Bian Liu

• PhD
• Associate Professor at Icahn School of Medicine at Mount Sinai

We examined the associations between physical activity (PA)—measured through self-reported walking and vigorous activities—and pain occurrence (self-reported bothersome pain or frequent pain medication use), and persistent pain (pain occurring for two consecutive years). This analysis used a large, nationally representative sample of 2279 older adu...

[This corrects the article DOI: 10.2196/53330.].

Objectives. To identify youth subgroups based on lifestyle, BMI, and sociodemographic characteristics and examine the association between group membership and prediabetes/diabetes (preDM/DM) status. Methods. We analyzed data from 1,278 adolescents (ages 12-17) from the 2011-2018 National Health and Nutrition Examination Surveys. PreDM/DM was define...

Purpose To investigate changes in breast cancer incidence rates associated with Medicaid expansion in California. Methods We extracted yearly census tract-level population counts and cases of breast cancer diagnosed among women aged between 20 and 64 years in California during years 2010–2017. Census tracts were classified into low, medium and hig...

Background: The prevalence of Type 2 diabetes (DM) and prediabetes (preDM) has been increasing among youth in recent decades in the United States, prompting an urgent need for understanding and identifying their associated risk factors. Such efforts, however, have been hindered by the lack of easily accessible youth preDM/DM data. Objective: We...

Background Secondhand tobacco smoke exposure (TSE) increases susceptibility to respiratory diseases, but the mechanisms of action are poorly understood. Objective To study the effect of TSE in the nasal microbiome of children, and to evaluate whether such effect is dose-dependent with measured levels of cotinine in saliva and urine. Methods The s...

Background Lung function throughout adulthood predicts morbidity and mortality even among adults without chronic respiratory disease. Diet quality may represent a modifiable risk factor for lung function impairment later in life. We investigated associations between nutritionally-rich plant-centered diet and lung function across early and middle ad...

Background Young adult cancer survivors face medical financial hardships that may lead to delaying or forgoing medical care. This study describes the medical financial difficulties young adult cancer survivors in the United States experience in the post–Patient Protection and Affordable Care Act period. Method We identified 1009 cancer survivors a...

Certain dietary and physical activity (PA) behaviors may differentially predispose male and female adolescents to obesity and diabetes; however, sex differences in dietary and PA behaviors and in factors that impact these behaviors (e.g., self-efficacy, social support) in this population remain unknown. Using data from a community-based adolescent...

Background Medicare-funded Home Health Care (HHC) delivers skilled nursing, therapy, and related services through visits to the patient’s home. Nearly one-third (31%) of HHC patients have diagnosed dementia, but little is currently known regarding how HHC utilization and care delivery differs for Persons Living with Dementia (PLwD). Methods We dre...

We assessed the spatiotemporal patterns of hospitalization with comorbid cancer and dementia. Using the 2013–2018 inpatient claims data for Medicare fee-for-service (FFS) beneficiaries, we calculated hospitalization rates by dividing the total admissions from individuals with the co-presence of a major cancer (breast, prostate, lung, and colorectal...

Background Exposure misclassification based solely on the address at cancer diagnosis has been widely recognized though not commonly assessed. Methods We linked 1,015 mesothelioma cases diagnosed during 2011–2015 from the New York State Cancer Registry to inpatient claims and LexisNexis administrative data and constructed residential histories. Pe...

This cross-sectional study assesses county-level differences in home-based medical care and home health care by social vulnerability and metropolitan status.

Background Although increasing physical activity (PA) has been suggested to prevent and manage cognitive decline and dementia, its economic impact on healthcare systems and society is largely unknown. This study aimed to summarize evidence on the cost-effectiveness of PA interventions to prevent and manage cognitive decline and dementia. Methods E...

Background: Although increasing physical activity (PA) has been suggested to prevent and manage cognitive decline and dementia, its economic impact on healthcare systems and society is largely unknown. This study aimed to summarize evidence on the cost‑effectiveness of PA interventions to prevent and manage cognitive decline and dementia. Methods:...

