Research Roundup: Vaccines For Children Program; Employer Health Plan Differences

Health Affairs: Since The Start Of The Vaccines For Children Program, Uptake Has Increased, And Most Disparities Have Decreased
The Vaccines for Children program is a US government intervention aimed at increasing vaccination uptake by removing financial barriers that may prevent US children from accessing vaccinations. This study examined the impact that this intervention had on race and ethnicity–related and income-related disparities for diphtheria-tetanus-acellular pertussis, measles-mumps-rubella, and polio vaccinations, using data from the National Immunization Survey, 1995–2013. Vaccination rates increased across all races, ethnicities, and income groups following the introduction of the Vaccines for Children program. Disparities among race and ethnic groups narrowed considerably over time since the introduction of the vaccine program, although income-related disparities changed at different rates within racial and ethnic groups and in some cases increased. (Walsh, Doherty and O’Neill, 2/8)

Health Affairs: Exploring The Impact Of The US Measles Outbreak On Parental Awareness Of And Support For Vaccination
Using two national surveys of parents of children ages five and younger, collected immediately prior to and in the weeks following the 2014–15 US measles outbreak, this study examined the awareness of this vaccine-preventable disease outbreak among parents and whether awareness of the outbreak affected their beliefs about childhood vaccination, confidence, and intentions. The study found that while most parents were aware of the outbreak, many were not, and the level of familiarity mattered, particularly on measures of confidence in vaccines and support for mandates requiring childhood vaccination. Increases in vaccine-related concerns were found as well, indicating that disease outbreaks foster not just awareness of vaccines and their potential to prevent disease but a range of parental responses. (Cacciatore, Nowak and Evans, 2/8)

The Kaiser Family Foundation: A Comparison Of The Availability And Cost Of Coverage For Workers In Small Firms And Large Firms: Update From The 2015 Employer Health Benefits Survey
Accessibility, affordability, and coverage of employer-sponsored health insurance vary greatly for small and large firms. The smallest firms are less than half as likely to offer coverage to their employees as are large firms. While family premiums are less expensive at small firms, covered workers face higher premium contributions and higher cost sharing in the form of higher deductibles. The lower offer rates combined with greater cost-sharing responsibilities for workers in small firms may limit the ability of small firms to attract and retain employees. ... While the[Affordable Care Act] has and will continue to meaningfully impact the availability and scope of insurance coverage, many of the contributing factors to the differences in cost sharing and premiums between small and large employer health benefits are likely to remain. (Long, Rae and Claxton, 2/5)

The Kaiser Family Foundation: Health Care Spending Among Low-Income Households With And Without Medicaid
To gain a better understanding of the impact of insurance on the health care spending and budgets of low-income households, we use data from the 2014 Consumer Expenditure Survey to compare health care spending among low-income households (those with income below 138% FPL or $27,310 for a family of three in 2014) covered by Medicaid to those households not covered by Medicaid. ... Those households with private insurance dedicate a substantial share of their modest budgets to premium and out-of-pocket health care costs—nearly one in every ten dollars (8%). Those households in which all members are covered by Medicaid spend about a tenth of what their counterparts with private coverage spend on health care costs, and devote a much smaller share of their total household budget to health-related expenses. (Majerol, Tolbert and Damico, 2/4)

Morbidity and Mortality Weekly Report: Disparities In Consistent Retention In HIV Care — 11 States And The District Of Columbia, 2011–2013
Among persons with HIV infection diagnosed in 2010 who were alive in December 2013, 38% of blacks with HIV infection were consistently retained in care during 2011–2013, compared with 50% of Hispanics/Latinos (Hispanics) and 49% of non-Hispanic whites (whites). Differences in consistent retention in care by race/ethnicity persisted when groups were stratified by sex or transmission category. Among blacks, 35% of males were consistently retained in care compared with 44% of females. Differences in HIV care retention by race/ethnicity were established during the first year after diagnosis. Efforts to establish early HIV care among blacks are needed to mitigate racial/ethnic disparities in HIV outcomes over time. (Dasgupta, Oster, Li and Hall, 2/5)

Here is a selection of news coverage of other recent research:

Medscape: Therapy, Antidepressants Similarly Effective For Depression
Cognitive behavioral therapy (CBT) is as effective for treating depression as antidepressants, and given its relative lack of potential harms, should be strongly considered as the first-line treatment, according to a new guideline issued by the American College of Physicians (ACP). The guideline is based on a systematic review of randomized controlled trials from 1990 through September 2015 comparing the benefits of second-generation antidepressants (SGAs) and nonpharmacologic interventions such as psychotherapies, complementary and alternative medicines (including acupuncture and St John's wort [Hypericum perforatum]), and exercise. The guideline was published online February 9 in the Annals of Internal Medicine. (Frellick, 2/9)

MedPage Today: Interventions Alter Antibiotic Script Practices
Having to justify an antibiotics prescription for acute respiratory tract infections, or being compared with their peers for number of scripts written, lowered rates of inappropriate antibiotic prescribing practices for up to 18 months among primary care physicians, researchers reported. (Wickline Wallen, 2/9)

Medscape: Women Underrepresented In Medical Leadership Roles
The numbers of men and women in medical school and medical residency programs are approximately equal, but the proportion of women in leadership positions in nine major clinical specialties is much lower, according to a new study. (Brown, 2/8)

Reuters: Drop In Prostate Cancer Screening Reveals Split Among Doctors
After U.S. guidelines advised against routine tests, declines in prostate cancer screening have been sharper among primary care doctors than urologists, according to a new study that suggests the medical community remains divided over the best way to look for these tumors. (Rapaport, 2/8)

Reuters: Emotional Distress Tied To Weapon Use For Teens
Even though a wide range of social and economic factors may influence whether teens get involved with weapons, two things appear to increase the odds for white, black and Hispanic youth alike – emotional distress and substance abuse – a recent U.S. study suggests. Earlier involvement with weapons is also tied to higher future odds of carrying or using a gun or knife for youth in all three groups, the study found. (Rapaport, 2/5)