Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-15 (of 15 Records) |
Query Trace: Sacks JJ[original query] |
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Improving estimates of alcohol-attributable deaths in the United States: Impact of adjusting for the underreporting of alcohol consumption
Esser MB , Sherk A , Subbaraman MS , Martinez P , Karriker-Jaffe KJ , Sacks JJ , Naimi TS . J Stud Alcohol Drugs 2022 83 (1) 134-144 OBJECTIVE: Self-reported alcohol consumption in U.S. public health surveys covers only 30%-60% of per capita alcohol sales, based on tax and shipment data. To estimate alcohol-attributable harms using alcohol-attributable fractions, accurate measures of total population consumption and the distribution of this drinking are needed. This study compared methodological approaches of adjusting self-reported survey data on alcohol consumption to better reflect sales and assessed the impact of these adjustments on the distribution of average daily consumption (ADC) levels and the number of alcohol-attributable deaths. METHOD: Prevalence estimates of ADC levels (i.e., low, medium, and high) among U.S. adults who responded to the 2011-2015 Behavioral Risk Factor Surveillance System (BRFSS; N = 2,198,089) were estimated using six methods. BRFSS ADC estimates were adjusted using the National Alcohol Survey, per capita alcohol sales data (from the Alcohol Epidemiologic Data System), or both. Prevalence estimates for the six methods were used to estimate average annual alcohol-attributable deaths, using a population-attributable fraction approach. RESULTS: Self-reported ADC in the BRFSS accounted for 31.3% coverage of per capita alcohol sales without adjustments, 36.1% using indexed-BRFSS data, and 44.3% with National Alcohol Survey adjustments. Per capita sales adjustments decreased low ADC prevalence estimates and increased medium and high ADC prevalence estimates. Estimated alcohol-attributable deaths ranged from approximately 91,200 per year (BRFSS unadjusted; Method 1) to 125,200 per year (100% of per capita sales adjustment; Method 6). CONCLUSIONS: Adjusting ADC to reflect total U.S. alcohol consumption (e.g., adjusting to 73% of per capita sales) has implications for assessing the impact of excessive drinking on health outcomes, including alcohol-attributable death estimates. |
Distribution of drinks consumed by U.S. adults by average daily alcohol consumption: A comparison of 2 nationwide surveys
Esser MB , Sacks JJ , Sherk A , Karriker-Jaffe KJ , Greenfield TK , Pierannunzi C , Brewer RD . Am J Prev Med 2020 59 (5) 669-677 INTRODUCTION: Estimates of alcohol consumption in the Behavioral Risk Factor Surveillance System are generally lower than those in other surveys of U.S. adults. This study compares the estimates of adults' drinking patterns and the distribution of drinks consumed by average daily alcohol consumption from 2 nationwide telephone surveys. METHODS: The 2014-2015 National Alcohol Survey (n=7,067) and the 2015 Behavioral Risk Factor Surveillance System (n=408,069) were used to assess alcohol consumption among adults (≥18 years), analyzed in 2019. The weighted prevalence of binge-level drinking and the distribution of drinks consumed by average daily alcohol consumption (low, medium, high) were assessed for the previous 12 months using the National Alcohol Survey and the previous 30 days using the Behavioral Risk Factor Surveillance System, stratified by respondents' characteristics. RESULTS: The prevalence of binge-level drinking in a day was 26.1% for the National Alcohol Survey; the binge drinking prevalence was 17.4% for the Behavioral Risk Factor Surveillance System. The prevalence of high average daily alcohol consumption among current drinkers was 8.2% for the National Alcohol Survey, accounting for 51.0% of total drinks consumed, and 3.3% for the Behavioral Risk Factor Surveillance System, accounting for 27.7% of total drinks consumed. CONCLUSIONS: National Alcohol Survey yearly prevalence estimates of binge-level drinking in a day and high average daily consumption were consistently greater than Behavioral Risk Factor Surveillance System monthly binge drinking and high average daily consumption prevalence estimates. When planning and evaluating prevention strategies, the impact of different survey designs and methods on estimates of excessive drinking and related harms is important to consider. |
Where have all the patients gone Profile of US adults who report doctor-diagnosed arthritis but are not being treated
