Preventing Chronic Disease最新文献

Introduction: E-cigarettes are the most commonly used tobacco product among youth. Most e-cigarettes contain nicotine, which is highly addictive and can harm the developing brain. Youth e-cigarette use is associated with poor mental health.

Methods: We analyzed self-reported data from the 2024 National Youth Tobacco Survey to describe e-cigarette use and symptoms of depression and anxiety among US middle and high school students.

Results: In 2024, 42.1% of youth who currently used e-cigarettes reported moderate-to-severe symptoms of depression and anxiety compared with 21.0% of youth who never or formerly used e-cigarettes. Among youth who currently used e-cigarettes, those with moderate-to-severe symptoms of depression and anxiety (vs no-to-mild symptoms) more frequently reported symptoms of dependence - wanting to use an e-cigarette within 30 minutes of waking (28.2% vs 15.6%, P < .001) and having strong cravings (37.6% vs 22.4%, P < .001) - and "feeling anxious, stressed, or depressed" as a reason for first (41.8% vs 18.4%, P < .001) and current (51.0% vs 25.2%, P < .001) use. Most youth who used e-cigarettes attempted to quit in the past year (69.4%), but over half (58.5%) did not use any quitting resources.

Conclusion: Moderate-to-severe symptoms of depression and anxiety are common among youth who use e-cigarettes. Youth with these symptoms may need additional support to prevent or quit e-cigarette use. Integrating mental health support into comprehensive approaches to tobacco use prevention and cessation, paired with strengthening the foundations of healthy communities for youth, may reduce youth e-cigarette use.

Colorectal cancer (CRC) screening allows for early detection and prevention through removal of polyps. In 2021, the US Preventive Services Task Force updated recommendations to screen adults aged 45 to 75 years. We analyzed 2022 Behavioral Risk Factor Surveillance System data to establish baseline prevalence estimates for those eligible for screening aged 45 to 75, including those aged 45 to 49 years who are newly eligible. Only 61.4% of adults aged 45 to 75 were up to date with CRC screening, below the Healthy People 2030 target (72.8%). Public health and clinical systems can prioritize identifying and screening adults not up to date on screening to reduce CRC risk.

Introduction: Significant differences exist in the risk of diabetes and diabetes-related complications by income level in the United States. We assessed 1) to what extent medical expenditures in total and by health service type differ by income levels, and 2) how demographic and socioeconomic factors and health status are associated with these differences.

Methods: Data from the 2017 through 2021 Medical Expenditure Panel Survey were analyzed to estimate annual per-person medical expenditures for adults with diabetes. These expenditures were categorized by service type (inpatient, outpatient, prescription, home health care services, emergency department, or other) and compared across income groups based on the federal poverty level (FPL): poor (<125% FPL), low (125% to <200% FPL), middle (200% to <400% FPL), and high (≥400% FPL). One-way analysis of variance was used to test group differences, and a regression-based decomposition identified factors driving expenditure disparities. All expenditures were adjusted to 2021 US dollars.

Results: Mean total medical expenditures were significantly higher for the poor-income group compared with the low-income, middle-income, and high-income groups, though no significant differences were observed among the latter 3 groups. Prescription drugs and home health care services in the poor-income group accounted for most of this difference. Key factors associated with the higher expenditures in this group included elevated disability rates, poorer physical health status, and dual Medicaid-Medicare coverage.

Conclusion: Adults with diabetes from the poorest households incurred the highest medical expenditures, largely driven by poor physical health and higher rates of disability. Reducing disability and improving health outcomes for this group may help lower their medical expenses.

Introduction: Community health workers (CHWs) can improve health by helping people navigate health care services and systems and connecting them to community services that address nonmedical factors such as food insecurity, housing, and transportation. While CHWs have long been part of the US public health system, there are no data, to our knowledge, on the public's familiarity and interactions with CHWs.

Methods: We analyzed data from the 2022 Porter Novelli FallStyles and Estilos surveys, online market research surveys of the general public delivered in English (FallStyles) or primarily Spanish (Estilos). Each survey asked the same 4 questions on familiarity and interactions with CHWs, including, for respondents reporting having interacted with CHWs, the types of issues CHWs helped them with.

Results: Of 3,410 FallStyles respondents, 52.1% were familiar with CHWs, and 16.7% had interacted with a CHW. Of 954 Estilos respondents, 62.4% were familiar with CHWs, and 42.0% had interacted with a CHW. Among respondents who indicated being helped by CHWs, the majority encountered CHWs in health care settings (60.8% of FallStyles respondents; 64.2% of Estilos respondents) and less than one-quarter reported encountering CHWs in their community or place of worship (21% of FallStyles respondents; 22.2% of Estilos respondents).

Conclusion: A large proportion of people who are Hispanic or Latino are familiar with or have had interactions with CHWs. The low levels of familiarity with CHWs among FallStyles respondents highlight opportunities for greater public awareness and understanding of the multifaceted role and scope of the CHW workforce across public health, health care, and community settings to enhance the health and wellness of all people.

Introduction: Cognitive health is influenced by a complex interplay of factors throughout the lifespan. Identifying childhood adversities and social needs can be important in mitigating subjective cognitive decline and promoting healthy aging. This study analyzes the role of social drivers of health on adverse childhood experiences and subjective cognitive decline.

Methods: We conducted structural equation modeling on data from the 2023 Behavioral Risk Factor Surveillance System to investigate the association among adverse childhood experiences, social drivers of health, and subjective cognitive decline in a sample of adults aged 45 years or older (n = 35,754).

Results: In our study sample, 17.7% reported experiencing subjective cognitive decline within the past 12 months. Adverse childhood experiences were significantly associated with greater subjective cognitive decline (β = 0.136, P < .001). Adverse childhood experiences were negatively associated with both social drivers of health, perceived social support (β = -0.517, P < .001), and socioeconomic stability (β = -0.022, P = .047). However, greater perceived social support (β = -0.260, P < .001) and socioeconomic stability (β = -0.086, P < .001) reduced the effects of adverse childhood experiences on subjective cognitive decline.

Conclusion: Adverse childhood experiences were significantly associated with subjective cognitive decline; however, this association was attenuated when mediated by perceived social support and socioeconomic stability. These findings can inform public health providers and policymakers to implement targeted interventions, such as promoting resilience, reinforcing nurturing parenting styles, strengthening community networks, and integrating behavioral health into primary care settings.