American Journal of Preventive Medicine最新文献_第6页

National Estimates of Work-Related Emergency Department–Treated Finger, Hand, and Wrist Injuries, U.S. 2015–2022 2015-2022年美国全国与工作有关的急诊部门治疗的手指、手部和手腕损伤估计。

IF 4.5 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

American Journal of Preventive Medicine

Pub Date : 2026-03-01 Epub Date: 2025-09-25 DOI: 10.1016/j.amepre.2025.108134

Melody K. Gwilliam PhD, MPH, MSJ , Susan J. Derk MA , Christina M. Socias-Morales DrPH , Scott A. Hendricks MS , Karen E. Innes PhD , Audrey A. Reichard MPH , Gordon S. Smith MB, ChB, MPH

Introduction

Work-related injuries often occur to fingers, hands, and wrists; however, research on risk factors is limited. The aim of this study was to analyze (in 2024) national estimates and trends of work-related fingers, hands, and wrists emergency department–treated traumatic injuries (2015–2022).

Methods

The National Electronic Injury Surveillance System—Occupational Supplement was used to analyze fingers, hands, and wrists injuries. Estimates and rates per 10,000 full-time equivalent workers were calculated using employment labor force estimates from the Current Population Survey. Patterns of injury severity and identification of at-risk populations were calculated, including adjusting for industry.

Results

Nearly 5 million work-related emergency department–treated injuries were fingers, hands, and wrists, with 2% severe. Two thirds (67%) of these injuries were among males; however, females had higher odds of severe injuries than males when adjusting for industry. Rates of injury decreased with increasing age groups; however, adjusting for industry found a higher likelihood of injuries among older age groups. Healthcare and social assistance workers experienced the highest number of fingers, hands, and wrists injuries (814,100 injuries). However, accommodation/food service workers had the highest injury rates (81 per 10,000 full-time equivalents). Construction (24%) and manufacturing (23%) workers had the highest percentage of severe fingers, hands, and wrists injury rates. However, the highest rates for severe fingers, hands, and wrists injury rates were for agriculture, forestry, fishing, and hunting and construction workers (35.3 and 23.4 per 100,000 full-time equivalent workers). Injury rates declined significantly from 2015 to 2021 and then increased in 2022.

Conclusions

These findings improve the understanding of work-related fingers, hands, and wrists injury risks. Industry-specific surveillance and targeted interventions for high-risk industries such as construction and manufacturing could assist in reducing fingers, hands, and wrists injuries.

工作相关伤害常发生在手指、手和手腕（FHW）；然而，对危险因素的研究是有限的。该研究的目的是分析（2024年）2015-2022年全国与工作相关的FHW急诊科（ED）治疗的创伤性损伤的估计和趋势。方法：采用国家电子伤害监测系统-职业补充资料对FHW伤害进行分析。每1万名全职等效工人的估计值和比率是根据当前人口调查的就业劳动力估计值计算的。计算了伤害严重程度的模式和危险人群的识别，包括对行业的调整。结果：近500万因工ed治疗的伤害为FHW，其中2%为重症。三分之二（67%）的这些伤害发生在男性中，然而，在调整行业后，女性的严重伤害几率高于男性。受伤率随着年龄组的增加而下降，但根据行业调整后发现，年龄较大的年龄组受伤的可能性更高。保健和社会援助工作者遭受的外来务工人员伤害最多（814 100人受伤）。然而，住宿/餐饮服务工作者的受伤率最高（每10,000名全职员工中有81人受伤）。建筑业（24%）和制造业（23%）的工人有严重FHW的比例最高。然而，严重的FTE伤害率最高的是农业、林业、渔业、狩猎和建筑业（每10万名FTE工人中有35.3人和23.4人）。2015-2021年间，受伤率显著下降，然后在2022年上升。结论：这些发现提高了对与工作相关的FHW伤害风险的理解。针对建筑和制造业等高风险行业的行业特定监督和有针对性的干预措施可以帮助减少FHW伤害。

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引用次数: 0

The Park RX RCT: Impact on Physical Activity Among Youth 公园rx随机对照试验（rct）：对青少年身体活动（pa）的影响。

IF 4.5 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

American Journal of Preventive Medicine

Pub Date : 2026-03-01 Epub Date: 2025-10-14 DOI: 10.1016/j.amepre.2025.108154

Deborah A. Cohen MD, MPH , Robert L. Zarr MD , Erika L. Estrada MPH , Haoyuan Zhong MS , Bing Han PhD

Introduction

Most youth do not achieve recommended levels of physical activity, so finding methods to increase physical activity would be beneficial to health. The objective of this study was to determine whether clinician prescriptions for park visits would increase physical activity among youth.