Theis KA , Brady TJ , Sacks JJ . J Clin Rheumatol 2019 25 (8) 341-347 BACKGROUND: Patients only benefit from clinical management of arthritis if they are under the care of a physician or other health professional. OBJECTIVES: We profiled adults who reported doctor-diagnosed arthritis who are not currently being treated for it to understand better who they are. METHODS: Individuals with no current treatment (NCT) were identified by "no" to "Are you currently being treated by a doctor or other health professional for arthritis or joint symptoms?" Demographics, current symptoms, physical functioning, arthritis limitations and interference in life activities, and level of agreement with treatment and attitude statements were assessed in this cross-sectional, descriptive study of noninstitutionalized US adults aged 45 years or older with self-reported, doctor-diagnosed arthritis (n = 1793). RESULTS: More than half of the study population, 52%, reported NCT (n = 920). Of those with NCT, 27% reported fair/poor health, 40% reported being limited by their arthritis, 51% had daily arthritis pain, 59% reported 2 or more symptomatic joints, and 19% reported the lowest third of physical functioning. Despite NCT, 83% with NCT agreed or strongly agreed with the importance of seeing a doctor for diagnosis and treatment. CONCLUSIONS: Greater than half of those aged 45 years or older with arthritis were not currently being treated for it, substantial proportions of whom experienced severe symptoms and poor physical function and may benefit from clinical management and guidance, complemented by community-delivered public health interventions (self-management education, physical activity). Further research to understand the reasons for NCT may identify promising intervention points to address missed treatment opportunities and improve quality of life and functioning. |
Supporting self-management education for arthritis: Evidence from the Arthritis Conditions and Health Effects Survey on the influential role of health care providers
Murphy LB , Theis KA , Brady TJ , Sacks JJ . Chronic Illn 2019 17 (3) 1742395319869431 OBJECTIVE: Self-management education programs are recommended for many chronic conditions. We studied which adults with arthritis received a health care provider's recommendation to take a self-management education class and who attended. METHODS: We analyzed data from a 2005--2006 national telephone survey of US adults with arthritis >/=45 years (n = 1793). We used multivariable-adjusted prevalence ratios (PR) from logistic regression models to estimate associations with: (1) receiving a health care provider recommendation to take a self-management education class; and (2) attending a self-management education class. RESULTS: Among all adults with arthritis: 9.9% received a health care provider recommendation to take an self-management education class; 9.7% attended a self-management education class. Of those receiving a recommendation, 52.0% attended a self-management education class. The strongest association with self-management education class attendance was an health care provider recommendation to take one (PR = 8.9; 95% CI = 6.6-12.1). CONCLUSIONS: For adults with arthritis, a health care provider recommendation to take a self-management education class was strongly associated with self-management education class attendance. Approximately 50% of adults with arthritis have >/=1 other chronic conditions; by recommending self-management education program attendance, health care providers may activate patients' self-management behaviors. If generalizable to other chronic conditions, this health care provider recommendation could be a key influencer in improving outcomes for a range of chronic conditions and patients' quality of life. |
Measuring Alcohol Outlet Density: An Overview of Strategies for Public Health Practitioners
Sacks JJ , Brewer RD , Mesnick J , Holt JB , Zhang X , Kanny D , Elder R , Gruenewald PJ . J Public Health Manag Pract 2019 26 (5) 481-488 CONTEXT: Excessive alcohol use is responsible for 88 000 deaths in the United States annually and cost the United States $249 billion in 2010. There is strong scientific evidence that regulating alcohol outlet density is an effective intervention for reducing excessive alcohol consumption and related harms, but there is no standard method for measuring this exposure. PROGRAM: We overview the strategies available for measuring outlet density, discuss their advantages and disadvantages, and provide examples of how they can be applied in practice. IMPLEMENTATION: The 3 main approaches for measuring density are container-based (eg, number of outlets in a county), distance-based (eg, average distance between a college and outlets), and spatial access-based (eg, weighted distance between town center and outlets). EVALUATION: While container-based measures are the