By Dr. Chinta SidharthanJul 9 2023Reviewed by Benedette Cuffari, M.Sc. In a recent study published in BMC Medicine, researchers discuss a 2023 study by Tian et al., which analyzed the J-shaped association between health and the consumption of alcohol, and address important factors to consider when interpreting this association.
This data was analyzed to identify an association between light to moderate levels of alcohol consumption, as well as cause-specific and all-cause mortality among the United States population. From this data, the association formed a J-shaped curve, where low levels of alcohol consumption provide certain health benefits; however, after a certain threshold, health risks increase rapidly.
In the present study, researchers discuss the various methodological issues to consider while interpreting this J-shaped association between alcohol consumption and disease or mortality risks. While interpreting the J-shaped association between alcohol consumption and health risks, one must also consider reverse causation. Individuals who abstain from drinking might already be in poor health, while those who are active and health conscious might drink in moderation while also following other practices that provide health benefits.
The theoretical minimal exposure levels of alcohol vary across individuals of different ages and regions, thus posing the problem of defining optimal alcohol consumption levels. The beneficial effects of alcohol consumption might also vary with factors such as age, as recommended alcohol consumption levels for younger individuals are close to zero.
Given that it is difficult to distinguish between the effects of various confounding factors and biases while determining the association between alcohol consumption and health, a Mendelian randomization approach was used to evaluate these correlations.
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Evaluating the accessibility and value of U.S. ambulatory care among Medicaid expansion states and non-expansion states, 2012–2015 - BMC Health Services ResearchBackground While the Affordable Care Act’s Medicaid expansion improved healthcare coverage and access for millions of uninsured Americans, less is known about its effects on the overall accessibility and quality of care across all payers. Rapid volume increases of newly enrolled Medicaid patients might have unintentionally strained accessibility or quality of care. We assessed changes in physician office visits and high- and low-value care associated with Medicaid expansion across all payers. Methods Prespecified, quasi-experimental, difference-in-differences analysis pre and post Medicaid expansion (2012–2015) in 8 states that did and 5 that did not choose to expand Medicaid. Physician office visits sampled from the National Ambulatory Medical Care Survey, standardized with U.S. Census population estimates. Outcomes included visit rates per state population and rates of high or low-value service composites of 10 high-value measures and 7 low-value care measures respectively, stratified by year and insurance. Results We identified approximately 143 million adults utilizing 1.9 billion visits (mean age 56; 60% female) during 2012–2015. Medicaid visits increased in expansion states post-expansion compared to non-expansion states by 16.2 per 100 adults (p = 0.031 95% CI 1.5–31.0). New Medicaid visits increased by 3.1 per 100 adults (95% CI 0.9–5.3, p = 0.007). No changes were observed in Medicare or commercially-insured visit rates. High or low-value care did not change for any insurance type, except high-value care during new Medicaid visits, which increased by 4.3 services per 100 adults (95% CI 1.1–7.5, p = 0.009). Conclusions Following Medicaid expansion, the U.S. healthcare system increased access to care and use of high-value services for millions of Medicaid enrollees, without observable reductions in access or quality for those enrolled in other insurance types. Provision of low-value care continued at similar rates post-expansion, informing future federal poli
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Package holiday boom of 1960s 'fuels record high in skin cancer cases'Cancer Research UK says 17,500 people are now diagnosed with melanoma, the most serious type of the disease, in the UK every year.
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