Hepatitis C Testing Increased Among Baby Boomers Following The 2012 Change To CDC Testing Recommendations.
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ABSTRACT:
SUBMITTER: Barocas JA
PROVIDER: S-EPMC5721349 | biostudies-literature | 2017 Dec
REPOSITORIES: biostudies-literature
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Hepatitis C Testing Increased Among Baby Boomers Following The 2012 Change To CDC Testing Recommendations.
Barocas Joshua A JA Wang Jianing J White Laura F LF Tasillo Abriana A Salomon Joshua A JA Freedberg Kenneth A KA Linas Benjamin P BP
Health affairs (Project Hope) 20171201 12
In 2012 the Centers for Disease Control and Prevention recommended routine testing for hepatitis C for people born in the period 1945-65. Until now, the recommendation's impact on hepatitis C screening rates in the United States has not been fully understood. We used an interrupted time series with comparison group design to analyze hepatitis C screening rates in the period 2010-14 among 2.8 million commercially insured adults in the MarketScan database. Hepatitis C screening rates increased yea ...[more]
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| S-EPMC7474142 | biostudies-literature
Project description:Optimal mental health underpins full social participation. As people age, they confront personal and cultural challenges, the effects of which on mental health are not fully understood. The aim of this research was to learn from women of the Baby Boomer generation (born 1946-1964) what contributes to and hinders their mental health and wellbeing. Eighteen women participated in qualitative interviews (in English); data were analysed thematically. Participants were located across Australia in rural and urban areas; not all were born in Australia. They were diverse in education, employment status, and experiences of life and ageing. The women nominated as the main contributors to poor mental health in older women Illness and disability, Financial insecurity, Maltreatment, and Loss and grief. Contributors to good mental health were identified as Social interdependence, Feeling valued, Physical activity, Good nutrition, and Having faith or belief. Women's accounts supplied other influences on mental health, both associated with the person (Personality and Intimate relationships and sex) and with society (Constructs of ageing, Gender, and Culture). Women also specified what they needed from others in order to improve their mental health as they aged: Public education about ageing, Purposeful roles for older women in society, Adequate services and resources, and Sensitive health care. In sum, older women wanted to be treated with respect and for their lives to have meaning. It is evident from these results that circumstances throughout life can have profound influences on women's mental health in older age. Anti-discriminatory policies, informed and inclusive health care, and social structures that support and enhance the lives of girls and women at all ages will therefore benefit older women and increase the potential for their continuing contribution to society. These conclusions have implications for policy and practice in well-resourced countries.
| S-EPMC7802969 | biostudies-literature
Project description:Hepatitis C virus (HCV) infection is a major source of morbidity and mortality in the United States. HCV is transmitted primarily through parenteral exposures to infectious blood or body fluids that contain blood, most commonly through injection drug use. No vaccine against hepatitis C exists and no effective pre- or postexposure prophylaxis is available. More than half of persons who become infected with HCV will develop chronic infection. Direct-acting antiviral treatment can result in a virologic cure in most persons with 8-12 weeks of all-oral medication regimens. This report augments (i.e., updates and summarizes) previously published recommendations from CDC regarding testing for HCV infection in the United States (Smith BD, Morgan RL, Beckett GA, et al. Recommendations for the identification of chronic hepatitis C virus infection among persons born during 1945-1965. MMWR Recomm Rec 2012;61[No. RR-4]). CDC is augmenting previous guidance with two new recommendations: 1) hepatitis C screening at least once in a lifetime for all adults aged ?18 years, except in settings where the prevalence of HCV infection is <0.1% and 2) hepatitis C screening for all pregnant women during each pregnancy, except in settings where the prevalence of HCV infection is <0.1%. The recommendation for HCV testing that remains unchanged is regardless of age or setting prevalence, all persons with risk factors should be tested for hepatitis C, with periodic testing while risk factors persist. Any person who requests hepatitis C testing should receive it, regardless of disclosure of risk, because many persons might be reluctant to disclose stigmatizing risks.
