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Prevalence and Incidence01:08

Prevalence and Incidence

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In statistical epidemiology and health sciences, two essential metrics—prevalence and incidence—are fundamental for understanding disease dynamics within a population. These measures enable public health officials, epidemiologists, and researchers to assess the burden of diseases, allocate resources effectively, and design impactful public health policies and interventions.
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The actuarial approach, a statistical method originally developed for life insurance risk assessment, is widely used to calculate survival rates in clinical and population studies. This method accounts for participants lost to follow-up or those who die from causes unrelated to the study, ensuring a more accurate representation of survival probabilities.
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In practice, we rarely know the population standard deviation. In the past, when the sample size was large, this did not present a problem to statisticians. They used the sample standard deviation s as an estimate for σ and proceeded as before to calculate a confidence interval with close enough results. However, statisticians ran into problems when the sample size was small. A small sample size caused inaccuracies in the confidence interval.
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Estimating Health Condition Prevalence Among a Statewide Cohort with Recent Homelessness or Incarceration.

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Individuals experiencing homelessness or incarceration face significant health disparities, with higher rates of physical, mental, and substance use conditions. New payment models are needed to address this complex health and social needs.

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Area of Science:

  • Public Health
  • Health Services Research
  • Epidemiology

Background:

  • Public health data systems often lack timely information on individuals with severe disadvantages like homelessness or incarceration.
  • Accurate population-level data is crucial for understanding and addressing the health needs of vulnerable groups.

Purpose of the Study:

  • To estimate the prevalence of physical, mental, and substance use conditions in a statewide cohort including individuals with recent homelessness or incarceration.
  • To identify health disparities within this population.

Main Methods:

  • An observational cohort analysis using linked statewide electronic health record (EHR) and administrative data from the Minnesota Electronic Health Record Consortium (MNEHRC).
  • Included adults with encounters at MNEHRC-participating health systems between 2021-2023.
  • Calculated age- and sex-adjusted prevalence rates for 22 health conditions, stratified by recent homelessness, jail incarceration, or prison incarceration.

Main Results:

  • The cohort comprised over 4.3 million individuals, including over 20,000 with recent homelessness and over 50,000 with recent jail incarceration.
  • Individuals with recent homelessness or incarceration showed higher prevalence of asthma, COPD, and substance use disorders (including opioid use disorder) compared to the general population.
  • Those experiencing recent homelessness had the highest rates of mental health disorders; recently homeless Black individuals exhibited the highest rates of psychotic disorder diagnoses.

Conclusions:

  • Significant health disparities exist among individuals with recent homelessness or incarceration, particularly concerning mental health and substance use.
  • There is a need for healthcare payment and delivery models that address the complex co-occurring health and social needs of these populations.