Garland-Forshee R.Y.,Oregon Health Authority
Preventing Chronic Disease | Year: 2014
Introduction Research on lesbian, gay, and bisexual (LGB) individuals' health and health practices has primarily consisted of convenience studies focused on HIV/AIDS, substance use, or mental illness. We examined health-related disparities among Oregon LGB men and women compared with heterosexual men and women using data from a population-based survey. Methods Data from the 2005 through 2008 Oregon Behavioral Risk Factor Surveillance System were used to examine associations between sexual orientation and chronic conditions, health limitations, health risk factors, and protective health practices. Results Compared with heterosexual women, lesbian and bisexual women were significantly more likely to smoke cigarettes, be obese, binge drink, and have chronic conditions, and less likely to engage in protective health practices. Compared with heterosexual men, gay men were significantly less likely to be obese, more likely to binge drink, and more likely to engage in protective health practices. Compared with heterosexual men, bisexual men were significantly more likely to have a physical disability, smoke cigarettes, binge drink, and more likely to get an HIV test. Conclusions Health disparities among Oregon LGB individuals were most prominent among lesbian and bisexual women. Gay men had the most protective health practices, but they were more likely than heterosexual men to engage in risky behaviors that lead to chronic diseases later in life. Targeted public health interventions should be provided in environments that avoid stigmatizing and discriminating against LGB individuals where they live, work, learn, and socialize.
Henkle E.,Oregon Health Authority |
Winthrop K.L.,Oregon Health And Science University
Clinics in Chest Medicine | Year: 2015
Diseases and therapies that reduce cell-mediated immunity increase the risk of nontuberculous mycobacterial (NTM) disease. Extrapulmonary NTM disease, including disseminated, skin, and catheter-related disease, is more common in immunosuppressed than immunocompetent patients. Mycobacterium avium complex remains the most common cause of NTM infection, but rapid growers including Mycobacterium abscessus, Mycobacterium chelonae, and Mycobacterium fortuitum play an important role in skin and catheter-related infections. With the exception of antibiotic prophylaxis for AIDS patients, the prevention of NTM remains difficult. Management is complicated, involving restoration of immune function and removal of catheters in addition to treatment with species-specific antibiotics per current guidelines. © 2015 Elsevier Inc.
Morris D.S.,Oregon Health Authority
Preventing chronic disease | Year: 2012
Preventing youth smoking initiation is a priority for tobacco control programs, because most adult tobacco smokers become addicted during adolescence. Interventions that restrict the affordability, accessibility, and marketing of cigarettes have been effective in reducing youth cigarette smoking. However, increasing numbers of youth are smoking tobacco using hookahs. Predictors of smoking tobacco with hookahs are the same as those for smoking cigarettes. Established interventions that curb youth cigarette smoking should therefore be effective in reducing hookah use. Potential policy interventions include equalizing tobacco tax rates for all tobacco types, requiring warning labels on hookah tobacco and accurate labeling of product contents, extending the cigarette flavoring ban to hookah tobacco, enacting smoke-free air laws and removing exemptions for hookah lounges, and expanding shipping restrictions on tobacco products.
Tynan M.A.,Oregon Health Authority |
Weston T.,Health Promotion and Chronic Disease Prevention Section
Tobacco Control | Year: 2015
Background In 2009, a US$21.95 per pound disparity was created in the Federal excise tax between roll-yourown cigarette tobacco (RYO) and pipe tobacco in the USA. After this disparity was created, pipe tobacco sales increased and RYO sales declined as some manufacturers repackaged roll-your-own tobacco as pipe tobacco and retailers began to offer cigarette rolling machines for consumers to use. A Federal law was passed in 2012 limiting the availability of these machines, however, it was unclear what impact this law had on the sales of roll-your-own tobacco labelled as pipe tobacco. Methods The quantity of RYO sold as pipe tobacco each month was estimated using objective data on Federal excise taxes. Results From April 2009 through June 2013, 107 million pounds of RYO were sold as pipe tobacco, reducing Federal excise tax collections by US$2.36 billion. The amount of RYO taxed as pipe tobacco climbed steadily and then levelled off following the July 2012 Federal law. Conclusions The Federal law did not correct the market shift that occurred in pipe and RYO sales beginning in 2009. Even without access to commercial rolling machines, smokers are continuing to take advantage of the tax disparity. Without a solution, states will continue to lose revenue, and smokers who would otherwise quit will continue to have a low-cost alternative product available for purchase. Potential solutions include: (1) US Treasury Department distinguishing between RYO and pipe tobacco based on physical characteristics and (2) changing the Federal excise tax so that RYO and pipe tobacco are taxed at the same rate. © 2015, BMJ Publishing Group. All rights reserved.
Robison S.G.,Oregon Health Authority
Public Health Reports | Year: 2015
Objective. While U.S. adolescent immunization rates are available annually at national and state levels, finding pockets of need may require county or sub-county information. Immunization information systems (IISs) are one tool for assessing local immunization rates. However, the presence of IIS records dating back to early childhood and challenges in capturing mobility out of IIS areas typically leads to denominator inflation. We examined the feasibility of weighting adolescent immunization records by length of time since last report to produce more accurate county adolescent counts and immunization rates. Methods. We compared weighted and unweighted adolescent denominators from the Oregon ALERT IIS, along with county-level Census Bureau estimates, with school enrollment counts from Oregon’s annual review of seventh-grade school immunization compliance for public and private schools. Adolescent immunization rates calculated using weighted data, for the state as a whole, were also checked against comparable National Immunization Survey (NIS) rates. Results. Weighting individual records by the length of time since last activity substantially improved the fit of IIS data to county populations for adolescents. A nonlinear logarithmic (ogive) weight produced the best fit to the school count data of all examined estimates. Overall, the ogive weighted results matched NIS adolescent rates for Oregon. Conclusion. The problem of mobility-inflated counts of teenagers can be addressed by weighting individual records based on time since last immuniza- tion. Well-populated IISs can rely on their own data to produce adolescent immunization rates and find pockets of need. © 2015 Association of Schools and Programs of Public Health.