Last data update: Nov 11, 2024. (Total: 48109 publications since 2009)
Records 1-9 (of 9 Records) |
Query Trace: Lochner K[original query] |
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The health status of women with children living in public and assisted housing: Linkage of the National Health Interview Survey to U.S. Department of Housing and Urban Development Administrative Data
Helms Garrison V , Bachand JV , Zhang C , Cox C , Golden C , Lochner KA . Cityscape 2024 26 (1) 49-64 For more than a decade, the U.S. Department of Housing and Urban Development (HUD) and the National Center for Health Statistics (NCHS) have partnered to link NCHS national health survey data with HUD administrative records on persons participating in federal public and assisted housing programs. This study used 2015-18 National Health Interview Survey (NHIS)-HUD linked data to examine women 18-44 years old with children and renting their home who were receiving HUD assistance (n=852) and a comparison population of women of the same age with children, who were low-income renters but did not link to HUD records at the time of their NHIS interview (n=894). The population of HUD-assisted women differed from the comparison group on key sociodemographic characteristics and health indicators. HUD-assisted women were more likely to report their health as fair or poor and to being a current smoker. HUD-assisted women also were less likely to be uninsured and more likely to have a regular source of care. The findings in this article are exploratory but demonstrate how the NCHS-HUD-linked data can be a resource for researchers and policymakers in further examining housing status as an important social determinant of health. |
Vital signs for pediatric health: High school graduation
Hoagwood K , Walker DK , Edwards A , Kaminski JW , Kelleher KJ , Spandorfer J , Fox EG . NAM Perspect 2023 2023 In 2015, the Institute of Medicine (now the National Academy of Medicine) released the report Vital Signs: Core Metrics for Health and Health Care Progress as a “basic, minimum slate of core metrics for use as sentinel indices of performance at various levels with respect to the key elements of health and health care progress” (IOM, 2015). Although indicators of pediatric health were included in that report as key elements of healthy behaviors, healthy communities, and preventive services, the core measures in the report emphasized indicators of adult health. This series of papers, “Vital Signs for Pediatric Health”, describes four metrics across the pediatric life course, each measuring how well the health care system is building the physical, cognitive, and socio-emotional health of the pediatric population, thereby laying the foundation for life-long health and well-being. The metrics—infant mortality, school readiness, chronic absenteeism, and high school graduation—were selected to focus on four different developmental stages of growth. A standardized set of core metrics to assess pediatric health could provide data to support health systems in identifying important areas for attention among their pediatric population and enable them to respond in a timely way. This rapid response is especially important in pediatric health systems as children undergo rapid development within a short time span. | | This paper discusses one of those four measures—high school graduation—as a pediatric vital sign because it reflects more than a number. Successful completion of high school also reflects the degree to which healthy growth and development has been supported throughout childhood. Earning a high school diploma is a predictor of adult success, including better employment outcomes, better adult physical and mental health, and decreased likelihood of involvement with the criminal justice system (NCES, 2021b; Blackwell et al., 2014; Lochner and Moretti, 2004). Those who do not graduate from high school face a greater likelihood of health risks as adults, including lower life expectancy, limited employment prospects, lower lifetime wages, and increased risk of incarceration (APHA, 2018). | | The remainder of this paper defines high school graduation rate, the selection of the specific measure that can assess high school graduation, and the technical integrity of the measure. The paper also describes disparities by state, race and ethnicity, and socio-economic status and delineates the importance of a high school diploma, including impacts on employment, future earnings, and individual health. It is important to note that the General Equivalency Diploma (GED) is not considered in this paper. Research shows that adults with GEDs have health outcomes more similar to high school dropouts than to graduates and perform at the level of dropouts in the labor market (Zajacova, 2012; Heckman and LaFontaine, 2007). Finally, the paper lays out the challenges in linking education data with health systems data to help communities have a broader impact on improving the health and well-being of their populations, implementation challenges more broadly, and potential ways to improve use of this metric to increase high school graduation rates. |
Trends in COVID-19 Cases, Emergency Department Visits, and Hospital Admissions Among Children and Adolescents Aged 0-17 Years - United States, August 2020-August 2021.
