Does health plan type influence receipt of an annual influenza vaccination?

BACKGROUND: The influenza virus caused 48.8 million people to fall ill and 79 400 deaths during the 2017-2018 influenza season, yet less than 50% of US adults receive an annual flu vaccination (AFV). Having health insurance coverage influences whether individuals receive an AFV. The current study aims to determine if an association exists between an individual's health plan type (HPT) and their receipt of an AFV. METHODS: Data from the 2017 Behavioral Risk Factor Surveillance System and the optional 'Health Care Access' module were used for this study. The final study sample size was 35 684. Multivariable weighted and adjusted logistic regression models were conducted to investigate the association between HPT and AFV. RESULTS: Medicare coverage was significantly associated with an increase in AFV for both men (adjusted OR (AOR) 1.62 (95% CI 1.28 to 2.06)) and women (AOR 1.28 (95% CI 1.00 to 1.53)). For men, other sources of coverage were also significantly positively associated with AFV (AOR 1.67 (95% CI 1.27 to 2.19)), while for women obtaining coverage on their own was significantly negatively associated with AFV (AOR 0.75 (95% CI 0.59 to 0.97)). CONCLUSION: These findings are of interest to health policy makers as these show there are HPTs which are effective at improving vaccination rates. Adopting methods used by these HPTs could help the USA reach its Healthy People 2020 AFV coverage goal of 70%.

The association between history of screening for cancer and receipt of an annual flu vaccination: Are there reinforcing effects of prevention seeking?

BACKGROUND: Receipt of an annual flu vaccination (AFV) is a preventative health measure that reduces the risk of infection with the flu. Screening for cancer (SC) is another recommended preventative health measure. The current study hypothesizes that people who have previously obtained a cancer screening are motivated to receive other preventative health measures. METHODS: Testing the association between a history of SC and receipt of an AFV used data from the 2016 Behavioral Risk Factor Surveillance System survey. The association was investigated using weighted and adjusted multivariable logistic regression models on multiple age-based groups chosen according to cancer screening recommendations. RESULTS: The odds of individuals with a history of SC receiving an AFV were significantly greater in women screened for colorectal cancer, breast cancer, and colorectal cancer, and men screened for colorectal cancer, when compared with those without a history of SC after adjusting for confounders of interest. It is notable that no association was found between screening for cervical cancer and the receipt of AFV for women aged 30-65 years (odds ratio: 1.06; 95% confidence interval: 0.92, 1.21), and 50-65 years (odds ratio: 1.14; 95% confidence interval: 0.93, 1.40). CONCLUSIONS: More research is necessary to understand why cervical cancer screenings are not associated with receipt of an AFV.

Learning from episodes of degradation and recovery in variable Australian rangelands.

Land-change science emphasizes the intimate linkages between the human and environmental components of land management systems. Recent theoretical developments in drylands identify a small set of key principles that can guide the understanding of these linkages. Using these principles, a detailed study of seven major degradation episodes over the past century in Australian grazed rangelands was reanalyzed to show a common set of events: (i) good climatic and economic conditions for a period, leading to local and regional social responses of increasing stocking rates, setting the preconditions for rapid environmental collapse, followed by (ii) a major drought coupled with a fall in the market making destocking financially unattractive, further exacerbating the pressure on the environment; then (iii) permanent or temporary declines in grazing productivity, depending on follow-up seasons coupled again with market and social conditions. The analysis supports recent theoretical developments but shows that the establishment of environmental knowledge that is strictly local may be insufficient on its own for sustainable management. Learning systems based in a wider community are needed that combine local knowledge, formal research, and institutional support. It also illustrates how natural variability in the state of both ecological and social systems can interact to precipitate nonequilibrial change in each other, so that planning cannot be based only on average conditions. Indeed, it is this variability in both environment and social subsystems that hinders the local learning required to prevent collapse.