| S-EPMC7147910 | biostudies-literature
Project description:Background: Liver cancer rates are rising and hepatitis C virus (HCV) is the primary cause. The CDC recommends a one-time HCV screening for all persons born 1945-1965 (baby boomers). However, 14% of baby boomers have been screened. Few studies have examined primary care providers' (PCP) perspectives on barriers to HCV screening. This study examines current HCV screening practices, knowledge, barriers, and facilitators to HCV screening recommendation for baby boomers among PCPs.Methods: We conducted a mixed methods pilot study of PCPs. Quantitative: We surveyed PCPs from 3 large academic health systems assessing screening practices, knowledge (range:0-9), self-efficacy to identify and treat HCV (range:0-32), and barriers (range:0-10). Qualitative: We conducted interviews assessing patient, provider, and clinic-level barriers to HCV screening for baby boomers in primary care. Interviews were audio recorded, transcribed, and analyzed with content analysis.Results: The study sample consisted of 31 PCPs (22 survey participants and nine interview participants). All PCPs were aware of the birth cohort screening recommendation and survey participants reported high HCV testing recommendation, but qualitative interviews indicated other priorities may supersede recommending HCV testing. Provider knowledge of viral transmission was high, but lower for infection prevalence. While survey participants reported very few barriers to HCV screening in primary care, interview participants provided a more nuanced description of barriers such as lack of time.Conclusions: There is a need for provider education on both HCV treatment as well as how to effectively recommend HCV screening for their patients. As HCV screening guidelines continue to expand to a larger segment of the primary care population, it is important to understand ways to improve HCV screening in primary care.
| S-EPMC7713319 | biostudies-literature
Project description:OBJECTIVE:We describe sources expected to provide for future care needs among baby-boomers in their late sixties and examine how expectations vary according to earlier health and social experiences. We hypothesised that greater integration in social relationships across adulthood is associated with greater expectation of informal care, and that greater morbidity over a longer time period is associated with greater expectation of formal care. METHOD:The MRC National Survey of Health and Development, a population-based birth cohort study set in mainland Britain, provided data on care expectations for 2135 participants aged 68-69. The outcome was who, besides the partner or spouse, is expected to provide for the future care needs, coded as adult children, other relatives, friends/neighbours, paid/professional care, or no one. Adult children were taken as the reference category and the latter two categories were combined as 'formal care' in the multiple regression analysis. RESULTS:91% had an adult child, of whom 74% expected them to provide care if needed, and 11% expected formal care. The latter rose to 33% of those with no adult children. Geographical distance to adult children (over 25 miles) was strongly correlated with expectations but, independently of this, lack of someone to help in a crisis from midlife onwards and low social contact were associated with expecting formal care. Expectations did not differ by number of chronic conditions, functional limitations or longstanding illness from age 60?+?. CONCLUSION:Those lacking social relationships in midlife onwards and those living further from adult children are more likely to expect formal help with their future care needs. As personal care needs are projected to rise with population ageing and families are increasingly expected to provide for these needs, initiatives to remove barriers to smaller distances between ageing parents and their children and to support and maintain high-quality family relationships across the life course should be considered.
| S-EPMC6189454 | biostudies-literature
Project description:This article investigates White, Black, and Hispanic men's and women's access and midlife labor market returns to college quality. To do so, we use data from the National Longitudinal Survey of Youth-1979 Cohort (NLSY-79), merged with college quality information from the Barron's Admissions Competitiveness Index. Although prior research has investigated similar dynamics in access and returns to higher education, this work typically excludes Hispanics and does not assess enrollments at community colleges and other less competitive colleges where Black and Hispanic enrollments tend to cluster. We find that Black-White and Hispanic-White differences in college quality, to Whites' advantage, were fully explained or reversed once we accounted for differences in students' backgrounds. At midlife, Hispanic and especially Black men had lower rates of labor force participation than White men who attended colleges of the same quality. Including such differences (i.e., years of no or part-time work) in assessing the earnings returns to college quality demonstrated striking disadvantages facing college-educated Black men relative to White men, which were not fully accounted for by background characteristics. Employment and earnings returns to college quality were not as disparate by race for women. Relative to White women, we find earnings advantages for Hispanic women among those who attended community colleges. This article demonstrates the utility of taking an intersectional and life course approach to the study of higher education and the economic returns to schooling.
