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Background: One of the goals of the Multi-site Clinical Assessment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (MCAM) study was to evaluate whether clinicians experienced in diagnosing and caring for patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) recognized the same clinical entity. Methods: We enrolled participants from seven specialty clinics in the United States. We used baseline data (n = 465) on standardized questions measuring general clinical characteristics, functional impairment, post-exertional malaise, fatigue, sleep, neurocognitive/autonomic symptoms, pain, and other symptoms to evaluate whether patient characteristics differed by clinic. Results: We found few statistically significant and no clinically significant differences between clinics in their patients' standardized measures of ME/CFS symptoms and function. Strikingly, patients in each clinic sample and overall showed a wide distribution in all scores and measures. Conclusions: Illness heterogeneity may be an inherent feature of ME/CFS. Presenting research data in scatter plots or histograms will help clarify the challenge. Relying on case–control study designs without subgrouping or stratification of ME/CFS illness characteristics may limit the reproducibility of research findings and could obscure underlying mechanisms. [ABSTRACT FROM AUTHOR]

Objectives: Surveillance of cigarette smoking behavior provides evidence for evaluating the impact of current tobacco control measures. We examined temporal changes and demographic differences in the incidence and mean age of starting to smoke cigarettes regularly in the United States. Methods: We conducted retrospective birth-cohort and cross-sectional analyses using self-reported data from the 1997-2018 National Health Interview Survey to evaluate trends and demographic differences in the incidence and mean age of starting to smoke cigarettes regularly among participants aged 18-84 years. We estimated the incidence and mean age of starting to smoke cigarettes regularly by using Poisson and linear regression. Results: Among adults born during 1950-1999, the incidence of starting to smoke cigarettes regularly before age 35 years decreased by 18.8% (95% CI, 17.0%-20.7%) per 10 years, with a peak incidence at age about age 18 years. Male, non-Hispanic White, and US-born people had a higher incidence of starting to smoke cigarettes regularly than female, other racial and ethnic, and non–US-born people, respectively (P <.001 for all). From 1997 to 2018, the mean age of starting to smoke cigarettes regularly decreased by 0.4% (95% CI, 0.2%-0.6%) per 10 years among adults who ever smoked. Conclusion: The incidence of starting to smoke cigarettes regularly decreased dramatically at all ages during the study period, which suggests a positive impact of current tobacco control measures. For evaluating trends in starting to smoke cigarettes regularly, incidence can be a more sensitive indicator of temporal change than mean age. Differences in smoking incidence by demographic subgroup suggest that additional opportunities exist to further reduce the incidence of starting to smoke cigarettes regularly. [ABSTRACT FROM AUTHOR]

In 2019, Hispanics in the US had a life expectancy advantage of 3.0 years and 7.1 years over non-Hispanic Whites and non-Hispanic Blacks, respectively, despite having real-household income values 26 percentage points lower than Non-Hispanic White households. Hispanics appear to have equal or even better health outcomes relative to non-Hispanic Whites across various health measures. This is known as the Hispanic health paradox. This paper underscores the importance of disaggregating Hispanics by ancestry and age profile when discussing the paradox across key health outcomes. It also provides an overview of the leading explanations, such as the salmon bias and the healthy immigrant effect. Further, it highlights the role of healthcare access and usage in this discussion. Ignoring these sources of bias have important consequences for how morbidity and mortality among Hispanics are measured within widely used national datasets. [ABSTRACT FROM AUTHOR]

Purpose of Review: Peripheral artery disease (PAD) is a chronic, obstructive disease of the peripheral vasculature which is a coronary heart disease risk equivalent. African Americans (AA) are at the highest risk for developing this disease at every age group. The purpose of this review is to shed light on the risk factors for PAD and their implications for disease manifestation in AA, and to highlight ways to combat these known racial disparities in order to achieve cardiovascular health equity in this population. Recent Findings: Even after controlling for differences in the prevalence of known cardiovascular risk factors, AA are still significantly more likely to have PAD. In part, due to a disproportionate amount of cardiovascular risk factors and detrimental socioeconomic factors, AA with PAD have a worse prognosis and more unfavorable outcomes than other ethnic groups with PAD. AA with PAD are more likely to have limb loss with amputation and less likely to receive revascularization leading to limb salvage. Summary: Advanced age, cigarette smoking, diabetes, hypertension, hyperlipidemia, chronic kidney disease, and poor socioeconomic status or education level have all been associated with increased risk of PAD. AA have a higher likelihood of having many, but not all, of these conditions. Nevertheless, increased cardiovascular risk for PAD combined with a relative lack of awareness about the disease in the AA community leads to poor health outcomes. Targeted interventions that partner healthcare access and delivery in community-based, non-traditional health care settings as well as the traditional clinics and hospitals may prove to be a more successful means of outreach in this high-risk population. [ABSTRACT FROM AUTHOR]