simplest to calculate and most intuitive, distance-based or spatial access-based measures are unconstrained by geopolitical boundaries and allow for assessment of clustering (an amplifier of certain alcohol-related harms). Spatial access-based measures can also be adjusted for population size/demographics but are the most resource-intensive to produce. DISCUSSION: Alcohol outlet density varies widely across and between locations and over time, which is why it is important to measure it. Routine public health surveillance of alcohol outlet density is important to identify problem areas and detect emerging ones. Distance- or spatial access-based measures of alcohol outlet density are more resource-intensive than container-based measures but provide a much more accurate assessment of exposure to alcohol outlets and can be used to assess clustering, which is particularly important when assessing the relationship between density and alcohol-related harms, such as violent crime. |
Measuring Alcohol Outlet Density: An Overview of Strategies for Public Health Practitioners
Sacks JJ , Brewer RD , Mesnick J , Holt JB , Zhang X , Kanny D , Elder R , Gruenewald PJ . J Public Health Manag Pract 2019 26 (5) 481-488 CONTEXT: Excessive alcohol use is responsible for 88 000 deaths in the United States annually and cost the United States $249 billion in 2010. There is strong scientific evidence that regulating alcohol outlet density is an effective intervention for reducing excessive alcohol consumption and related harms, but there is no standard method for measuring this exposure. PROGRAM: We overview the strategies available for measuring outlet density, discuss their advantages and disadvantages, and provide examples of how they can be applied in practice. IMPLEMENTATION: The 3 main approaches for measuring density are container-based (eg, number of outlets in a county), distance-based (eg, average distance between a college and outlets), and spatial access-based (eg, weighted distance between town center and outlets). EVALUATION: While container-based measures are the simplest to calculate and most intuitive, distance-based or spatial access-based measures are unconstrained by geopolitical boundaries and allow for assessment of clustering (an amplifier of certain alcohol-related harms). Spatial access-based measures can also be adjusted for population size/demographics but are the most resource-intensive to produce. DISCUSSION: Alcohol outlet density varies widely across and between locations and over time, which is why it is important to measure it. Routine public health surveillance of alcohol outlet density is important to identify problem areas and detect emerging ones. Distance- or spatial access-based measures of alcohol outlet density are more resource-intensive than container-based measures but provide a much more accurate assessment of exposure to alcohol outlets and can be used to assess clustering, which is particularly important when assessing the relationship between density and alcohol-related harms, such as violent crime. |
Arthritis prevalence: which case definition for surveillance
Murphy LB , Sacks JJ , Helmick CG , Brady TJ , Boring MA , Moss S , Barbour KE , Guglielmo D , Hootman JM , Theis KA . Arthritis Rheumatol 2018 71 (1) 172-175 In the article titled "Updated Estimates Suggest a Much Higher Prevalence of Arthritis in United States Adults than Previous Ones", Jafarzadeh and Felson present an alternative estimate of arthritis prevalence. (1) Specifically, using a new case definition for arthritis and applying Bayesian methods to correct for misclassification, Jafarzadeh and Felson analyzed National Health Interview Survey (NHIS) data and estimated that in 2015, 91.2 million US adults had arthritis. In contrast, CDC had estimated from the 2013-2015 NHIS that 54.4 million US adults had doctor-diagnosed arthritis. (2) In this letter, we make two observations about their methods and discuss implications for public health surveillance of arthritis. This article is protected by copyright. All rights reserved. |
Operationalizing surveillance of chronic disease self-management and self-management support
Brady TJ , Sacks JJ , Terrillion AJ , Colligan EM . Prev Chronic Dis 2018 15 E39 Sixty percent of US adults have at least one chronic condition, and more than 40% have multiple conditions. Self-management (SM) by the individual, along with self-management support (SMS) by others, are nonpharmacological interventions with few side effects that are critical to optimal chronic disease control. Ruiz and colleagues laid the conceptual groundwork for surveillance of SM/SMS at 5 socio-ecological levels (individual, health system, community, policy, and media). We extend that work by proposing operationalized indicators at each socio-ecologic level and suggest that the indicators be embedded in existing surveillance systems at national, state, and local levels. Without a robust measurement system at the population level, we will not know how far we have to go or how far we have come in making SM and SMS a reality. The data can also be used to facilitate planning and service delivery strategies, monitor temporal changes, and stimulate SM/SMS-related research. |