Siegel DA , Reses HE , Cool AJ , Shapiro CN , Hsu J , Boehmer TK , Cornwell CR , Gray EB , Henley SJ , Lochner K , Suthar AB , Lyons BC , Mattocks L , Hartnett K , Adjemian J , van Santen KL , Sheppard M , Soetebier KA , Logan P , Martin M , Idubor O , Natarajan P , Sircar K , Oyegun E , Dalton J , Perrine CG , Peacock G , Schweitzer B , Morris SB , Raizes E . MMWR Morb Mortal Wkly Rep 2021 70 (36) 1249-1254 Although COVID-19 generally results in milder disease in children and adolescents than in adults, severe illness from COVID-19 can occur in children and adolescents and might require hospitalization and intensive care unit (ICU) support (1-3). It is not known whether the B.1.617.2 (Delta) variant,* which has been the predominant variant of SARS-CoV-2 (the virus that causes COVID-19) in the United States since late June 2021,(†) causes different clinical outcomes in children and adolescents compared with variants that circulated earlier. To assess trends among children and adolescents, CDC analyzed new COVID-19 cases, emergency department (ED) visits with a COVID-19 diagnosis code, and hospital admissions of patients with confirmed COVID-19 among persons aged 0-17 years during August 1, 2020-August 27, 2021. Since July 2021, after Delta had become the predominant circulating variant, the rate of new COVID-19 cases and COVID-19-related ED visits increased for persons aged 0-4, 5-11, and 12-17 years, and hospital admissions of patients with confirmed COVID-19 increased for persons aged 0-17 years. Among persons aged 0-17 years during the most recent 2-week period (August 14-27, 2021), COVID-19-related ED visits and hospital admissions in the states with the lowest vaccination coverage were 3.4 and 3.7 times that in the states with the highest vaccination coverage, respectively. At selected hospitals, the proportion of COVID-19 patients aged 0-17 years who were admitted to an ICU ranged from 10% to 25% during August 2020-June 2021 and was 20% and 18% during July and August 2021, respectively. Broad, community-wide vaccination of all eligible persons is a critical component of mitigation strategies to protect pediatric populations from SARS-CoV-2 infection and severe COVID-19 illness. |
Proposed outcomes measures for state public health genomic programs.
Doyle DL , Clyne M , Rodriguez JL , Cragun DL , Senier L , Hurst G , Chan K , Chambers DA . Genet Med 2018 20 (9) 995-1003 PurposeTo assess the implementation of evidence-based genomic medicine and its population-level impact on health outcomes and to promote public health genetics interventions, in 2015 the Roundtable on Genomics and Precision Health of the National Academies of Sciences, Engineering, and Medicine formed an action collaborative, the Genomics and Public Health Action Collaborative (GPHAC). This group engaged key stakeholders from public/population health agencies, along with experts in the fields of health disparities, health literacy, implementation science, medical genetics, and patient advocacy.MethodsIn this paper, we present the efforts to identify performance objectives and outcome metrics. Specific attention is placed on measures related to hereditary breast ovarian cancer (HBOC) syndrome and Lynch syndrome (LS), two conditions with existing evidence-based genomic applications that can have immediate impact on morbidity and mortality.ResultsOur assessment revealed few existing outcome measures. Therefore, using an implementation research framework, 38 outcome measures were crafted.ConclusionEvidence-based public health requires outcome metrics, yet few exist for genomics. Therefore, we have proposed performance objectives that states might use and provided examples of a few state-level activities already under way, which are designed to collect outcome measures for HBOC and LS.GENETICS in MEDICINE advance online publication, 4 January 2018; doi:10.1038/gim.2017.229. |
Prevalence of dementia subtypes in United States Medicare fee-for-service beneficiaries, 2011-2013
Goodman RA , Lochner KA , Thambisetty M , Wingo TS , Posner SF , Ling SM . Alzheimers Dement 2017 13 (1) 28-37 INTRODUCTION: Rapid growth of the older adult population requires greater epidemiologic characterization of dementia. We developed national prevalence estimates of diagnosed dementia and subtypes in the highest risk United States (US) population. METHODS: We analyzed Centers for Medicare & Medicaid administrative enrollment and claims data for 100% of Medicare fee-for-service beneficiaries enrolled during 2011-2013 and age ≥68 years as of December 31, 2013 (n = 21.6 million). RESULTS: Over 3.1 million (14.4%) beneficiaries had a claim for a service and/or treatment for any dementia subtype. Dementia not otherwise specified was the most common diagnosis (present in 92.9%). The most common subtype was Alzheimer's (43.5%), followed by vascular (14.5%), Lewy body (5.4%), frontotemporal (1.0%), and alcohol induced (0.7%). The prevalence of other types of diagnosed dementia was 0.2%. DISCUSSION: This study is the first to document concurrent prevalence of primary dementia subtypes among this US population. The findings can assist in prioritizing dementia research, clinical services, and caregiving resources. |
County-level variation in per capita spending for multiple chronic conditions among fee-for-service Medicare beneficiaries, United States, 2014