The prevalence of type 2 diabetes mellitus (DM) and prediabetes (preDM) is rapidly increasing among youth, posing significant health and economic consequences. To address this growing concern, we created the most comprehensive youth-focused diabetes dataset to date derived from National Health and Nutrition Examination Survey (NHANES) data from 199...

Introduction: With increasing tobacco product varieties, understanding tobacco use (TU) profiles and their associations with tobacco dependence (TD) has also become increasingly challenging. Aims and methods: We aimed to identify TU profiles and their associations with TD over time, and to identify subgroups with high risk of TD. We included 346...

Background Injury is a significant health burden for children and young adult and may be an increasing concern in a warming climate. Research reveals many impacts to children’s health associated with hot weather and heatwave events, including a growing literature on the association between high ambient temperature and injury, which may vary by inte...

Introduction: Hospital staff discussing smoking with children and their families can impact tobacco control, which is crucial in reducing the harmful effects of tobacco smoke exposure. Our study aims to assess staff comfort level in discussing smoking with patients or their families, and coworkers, after the implementation of a hospital-wide tobac...

Background Lung function throughout adulthood predicts morbidity and mortality even among adults without chronic respiratory disease. Diet quality may represent a modifiable risk factor for lung function impairment later in life. We investigated associations between nutritionally-rich plant-centered diet and lung function decline across early and m...

Aims: We examine the association between high ambient temperature and acute mental health-related healthcare encounters in New York City for children, adolescents and young adults. Methods: This case-crossover study included emergency department (ED) visits and hospital encounters with a primary diagnosis of any mental health disorder during war...

Background: Homebound status is a final common pathway for people with a variety of diseases and conditions. There are 7 million homebound older adults in the United States. Despite concerns regarding their high healthcare costs and utilization and limited access to care, the unique subsets within the homebound population are understudied. Better...

We assessed the association between physical activity (PA) patterns and cognitive health. Using the 2011–2014 National Health and Nutrition Examination Survey data among older adults (≥60 years), we defined scoring below the 25th percentile in the average z-scores from 3 cognitive tests as having low cognitive performance. We used latent class anal...

Objectives: Previous studies showed that older adults with fair or poor self-rated health (SRH) were more likely to experience delayed care during the COVID-19 pandemic. We aim to understand delayed care patterns by SRH during the COVID-19 pandemic among US older adults. Methods: Using a nationally representative sample of older adults (≥ 70 yea...

Objectives Home-based medical care (HBMC) delivers physician or advanced practice provider–led medical services for patients in private residences and domiciliary settings (eg, assisted living facilities, group/boarding homes). We aimed to examine the time trends in HBMC utilization by care settings. Design Analyses of HBMC utilization at the nati...

Background Although racial and ethnic minorities disproportionately use some hospitals, hospital-based racial and ethnic composition relative to geographic region and its association with quality indicators has not been systematically analyzed. Methods We used four race and ethnicity categories: non-Hispanic white (NHW), non-Hispanic black (NHB),...

Objectives This study aimed to summarize evidence on the economic outcomes of prenatal and postpartum interventions for the management of gestational diabetes mellitus and hypertensive disorders of pregnancy (HDP), assess the quality of each study, and identify research gaps that may inform future research. Methods Electronic databases including P...

Outcomes 1. Describe the association between telemedicine utilization and patient characteristics 2. Propose ways to increase telemedicine utilization Importance Given a shortage of specialty palliative care clinicians and geographic variation in availability, telemedicine has been proposed as one way to improve access to palliative care services...

Outcomes 1. Describe disparities in telemedicine utilization for patients with cancer in the ambulatory palliative care setting 2. Identify strategies to address disparities in telemedicine access for patients with cancer in the ambulatory palliative care setting Original Research Background Given a shortage of specialty palliative care clinicians...

