates based on census data. Rates did not differ significantly by population data source in the remaining seven counties examined. CONCLUSION: Although year 2000 population estimates from the DOF did not differ markedly from census counts at the state or county levels, greater discrepancies were observed for race-stratified, age-specific groups within counties. Because breast cancer incidence rates must be calculated with age-specific data, differences between population data sources at the age-race level may lead to mis-estimation of breast cancer incidence rates in county populations affected by these differences, as was observed in Marin County. Although intercensal rates based on population projections are important for timely breast cancer surveillance, these rates are prone to bias due to the error of closure between population projections and decennial census population counts. Intercensal rates should be interpreted with this potential bias in mind

    Sodium and potassium intakes among US adults: NHANES 2003–2008

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    Background: The American Heart Association (AHA), Institute of Medicine (IOM), and US Departments of Health and Human Services and Agriculture (USDA) Dietary Guidelines for Americans all recommend that Americans limit sodium intake and choose foods that contain potassium to decrease the risk of hypertension and other adverse health outcomes. Objective: We estimated the distributions of usual daily sodium and potassium intakes by sociodemographic and health characteristics relative to current recommendations. Design: We used 24-h dietary recalls and other data from 12,581 adults aged 20ywhoparticipatedinNHANESin20032008.Estimatesofsodiumandpotassiumintakeswereadjustedforwithinindividualdaytodayvariationbyusingmeasurementerrormodels.SEsand9520 y who participated in NHANES in 2003–2008. Estimates of sodium and potassium intakes were adjusted for withinindividual day-to-day variation by using measurement error models. SEs and 95% CIs were assessed by using jackknife replicate weights. Results: Overall, 99.4% (95% CI: 99.3%, 99.5%) of US adults consumed more sodium daily than recommended by the AHA (,1500 mg), and 90.7% (89.6%, 91.8%) consumed more than the IOM Tolerable Upper Intake Level (2300 mg). In US adults who are recommended by the Dietary Guidelines to further reduce sodium intake to 1500 mg/d (ie, African Americans aged 51 y or persons with hypertension, diabetes, or chronic kidney disease), 98.8% (98.4%, 99.2%) overall consumed .1500 mg/d, and 60.4% consumed .3000 mg/d—more than double the recommendation. Overall, ,2% of US adults and w5% of US men consumed $4700 mg K/d (ie, met recommendations for potassium). Conclusion: Regardless of recommendations or sociodemographic or health characteristics, the vast majority of US adults consume too much sodium and too little potassium

    Lead exposure and periodontitis in US adults

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    Lead is known to have significant effects on bone metabolism and the immune system. This study tested the hypothesis that lead exposure affects periodontitis in adults. Material and Methods:  This study used the data from the Third National Health and Nutrition Examination Survey (NHANES III, 1988–94). It analyzed data from 2500 men and 2399 women, 20–56 yr old, who received complete periodontal examination. Periodontitis was defined as the presence of > 20% of mesial sites with ≥ 4 mm of attachment loss. Lead exposure was grouped into three categories:  7 μg/dL. Covariates were cotinine levels, poverty ratio, race/ethnicity, education, bone mineral density, diabetes, calcium intake, dental visit, and menopause (for women). All analyses were performed separately for men and women and considering the effect design. Univariate, bivariate, and stratified analysis was followed by multivariable analysis by estimating prevalence ratios through poisson regression. Results:  After adjustment for confounders, the prevalence ratios, comparing those with a lead blood level of > 7 μg/dL to those with a lead blood level of < 3 μg/dL was 1.70 (95% confidence interval (CI): 1.02, 2.85) for men and 3.80 (95% CI: 1.66, 8.73) for women. Conclusion:  The lead blood level was positively and statistically associated with periodontitis for both men and women. Considering the public health importance of periodontitis and lead exposure, further studies are necessary to confirm this association.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65253/1/j.1600-0765.2006.00913.x.pd

