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1. Access Is Necessary but Not Sufficient: Factors Influencing Delay and Avoidance of Health Care Services

   https://doi.org/10.1177/2381468318760298  

   Smith, Kyle T.; Monti, Denise; Mir, Nageen; Peters, Ellen; Tipirneni, Renuka; Politi, Mary C. (January 2018, MDM Policy & Practice)

   null (Ed.)

   Background: Despite recently expanded access to health insurance, consumers still face barriers to using their coverage to obtain needed health care. Objective: To examine the characteristics of those who delay or avoid health care due to costs. Methods: Participants were recruited via Amazon MTurk and completed a survey assessing demographic characteristics, financial toxicity, health care minimizer-maximizer tendencies, health insurance knowledge, numeracy, delaying/avoiding any care, and delaying/avoiding six common health care services (three preventive and three nonpreventive services). Validated measures were used when available. Delay/avoidance behaviors were categorized into delaying/avoiding any care, preventive care, and nonpreventive care. Logistic regression models examined 1) financial toxicity, 2) minimizer-maximizer tendencies, 3) numeracy, 4) health insurance knowledge, and 5) knowledge of preventive care coverage separately on three forms of delay/avoidance behaviors, controlling for chronic conditions, insurance status, and/or income where appropriate. Results: Of 518 respondents, 470 did not fail attention-check questions and were used in analyses. Forty-five percent of respondents reported delaying/avoiding care due to cost. Multivariable analyses found that financial toxicity was related to delaying/avoiding any care (odds ratio [OR] = 0.884, P < 0.001), preventive care (OR = 0.906, P < 0.001), and nonpreventive care (OR = 0.901, P < 0.001). A tendency to minimize seeking health care (OR = 0.734, P < 0.001) and lower subjective numeracy (OR = 0.794, P = 0.023) were related to delaying/avoiding any care. General health insurance knowledge (OR = 0.989, P = 0.023) and knowledge of preventive care coverage (OR = 0.422, P < 0.001) were related to delaying/avoiding preventive care. Conclusions: Many people delay or avoid health care due to costs, even when insured. Results suggest that there may be different reasons individuals delay or avoid preventive and nonpreventive care. Findings may inform interventions to educate consumers and support discussions about health care costs to facilitate appropriate health care utilization. 

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2. The association between the problem list and chronic pain management

   https://doi.org/10.1007/s44250-022-00016-4  

   Rylee, Tina L; Copenhaver, David; Drake, Christiana; Joseph, Jill (December 2023, Discover Health Systems)

   Abstract BackgroundRoughly a quarter of the US population suffers from moderate to severe chronic pain for at least six months in any given year. The complexity of managing chronic pain has encouraged providers to use innovative methods to address it. Research has shown that problem lists are potential tools that support the care of patients with diabetes and chronic kidney disease. ObjectivesTo examine the extent to which the inclusion of chronic pain in a problem list is associated with follow-up specialty pain care. MethodsThe association between chronic pain documentation on the problem list and specialty pain care was investigated in this retrospective cohort study using 4531 patient records. ResultsChronic pain documentation in the problem list was associated with higher odds of receiving specialty pain care. The most common diagnosis was chronic pain (69.7%). A migraine diagnosis was associated with decreased odds of receiving specialty care, and chronic pain syndrome was associated with increased odds of receiving specialty care compared with the other chronic pain groups. ConclusionDocumenting chronic pain on the problem list was associated with a higher likelihood of patients receiving specialty pain care. 

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3. The Social Division of Care Work Time Over Half a Century

   https://doi.org/10.1215/00703370-11879571  

   Gonalons-Pons, Pilar; Ansari-Thomas, Zohra (April 2025, Demography)

   Abstract This study introduces a demographic framework to analyze the social division of care work time, defined as the sum of paid and unpaid care work time provided to children and adults in a population. Combining data from the American Heritage Time Use Survey (AHTUS) and the Current Population Survey Annual Social and Economic Supplement (CPS-ASEC), we focus on routine interactive care and analyze how the volume and social division of this care work has evolved in the United States over a half century (1965–2018). Results reveal relative stability in the division of care work across domains (paid vs. unpaid and child vs. adult) but substantial change across social groups (by gender and race). The share of total care work provided by paid caregivers remained stable, challenging expectations about defamilialization, whereas the share of total care work going to adults increased over time. Gender and race inequality in total care work time experienced notable declines. Analyses show that these changes are driven by men's increased involvement in unpaid childcare and non-White women's declined involvement in some paid care jobs, respectively. Our framework provides new tools to examine how demographic, social, and economic changes impact the social organization of care work time. 

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4. Skin Deep

   https://doi.org/10.70312/QVNS  

   Nading, Alex (June 2025, Limn)

   What if skin care is really planetary care? 

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5. Life history, mating dynamics and the origin of parental care

   https://doi.org/10.1111/jeb.13959  

   Azad, Tamjeed; Alonzo, Suzanne H.; Bonsall, Michael B.; Klug, Hope (November 2021, Journal of Evolutionary Biology)

   Abstract Parental care, mating dynamics and life history co‐evolve. Understanding the diversity of reproductive patterns found in nature is a major focus of evolutionary ecology research. Previous research suggests that the origin of parental care of eggs will be favoured when egg and adult death rates and juvenile survival are relatively high. However, the previous research that explored the link between care and life history did not account for among‐species variation in mating dynamics. As mating dynamics are generally expected to influence care, we explore, theoretically, the life‐history conditions (stage‐specific rates of maturation and survival) that favour parental care across three mating scenarios: reproductive rate (1) is unaffected by males (assuming that some males are present), (2) increases as male abundance increases or (3) decreases as male abundance increases. Across scenarios, all forms of care were most strongly favoured when egg and adult death rates, juvenile survival and female egg maturation rates were relatively high. When reproductive rate was unaffected by male abundance or increased as male abundance increased, as we might expect in systems in which females are mate‐limited, all forms of care were most strongly favoured when male egg maturation rate (i.e. the rate at which male eggs develop, mature and hatch) was moderate or high. When greater male abundance inhibited reproduction, which might occur in systems with intense male–male competition, all forms of care were most strongly favoured when male egg maturation rate was low‐to‐moderate. These results suggest that life history affects the evolution of parental care, and sex‐specific life history can interact with mating dynamics to influence the origin of care. 

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