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Vahabi M.,Ryerson University | Damba C.,Epidemiologist
International Journal for Equity in Health | Year: 2013

Abstract. Objective. In Canada, recent immigrant households experience more food insecurity than the general population, but limited information is available about the personal, cultural, and social factors that contribute to this vulnerability. This study focused on recent Latin American (LA) immigrants to explore their perceived barriers in acquiring safe, nutritious, and culturally-appropriate food. Design. A cross-sectional mixed-method design was applied to collect information from a convenience sample of 70 adult Spanish/Portuguese speakers who had arrived in Toronto within the last five years. Face-to-face interviews were conducted with primary household caregivers to obtain responses about barriers to acquiring food for their households; data were analyzed using a thematic analysis technique. Results: Four main categories of barriers were identified: limited financial resources; language difficulty; cultural food preferences; and poor knowledge of available community-based food resources and services. Inadequate income was the main impediment in accessing adequate food, and was related to affordability of food items, accessibility of food outlets and transportation cost, and limited time for grocery shopping due to work conditions. Language barriers affected participants' ability to obtain well-paid employment and their awareness about and access to available community-based food resources. Cultural barriers were related to food preferences and limited access to culturally-appropriate foods and resources. Conclusion: The main barrier to food security among our sample of LA newcomers to Toronto is limited financial resources, highlighting the need for policies and strategies that could improve their financial power to purchase sufficient, nutritious, and culturally-acceptable food. Linguistic barriers and limited information among newcomers suggest the need to provide linguistically- and culturally-appropriate information related to community-based food programs and resources, as well as accessible subsidized English language programs, in the community and at workplaces. Participatory community-based food programs can augment, in a socially acceptable manner, food resources and reduce the social stigma attached to food charity. Finally, it is crucial to monitor and evaluate existing social and community-based services for their accessibility, cultural appropriateness and diversity, and effectiveness. © 2013 Vahabi and Damba; licensee BioMed Central Ltd.

Tripp M.K.,University of Texas M. D. Anderson Cancer Center | Watson M.,Epidemiologist | Swetter S.M.,Palo Alto University | Gershenwald J.E.,University of Kang Ning
CA Cancer Journal for Clinicians | Year: 2016

Answer questions and earn CME/CNE Although overall cancer incidence rates are decreasing, melanoma incidence rates continue to increase about 3% annually. Melanoma is a significant public health problem that exacts a substantial financial burden. Years of potential life lost from melanoma deaths contribute to the social, economic, and human toll of this disease. However, most cases are potentially preventable. Research has clearly established that exposure to ultraviolet radiation increases melanoma risk. Unprecedented antitumor activity and evolving survival benefit from novel targeted therapies and immunotherapies are now available for patients with unresectable and/or metastatic melanoma. Still, prevention (minimizing sun exposure that may result in tanned or sunburned skin and avoiding indoor tanning) and early detection (identifying lesions before they become invasive or at an earlier stage) have significant potential to reduce melanoma incidence and melanoma-associated deaths. This article reviews the state of the science on prevention and early detection of melanoma and current areas of scientific uncertainty and ongoing debate. The US Surgeon General's Call to Action to Prevent Skin Cancer and US Preventive Services Task Force reviews on skin cancer have propelled a national discussion on melanoma prevention and screening that makes this an extraordinary and exciting time for diverse disciplines in multiple sectors-health care, government, education, business, advocacy, and community-to coordinate efforts and leverage existing knowledge to make major strides in reducing the public health burden of melanoma in the United States. © 2016 American Cancer Society, Inc.

Lancucki L.,NHS Cancer Screening Programmes | Fender M.,Association EVE | Koukari A.,Office for An Ageing Australia | Lynge E.,Copenhagen University | And 8 more authors.
Journal of Medical Screening | Year: 2010

Objectives: To analyse cervical screening coverage data by age over time in a number of developed countries throughout the world, with specific emphasis on trends for younger women and on age differentials between younger and older women. Methods: Routinely collected cervical screening statistics and survey data were collected on the proportion of women who have undergone cervical screening with cytology in seven countries in the period 1995 to 2005. Results: Data for the 25-29 age group were examined. Coverage fell in most countries, in three by more than 5 percentage points. In two countries w ile overall coverage rose in the period, the rise was not as steep in the youngest group of women. Data for each available 5-year age group for the different countries shows a similar gradient in most, regardless of the absolute level of coverage. Although the trend is not uniform in every country, it appears that generally the gap between coverage of younger women and coverage of older women increased, sometimes dramatically, between the mid-1990s and the mid-2000s. Conclusions There is a general trend in developed countries towards lower coverage in young women (25-29 years old). No common underlying cause has been clearly identified and there is a need for further studies to investigate the possible reasons for this phenomenon.

Gjelsvik A.,Brown University | Dumont D.M.,Epidemiologist | Nunn A.,Brown University | Rosen D.L.,University of North Carolina at Chapel Hill
Journal of Health Care for the Poor and Underserved | Year: 2014

Background. Incarceration of a household member has been associated with adverse outcomes for child well-being. Methods. We assessed the association between childhood exposure to the incarceration of a household member and adult health-related quality of life (HRQOL) in the 2009/2010 Behavioral Risk Factor Surveillance System controlling for age, race/ethnicity, education, and additional adverse childhood experiences. Results. Adults who lived in childhood with an incarcerated household member had higher risk of poor HRQOL compared with adults who had not (adjusted relative risk [ARR] 1.18; 95% CI 1.07, 1.31). Among Black adults the association was strongest with the physical health component of HRQOL (ARR 1.58 [95% CI 1.18, 2.12]); among White adults, the association was strongest with the mental health component of HRQOL (ARR 1.29, [95% CI 1.07-1.54]). Conclusions. Living with an incarcerated household member during childhood is associated with higher risk of poor HRQOL during adulthood, suggesting that the collateral damages of incarceration for children are long-term. © Meharry Medical College.

Garfield R.,Columbia University | Garfield R.,Karolinska Institutet | Polonsky J.,Epidemiologist
Prehospital and Disaster Medicine | Year: 2010

The Darfur region of Sudan has been an intense focus of humanitarian concern since rebellions began there early in 2003. In 2004, the US Secretary of State declared that conflict in Darfur represented genocide. Since 2003, many sample surveys and various mortality estimates for Darfur have been made. Nonetheless, confusion and controversy surrounding mortality levels and trends have continued. For this project, results were reviewed from the highest quality field surveys on mortality in Darfur conducted between 2003 and 2008. Trend analysis demonstrated a dramatic decline in mortality over time in Darfur. By 2005, mortality levels had fallen below emergency levels and have continued to decline. Deaths directly due violence have declined as a proportion of all of the deaths in Darfur. Declining mortality in Darfur was not associated with other proximate improvements in well-being, such as improved nutrition. Without large-scale, humanitarian intervention, continuing high rates of mortality due to violence likely would have occurred. If mortality had continued at the high rate documented in 2004, by January 2009, there would have been 330,000 additional deaths. With the humanitarian assistance provided through the United Nations and non-governmental organizations, these people are alive today. A focus on excess deaths among non-combatants may draw attention away from other needs, such as establishing better security, improving service delivery to the displaced, and advocating for internally displaced persons to be reached today and to re-establish their lives and livelihoods tomorrow. © World Association for Disaster and Emergency Medicine 2010.

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