| S-EPMC10704403 | biostudies-literature
Project description:Background and objectiveChronic medical conditions accumulate within individuals with age. However, knowledge concerning the trends, patterns and determinants of multimorbidity remains limited. This study assessed the prevalence and patterns of multimorbidity using extensive individual phenotyping in a general population of Australian middle-aged adults.MethodsParticipants (n = 5029, 55% female), born between 1946 and 1964 and attending the cross-sectional phase of the Busselton Healthy Ageing Study (BHAS) between 2010 and 2015, were studied. Prevalence of 21 chronic conditions was estimated using clinical measurement, validated instrument scores and/or self-reported doctor-diagnosis. Non-random patterns of multimorbidity were explored using observed/expected (O/E) prevalence ratios and latent class analysis (LCA). Variables associated with numbers of conditions and class of multimorbidity were investigated.ResultsThe individual prevalence of 21 chronic conditions ranged from 2 to 54% and multimorbidity was common with 73% of the cohort having 2 or more chronic conditions. (mean ± SD 2.75 ± 1.84, median = 2.00, range 0-13). The prevalence of multimorbidity increased with age, obesity, physical inactivity, tobacco smoking and family history of asthma, diabetes, myocardial infarct or cancer. There were 13 pairs and 27 triplets of conditions identified with a prevalence > 1.5% and O/E > 1.5. Of the triplets, arthritis (> 50%), bowel disease (> 33%) and depression-anxiety (> 33%) were observed most commonly. LCA modelling identified 4 statistically and clinically distinct classes of multimorbidity labelled as: 1) "Healthy" (70%) with average of 1.95 conditions; 2) "Respiratory and Atopy" (11%, 3.65 conditions); 3) "Non-cardiometabolic" (14%, 4.77 conditions), and 4) "Cardiometabolic" (5%, 6.32 conditions). Predictors of multimorbidity class membership differed between classes and differed from predictors of number of co-occurring conditions.ConclusionMultimorbidity is common among middle-aged adults from a general population. Some conditions associated with ageing such as arthritis, bowel disease and depression-anxiety co-occur in clinically distinct patterns and at higher prevalence than expected by chance. These findings may inform further studies into shared biological and environmental causes of co-occurring conditions of ageing. Recognition of distinct patterns of multimorbidity may aid in a holistic approach to care management in individuals presenting with multiple chronic conditions, while also guiding health resource allocation in ageing populations.
| S-EPMC8359115 | biostudies-literature
Project description:Baby boomers and older adults, a subset of the population at high risk for chronic disease, social isolation, and poor health outcomes, are increasingly utilizing the Internet and social media (Web 2.0) to locate and evaluate health information. However, among these older populations, little is known about what factors influence their eHealth literacy and use of Web 2.0 for health information.The intent of the study was to explore the extent to which sociodemographic, social determinants, and electronic device use influences eHealth literacy and use of Web 2.0 for health information among baby boomers and older adults.A random sample of baby boomers and older adults (n=283, mean 67.46 years, SD 9.98) participated in a cross-sectional, telephone survey that included the eHealth literacy scale (eHEALS) and items from the Health Information National Trends Survey (HINTS) assessing electronic device use and use of Web 2.0 for health information. An independent samples t test compared eHealth literacy among users and non-users of Web 2.0 for health information. Multiple linear and logistic regression analyses were conducted to determine associations between sociodemographic, social determinants, and electronic device use on self-reported eHealth literacy and use of Web 2.0 for seeking and sharing health information.Almost 90% of older Web 2.0 users (90/101, 89.1%) reported using popular Web 2.0 websites, such as Facebook and Twitter, to find and share health information. Respondents reporting use of Web 2.0 reported greater eHealth literacy (mean 30.38, SD 5.45, n=101) than those who did not use Web 2.0 (mean 28.31, SD 5.79, n=182), t217.60=-2.98, P=.003. Younger age (b=-0.10), more education (b=0.48), and use of more electronic devices (b=1.26) were significantly associated with greater eHealth literacy (R(2) =.17, R(2)adj =.14, F9,229=5.277, P<.001). Women were nearly three times more likely than men to use Web 2.0 for health information (OR 2.63, Wald= 8.09, df=1, P=.004). Finally, more education predicted greater use of Web 2.0 for health information, with college graduates (OR 2.57, Wald= 3.86, df =1, P=.049) and post graduates (OR 7.105, Wald= 4.278, df=1, P=.04) nearly 2 to 7 times more likely than non-high school graduates to use Web 2.0 for health information.Being younger and possessing more education was associated with greater eHealth literacy among baby boomers and older adults. Females and those highly educated, particularly at the post graduate level, reported greater use of Web 2.0 for health information. More in-depth surveys and interviews among more diverse groups of baby boomers and older adult populations will likely yield a better understanding regarding how current Web-based health information seeking and sharing behaviors influence health-related decision making.