Study design

This RCT was conducted from 2020 to 2023 with 12 months' follow-up.

Setting/participants

This RCT was conducted in a federally qualified health center outpatient clinic in Washington, DC and focused on youth aged 6–16 years with 1 or more diagnoses of chronic conditions that usually require 2 or more routine healthcare provider visits per year.

Intervention

Receiving park prescriptions from their healthcare provider during regular clinic visits, about every 3 months.

Main outcome measures

Accelerometry-measured minutes of moderate-to-vigorous physical activity, BMI, blood pressure, and self-report of park visit frequency and time spent in park were measured.

Results

Of the 514 randomized participants, the median age was 10.4 years (SD=2.7) and included 246 females (47.9%), 268 males, (52.1%) 451 Latinx (87.7%), and 52 African Americans (10.1%). Intent-to-treat analyses showed a significant change of daily moderate-to-vigorous physical activity, increasing by 2.03 minutes (SE=0.86) at 3 months and 1.98 minutes (SE=0.88) at 6 months compared with the controls, which translates to slightly more than a 12% increase. Moderate-to-vigorous physical activity increases were primarily among boys and children aged 11–16 years. There was no change in BMI or blood pressure. Self-report of park visits increased at 3 and 12 months.

Conclusions

Issuing park prescriptions has a positive impact on moderate-to-vigorous physical activity for low-income youth. Future studies should replicate this intervention, given that the positive findings suggest that Park Rx is likely to be beneficial and should be widely adopted by healthcare providers.

Trial registration

This trial is registered with Number NCT04114734.

大多数年轻人没有达到推荐的身体活动水平（PA），因此找到增加PA的方法将有利于健康。本研究的目的是确定临床医生处方公园参观是否会增加青少年的PA。研究设计：本随机临床试验（RCT）于2020-2023年进行，随访12个月。背景/参与者：该随机对照试验在华盛顿特区的一家联邦合格健康中心门诊诊所进行，主要针对6-16岁的青少年，他们被诊断患有一种或多种慢性疾病，通常每年需要两次或两次以上的常规医疗服务提供者就诊。干预措施：大约每3个月，在定期诊所就诊期间，从他们的卫生保健提供者那里获得公园处方。主要观察指标：测量受试者的中高强度体力活动时间（MVPA）、身体质量指数（BMI）、血压（BP）以及公园访问频率和公园停留时间的自我报告。结果：在514名随机参与者中，中位年龄为10.4岁（SD 2.7），包括246名女性（47.9%），268名男性（52.1%），451名拉丁裔（87.7%）和52名非洲裔美国人（10.1%）。意向治疗分析显示每日MVPA变化显著，增加2.03。

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引用次数: 0

Healthcare and Nonhealthcare Costs: Youth With Diabetes and Food Insecurity 医疗保健和非医疗保健费用：青年糖尿病患者和粮食不安全。

IF 4.5 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

American Journal of Preventive Medicine

Pub Date : 2026-03-01 Epub Date: 2025-08-12 DOI: 10.1016/j.amepre.2025.108028

Alice M. Ellyson MS, PhD , Jason A. Mendoza MD, MPH , Angela D. Liese PhD , Ashley Tabah , Traci A. Bekelman MPH, PhD , A. Caroline Rudisill MSc, PhD , Dana Dabelea MD, PhD , Edward A. Frongillo PhD , Catherine Pihoker MD , Faisal S. Malik MD, MSHS , Davene R. Wright PhD

Introduction

This study prospectively evaluated the association of household food insecurity with acute care costs and productivity loss in youth and young adults with Type 1 and Type 2 diabetes.

Methods

This observational cohort study included 1,256 youth and young adults with Type 1 and Type 2 diabetes from the SEARCH for Diabetes in Youth Food Security Study, with data collected at 3 time points between 2015 and 2022. Both household food insecurity (measured using the U.S. Household Food Security Survey Module) and costs (measured using survey responses on utilization and productivity losses) were self-reported by young adult participants or the caregivers of adolescents. The relationship between household food insecurity and costs was analyzed using generalized adjusted linear regression. The authors also analyzed the moderating role of continuous health insurance coverage.