Outcomes 1. Describe how providers who participated in the same goals-of-care discussion view elements of that discussion 2. Describe potential implications of provider concordance or lack of concordance during difficult conversations and potential relationship to communication quality Original Research Background Little is known about concordance...

Socioeconomic indexes are widely used in public health to facilitate neighborhood-scale analyses. Although they are calculated with high levels of precision, they are rarely reported with accompanying measures of uncertainty (e.g., 90% confidence intervals). Here we use the variance replicate tables that accompany the United States Census Bureau's...

Preventive measures, health behaviors, environmental exposures, and sociodemographic characteristics affect individual-level cancer risks. It is unclear how they influence neighborhood-level cancer risks. We developed a large-scale neighborhood health dataset for 72,337 census tracts in the United States by combining data from three publicly availa...

Background In the United States, firearms now rank as the second-leading cause of death among children and adolescents, trailing only motor-vehicle accidents. Prior reports have calculated that 87% of all children aged 0-14 killed by firearms in high-income countries are US children. This study sets out to determine how rates of gun ownership, surr...

Rationale: Protective effects of a high quality diet on respiratory health, particularly among youths exposed to environmental tobacco smoke (ETS), are unknown. Objectives: To assess if a higher quality diet is associated with improved respiratory symptoms and lung function among adolescents, and if these associations are modified by ETS exposur...

The Cook Partisan Voting Index (PVI) determines how strongly a state leans toward the Democratic or Republican Party in US presidential elections compared to the nation. We set out to determine the correlation between childhood health outcomes and state-level partisanship using PVI. Sixteen measures of childhood health were obtained from several US...

COVID-19 has highlighted increasing reliance on information and communication technology (ICT) and challenges in access and use. ICT access also provides resources that benefit users’ mental health. Our study describes changes in the use of ICT before and during the COVID-19 pandemic among cancer patients with and without dementia. We identified 19...

Background: While literature on the overall health burden of high temperature exposures on children continues to grow, little is known about whether children with chronic diseases are particularly vulnerable to the adverse health impacts of extreme heat. Methods: We used New York Statewide Planning and Research Cooperative System (SPARCS) data on c...

Objectives: Once the COVID-19 pandemic arrived in New York City (NYC), stay-at-home orders led to more time spent indoors, potentially increasing exposure to secondhand marijuana and tobacco smoke via incursions from common areas or neighbors. The objective of this study was to characterize housing-based disparities in marijuana and tobacco incurs...

Background Little is known about how unpaid family caregivers may already be engaged in caregiving activities prior to their care recipient's cancer diagnosis. We examined pre-cancer diagnosis caregiving patterns and their association with caregiving strain. Methods We conducted a population-based analysis of 2011–2017 National Health and Aging Tr...

Background: Given a shortage of specialty palliative care clinicians and geographic variation in availability, telemedicine has been proposed as one way to improve access to palliative care services for patients with cancer. However, the enduring digital divide raises questions about whether unequal access will exacerbate healthcare disparities....

Background: Malignant pleural mesothelioma (MPM) is a rare and aggressive malignancy with a dismal prognosis. We aimed to identify predictors of survival among male and female MPM patients in the United States. Methods: We identified MPM cases reported by 18 cancer registries in the Surveillance, Epidemiology, and End Results Program (2000-2017)...

Introduction: Understanding trends and associated factors in internet-based health care communication (IBHC) among cancer survivors is important for meeting patient needs because their reliance on telehealth is growing. We aimed to examine IBHC use among cancer survivors in the US. Methods: We identified adult cancer survivors aged 18 to 64 (n =...

Background Cancer and dementia have often been studied in isolation. We aimed to examine the spatiotemporal trend of inpatient admissions with both cancer and dementia diagnoses. Methods Using state-wide inpatient claims data, we identified all hospital admissions for patients aged ≥50 years with both cancer and dementia diagnoses in New York Stat...