2010 national and state costs of excessive alcohol consumption
Sacks JJ , Gonzales KR , Bouchery EE , Tomedi LE , Brewer RD . Am J Prev Med 2015 49 (5) e73-9 INTRODUCTION: Excessive alcohol use cost the U.S. $223.5 billion in 2006. Given economic shifts in the U.S. since 2006, more-current estimates are needed to help inform the planning of prevention strategies. METHODS: From March 2012 to March 2014, the 26 cost components used to assess the cost of excessive drinking in 2006 were projected to 2010 based on incidence (e.g., change in number of alcohol-attributable deaths) and price (e.g., inflation rate in cost of medical care). The total cost, cost to government, and costs for binge drinking, underage drinking, and drinking while pregnant were estimated for the U.S. for 2010 and allocated to states. RESULTS: Excessive drinking cost the U.S. $249.0 billion in 2010, or about $2.05 per drink. Government paid for $100.7 billion (40.4%) of these costs. Binge drinking accounted for $191.1 billion (76.7%) of costs; underage drinking $24.3 billion (9.7%) of costs; and drinking while pregnant $5.5 billion (2.2%) of costs. The median cost per state was $3.5 billion. Binge drinking was responsible for >70% of these costs in all states, and >40% of the binge drinking-related costs were paid by government. CONCLUSIONS: Excessive drinking cost the nation almost $250 billion in 2010. Two of every $5 of the total cost was paid by government, and three quarters of the costs were due to binge drinking. Several evidence-based strategies can help reduce excessive drinking and related costs, including increasing alcohol excise taxes, limiting alcohol outlet density, and commercial host liability. |
Alternative methods for defining osteoarthritis and the impact on estimating prevalence in a US population-based survey
Cisternas MG , Murphy L , Sacks JJ , Solomon DH , Pasta DJ , Helmick CG . Arthritis Care Res (Hoboken) 2015 68 (5) 574-80 OBJECTIVE: Provide a contemporary estimate of osteoarthritis (OA) by comparing accuracy and prevalence of alternative definitions of OA. METHODS: The Medical Expenditure Panel Survey (MEPS) household component (HC) records respondent-reported medical conditions as open-ended responses; professional coders translate these responses into ICD-9-CM codes for the medical conditions files. Using these codes and other data from the MEPS-HC medical conditions files, we constructed three case definitions of OA and assessed them against medical provider diagnoses of ICD-9-CM 715 [osteoarthrosis and allied disorders] in a MEPS subsample. The three definitions were: 1) strict = ICD-9-CM 715; 2) expanded = ICD-9-CM 715, 716 [other and unspecified arthropathies], OR 719 [other and unspecified disorders of joint]); and 3) probable = strict OR expanded + respondent-reported prior diagnosis of OA or other arthritis excluding rheumatoid arthritis (RA). RESULTS: Sensitivity and specificity of the three definitions were: strict - 34.6% and 97.5%; expanded - 73.8% and 90.5%; and probable - 62.9% and 93.5%. CONCLUSION: The strict definition for OA (ICD-9-CM 715) excludes many individuals with OA. The probable definition of OA has the optimal combination of sensitivity and specificity relative to the two other MEPS-based definitions and yields a national annual estimate of 30.8 million adults with OA (13.4% of US adult population) for 2008 - 2011. |
Psoriasis and psoriatic arthritis: a public health agenda
Helmick CG , Sacks JJ , Gelfand JM , Bebo B Jr , Lee-Han H , Baird T , Bartlett C . Am J Prev Med 2013 44 (4) 424-6 Robust clinical, biomedical, and public health efforts currently address chronic conditions such as heart disease, diabetes, and cancer. However, similar efforts are less common for nonfatal conditions such as psoriasis, which is estimated to affect between 1% and 3% of the adult population,1,2 and psoriatic arthritis, an inflammatory arthritis found in up to one third of adults with psoriasis.3 Both diseases present a substantial public health burden in terms of healthcare costs ($650 million in 1997)1; employment and ability to work4; and quality of life.5,6 | In 2008, the National Psoriasis Foundation (NPF) approached the CDC to explore how a public health perspective could be incorporated into existing clinical and biomedical perspectives. In 2010, the U.S. Congress included funding for the CDC | … to support the collection of epidemiological and longitudinal data on individuals with psoriasis and psoriatic arthritis, including children and adolescents, to better understand the co-morbidities associated with psoriasis, examine the relationship of psoriasis to other public health concerns, and gain insight into the long-term impact and treatment of these two conditions.7 | In other words, the funding was to begin developing and addressing a public health agenda for psoriasis and psoriatic arthritis. |
