Disparities in Health Care Utilization by Smoking Status – NHANES 1999-2004

Kahende, Jennifer; Adhikari, Bishwa B.; Maurice, Emmanuel; Rock, Valerie; Malarcher, Ann

doi:10.3390/ijerph6031095

Cited by 73 publications

(58 citation statements)

References 24 publications

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“…Some investigators have shown that former and current smokers use more primary care services than never smokers (Kahende, Adhikari, Maurice, Rock, & Malarcher, 2009;Levine et al, 2012), while others have shown that former smokers use outpatient care more often and current smokers less often than non-smokers (Jorm, Shepherd, Rogers, & Blyth, 2012). Our study extends prior research by examining the relationship between smoking patterns and health care utilization.…”

Section: Discussionsupporting

confidence: 63%

The contribution of parental smoking history and socio-demographic factors to the smoking behavior of Israeli women

Segal‐Engelchin

Friedmann

Cwikel

2013

Psychology, Health & Medicine

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This study examined the interplay between sociodemographic factors and parental smoking history in shaping the smoking behavior of Israeli women (N = 302). The study was conducted in the Negev region, which is characterized by a high proportion of immigrants and high percentage of low socioeconomic and educational groups. The specific objectives of this study were to examine: (1) The prevalence and characteristics of women smokers, ex-smokers and never-smokers; and (2) the contribution of education and parent smoking history to women's current smoking. Low levels of education, being Israeli born or veteran immigrants of European-American origin significantly increased the risk of smoking, whereas an orthodox lifestyle and new immigrant status significantly reduced the likelihood of smoking. Occasional smokers reported significantly higher primary care utilization than never smokers. A significant relationship between smoking and pain, gynecological symptoms and depression was found. Results indicate that childhood exposure to maternal smoking was a significant risk factor for smoking, whereas paternal past smoking negatively affects smoking in women. Also, results show that parental educational level affects women's smoking behavior indirectly by influencing their own educational attainment, which in turn is negatively associated with the likelihood of smoking. Mothers with higher education were more likely to smoke, an effect that was reversed for their daughters. Our results demonstrate how demographic, parental and lifestyle factors affect women's smoking in a multi-ethnic society and highlight the need to examine both generational and intergenerational effects.

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Section: Discussionsupporting

confidence: 63%

The contribution of parental smoking history and socio-demographic factors to the smoking behavior of Israeli women

Segal‐Engelchin

Friedmann

Cwikel

2013

Psychology, Health & Medicine

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“…28 PWH were not entirely comparable to the NHANES study population with respect to prevalence of traditional risk factors for hypertension such as diabetes, obesity, renal function or smoking. 29–33 Specifically, while the mean BMI and prevalence of diabetes were similar between the 2 groups 29;31;32 , PWH had a higher prevalence of never smokers (~40% NHANES vs. ~66% PWH) 30 and a lower prevalence of renal disease (eGFR<60 ml/min/1.73 m 2 : ~12% NHANES vs. ~5% PWH (data not shown). 33 …”

Section: Discussionmentioning

confidence: 85%

Prevalence and Risk Factors for Hypertension in Hemophilia

et al. 2013

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Hypertension is a major risk factor for intracranial hemorrhage. We therefore investigated the prevalence, treatment and control of hypertension in adult patients with hemophilia (PWH). PWH ≥18 years (n=458) from 3 geographically different cohorts in the United States were evaluated retrospectively for hypertension and risk factors. Results were compared to the nationally representative sample provided by the contemporary National Health and Nutrition Examination Survey (NHANES). PWH had a significantly higher prevalence of hypertension compared to NHANES. Overall, the prevalence of hypertension was 49.1% in PWH compared to 31.7 % in NHANES. At ages 18–44, 45–64, 65–74, and ≥ 75 the prevalence of hypertension for PWH was 31.8%, 72.6%, 89.7%, and 100.0% compared to 12.5%, 41.2%, 64.1%, and 71.7% in NHANES, respectively. Of treated hypertensive PWH, only 27.1% were controlled, compared to 47.7% in NHANES (all p-values <0.05). Age, body mass index, diabetes and renal function were independently associated with hypertension. Among patients with moderate or severe hemophilia there was a trend (~ 1.5-fold) for higher odds of having hypertension compared to patients with mild hemophilia. Based on these results, new care models for adult PWH and further studies for the etiology of hypertension in hemophilia are recommended.

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“…[4,[12][13][14][15] Another study in a developed country also found that current smokers were more likely to be hospitalized compared to nonsmokers. In addition, current smokers were more likely to have frequent outpatient visits compared to nonsmokers.…”

Section: Discussionmentioning

confidence: 95%

“…In addition, current smokers were more likely to have frequent outpatient visits compared to nonsmokers. [13] A previous study in Germany has reported the association between smoking status and total health-care cost. [4] Similarly, the current and former smoking behavior in our study also has a positive influence on health-care utilization and total costs.…”

Section: Discussionmentioning

confidence: 99%