Background: The COVID-19 pandemic has highlighted the importance of using information and communication technology (ICT) to address daily and healthcare needs. The barriers for older adults in the U.S. to learn a new technology to go online during the pandemic remain to be studied. Methods: Using data from the 2019-2020 National Health and Aging...

Background Emerging literature has documented heat-related impacts on child health, yet few studies have evaluated the effects of heat among children of different age groups and comparing emergency department (ED) and hospitalisation risks. Objectives To examine the differing associations between high ambient temperatures and risk of ED visits and...

Prediabetes and diabetes mellitus (preDM/DM) have become alarmingly prevalent among youth in recent years. However, simple questionnaire-based screening tools to reliably assess diabetes risk are only available for adults, not youth. As a first step in developing such a tool, we used a large-scale dataset from the National Health and Nutritional Ex...

Using insurance as a single indicator of healthcare access in examining the association between race/ethnicity and healthcare encounter-based interventions for smoking may not be adequate. In this study, we assessed the role of healthcare access using multifactorial measures in accounting for racial/ethnic disparities in the receipt of provider-pat...

Objective: We aimed to examine the influence of increasing levels of discussion (both asked and advised, either asked or advised but not both, and neither asked nor advised) on quit behavior. Methods: We included 4133 adult current smokers from the 2015 National Health Interview Survey. The primary outcomes were quit intent and quit attempt, and...

Hurricane Harvey facilitated exposure to various toxic substances and floodwater throughout the greater Houston metropolitan area. Although disparities exist in this exposure and vulnerable populations can bear a disproportionate impact, no research has integrated disparities in exposure to toxic incidents following Hurricane Harvey. The objective...

There is growing evidence on the effect of face mask use in controlling the spread of COVID-19. However, few studies have examined the effect of local face mask policies on the pandemic. In this study, we developed a dynamic compartmental model of COVID-19 transmission in New York City (NYC), which was the epicenter of the COVID-19 pandemic in the...

The human papillomavirus (HPV) vaccine protects against cancers caused by HPV. The study objective was to examine the effect of the Affordable Care Act (ACA) dependent child coverage provision on HPV vaccination initiation, HPV vaccine completion, HPV infection, and health insurance coverage among young women. Using cross-sectional data from the Na...

Acute hypoxemic respiratory failure is the major complication of coronavirus disease 2019, yet optimal respiratory support strategies are uncertain. We aimed to describe outcomes with high-flow oxygen delivered through nasal cannula and noninvasive positive pressure ventilation in coronavirus disease 2019 acute hypoxemic respiratory failure and ide...

socioeconomic indexes that capture information about wealth, education, employment, and housing are in wide use in public health. Here we compare the widely used Area Deprivation Index (ADI) to the Yost index. Though they are derived largely from the same data, there are substantial differences between the two. Examination of the geographic areas w...

Introduction: Statistical methods to assess the impact of an intervention are increasingly used in clinical research settings. However, a comprehensive review of the methods geared toward practitioners is not yet available. Methods and materials: We provide a comprehensive review of three methods to assess the impact of an intervention: differen...

Introduction: The Cook Partisan Voting Index (PVI) determines how strongly a state leans toward the Democratic or Republican Party in presidential elections compared to the nation. We set out to determine the correlation between childhood health outcomes and state-level partisanship using PVI. Materials and Methods: 16 measures of childhood health...

Dementia and cancer occur commonly in older adults. Yet, little is known about the effect of dementia on cancer treatment and outcomes in patients diagnosed with cancer, and no guidelines exist. We performed a mixed studies review to assess the current knowledge and gaps on the impact of dementia on cancer treatment decision-making, cancer treatmen...

Background On April 17, 2020, the State of New York (NY) implemented an Executive Order that requires all people in NY to wear a face mask or covering in public settings where social distancing cannot be maintained. Although the Centers for Disease Control and Prevention recommended face mask use by the general public, there is a lack of evidence o...