Results

Each additional 1-point increase in the household food insecurity score was associated with a $1,077 (95% CI=663; 1,491) increase in measured 12-month costs. Costs were $4,384 (95% CI=2,635; 6,133) higher in households that were experiencing household food insecurity than in those that were not. Youth and young adults with continuous health insurance coverage saw smaller increases in costs ($864, 95% CI=461; 1,267) than those without continuous coverage ($1,820; 95% CI=379; 3,261).

Conclusions

This study found a positive association between household food insecurity and costs for youth and young adults with diabetes, and this relationship was modified by continuous health insurance coverage. Future work should use linked claims and electronic health record data to better inform efforts aimed at reducing household food insecurity burden and improving the continuity of insurance coverage for this population.

本研究前瞻性地评估了1型和2型糖尿病青年和青年会（YYA）的家庭粮食不安全与急性护理成本和生产力损失的关系。方法：本观察性队列研究纳入了2015-2022年三个时间点收集的数据，其中包括来自青年食品安全研究中糖尿病搜索的1,256名1型和2型糖尿病青少年。家庭粮食不安全（HFI，使用美国家庭粮食安全调查模块进行测量）和成本（使用利用率和生产力损失的调查回复进行测量）均由年轻成年参与者或青少年的照顾者自我报告。采用广义调整线性回归分析了HFI与成本之间的关系。我们还分析了连续健康保险覆盖的调节作用。结果：HFI评分每增加1分，测量的12个月成本增加1,077美元（95%CI=[663, 1,491]）。与没有经历HFI的家庭相比，经历HFI的家庭的成本高出4,384美元（95%CI=[2,635, 6,133]）。与没有持续医疗保险的年轻人（1,820美元，95%CI=[379, 3,261]）相比，拥有持续医疗保险的年轻人和年轻人的成本增幅较小（864美元，95%CI=[461, 1,267]）。结论：本研究发现HFI与YYA合并糖尿病的费用呈正相关，并且这种关系被持续的健康保险覆盖所修正。未来的工作应使用相关的索赔和电子健康记录数据，以更好地为旨在减轻HFI负担和改善该人群保险覆盖连续性的工作提供信息。

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引用次数: 0

Cost-Effectiveness and Health Equity Improvements From Excluding Sugar-Sweetened Beverages From the Supplemental Nutrition Assistance Program 将含糖饮料排除在补充营养援助计划之外，提高了成本效益和健康公平性。

IF 4.5 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

American Journal of Preventive Medicine

Pub Date : 2026-03-01 Epub Date: 2025-09-08 DOI: 10.1016/j.amepre.2025.108082

Aviva A. Musicus ScD , Jessica L. Barrett MPH , Stephanie M. McCulloch MS, MPH , Michael W. Long ScD, MPH , Zachary J. Ward PhD, MPH , Angie L. Cradock ScD, MPE , Sara N. Bleich PhD , Steven L. Gortmaker PhD

Introduction

Excluding sugar-sweetened beverages from eligible purchases in the Supplemental Nutrition Assistance Program has been proposed as a strategy to improve diet quality and health. This study estimates the cost-effectiveness of this policy and its potential impact on health equity.

Methods

The Childhood Obesity Intervention Cost-Effectiveness Study microsimulation and systematic review process was used in 2024 to estimate the potential impact of excluding sugar-sweetened beverages from Supplemental Nutrition Assistance Program–eligible purchases over a 10-year period (2023–2032) for the U.S. population. Health outcomes related to excess weight, costs, and relative changes in obesity prevalence by income, race, and ethnicity groups in 2032 were estimated.

Results

The policy is projected to be cost-saving, prevent 279,000 cases of obesity (95% uncertainty interval=149,000−446,000), and contribute 115,000 (95% uncertainty interval=60,100−187,000) quality-adjusted life years gained over 10 years among Supplemental Nutrition Assistance Program participants. The policy could save an estimated $2.75 billion in healthcare costs related to excess weight over 10 years, resulting in $3.35 in healthcare cost savings per dollar spent on implementation. Reductions in obesity prevalence were estimated to be 3.5 times greater among individuals with income ≤130% of the federal poverty level than the overall mean and 3–3.5 times greater among non-Hispanic Black and Hispanic individuals than among non-Hispanic White individuals.

