American journal of public health最新文献

Chronic care management is effective. Barriers to program durability include dependence on the provider-nurse duo to carry out labor-intensive services and the lack of a fiscally sustainable model. Between January and October 2022, an expanded chronic care management team-consisting of a provider, nurse, community health worker, and pharmacist-conducted a four-month intervention in an ambulatory setting. This intervention, using a convenience sample of 134 Medicare patients with uncontrolled type 2 diabetes or hypertension, demonstrated statistically significant improvements in controlling type 2 diabetes (P < .01) and blood pressure (P < .001). Direct provider workload decreased, and the Medicare reimbursement rate was 85.5%. (Am J Public Health. 2025;115(2):133-137. https://doi.org/10.2105/AJPH.2024.307886).

Objectives. To map US state Supplemental Nutrition Assistance Program (SNAP) bans for individuals with felony drug convictions between 2004 and 2021. Methods. Using standard legal-mapping methodology, we categorized states as maintaining the lifetime ban imposed by federal law, modifying the lifetime ban, or fully opting out of the lifetime ban in each year. Among states with modified bans in 2021, we coded types of modifications. Results. As of 2021, 26 states and the District of Columbia fully opted out of the lifetime ban, 23 states modified bans, and 1 state maintained a lifetime ban. Among states with modified bans in 2021, 13 states required compliance with parole and probation, 12 states required drug treatment, 7 states required drug testing, and 9 states limited eligibility to certain populations. Conclusions. Most states effectively de-implemented the federal lifetime ban on SNAP for people with felony drug convictions by fully opting out or modifying bans over time. However, some states still had stringent modified ban provisions. Public Health Implications. These findings underscore the need to study the effects of this patchwork of drug conviction-related ban policies on substance use and nutrition-related outcomes. (Am J Public Health. 2025;115(2):170-177. https://doi.org/10.2105/AJPH.2024.307873).

Objectives. To describe progression, content, and stringency of state legislation regulating indoor tanning and association with state government political party leadership. Methods. Trained research assistants used legal mapping methods to code legislative bills on indoor tanning introduced in US states, the District of Columbia, and Puerto Rico. We calculated composite scores on the stringency of age restrictions and of warnings, operator requirements, and enforcement. We evaluated associations of the political party of the legislative sponsor and legislature majority. Results. Between 1992 and 2023, 184 bills were introduced in 49 of 50 states and DC (56 laws were enacted, and 126 bills failed). An under-18 ban was enacted in 22 states and DC. Party affiliation of the bill sponsor and legislature majority combined to affect bill passage and age restrictions. Conclusions. In many states, it took several years and proposed bills before a law on indoor tanning was enacted. Enacted bills were more stringent than failed bills. Public Health Implications. Increasing support for stringent regulations on indoor tanning is evident and may motivate other states or the federal government to prohibit minors from using indoor tanning facilities. (Am J Public Health. 2025;115(2):191-200. https://doi.org/10.2105/AJPH.2024.307894).

Objectives. To estimate the effect of influenza vaccination disparities. Methods. We compared symptomatic influenza cases between Black and White races in 2 scenarios: (1) race- and age-specific vaccination coverage and (2) equal vaccination coverage. We also compared differences in household composition between races. We used the Framework for Reconstructing Epidemiological Dynamics, an agent-based model that assigns US Census‒based age, race, households, and geographic location to agents (individual people), in US counties of varying racial and age composition. Results. Influenza cases were highest in counties with higher proportions of children. Cases were up to 30% higher in Black agents with both race-based and race-equal vaccination coverage. Compared with corresponding categories of White households, cases in Black households without children were lower and with children were higher. Conclusions. Racial disparities in influenza cases persisted after equalizing vaccination coverage. The proportion of children in the population contributed to the number of influenza cases regardless of race. Differences in household composition may provide insight into racial differences and offer an opportunity to improve vaccination coverage to reduce influenza burden for both races. (Am J Public Health. 2025;115(2):209-216. https://doi.org/10.2105/AJPH.2024.307878).

Because residents of rural areas in the United States experience a persistent disadvantage in life expectancy relative to their urban counterparts, it is critical to consider the structural and social determinants that affect the health of rural populations. White Americans constitute 3 out of every 4 (76%) rural residents, and there is growing evidence that rurality is a predictor of poor health status for White Americans in ways that are not present for racially minoritized populations or nonrural White populations. We offer a framework to describe Whiteness as a fundamental determinant of the health of rural White Americans, which is useful to more precisely characterize and address the heterogeneous yet unique factors that drive their health. While Whiteness is a dynamic system that typically upholds White Americans' social supremacy, we provide examples of intermediate (e.g., rural culture, environment) and intrapersonal (e.g., psychosocial) factors through which Whiteness can harm rural White Americans' health (e.g., chronic disease, mental health). We conclude with a discussion of implications and recommendations that may help to advance research to promote health and well-being among rural White Americans. (Am J Public Health. 2025;115(2):152-160. https://doi.org/10.2105/AJPH.2024.307904).