| S-EPMC4381816 | biostudies-literature
Project description:ObjectiveDespite the popular belief that baby boomers are ageing in better health than previous generations, limited scientific evidence is available since baby boomers have turned retirement age only recently. This study aimed to compare self-reported health status at ages 65-70 years among three cohorts of older people born before, during and at the end (baby boomers) of the Second World War.DesignRepeated cross-sectional population-based study.SettingCommunity in a region of French-speaking Switzerland.ParticipantsCommunity-dwelling older adults who enrolled in the Lausanne cohort 65+ study at ages 65-70 years in 2004 (n=1561), 2009 (n=1489) or 2014 (n=1678).OutcomesNumber of self-reported chronic conditions (from a list of 11) and chronic symptoms (from a list of 11); depressive symptoms; self-rated health (very good, good, average, poor or very poor); fear of disease (not afraid at all, barely afraid, a bit afraid, quite afraid or very afraid); self-perception of ageing; disability in basic and instrumental activities of daily living.ResultsThere was no significant difference between cohorts in the number of self-reported chronic conditions and chronic symptoms as well as the presence of difficulty in basic activities of daily living, depressive symptoms, fear of disease and negative self-perception of ageing. In women only, significant differences between cohorts were observed in self-rated health (p=0.005) and disability in instrumental activities of daily living (p=0.003), but these associations did not remain significant in logistic regression models adjusted for sociodemographic characteristics and unhealthy behaviours.ConclusionsDespite important sociodemographic differences between older baby boomers and earlier cohorts, most health indicators did not suggest any trend towards a compression of morbidity. Future studies comparing these three cohorts at more advanced age are required to further investigate whether differences emerge later in life.
| S-EPMC6368217 | biostudies-literature
Project description:BackgroundAs of 2021, 21 US states and territories allowed recreational cannabis use. Although previous research has identified an overall increase in prevalence of cannabis use after legalization, it has been less clear how this change will affect different parts of the population, including older adults, and specifically Baby Boomers, born 1946-1964, given their historically higher rates of use and a higher prevalence of comorbid conditions that could be either exacerbated or addressed by cannabis use. In this study we assessed whether implementation of recreational retail sales in California was associated with increased prevalence of cannabis use among Baby Boomers.MethodsWe conducted a retrospective study of cannabis use prevalence one year before and after the implementation of recreational retail sales in California using the California Health Interview Survey (CHIS), a statewide public health surveillance dataset.ResultsWe found that cannabis use prevalence did not change among Baby Boomers but increased among non-Baby Boomers. Most of the factors found to be predictive of cannabis use in past research did not predict cannabis use among Baby Boomers.ConclusionsBaby Boomers did not change their consumption of cannabis in the first year after opening the retail market, despite previous research suggesting that cannabis consumption increases with access, and most previously identified predictors of use did not identify people who use cannabis in this generation. Further research is needed to determine whether these effects persist over time.
| S-EPMC8898516 | biostudies-literature