Conclusions

Excluding sugar-sweetened beverages from Supplemental Nutrition Assistance Program–eligible purchases could be a cost-saving strategy to improve health and health equity between income, racial, and ethnic groups. The U.S. Department of Agriculture could use pilot studies to test the real-world effects of excluding sugar-sweetened beverages from the Supplemental Nutrition Assistance Program.

在补充营养援助计划（SNAP）的合格购买中排除含糖饮料（SSBs）已被提议作为改善饮食质量和健康的策略。这项研究估计了这项政策的成本效益及其对卫生公平的潜在影响。方法：在2024年使用儿童肥胖干预成本效益研究（CHOICES）微观模拟和系统评价过程来估计在十年期间（2023-2032年）对美国人口从符合snap条件的购买中排除ssb的潜在影响：估计2032年与超重、成本和按收入、种族和民族分组的肥胖患病率的相对变化相关的健康结果。结果：该政策预计将节省成本，预防279,000例肥胖（95% UI: 149,000-446,000），并在SNAP参与者中贡献115,000例（95% UI: 60,100-187,000）质量调整生命年。该政策可在十年内节省约27.5亿美元与超重有关的医疗费用，每一美元的执行费用可节省3.35美元的医疗费用。据估计，与总体平均水平相比，收入≤联邦贫困水平130%的个人的肥胖患病率下降幅度是3.5倍，非西班牙裔黑人和西班牙裔个人的肥胖患病率下降幅度是非西班牙裔白人的3-3.5倍。结论：从符合snap条件的购买中排除ssb可能是一种节省成本的策略，可以改善收入、种族和民族群体之间的健康和健康公平。美国农业部可以使用试点研究来测试将ssb排除在SNAP之外的实际效果。

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引用次数: 0

Spatial Association of Area-Level Credit Scores and Firearm Violence: A Novel Measure of Socioeconomic Position for Violence and Injury Research 区域信用评分与枪支暴力的空间关联：暴力与伤害研究中社会经济地位的新测度。

IF 4.5 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

American Journal of Preventive Medicine

Pub Date : 2026-03-01 Epub Date: 2025-09-12 DOI: 10.1016/j.amepre.2025.108100

Mudia Uzzi PhD, MSc , Pilar Ocampo MPH , William Wical PhD , Kyle Aune PhD , Mac McComas MA , Lorraine T. Dean ScD

Introduction

Scholars use socioeconomic position measures to describe the relationship of social inequities with violence and injury. Area-level credit scores are a novel measure of socioeconomic position that reflect elements of a geographic area’s social and economic structure beyond what traditional measures capture. This study assessed the spatial association between area-level credit scores and firearm violence.

Methods

An ecologic cross-sectional study was performed on 1,324 census block groups in Philadelphia, Pennsylvania. A quasi-Poisson spatial regression analysis was conducted to determine the association between area-level credit scores in 2017 and block group-level firearm violence in 2018. The regression model included several socioeconomic position and structural factors as control variables and eigenvector spatial filtering accounted for residual spatial autocorrelation.

Results

Census block groups with subprime area-level credit scores had a firearm violence incidence rate that was more than 4 times higher (incidence rate ratio, 4.74; 95% CI=2.60, 8.96; p<0.001) than that of block groups with prime scores, even after controlling for other social and economic factors. For every 1 standard deviation increase in credit scores, the rate of firearm violence decreased by 63%.

Conclusions

There is a significant spatial association between area-level credit scores and firearm violence. This association is notably stronger than other measures of socioeconomic position, including education and poverty. Area-level credit scores are a novel measure of socioeconomic position that can provide critical insights into the socioeconomic environment of a geographic area and could be a valuable target for reparative social and economic policies to reduce violence and injury.

引言：学者们使用社会经济地位测量来描述社会不平等与暴力和伤害的关系。区域级信用评分是一种衡量社会经济地位的新方法，它反映了一个地理区域的社会和经济结构的要素，超出了传统方法所能捕捉的范围。本研究评估了地区信用评分与枪支暴力之间的空间关联。方法：对宾夕法尼亚州费城1324个人口普查街区进行生态横断面研究。通过准泊松空间回归分析，确定2017年地区信用评分与2018年街区群体枪支暴力之间的关系。回归模型以社会经济地位和结构因素为控制变量，特征向量空间滤波处理残差空间自相关。结果：信用评分为次级的人口普查街区群体的枪支暴力发生率高出4倍以上（IRR= 4.74; 95% CI: 2.60, 8.96; p）结论：信用评分与枪支暴力之间存在显著的空间关联。这种关联明显强于其他衡量社会经济地位的指标，包括教育和贫困。地区级信用评分是衡量社会经济地位的一种新方法，可以提供对地理区域社会经济环境的重要见解，并可能成为减少暴力和伤害的补偿性社会和经济政策的有价值目标。

