Last data update: Jun 17, 2024. (Total: 47034 publications since 2009)
Records 1-15 (of 15 Records) |
Query Trace: Gerzoff RB [original query] |
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Prevalence of Visual Acuity Loss or Blindness in the US: A Bayesian Meta-analysis
Flaxman AD , Wittenborn JS , Robalik T , Gulia R , Gerzoff RB , Lundeen EA , Saaddine J , Rein DB . JAMA Ophthalmol 2021 139 (7) 717-723 ![]() IMPORTANCE: Globally, more than 250 million people live with visual acuity loss or blindness, and people in the US fear losing vision more than memory, hearing, or speech. But it appears there are no recent empirical estimates of visual acuity loss or blindness for the US. OBJECTIVE: To produce estimates of visual acuity loss and blindness by age, sex, race/ethnicity, and US state. DATA SOURCES: Data from the American Community Survey (2017), National Health and Nutrition Examination Survey (1999-2008), and National Survey of Children's Health (2017), as well as population-based studies (2000-2013), were included. STUDY SELECTION: All relevant data from the US Centers for Disease Control and Prevention's Vision and Eye Health Surveillance System were included. DATA EXTRACTION AND SYNTHESIS: The prevalence of visual acuity loss or blindness was estimated, stratified when possible by factors including US state, age group, sex, race/ethnicity, and community-dwelling or group-quarters status. Data analysis occurred from March 2018 to March 2020. MAIN OUTCOMES OR MEASURES: The prevalence of visual acuity loss (defined as a best-corrected visual acuity greater than or equal to 0.3 logMAR) and blindness (defined as a logMAR of 1.0 or greater) in the better-seeing eye. RESULTS: For 2017, this meta-analysis generated an estimated US prevalence of 7.08 (95% uncertainty interval, 6.32-7.89) million people living with visual acuity loss, of whom 1.08 (95% uncertainty interval, 0.82-1.30) million people were living with blindness. Of this, 1.62 (95% uncertainty interval, 1.32-1.92) million persons with visual acuity loss are younger than 40 years, and 141 000 (95% uncertainty interval, 95 000-187 000) persons with blindness are younger than 40 years. CONCLUSIONS AND RELEVANCE: This analysis of all available data with modern methods produced estimates substantially higher than those previously published. |
Eye care among US adults at high risk for vision loss in the United States in 2002 and 2017
Saydah SH , Gerzoff RB , Saaddine JB , Zhang X , Cotch MF . JAMA Ophthalmol 2020 138 (5) 479-489 Importance: Timely eye care can prevent unnecessary vision loss. Objectives: To estimate the number of US adults 18 years or older at high risk for vision loss in 2017 and to evaluate use of eye care services in 2017 compared with 2002. Design, Setting, and Participants: This survey study used data from the 2002 (n = 30920) and 2017 (n = 32886) National Health Interview Survey, an annual, cross-sectional, nationally representative sample of US noninstitutionalized civilians. Analysis excluded respondents younger than 18 years and those who were blind or unable to see. Covariates included age, sex, race/ethnicity, marital status, educational level, income-to-poverty ratio, health insurance status, diabetes diagnosis, vision or eye problems, and US region of residence. Main Outcomes and Measures: Three self-reported measures were visiting an eye care professional in the past 12 months, receiving a dilated eye examination in the past 12 months, and needing but being unable to afford eyeglasses in the past 12 months. Adults at high risk for vision loss included those who were 65 years or older, self-reported a diabetes diagnosis, or had vision or eye problems. Multivariable logistic regression models incorporating sampling weights were used to investigate associations between measures and covariates. Temporal comparisons between 2002 and 2017 were derived from estimates standardized to the US 2010 census population. Results: Among 30 920 individuals in 2002, 16.0% were 65 years or older, and 52.0% were female; among 32 886 individuals in 2017, 20.0% were 65 years or older, and 51.8% were female. In 2017, more than 93 million US adults (37.9%; 95% CI, 37.0%-38.7%) were at high risk for vision loss compared with almost 65 million (31.5%; 95% CI, 30.7%-32.3%) in 2002, a difference of 6.4 (95% CI, 5.2-7.6) percentage points. Use of eye care services improved (56.9% [95% CI, 55.7%-58.7%] reported visiting