Role of food insecurity in prescription delay among adults with asthma: results from the California health interview survey.

Background: Food insecurity remains a major public health concern in the United States. Studies have noted that food insecurity can lead to lower healthcare utilization and poorer health status. Despite the continuous burden of asthma, little research has shown whether food insecurity serves as a social determinant to poor asthma care. In this study, we specifically focused on whether food insecurity can lead to delay in prescription medication for adults with asthma in California.Methods: We utilized the California Health Interview Survey. Survey weighted descriptive, univariate, and multivariable logistic regression analyses were conducted. A total of 11,645 observations, representing an average annual population size of 1,085,481 was included in this study.Results: Nearly 15% and 8% of participants were food insecure and had current asthma, respectively. Based on adjusted odds ratio, food insecure adults were 148% more likely to report delay in asthma prescription, as compared to those who were food secure (adjusted odds ratio =2.48; 95% CI: 1.58, 3.89).Conclusions: Given the delay in prescription, and thus appropriate health care, demonstrated in our study, targeted measures at point of care should be implemented to identify such at-risk patients early and provide resources for food aid to ensure optimal health outcomes.

Prevalence and Correlates of Sleep Apnea Among US Male Veterans, 2005-2014.

The objective of this study was to assess the prevalence of and factors associated with sleep apnea among US male veterans. We used data from the 2005-2014 National Survey on Drug Use and Health to conduct survey-weighted descriptive, bivariate, and regression analyses. The prevalence of sleep apnea increased from 3.7% to 8.1% (P for trend <.001 for adjusted model) from 2005 through 2014. Increasing severity of psychological distress and unmet mental health care need were associated with increased odds of sleep apnea, as was a diagnosis of asthma. Increased screening of sleep health is critical to improve the health outcomes of veterans.

Unmet Healthcare Needs among College Students during the COVID-19 Pandemic: Implications for System-Wide and Structural Changes for Service Delivery.

BACKGROUND: During the COVID-19 pandemic, college students faced health disparities in addition to a negative burden on academic performance; however, little is reported in the literature regarding healthcare utilization. METHODS: A cross-sectional survey was conducted among consenting college student participants aged 18 or older from a Hispanic-serving institution. Descriptive and bivariate statistics were used to analyze demographic characteristics and the types of healthcare services needed by such characteristics. Logistic regression was used to adjust for noted sex differences in associations between reporting limited healthcare services and types of healthcare services. RESULTS: The study population of 223 participants was mostly Hispanic/Latino (65%) and female (73%). Of the population, 11% reported they could not obtain needed healthcare services, with time being reported as the most common reason. Significant associations were found between seeking general healthcare services/routine screening, seeking mental health services, and seeking sexual health services with reporting limited healthcare services, with sex-adjusted odds ratios and 95% confidence intervals of 1.90 (95% CI: 1.08, 3.36), 3.21 (95% CI: 1.44, 4.15), and 2.58 (95% CI: 1.05, 6.35), respectively. CONCLUSIONS: Availability and inability to obtain health services may exacerbate college student health disparities. Targeted interventions are needed in the population to mitigate the potential burdens of unmet healthcare needs, particularly among minority college students.

Burden of Mental Illness among Primary HIV Discharges: A Retrospective Analysis of Inpatient Data.

Background: Empirical evidence demonstrates the substantial burden of mental illness among people living with HIV and AIDS (PLWHA). Current literature also notes the co-morbidity of these two illnesses and its impact on quality of life and mortality. However, little evidence exists on patient outcomes, such as hospital length of stay or post-discharge status. Methods: A retrospective analysis of National Inpatient Sample data was conducted. The study population was defined as discharges having a primary diagnosis of HIV based on International Classification of Disease, 10th Revision, Clinical Modification (ICD-10-CM) codes in primary diagnosis field. Clinical Classification Software (CCS) codes are used to identify comorbid mental illness. Length of stay was defined as number of days between hospital admission and discharge. Disposition (or post-discharge status) was defined as routine versus not routine. Patient and hospital characteristics were used as control variables. All regression analyses were survey-weighted and adjusted for control variables. Results: The weighted population size (N) for this study was 26,055 (n = 5211). Among primary HIV discharges, presence of any mental illness as a secondary discharge was associated with 12% higher LOS, when compared to a lack of such comorbidity (incidence rate ratio [IRR] = 1.12, 95% confidence interval [CI] = 1.05, 1.22, p < 0.01). Likewise, among primary HIV discharges, those with mental illness had a 21% lower routine disposition, when compared to those without any mental illness (OR = 0.79, 95% CI = 0.68, 0.91, p < 0.001). Conclusion: Our results highlight the need for improved mental health screening and coordinated care to reduce the burden of mental illness among HIV discharges.

Experiences of violence and mental health outcomes among Asian American transgender adults in the United States.