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引用次数: 0

Association Between Concussion and Risk of Suicide Among Youth and Young Adults 青少年和年轻人中脑震荡与自杀风险之间的关系。

IF 4.5 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

American Journal of Preventive Medicine

Pub Date : 2026-03-01 Epub Date: 2025-09-23 DOI: 10.1016/j.amepre.2025.108127

Jingzhen Yang PhD , Guy N. Brock PhD , Danielle L. Steelesmith PhD , Amanda J. Thompson PhD , Elyse N. Llamocca PhD , Jeffrey A. Bridge PhD , Cynthia A. Fontanella PhD

Introduction

Limited data exist on the risk of suicide after diagnosed concussion, particularly among youth. This study addresses that gap by examining the association between concussion and suicide among youth enrolled in Ohio Medicaid.

Methods

This retrospective longitudinal cohort study used Ohio Medicaid claims linked with death certificate data from January 1, 2011 to December 30, 2020. The sample included 417,512 youth and young adults aged 5–24 years diagnosed with either concussion (n=41,341) or orthopedic injury (n=376,171) and followed for up to 10 years. Cox regression models with inverse probability of treatment weighting estimated the association between injury type and time to suicide death. Additional analyses evaluated the impact of concussions sustained during follow-up. Analyses were conducted between April and August 2024.

Results

There were 42 suicides in the concussion group and 229 in the orthopedic injury group. Youth with concussion had a higher suicide hazard than those with orthopedic injury (hazard ratio=1.65, 95% CI=1.18, 2.30) in inverse probability of treatment weighting–adjusted models. The 5-year risk difference was 0.034% (95% CI=0.006%, 0.061%), equating to 34 additional suicides per 100,000 individuals. Concussions during follow-up were also associated with elevated suicide hazard (hazard ratio=1.52 per concussion event, 95% CI=1.12, 2.05) after adjusting for demographic and clinical covariates.

Conclusions

Concussions were associated with >60% increased suicide hazard relative to orthopedic injuries. Each subsequent concussion further elevated the suicide hazard. Targeted suicide prevention strategies for youth with concussions may help reduce this risk.

作品简介:。关于确诊脑震荡后自杀风险的数据有限，尤其是在青少年中。本研究通过调查参加俄亥俄州医疗补助计划的青少年中脑震荡和自杀之间的关系来解决这一差距。方法:。这项回顾性纵向队列研究使用了2011年1月1日至2020年12月30日期间与死亡证明数据相关的俄亥俄州医疗补助申请。样本包括417,512名年龄在5-24岁之间的青年和年轻人，他们被诊断为脑震荡（n=41,341）或骨科损伤（n= 376,171），随访时间长达10年。采用治疗加权逆概率（IPTW）的Cox回归模型估计了伤害类型与自杀死亡时间之间的关系。其他分析评估了随访期间持续脑震荡的影响。分析在2024年4月至8月期间进行。结果：脑震荡组自杀42例，成骨不全组自杀229例。在iptw校正模型中，脑震荡青少年的自杀风险高于成骨不全患者（HR=1.65, 95% CI=1.18-2.30）。5年风险差异为0.034% (95% CI=0.006%-0.061%)，相当于每10万人中有34人额外自杀。在调整人口统计学和临床协变量后，随访期间的脑震荡也与自杀风险升高相关（每脑震荡事件的HR=1.52, 95% CI=1.12-2.05）。结论：与骨科损伤相比，脑震荡与自杀风险增加60%以上有关。随后的每一次脑震荡都进一步增加了自杀的危险。针对青少年脑震荡患者的有针对性的自杀预防策略可能有助于降低这种风险。

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引用次数: 0

Perceived Difficulty of Flavored Tobacco Purchase: Early Effects of a Statewide Flavor Policy Among Young People 感知到购买加味烟草的困难：对年轻人的全州风味政策的早期影响。

IF 4.5 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

American Journal of Preventive Medicine

Pub Date : 2026-03-01 Epub Date: 2025-05-08 DOI: 10.1016/j.amepre.2025.107651

Jennifer M. Kreslake PhD, MPH , Elizabeth L. Seaman Jones PhD, MHS , Stephanie N. Yoon MPP , Jamie Cordova MPH , Barbara A Schillo PhD , Kristy Marynak PhD, MPP

Introduction

In December 2022, California enacted a policy restricting the sale of flavored tobacco products. This study tested whether perceived difficulty of purchasing flavored tobacco products from retailers changed among youth and young adults following the enactment of California’s policy.