an eye care professional annually, and 59.8% [95% CI, 58.6%-61.0%] reported receiving a dilated eye examination), but 8.7% (95% CI, 8.0%-9.5%) said they could not afford eyeglasses (compared with 51.1% [95% CI, 49.9%-52.3%], 52.4% [95% CI, 51.2%-53.6%], and 8.3% [95% CI, 7.7%-8.9%], respectively, in 2002). In 2017, individuals with lower income compared with high income were more likely to report eyeglasses as unaffordable (13.6% [95% CI, 11.6%-15.9%] compared with 5.7% [95% CI, 4.9%-6.6%]). Conclusions and Relevance: Compared with data from 2002, more US adults were at high risk for vision loss in 2017. Although more adults used eye care, a larger proportion reported eyeglasses as unaffordable. Focusing resources on populations at high risk for vision loss, increasing awareness of the importance of eye care, and making eyeglasses more affordable could promote eye health, preserve vision, and reduce disparities. |
Vision impairment and subjective cognitive decline-related functional limitations - United States, 2015-2017
Saydah S , Gerzoff RB , Taylor CA , Ehrlich JR , Saaddine J . MMWR Morb Mortal Wkly Rep 2019 68 (20) 453-457 Vision impairment affects approximately 3.22 million persons in the United States and is associated with social isolation, disability, and decreased quality of life (1). Cognitive decline is more common in adults with vision impairment (2,3). Subjective cognitive decline (SCD), which is the self-reported experience of worsening or more frequent confusion or memory loss within the past 12 months, affects 11.2% of adults aged >/=45 years in the United States (4). One consequence of SCD is the occurrence of functional limitations, especially those related to usual daily activities; however, it is not known whether persons with vision impairment are more likely to have functional limitations related to SCD (4). This report describes the association of vision impairment and SCD-related functional limitations using Behavioral Risk Factor Surveillance System (BRFSS) surveys for the years 2015-2017. Adjusting for age group, sex, race/ethnicity, education level, health insurance, and smoking status, 18% of adults aged >/=45 years who reported vision impairment also reported SCD-related functional limitations, compared with only 4% of those without vision impairment. Preventing, reducing, and correcting vision impairments might lead to a decrease in SCD-related functional limitations among adults in the United States. |
Tax avoidance and evasion: Cigarette purchases from Indian reservations among US adult smokers, 2010-2011
Wang X , Xu X , Tynan MA , Gerzoff RB , Caraballo RS , Promoff GR . Public Health Rep 2017 132 (3) 33354917703653 Excise taxes are the primary public health strategy used to increase the price of cigarettes in the United States. Rather than quitting or reducing consumption of cigarettes, some price-sensitive smokers may avoid state and local excise taxes by purchasing cigarettes from Indian reservations. The objectives of this study were to (1) provide the most recent state-specific prevalence of purchases made on Indian reservations by non-American Indians/Alaska Natives (non-AI/ANs) and (2) assess the impact of these purchases on state tax revenues. We used data from a large national and state-representative survey, the 2010-2011 Tobacco Use Supplement to the Current Population Survey, which collects self-reported measures on cigarette use and purchases. Nationwide, 3.8% of non-AI/AN smokers reported purchasing cigarettes from Indian reservations. However, in Arizona, Nevada, New Mexico, New York, Oklahoma, and Washington State, about 15% to 30% of smokers reported making such purchases, resulting in annual tax revenue losses ranging from $3.5 million (Washington State) to $292 million (New York) during 2010-2011. Strategies to reduce the sale of non- or lower-taxed cigarettes to non-AI/ANs on Indian reservations have the potential to decrease smoking prevalence and recoup lost revenue from purchases made on reservations. |
Big differences in state tobacco-control spending