    Behavioral determinants of successful early melanoma detection

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    BACKGROUND. Reduced melanoma mortality should result from an improved understanding of modifiable factors related to early detection. The authors of this report surveyed newly diagnosed patients to identify differences in prediagnosis behavioral and medical care factors associated with thinner versus thicker melanoma. METHODS. In total, 566 adults with invasive melanoma completed questionnaires within 3 months of diagnosis on demographics, health care access, skin self‐examination (SSE), and physician skin examination (PSE) practices in the year before diagnosis. SSE was measured by us e of a melanoma picture aid and routine examination of some/all body sites versus none. Patient‐reported partial or full‐body PSE also was assessed. Melanoma thickness was dichotomized at 1 mm. RESULTS. Patient ranged in age from 18 years to 99 years, and 61% were men. The median tumor thickness was 1.25 mm, and 321 tumors (57%) were >1 mm thick. Thinner tumors (≤1 mm) were associated with age ≤60 years ( P = .0002), women ( P = .0127), higher education level ( P = .0122), and physician discovery ( P ≤ .0001). Patients who used a melanoma picture aid and performed routine SSE were more likely to have thinner tumors than those who did not (odds ratio [OR], 2.66; 95% confidence interval [CI], 1.48‐4.80). Full‐body PSE was associated with thinner tumors (OR, 2.51; 95% CI, 1.62‐3.87), largely because of the effect of PSE in men aged >60 years (OR, 4.09 95% CI, 1.88‐8.89). CONCLUSIONS. SSE and PSE were identified as complementary early detection strategies, particularly in men aged >60 years, in whom both partial and full‐body PSE were associated with thinner tumors. Given the high rates of physician access, PSE may be a more practical approach for successful early detection in this subgroup with highest mortality. Cancer 2012. © 2011 American Cancer Society. Physician skin examination (PSE) in the year before melanoma diagnosis is strongly associated with thinner tumors in men aged >60 years. Improving rates of PSE in this high‐risk group is likely to result in earlier detection of melanoma.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/92369/1/26707_ftp.pd

    The publics' understanding of daily caloric recommendations and their perceptions of calorie posting in chain restaurants

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    <p>Abstract</p> <p>Background</p> <p>Calorie posting in chain restaurants has received increasing attention as a policy lever to reduce energy intake. Little research has assessed consumer understanding of overall daily energy requirements or perceived effectiveness of calorie posting.</p> <p>Methods</p> <p>A phone survey was conducted from May 1 through 17, 2009 with 663 randomly selected, nationally-representative adults aged 18 and older, including an oversample of Blacks and Hispanics in the United States. To examine differences in responses by race and ethnicity (White, Black, and Hispanic) and gender, we compared responses by conducting chi-squared tests for differences in proportions.</p> <p>Results</p> <p>We found that most Americans were knowledgeable about energy requirements for moderately active men (78%) and women (69%), but underestimated energy requirements for inactive adults (60%). Whites had significantly higher caloric literacy and confidence about their caloric knowledge than Blacks and Hispanics (p < 0.05). As compared to their counterparts, Blacks, Hispanics and women reported a significantly higher likelihood of eating at a chain restaurant and of selecting lower calorie foods where caloric information was posted. Most Americans favored the government requiring chain restaurants to post calorie information on menus at the point of purchase (68%). Support for government mandated calorie posting in chain restaurants was significantly higher among Blacks, Hispanics and women as compared to their counterparts. The public was divided about the mode of caloric information that would best help them make a lower calorie decision; a third favored number of calories (35%) which is the current standard mode of presenting caloric information in chain restaurants, a third favored a physical activity equivalent (26%), and a third favored percentage of total energy intake (39%).</p> <p>Conclusion</p> <p>Mandating calorie posting in chain restaurants may be a useful policy tool for promoting energy balance, particularly among Blacks, Hispanics and women who have higher obesity risk.</p
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