Methods

Data were from the Tobacco Epidemic Evaluation Network (TEEN+) study, a probability-based national longitudinal cohort (aged 13–24 years) survey which fielded prepolicy (W1: July–October 2022) and postpolicy (W2: March–June 2023). Respondents reported perceived difficulty (0=somewhat/very easy, 1=somewhat/very hard) at both waves. The analysis was restricted to respondents who had ever used tobacco by W1 (California n=527; rest of U.S. n=2,220). Weighted GEE analyses tested for differences in perceived difficulty at W2 versus W1.

Results

California respondents were significantly more likely to perceive difficulty in purchasing: flavored e-cigarettes (AOR=2.12, p<0.001); menthol cigarettes (AOR=2.16, p=0.007); and flavored cigars (AOR=2.76, p=0.012) at W2 versus W1. Among the rest of U.S. sample, no significant increases in perceived difficulty were observed for any product type at W2 versus W1. At W2, most California respondents perceived flavored products to be easy to purchase (flavored e-cigarettes: 73.8%; menthol cigarettes: 72.9%; flavored cigars: 83.2%).

Conclusions

California youth and young adults who had ever used tobacco were more likely to perceive difficulty in purchasing flavored tobacco products following California’s policy, compared to prepolicy. Increases in perceived difficulty were not observed among other U.S. respondents. Nonetheless, most perceive the purchase of flavored tobacco products to be somewhat or very easy following the California policy. Monitoring and enforcement are needed to ensure compliance with the statewide policy.

简介：2022年12月，加州颁布了一项限制销售调味烟草产品的政策。这项研究测试了在加州政策颁布后，年轻人和年轻人从零售商那里购买调味烟草产品的感知难度是否发生了变化。方法：数据来自烟草流行评估网络（TEEN+）研究，这是一项基于概率的全国纵向队列（13-24岁）调查，其中包括政策前（W1: 2022年7月至10月）和政策后（W2: 2023年3月至6月）。受访者报告了在这两个阶段的难度（0=有些/非常容易，1=有些/非常困难）。该分析仅限于曾经使用烟草的受访者(加利福尼亚州n=527；其余美国n= 2220)。加权GEE分析测试了W2与W1时PD的差异。结果：加州受访者明显更有可能感受到购买调味电子烟的困难（aOR: 2.12, p）。结论：与政策出台前相比，加州青少年和曾经使用过烟草的年轻人更有可能感受到在加州政策出台后购买调味烟草产品的困难。在其他美国受访者中没有观察到感知难度的增加。尽管如此，大多数人认为，按照加州的政策，购买调味烟草产品有些或非常容易。监督和执法是确保全州政策得到遵守的必要条件。

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引用次数: 0

Epidemiology of Cannabis Use Among Middle-Aged and Older Adults in the U.S. 美国中老年人大麻使用的流行病学。

IF 4.5 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

American Journal of Preventive Medicine

Pub Date : 2026-03-01 Epub Date: 2025-10-14 DOI: 10.1016/j.amepre.2025.108149

Ofir Livne MD , Malka Stohl MA , Jodi Gilman PhD , Terry E. Goldberg PhD , Melanie M. Wall PhD , Deborah S. Hasin PhD

Introduction

The prevalence of medical cannabis use, consumption methods, other key cannabis behaviors, and attitudes toward use is understudied, and associations with any cannabis use among U.S. middle-age and older adults is of particular interest because they are especially vulnerable to the adverse effects of cannabis.

Methods

Health and Retirement Study data (N=1,324) were analyzed, calculating weighted prevalence for cannabis measures, including past-year use, consumption methods, medical use, health conditions for which cannabis was used, healthcare provider recommendations, attitudes toward acceptability, risks, and legalization, by primary age groups (50–64 and ≥65 years) and specified older age groups (65–74 and ≥75 years) and sex. Associations with any cannabis use were evaluated using multivariable logistic regression, adjusting for sex, race/ethnicity, household income, and employment.