Juang G , Walton K , Gerzoff RB , King BA , Chalupka FJ . Oncol Times 2015 37 (18) 58-60 3p Evidence-based, statewide tobacco control programs that are comprehensive, sustained, and accountable reduce smoking rates and tobacco-related diseases and deaths.1,2 States that made larger investments in tobacco prevention and control have seen larger declines in cigarettes sales than in the United States as a whole,3 and the prevalence of smoking has declined faster as spending for tobacco-control programs has increased.4,5 | CDC's Best Practices for Comprehensive Tobacco Control Programs (Best Practices) outlines the elements of an evidence-based state tobacco-control program and provides recommended state funding levels to substantially reduce tobacco-related disease, disability, and death.1,2 | To analyze states' spending in relation to program components outlined within Best Practices, CDC assessed state tobacco control programs' expenditures for fiscal year 2011 (the most recent year for which full data are available). In 2011, states spent approximately $658 million on tobacco control and prevention, which accounts for less than three percent of the states' revenues from the sale of tobacco products and only 17.8 percent of the level recommended by CDC. Evidence suggests that funding tobacco prevention and control efforts at the levels recommended in Best Practices could achieve larger and more rapid reductions in tobacco use and associated morbidity and mortality.2,3 |
State tobacco control program spending - United States, 2011
Huang J , Walton K , Gerzoff RB , King BA , Chaloupka FJ . MMWR Morb Mortal Wkly Rep 2015 64 (24) 673-678 Evidence-based, statewide tobacco control programs that are comprehensive, sustained, and accountable reduce smoking rates and tobacco-related diseases and deaths. States that made larger investments in tobacco prevention and control have seen larger declines in cigarettes sales than the United States as a whole, and the prevalence of smoking has declined faster as spending for tobacco control programs has increased. CDC's Best Practices for Comprehensive Tobacco Control Programs (Best Practices) outlines the elements of an evidence-based state tobacco control program and provides recommended state funding levels to substantially reduce tobacco-related disease, disability, and death. To analyze states' spending in relation to program components outlined within Best Practices, CDC assessed state tobacco control programs' expenditures for fiscal year 2011. In 2011, states spent approximately $658 million on tobacco control and prevention, which accounts for less than 3% of the states' revenues from the sale of tobacco products and only 17.8% of the level recommended by CDC. Evidence suggests that funding tobacco prevention and control efforts at the levels recommended in Best Practices could achieve larger and more rapid reductions in tobacco use and associated morbidity and mortality. |
Per-pack price reductions available from different cigarette purchasing strategies: United States, 2009-2010
Pesko MF , Xu X , Tynan MA , Gerzoff RB , Malarcher AM , Pechacek TF . Prev Med 2014 63 13-9 OBJECTIVE: Following cigarette excise tax increases, smokers may use cigarette price minimization strategies to continue their usual cigarette consumption rather than reducing consumption or quitting. This reduces the public health benefits of the tax increase. This paper estimates the price reductions for a wide-range of strategies, compensating for overlapping strategies. METHOD: We performed regression analysis on the 2009-2010 National Adult Tobacco Survey (N=13,394) to explore price reductions that smokers in the United States obtained from purchasing cigarettes. We examined five cigarette price minimization strategies: 1) purchasing discount brand cigarettes, 2) using price promotions, 3) purchasing cartons, 4) purchasing on Indian reservations, and 5) purchasing online. Price reductions from these strategies were estimated jointly to compensate for overlapping strategies. RESULTS: Each strategy provided price reductions of between 26 to 99 cents per pack. Combined price reductions were possible. Additionally, price promotions were used with regular brands to obtain larger price reductions than when price promotions were used with generic brands. CONCLUSION: Smokers can realize large price reductions from price minimization strategies, and there are many strategies available. Policymakers and public health officials should be aware of the extent that these strategies can reduce cigarette prices. |
Cigarette price-minimization strategies by U.S. smokers
