Food insecurity, social needs, and smoking status among patients in a county hospital system.
Food insecurity, social needs, and smoking status among patients in a county hospital system.
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县医院系统中患者的粮食不安全，社会需求和吸烟状况。
DOI：
10.1016/j.pmedr.2022.101963
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发表时间：
2022-10
影响因子：
2.8
通讯作者：
Fuehrer, Susan M.
中科院分区：
文献类型：
--
作者：
Kim-Mozeleski, Jin E.;Chagin, Kevin M.;Sehgal, Ashwini R.;Misak, James E.;Fuehrer, Susan M.
在美国，烟草使用越来越集中于粮食不安全等社会经济劣势的人群。先前的研究表明，粮食不安全会增加吸烟的几率，当前的研究旨在研究粮食不安全和其他社会需求，特别是财务压力、交通障碍和住房/公用设施不安全，与县医院系统中成年患者的吸烟状况之间的关系。我们分析了 MetroHealth System（美国俄亥俄州克利夫兰）患者电子健康记录的数据，涵盖自实施健康评估社会决定因素以来的两年时间（2019-2021 年；N = 45,151 名患者）。使用逻辑回归分析来检查与吸烟状况的关联。与总体吸烟率 (21%) 相比，在筛查交通障碍 (41%)、经济压力 (39%)、食品不安全 (34%) 和住房/公用设施不安全 (27%) 的患者中吸烟率较高。这些社交需求中的每一个都与当前吸烟的几率增加独立相关（所有 p < 0.05）。随着社会需求的增加，吸烟率依次增加；随着社交需求的增加，当前吸烟的几率较高（调整后的 OR 范围为 1.56 至 3.76，所有 p < 0.001），尤其是曾经吸烟的患者中当前吸烟的几率（调整后的 OR 范围为 1.39 至 3.01，所有 p < 0.001）之间存在剂量反应相关性。一些社会需求和吸烟状况之间存在很大的重叠。除了改善获得循证戒烟治疗和服务的机会外，研究结果还提出了解决社会需求可能会减少戒烟障碍，从而减少烟草使用差异的可能性。
Tobacco use in the U.S. is increasingly concentrated among populations with socioeconomic disadvantages such as food insecurity. Building on prior studies showing that food insecurity increases odds of cigarette smoking, the current study sought to examine how food insecurity and other social needs, particularly financial strain, transportation barriers, and housing/utility insecurity, were associated with smoking status among adult patients seen in a county hospital system. We analyzed data from the electronic health record of patients from The MetroHealth System (Cleveland, Ohio, USA), covering a two-year period since implementation of social determinants of health assessments (2019–2021; N = 45,151 patients). Logistic regression analyses were used to examine associations with smoking status. Compared to the overall smoking prevalence (21 %), smoking was higher among patients screening for transportation barriers (41 %), financial strain (39 %), food insecurity (34 %), and housing/utility insecurity (27 %). Each of these social needs was independently associated with increased odds of current smoking (all p < 0.05). Smoking prevalence increased sequentially as the number of social needs increased; with each addition of a social need, there was a dose-response association with higher odds of current smoking (adjusted ORs ranged from 1.56 to 3.76, all p < 0.001), and current smoking specifically among ever smoking patients (adjusted ORs ranged from 1.39 to 3.01, all p < 0.001). There was substantial overlap among several social needs and smoking status. Alongside improving access to evidence-based cessation treatments and services, the findings raise the possibility that addressing social needs might reduce barriers to quitting and thereby reduce tobacco use disparities.
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影响因子：
5.2
作者：
Mills, Sarah D.;Golden, Shelley D.;O'Leary, Meghan C.;Logan, Paige;Lich, Kristen Hassmiller
通讯作者：
Lich, Kristen Hassmiller
影响因子：
33.9
作者：
Babb, Stephen;Malarcher, Arm;Jamal, Ahmed
通讯作者：
Jamal, Ahmed
影响因子：
2.7
作者：
Farrelly, Matthew C.;Shafer, Paul R.
通讯作者：
Shafer, Paul R.
影响因子：
1.5
作者：
Bisgaier, Joanna;Rhodes, Karin V.
通讯作者：
Rhodes, Karin V.
DOI：
10.1177/0890117118784233
发表时间：
2019-03
期刊：
American journal of health promotion : AJHP
影响因子：
--
作者：
Kim-Mozeleski JE;Tsoh JY
通讯作者：
Tsoh JY