Results

Past-year cannabis use in the U.S. was reported by 18.5% and 5.9% of middle-age and older adults, respectively. Smoking was the primary consumption method in both groups. Approximately 25% of middle-aged adults and 20% of older adults who used cannabis consumed it for medical purposes, with ∼20% of those receiving a prescription or recommendation. Over 75% of individuals in both age groups viewed medical use as acceptable, and older adults were more likely to view cannabis as a gateway drug and to support restrictions of cannabis laws.

Conclusions

Cannabis use among both middle-aged and older U.S. adults is higher than previously reported in state- and national-level studies, with many engaging in cannabis behaviors associated with increased harm. Greater public health and clinical efforts are needed for tailored prevention and intervention strategies.

引言：对医用大麻使用的流行程度、消费方法、其他关键大麻行为和对使用的态度进行了充分的研究，并与美国中老年成年人中任何大麻使用的关联特别感兴趣，因为他们特别容易受到大麻的不利影响。方法：对健康和退休研究数据（n=1,324）进行分析，按主要年龄组（50-64岁，≥65岁）和特定老年年龄组（65-74岁，≥75岁）和性别计算大麻措施的加权流行率，包括过去一年的使用情况、消费方法、医疗使用、使用大麻的健康状况、医疗保健提供者的建议、对可接受性、风险和合法化的态度。使用多变量逻辑回归评估与任何大麻使用的关联，调整性别、种族/民族、家庭收入和就业。结果：去年在美国，18.5%的中年人和5.9%的老年人吸食大麻。吸烟是两组人群的主要消费方式。大约25%的中年人和20%的老年人使用大麻是出于医疗目的，其中约20%的人是根据处方或建议使用大麻的。在这两个年龄组中，75%以上的人认为医疗用途是可以接受的，老年人更有可能将大麻视为入门毒品，并支持限制大麻法律。结论：美国中年人和老年人使用大麻的比例高于此前在州和国家级研究中报道的水平，许多人从事大麻行为与危害增加有关。需要加大公共卫生和临床工作力度，制定有针对性的预防和干预战略。

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引用次数: 0

Illicit Drug Use During Pregnancy in States With and Without Punitive Prenatal Substance Use Policies 有和没有惩罚性产前药物使用政策的州在怀孕期间的非法药物使用情况。

IF 4.5 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

American Journal of Preventive Medicine

Pub Date : 2026-03-01 Epub Date: 2025-10-15 DOI: 10.1016/j.amepre.2025.108155

Anna E. Austin PhD , Laura C. Hergenrother MPhil , Meghan E. Shanahan PhD

Introduction

An increasing number of states have implemented punitive prenatal substance use policies. These include policies that consider prenatal substance use as grounds for substantiating abuse and neglect or for terminating parental rights (i.e., child abuse policies) and policies that require healthcare professionals to report prenatal substance use to child protective services (i.e., mandated reporting policies). Little research has examined whether these policies reduce substance use during pregnancy. The aim of this study was to examine the association of punitive state prenatal substance use policies with illicit drug use during pregnancy.

Methods

Data from 19 states’ 2016–2019 Pregnancy Risk Assessment Monitoring System survey (N= 20,356) were used. Log-binomial regression with a generalized estimating equation approach was conducted to calculate risk ratios and 95% CIs comparing the likelihood of self-reported illicit drug use during pregnancy (i.e., marijuana, synthetic marijuana, heroin, amphetamines, cocaine or crack, tranquilizers, or hallucinogens) among pregnant women in states with and without a punitive prenatal substance use policy. Analyses were conducted in spring 2025.

Results

In multivariable analyses adjusted for potential confounders, the likelihood of illicit drug use during pregnancy did not differ between women in states with a punitive prenatal substance use policy and women in states without a punitive prenatal substance use policy (risk ratio RR=1.02; 95% CI=0.93, 1.11).

Conclusions

Results indicate illicit drug use during pregnancy does not differ between states with and without punitive state prenatal substance use policies, suggesting that these policies do not reduce substance use during pregnancy.