Xu X , Pesko MF , Tynan MA , Gerzoff RB , Malarcher AM , Pechacek TF . Am J Prev Med 2013 44 (5) 472-6 BACKGROUND: Smokers may react to cigarette excise tax increases by engaging in price-minimization strategies (i.e., finding ways to reduce the cost of cigarette smoking) rather than by quitting or reducing their cigarette use, thereby reducing the public health benefits of such tax increases. PURPOSE: To evaluate the state and national prevalence of five common cigarette price-minimization strategies and the size of price reductions obtained from these strategies. METHODS: Using data from the 2009-2010 National Adult Tobacco Survey, the prevalence of five common price-minimization strategies by type of strategy and by smoker's cigarette consumption level were estimated. The price reductions associated with these price-minimization strategies also were evaluated. Analyses took place in November 2012. RESULTS: Approximately 55.4% of U.S. adult smokers used at least one of five price-minimization strategies in the previous year, with an average reduction of $1.27 per pack (22.0%). Results varied widely by state. CONCLUSIONS: Cigarette price-minimization strategies are practiced widely among current smokers, and resulting price reductions are relatively large. Policies that decrease opportunities to effectively apply cigarette price-minimization strategies would increase the public health gains of cigarette excise tax increases. |
National and state estimates of secondhand smoke infiltration among U.S. multiunit housing residents
King BA , Babb SD , Tynan MA , Gerzoff RB . Nicotine Tob Res 2012 15 (7) 1316-21 INTRODUCTION: Multiunit housing (MUH) residents are susceptible to secondhand smoke (SHS), which can infiltrate smoke-free living units from nearby units and shared areas where smoking is permitted. This study assessed the prevalence and characteristics of MUH residency in the United States, and the extent of SHS infiltration in this environment at both the national and state levels. METHODS: National and state estimates of MUH residency were obtained from the 2009 American Community Survey. Assessed MUH residency characteristics included sex, age, race/ethnicity, and poverty status. Estimates of smoke-free home rule prevalence were obtained from the 2006-2007 Tobacco Use Supplement to the Current Population Survey. The number of MUH residents who have experienced SHS infiltration was determined by multiplying the estimated number of MUH residents with smoke-free homes by the range of self-reported SHS infiltration (44%-46.2%) from peer-reviewed studies of MUH residents. RESULTS: One-quarter of U.S. residents (25.8%, 79.2 million) live in MUH (state range: 10.1% in West Virginia to 51.7% in New York). Nationally, 47.6% of MUH residents are male, 53.3% are aged 25-64 years, 48.0% are non-Hispanic White, and 24.4% live below the poverty level. Among MUH residents with smoke-free home rules (62.7 million), an estimated 27.6-28.9 million have experienced SHS infiltration (state range: 26,000-27,000 in Wyoming to 4.6-4.9 million in California). CONCLUSIONS: A considerable number of Americans reside in MUH and many of these individuals experience SHS infiltration in their homes. Prohibiting smoking in MUH would help protect MUH residents from involuntary SHS exposure. |
Prevalence of diabetes and intermediate hyperglycemia among adults from the first multinational study of noncommunicable diseases in six Central American countries: the Central America Diabetes Initiative (CAMDI)
Barcelo A , Gregg EW , Gerzoff RB , Wong R , Perez Flores E , Ramirez-Zea M , Cafiero E , Altamirano L , Ascencio Rivera M , de Cosio G , de Maza MD , del Aguila R , Emanuel E , Gil E , Gough E , Jenkins V , Orellana P , Palma R , Palomo R , Pastora M , Pena R , Pineda E , Rodriguez B , Tacsan L , Thompson L , Villagra L . Diabetes Care 2012 35 (4) 738-40 OBJECTIVE: The increasing burdens of obesity and diabetes are two of the most prominent threats to the health of populations of developed and developing countries alike. The Central America Diabetes Initiative (CAMDI) is the first study to examine the prevalence of diabetes in Central America. RESEARCH DESIGN AND METHODS: The CAMDI survey was a cross-sectional survey based on a probabilistic sample of the noninstitutionalized population of five Central American populations conducted between 2003 and 2006. The total sample population was 10,822, of whom 7,234 (67%) underwent anthropometry measurement and a fasting blood glucose or 2-h oral glucose tolerance test. RESULTS: The total prevalence of diabetes was 8.5%, but was higher in Belize (12.9%) and lower in Honduras (5.4%). Of the screened population, 18.6% had impaired glucose tolerance/impaired fasting glucose. CONCLUSIONS: As this population ages, the prevalence of diabetes is likely to continue to rise in a dramatic and devastating manner. Preventive strategies must be quickly introduced. |