PURPOSE: We addressed prevalence and factors associated with mental health outcomes (suicidal behavior and psychological distress) among Asian Americans (AA), who identify as transgender, a key group among sexual and gender minorities that is overlooked and understudied. METHODS: We used data from 2015 United States Transgender Survey during 2019-2020 with our population as census defined AA. Outcomes included suicidal ideation, suicidal thoughts, and serious psychological distress (SPD). Independent variables included any abuse, partner abuse, bathroom-related abuse, and additional covariates. Adjusted odds ratio and 95% confidence interval (aOR; 95% CI) for each outcome are adjusted for age, marital status, citizenship status, education level, employment status, as well as poverty status. RESULTS: Nearly 67% reported experiencing any abuse, 52% reported abuse from romantic/sexual partner(s), while 29% reported harassment/abuse when trying to use bathrooms. Moreover, 82% reported suicidal thoughts, 40% reported suicidal attempts, and 39% had SPD. Results demonstrated that any abuse/violence had higher odds of suicidal thoughts (adjusted odds ratio [aOR] = 2.67, 95% confidence interval (CI):[1.98-3.58], suicidal attempts (aOR = 2.83, 95% CI:[2.18-3.68]), and SPD (aOR = 1.56, 95% CI:[1.20, 2.04]). Abuse from romantic/sexual partners had higher odds of suicidal thoughts (aOR = 2.47, 95% CI:[1.76-3.47]), suicidal attempts (aOR = 2.17, 95% CI:[1.68-2.80]), and SPD (aOR = 2.72, 95% CI:[2.03-3.63]). Experience of harassment/abuse during bathroom use had increased odds of suicidal attempts (aOR = 1.81, 95% CI:[1.41-2.31]). CONCLUSION: Exposure to violence is common among AA transgender individuals and related to negative mental health outcomes. Initiatives to reduce exposure to abuse and providing resources for trauma-informed care are imperative to improve health outcomes.

"I Actually Don't Know What HIV Is": A Mixed Methods Analysis of College Students' HIV Literacy.

OBJECTIVE: Human immunodeficiency virus (HIV) remains a major public health issue with young adults facing a disproportionately higher rate of the burden. Our goal was to address the current literacy related to HIV, including biomedical prevention methods and barriers to care, such as cultural factors, from a sample of college students. METHODS: We conducted a convergent parallel mixed methods analysis where both qualitative and quantitative data were collected and analyzed separately. A thematic analysis was conducted to assess qualitative results, while descriptive statistics were conducted to assess quantitative survey results. RESULTS: HIV literacy was limited, with several participants reporting that they did not understand what HIV meant. While the majority knew the use of condoms, knowledge of other biomedical prevention methods was limited, as was the understanding the risk factors of HIV, with participants noting sharing a toilet seat and promiscuity as risk factors. Self-efficacy for HIV prevention was low among participants with many reporting that cultural barriers prevented discussion of risky behaviors and prevention methods in their families and social groups. CONCLUSION: Targeted, culturally sensitive, health education initiatives are needed to understand the high, low, or no risks of HIV as well as address stigmas related to HIV.

Low Human Papillomavirus Literacy Among Asian-American Women in California: an Analysis of the California Health Interview Survey.

BACKGROUND: Asian-Americans are one of the fastest growing minority groups in the USA, and the literature notes high rates of human papillomavirus (HPV). In this study, we aimed to address whether key social determinants of health, especially health literacy, in combination with English language proficiency, and immigration status, were key factors in HPV knowledge and awareness among Asian-Americans. METHODS: The data was collected from the California Health Interview Survey (CHIS). The study population consisted of Asian adult females from 18 to 65 years of age, with a sample size of 2050 representing a population of 1,552,710. Survey-weighted descriptive, bivariate, and multivariable Poisson regression were conducted with alpha less than .05 to denote significance. RESULTS: Nearly 45% of the population reported that they never heard of HPV, while 14% reported thinking HPV can cause AIDS, and 13% reported that HPV can go away on its own. HPV knowledge, however, was varied by Asian-American ethnicity as well as being foreign-born. Survey-weighted multivariable robust Poisson regression results show that, when compared with Japanese subgroup, Chinese, South Asians, and Koreans were less likely to have heard of HPV. Having heard of HPV was 31% lower among Asian-Americans who were foreign-born, as compared with those who were US-born. Foreign-born Asian-Americans were 196% more likely to think HPV causes AIDS. Ever having heard of HPV was also associated with low English language proficiency (70% lower), low health literacy (45% lower), and a combination of both (55%). While, those with low English language proficiency understood HPV is a sexually transmitted infection, a substantially high number associated it with AIDS. CONCLUSION: Interventions towards increasing health literacy among Asian Americans are imperative in order increase HPV vaccination rates to reduce cervical cancer rates/deaths.