BACKGROUND While public knowledge on the prevalence and adverse health effects of secondhand tobacco smoke (SHTS) exposure is well-established, information on the prevalence of secondhand marijuana smoke (SHMS) exposure is limited. METHODS A convenience sample of parents of children attending one of four pediatric practices in the Mount Sinai Heal...

We examined 4388 children from the 2003 to 2006 National Health and Nutrition Examination Survey and used survey-design-adjusted multivariable logistic regression to evaluate associations between dietary advanced glycation end product (AGE) and meat consumption frequencies and respiratory symptoms. Higher AGE intake was significantly associated wit...

Background: Biochemical verification of self-reported smoking status is not common among the population eligible for lung cancer screening (LCS). Methods: We used urinary NNAL (4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol and its glucuronides) and serum cotinine as the gold standard to determine the validity and reliability of self-reported smokin...

Background Stroke is a major cardiovascular disease that causes significant health and economic burden in the United States. Neighborhood community‐based interventions have been shown to be both effective and cost‐effective in preventing cardiovascular disease. There is a dearth of robust studies identifying the key determinants of cardiovascular d...

Background Stroke is a chronic cardiovascular disease that puts major stresses on U.S. health and economy. The prevalence of stroke exhibits a strong geographical pattern at the state-level, where a cluster of southern states with a substantially higher prevalence of stroke has been called the stroke belt of the nation. Despite this recognition, th...

Objectives: Given the high needs and costs associated with the care of children with medical complexity (CMC), innovative models of care are needed. Home-visiting care models are effective in subpopulations of pediatrics and medically complex adults, but there is no literature on this model for CMC. We describe the development and outcomes of a mu...

Background New York City (NYC) was the epicenter of the COVID-19 pandemic in the United States. On April 17, 2020, the State of New York implemented an Executive Order that requires all people in New York to wear a face mask or covering in public settings where social distancing cannot be maintained. It is unclear how this Executive Order has affec...

Background While residential mobility affects people’s health, the dynamic of neighborhood tenure and its associated factors among cancer patients and survivors have not been studied in detail. This cross-sectional study aimed to identify sociodemographic factors associated with neighborhood tenure and relocation after the first cancer diagnosis am...

Rationale Acute hypoxemic respiratory failure (AHRF) is the major complication of coronavirus disease 2019 (COVID-19), yet optimal respiratory support strategies are uncertain. Objectives To describe outcomes with high-flow oxygen delivered through nasal cannula (HFNC) and non-invasive positive pressure ventilation (NIPPV) in COVID-19 AHRF and iden...

Objective: The food retail environment is an important determinant of food access and the ability to achieve a healthy diet. However, immigrant communities may procure their food in different ways than the mainstream population owing to preferences for specific cultural products or limited English language proficiency. The objective of this analys...

Stroke exerts a massive burden on the US health and economy. Place-based evidence is increasingly recognized as a critical part of stroke management, but identifying the key determinants of neighborhood stroke prevalence and the underlying effect mechanisms is a topic that has been treated sparingly in the literature. We aim to fill in the research...

Cardiovascular disease is the leading cause of death in the United States. While abundant research has been conducted to identify risk factors for cardiovascular disease at the individual level, less is known about factors that may influence population cardiovascular health outcomes at the neighborhood level. The purpose of this study is to use Bay...

Objectives To identify and characterize the constellation, or clusters, of self-management behaviors in patients with chronic obstructive pulmonary disease (COPD) and comorbid hypertension. Methods Cluster analysis (n = 204) was performed with standardized scores for medication adherence to COPD and hypertension medications, inhaler technique, and...

Background Mammography use is affected by multiple factors that may change as public health interventions are implemented. We examined two nationally representative, population‐based surveys to seek consensus and identify inconsistencies in factors associated with mammography use in the entirety of the US population, and by black and white subgroup...