Long-term effects of a randomised trial of a 6-year lifestyle intervention in impaired glucose tolerance on diabetes-related microvascular complications: the China Da Qing Diabetes Prevention Outcome Study
Gong Q , Gregg EW , Wang J , An Y , Zhang P , Yang W , Li H , Jiang Y , Shuai Y , Zhang B , Zhang J , Gerzoff RB , Roglic G , Hu Y , Li G , Bennett PH . Diabetologia 2011 54 (2) 300-7 AIMS/HYPOTHESIS: We determined the effects of 6 years of lifestyle intervention in persons with impaired glucose tolerance (IGT) on the development of retinopathy, nephropathy and neuropathy over a 20 year period. METHODS: In 1986, 577 adults with IGT from 33 clinics in Da Qing, China were randomly assigned by clinic to a control group or one of three lifestyle intervention groups (diet, exercise, and diet plus exercise). Active intervention was carried out from 1986 to 1992. In 2006 we conducted a 20 year follow-up study of the original participants to compare the incidence of microvascular complications in the combined intervention group vs the control group. RESULTS: Follow-up information was obtained on 542 (94%) of the 577 original participants. The cumulative incidence of severe retinopathy was 9.2% in the combined intervention group and 16.2% in the control group (p = 0.03, log-rank test). After adjusting for clinic and age, the incidence of severe retinopathy was 47% lower in the intervention group than the control group (hazard rate ratio 0.53, 95% CI 0.29-0.99, p = 0.048). No significant differences were found in the incidence of severe nephropathy (hazard rate ratio 1.05, 95% CI 0.16-7.05, intervention vs control, p = 0.96) or in the prevalence of neuropathy (8.6% vs 9.1%, p = 0.89) among the 20 year survivors. CONCLUSIONS/INTERPRETATION: Lifestyle intervention for 6 years in IGT was associated with a 47% reduction in the incidence of severe, vision-threatening retinopathy over a 20 year interval, primarily due to the reduced incidence of diabetes in the intervention group. However, similar benefits were not seen for nephropathy or neuropathy. |
Correlates of depression among people with diabetes: the Translating Research Into Action for Diabetes (TRIAD) study
Waitzfelder B , Gerzoff RB , Karter AJ , Crystal S , Bair MJ , Ettner SL , Brown AF , Subramanian U , Lu SE , Marrero D , Herman WH , Selby JV , Dudley RA . Prim Care Diabetes 2010 4 (4) 215-22 AIM: The broad objective of this study was to examine multiple dimensions of depression in a large, diverse population of adults with diabetes. Specific aims were to measure the association of depression with: (1) patient characteristics; (2) outcomes; and (3) diabetes-related quality of care. METHODS: Cross-sectional analyses were performed using survey and chart data from the Translating Research Into Action for Diabetes (TRIAD) study, including 8790 adults with diabetes, enrolled in 10 managed care health plans in 7 states. Depression was measured using the Patient Health Questionnaire (PHQ-8). Patient characteristics, outcomes and quality of care were measured using validated survey items and chart data. RESULTS: Nearly 18% of patients had major depression, with prevalence 2-3 times higher among patients with low socioeconomic status. Pain and limited mobility were strongly associated with depression, controlling for other patient characteristics. Depression was associated with slightly worse glycemic control, but not other intermediate clinical outcomes. Depressed patients received slightly fewer recommended diabetes-related processes of care. CONCLUSIONS: In a large, diverse cohort of patients with diabetes, depression was most prevalent among patients with low socioeconomic status and those with pain, and was associated with slightly worse glycemic control and quality of care. |
Patients' willingness to discuss trade-offs to lower their out-of-pocket drug costs