越来越多的州实施了惩罚性产前物质使用政策。这些政策包括将产前药物使用视为虐待和忽视或终止父母权利的理由（即虐待儿童政策），以及要求保健专业人员向儿童保护服务机构报告产前药物使用情况的政策（即强制性报告政策）。很少有研究调查这些政策是否减少了怀孕期间的药物使用。本研究的目的是检查惩罚性国家产前物质使用政策与怀孕期间非法药物使用的关系。方法：使用美国19个州2016-2019年妊娠风险评估监测系统（PRAMS）调查数据（N= 20,356）。采用广义估计方程方法进行对数二项回归，计算风险比（rr）和95%置信区间（ci），比较有和没有惩罚性产前药物使用政策的州的孕妇在怀孕期间自我报告非法药物使用的可能性（即大麻、合成大麻、海洛因、安非他明、可卡因或可卡因、镇静剂或致幻剂）。分析于2025年春季进行。结果：在对潜在混杂因素进行调整的多变量分析中，有惩罚性产前物质使用政策的州和没有惩罚性产前物质使用政策的州的妇女在怀孕期间使用非法药物的可能性没有差异（RR=1.02, 95% CI 0.93, 1.11）。结论：结果表明，在有和没有惩罚性的州产前药物使用政策的情况下，怀孕期间的非法药物使用并没有差异，这表明这些政策并没有减少怀孕期间的药物使用。

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引用次数: 0

Medical Cannabis Use Across Ages 19–65 Years: U.S. Young and Middle Adults, 2018–2023 19-65岁的医用大麻使用：美国年轻人和中年人，2018-2023。

IF 4.5 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

American Journal of Preventive Medicine

Pub Date : 2026-03-01 Epub Date: 2025-07-26 DOI: 10.1016/j.amepre.2025.107994

Yvonne M. Terry-McElrath MSA, Megan E. Patrick PhD

Introduction

This study provides national data on cannabis use type (medical versus recreational only) across individuals aged 19–65 years and associations with overall cannabis use prevalence and frequency, including developmental and historical trends and sociodemographic and policy associations.

Methods

Data collected in 2018–2023 from individuals (N=33,647) aged 19–65 years participating in the Monitoring the Future Panel study were analyzed in 2024–2025. Developmental and historical trends and regression analyses examined past 12-month cannabis use type: no use, recreational-only use, or any medical cannabis used from their own written medical recommendation/prescription (with or without recreational use).

Results

Medical use was reported by 2.6% (2.3%, 2.8%) of all respondents and 9.8% (9.0%, 10.6%) of those reporting past 12-month use. Among all respondents, medical-use prevalence did not show evidence of significant developmental trends; among those reporting past 12-month use, there was an age-graded increase in medical use (p<0.001), corresponding to an age-graded decrease in recreational-only use (p<0.001). Medical-use prevalence increased across time in states with medical-use–only policy (p=0.002) but not in other states and was associated with being male (p<0.001). Past 30-day cannabis prevalence and frequency were higher among medical- than recreational-only use groups across ages (p<0.001).

Conclusions

Among U.S. young and middle adults, the proportion reporting medical use was consistent across age; observed age-graded increases in medical use among those reporting past 12-month cannabis use were due to decreasing recreational-only use. Medical use was associated with higher past 30-day frequency across age, indicating that it acts as a consistent risk factor for daily or near-daily use.

本研究提供了19-65岁大麻使用类型（医疗与仅用于娱乐）的国家数据，以及与大麻总体使用流行率和频率的关联，包括发展和历史趋势以及社会人口和政策关联。方法：对2024-2025年参与监测未来小组研究的19-65岁个体（N=33,647）在2018-2023年收集的数据进行分析。发展和历史趋势以及回归分析审查了过去12个月的大麻使用类型：不使用、仅用于娱乐或根据自己的书面医疗建议/处方使用任何医用大麻（有或没有娱乐用途）。结果：2.6%[2.3%，2.8%]的受访者报告有医疗使用，9.8%[9.0%，10.6%]的受访者报告过去12个月有医疗使用。在所有答复者中，医疗使用流行率没有明显的发展趋势；在报告过去12个月使用的人群中，医疗使用呈年龄分级增加(p结论：在美国年轻人和中年人中，报告医疗使用的比例在各个年龄段是一致的；在报告过去12个月大麻使用情况的人中，观察到的医疗使用按年龄分级增加是由于仅用于娱乐的大麻使用减少。医疗使用与各年龄段超过30天的频率较高相关，表明它是每日或近每日使用的一致风险因素。

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引用次数: 0