Anxiety is more common than depression among US adults with arthritis
Murphy LB , Sacks JJ , Brady TJ , Hootman JM , Chapman DP . Arthritis Care Res (Hoboken) 2012 64 (7) 968-76 BACKGROUND: There has been limited characterization of the burden of anxiety and depression, especially the former, among US adults with arthritis in the general population. The study objective was to estimate the prevalence and correlates of anxiety and depression among US adults with doctor-diagnosed arthritis. METHODS: The study sample comprised US adults aged ≥ 45 years with doctor-diagnosed arthritis (n=1,793) from Arthritis Condition and Health Effects Survey (a cross-sectional, population based, random digit dialed telephone interview survey). Anxiety and depression were measured using separate and validated subscales of the Arthritis Impact Measurement Scales. Prevalence was estimated for the sample overall and stratified by subgroups. Associations between correlates and each condition were estimated with prevalence ratios and 95% confidence intervals using logistic regression models. RESULTS: Anxiety was more common than depression (31% and 18% respectively); overall, a third of respondents reported at least one of the two conditions. Most (84%) of those with depression also had anxiety. Multivariable logistic regression modeling failed to identify a distinct profile of characteristics of those with anxiety or/and depression. Only half of respondents with anxiety and/or depression had sought help for their mental health condition in the past year. CONCLUSIONS: Despite the clinical focus on depression among people with arthritis, anxiety was almost twice as common as depression. Given their high prevalence, profound impact on quality of life, and range of effective treatments available, we encourage health care providers to screen all people with arthritis for both anxiety and depression. (c) 2012 by the American College of Rheumatology. |
Economic costs of excessive alcohol consumption in the U.S., 2006
Bouchery EE , Harwood HJ , Sacks JJ , Simon CJ , Brewer RD . Am J Prev Med 2011 41 (5) 516-24 BACKGROUND: Excessive alcohol consumption causes premature death (average of 79,000 deaths annually); increased disease and injury; property damage from fire and motor vehicle crashes; alcohol-related crime; and lost productivity. However, its economic cost has not been assessed for the U.S. since 1998. PURPOSE: To update prior national estimates of the economic costs of excessive drinking. METHODS: This study (conducted 2009-2010) followed U.S. Public Health Service Guidelines to assess the economic cost of excessive alcohol consumption in 2006. Costs for health care, productivity losses, and other effects (e.g., property damage) in 2006 were obtained from national databases. Alcohol-attributable fractions were obtained from multiple sources and used to assess the proportion of costs that could be attributed to excessive alcohol consumption. RESULTS: The estimated economic cost of excessive drinking was $223.5 billion in 2006 (72.2% from lost productivity, 11.0% from healthcare costs, 9.4% from criminal justice costs, and 7.5% from other effects) or approximately $1.90 per alcoholic drink. Binge drinking resulted in costs of $170.7 billion (76.4% of the total); underage drinking $27.0 billion; and drinking during pregnancy $5.2 billion. The cost of alcohol-attributable crime was $73.3 billion. The cost to government was $94.2 billion (42.1% of the total cost), which corresponds to about $0.80 per alcoholic drink consumed in 2006 (categories are not mutually exclusive and may overlap). CONCLUSIONS: On a per capita basis, the economic impact of excessive alcohol consumption in the U.S. is approximately $746 per person, most of which is attributable to binge drinking. Evidence-based strategies for reducing excessive drinking should be widely implemented. |
Should people who have joint symptoms, but no diagnosis of arthritis from a doctor, be included in surveillance efforts?