Matthews KA , Holt J , Gaglioti AH , Lochner KA , Shoff C , McGuire LC , Greenlund KJ . Prev Chronic Dis 2016 13 E162 The prevalence of Medicare beneficiaries aged 65 years or older with 6 or more concurrent chronic conditions (MCC6+) varies geographically (1). Preventing chronic disease costs less than treating it. Chronic diseases that are well managed progress slower than those that are untreated (2). Thus, understanding how Medicare spending is distributed across the United States among older adults with the highest burden of multiple chronic conditions can assist with targeting prevention and disease management efforts. The objective of this analysis was to describe the county-level variation in per capita Medicare spending among MCC6+ beneficiaries. |
Multiple chronic conditions among Medicare beneficiaries: state-level variations in prevalence, utilization, and cost, 2011
Lochner KA , Goodman RA , Posner S , Parekh A . Medicare Medicaid Res Rev 2013 3 (3) E1-E19 OBJECTIVES: Individuals with multiple (>2) chronic conditions (MCC) present many challenges to the health care system, such as effective coordination of care and cost containment. To assist health policy makers and to fill research gaps on MCC, we describe state-level variation of MCC among Medicare beneficiaries, with a focus on those with six or more conditions. METHODS: Using Centers for Medicare & Medicaid Services administrative data for 2011, we characterized a beneficiary as having MCC by counting the number of conditions from a set of fifteen conditions, which were identified using diagnosis codes on the claims. The study population included fee-for-service beneficiaries residing in the 50 U.S. states and Washington, DC RESULTS: Among beneficiaries with six or more chronic conditions, prevalence rates were lowest in Alaska and Wyoming (7%) and highest in Florida and New Jersey (18%); readmission rates were lowest in Utah (19%) and highest in Washington, DC (31%); the number of emergency department visits per beneficiary were lowest in New York and Florida (1.6) and highest in Washington, DC (2.7); and Medicare spending per beneficiary was lowest in Hawaii ($24,086) and highest in Maryland, Washington, DC, and Louisiana (over $37,000). CONCLUSION: These findings expand upon prior research on MCC among Medicare beneficiaries at the national level and demonstrate considerable state-level variation in the prevalence, health care utilization, and Medicare spending for beneficiaries with MCC. State-level data on MCC is important for decision making aimed at improved program planning, financing, and delivery of care for individuals with MCC. |
Estimating standard errors for life expectancies based on complex survey data with mortality follow-up: a case study using the National Health Interview Survey Linked Mortality Files
Schenker N , Parsons VL , Lochner KA , Wheatcroft G , Pamuk ER . Stat Med 2011 30 (11) 1302-11 Life expectancy is an important measure for health research and policymaking. Linking individual survey records to mortality data can overcome limitations in vital statistics data used to examine differential mortality by permitting the construction of death rates based on information collected from respondents at the time of interview and facilitating estimation of life expectancies for subgroups of interest. However, use of complex survey data linked to mortality data can complicate the estimation of standard errors. This paper presents a case study of approaches to variance estimation for life expectancies based on life tables, using the National Health Interview Survey Linked Mortality Files. The approaches considered include application of Chiang's traditional method, which is straightforward but does not account for the complex design features of the data; balanced repeated replication (BRR), which is more complicated but accounts more fully for the design features; and compromise, 'hybrid' approaches, which can be less difficult to implement than BRR but still account partially for the design features. Two tentative conclusions are drawn. First, it is important to account for the effects of the complex sample design, at least within life-table age intervals. Second, accounting for the effects within age intervals but not across age intervals, as is done by the hybrid methods, can yield reasonably accurate estimates of standard errors, especially for subgroups of interest with more homogeneous characteristics among their members. Published in 2011 by John Wiley & Sons, Ltd. |
Socioeconomic status and risk of diabetes-related mortality in the U.S
Saydah S , Lochner K . Public Health Rep 2010 125 (3) 377-88 OBJECTIVE: We examined disparities in diabetes-related mortality for socioeconomic status (SES) groups in nationally representative U.S. samples. METHODS: We analyzed National Health Interview Survey respondents linked to their death records and included those eligible for mortality follow-up who were aged 25 years and older at the time of interview and not missing information on covariates (n=527,426). We measured SES by education and family income. There were 5,613 diabetes-related deaths. RESULTS: Having less than a high school education was associated with a twofold higher mortality from diabetes, after controlling for age, gender, race/ethnicity, marital status, and body mass index, compared with adults with a college degree or higher education level (relative hazard [RH] = 2.05, 95% confidence interval [CI] 1.78, 2.35). Having a family income below poverty level was associated with a twofold higher mortality after adjustments compared with adults with the highest family incomes (RH=2.41, 95% CI 2.05, 2.84). Approximately one-quarter of the excess risk among those in the lowest SES categories was explained by adjusting for potential confounders. CONCLUSION: Findings from this nationally representative cohort demonstrate a socioeconomic gradient in diabetes-related mortality, with both education and income being important determinants of the risk of death. |
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