Tseng CW , Waitzfelder BE , Tierney EF , Gerzoff RB , Marrero DG , Piette JD , Karter AJ , Curb JD , Chung R , Mangione CM , Crosson JC , Dudley RA . Arch Intern Med 2010 170 (16) 1502-4 Efforts to reform the U.S. health care system have placed considerable attention on patients’ financial burden from out-of-pocket drug costs. Patients frequently have difficulty paying for medications and although they are encouraged to discuss ways to lower drug costs with physicians, such communication frequently fails to occur.1-4 Physicians may be reluctant to initiate these cost discussions because some cost-cutting strategies involve potential trade-offs such as increased dosing frequency, or risk of side effects, or lower treatment effectiveness.1 Knowing patients’ willingness to consider such less than optimal cost-lowering strategies could encourage physicians to discuss drug costs with their patients. |
Residence in a distressed county in Appalachia as a risk factor for diabetes, Behavioral Risk Factor Surveillance System, 2006-2007
Barker L , Crespo R , Gerzoff RB , Denham S , Shrewsberry M , Cornelius-Averhart D . Prev Chronic Dis 2010 7 (5) A104 INTRODUCTION: We compared the risk of diabetes for residents of Appalachian counties to that of residents of non-Appalachian counties after controlling for selected risk factors in states containing at least 1 Appalachian county. METHODS: We combined Behavioral Risk Factor Surveillance System data from 2006 and 2007 and conducted a logistic regression analysis, with self-reported diabetes as the dependent variable. We considered county of residence (5 classifications for Appalachian counties, based on economic development, and 1 for non-Appalachian counties), age, sex, race/ethnicity, education, household income, smoking status, physical activity level, and obesity to be independent variables. The classification "distressed" refers to counties in the worst 10%, compared with the nation as a whole, in terms of 3-year unemployment rate, per capita income, and poverty. RESULTS: Controlling for covariates, residents in distressed Appalachian counties had 33% higher odds (95% confidence interval, 1.10-1.60) of reporting diabetes than residents of non-Appalachian counties. We found no significant differences between other classifications of Appalachian counties and non-Appalachian counties. CONCLUSION: Residents of distressed Appalachian counties are at higher risk of diabetes than are residents of other counties. States with distressed Appalachian counties should implement culturally sensitive programs to prevent diabetes. |
Characteristics of insured patients with persistent gaps in diabetes care services: the Translating Research into Action for Diabetes (TRIAD) study
Gregg EW , Karter AJ , Gerzoff RB , Safford M , Brown AF , Tseng CW , Waitzfielder B , Herman WH , Mangione CM , Selby JV , Thompson TJ , Dudley RA . Med Care 2009 48 (1) 31-7 BACKGROUND: Although preventing diabetes complications requires long-term management, little is known about which patients persistently fail to get recommended care. OBJECTIVE: To determine the frequency and correlates of persistent, long-term gaps in diabetes care. METHODS: The study population included 8392 patients with diabetes. Patient surveys and medical records from 10 health plans over 3 years provided data on socioeconomic characteristics, access to care, social support, and mental and physical health, and diabetes preventive care services. We defined a "persistent gap" as a participant's missing a preventive care service for the entire 3 years. Services considered included hemoglobin A1c, cholesterol, and albuminuria tests, and foot and dilated eye examinations. RESULTS: Thirty percent of participants had at least 1 persistent gap. The most common gaps were lipid testing (11.6%), microalbuminuria testing (9.7%), and eye examinations (9.0%). Persistent gaps were 18% to 42% higher for young patients, lean persons, those with low income, employed persons, smokers, those with diabetes less than 5 years, and patients with none or 1 comorbid conditions. Sex, education, marital status, family demands, transportation, trust in physicians, and mental health were not associated with gaps in care. CONCLUSIONS: Persistent gaps in diabetes care are common even among insured patients. Patients with lower income, younger age, fewer years of diabetes, having fewer comorbidities, taking fewer medications, and poor health behaviors are vulnerable to persistent gaps in care and a group who warrant targeted interventions to improve preventive diabetes care. |
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- Page last updated:Jun 17, 2024
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