Bolen J , Helmick CG , Sacks JJ , Gizlice Z , Potter C . Arthritis Care Res (Hoboken) 2010 63 (1) 150-4 OBJECTIVE: In 2005, 27% of adults reported doctor-diagnosed arthritis (DrDx), and 14% reported chronic joint symptoms but no DrDx (i.e., possible arthritis [PA]). We evaluate the value of including persons classified as PA in surveillance of arthritis. METHODS: In 2005, Kansas, Oklahoma, North Carolina, and Utah added extra questions to their Behavioral Risk Factor Surveillance System (BRFSS) telephone survey targeted to a subsample of those classified as PA. RESULTS: Persons classified as PA (n = 2,884) were younger, more often male, and had less activity limitation than persons with DrDx. Of those classified as PA, half had seen a doctor for their symptoms, 12.5% reported arthritis; 61.9% gave other causes. Of the half who had not seen a doctor, most reported mild symptoms (64.8%). CONCLUSION: Only 6.3% of those classified as PA had what we considered arthritis. Most who did not see a doctor reported mild symptoms and, thus, would be unlikely to be amenable to medical and public health interventions for arthritis. Although including PA would slightly improve the sensitivity of detecting arthritis in the population, it would increase false positives that would interfere with targeting state intervention efforts and burden estimates. The ability to add back questions in BRFSS allows reintroduction of PA should national surveillance suggest it is warranted or studies document an increased rate at which PA turns into arthritis. Currently PA does not need to be included in state arthritis surveillance efforts, and limited question space on surveys is better spent on other arthritis issues. |
Arthritis restricts volunteer participation: prevalence and correlates of volunteer status among adults with arthritis
Theis KA , Murphy L , Hootman JM , Helmick CG , Sacks JJ . Arthritis Care Res (Hoboken) 2010 62 (7) 907-16 OBJECTIVE: To estimate, among adults ages > or = 45 years with arthritis, the prevalence and correlates of 1) volunteering, 2) arthritis-attributable restrictions among volunteers, and 3) arthritis as the main barrier to volunteering (AMBV) among non-volunteers. METHODS: Data were from the 2005-2006 Arthritis Conditions Health Effects Survey, a cross-sectional random-digit-dialed national telephone survey of noninstitutionalized US adults ages > or = 45 years with self-reported, doctor-diagnosed arthritis. Respondents (n = 1,793; weighted population 37.7 million) were asked if they currently volunteer (work outside the home without pay). Volunteers were asked if arthritis affects their amount or type of volunteering (arthritis-attributable volunteer limitation [AAVL]). Non-volunteers were asked if arthritis is the main reason they do not volunteer (AMBV). Univariable and multivariable-adjusted logistic regression analyses were performed to estimate associations between potential correlates and each outcome. RESULTS: One-third of the respondents reported volunteering. Among volunteers, 41% (4.9 million) reported AAVL. Among non-volunteers, 27% (6.8 million) reported AMBV. Fair/poor self-rated health was significantly associated with less volunteering (multivariable-adjusted odds ratio [OR] 0.5, 95% confidence interval [95% CI] 0.4-0.8) and greater AAVL (multivariable-adjusted OR 2.1, 95% CI 1.1-4.0) and AMBV (multivariable-adjusted OR 1.8, 95% CI 1.2-2.7). Poor physical function was the most strongly associated correlate of both AAVL and AMBV (multivariable-adjusted ORs 8.0 and 4.3, respectively). CONCLUSION: Volunteering is an important role with individual and societal benefits, but almost 12 million adults with arthritis are limited or do not participate in volunteering due to arthritis. Individuals with restrictions in volunteering reported a substantial burden of poor physical function and may benefit from effective, underused interventions designed to improve physical function, delay disability, and enhance arthritis self-management. |
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