American journal of public health最新文献

Objectives. To assess relationships between changes in population levels, health care access, health care grievances, and mortality in California prisons. Methods. We examined 30 California prisons using June 2013 to May 2023 data from California Correctional Health Care Services and the California Department of Justice. Associations between prison occupancy rates and care access, health care grievances, and mortality were estimated in linear or generalized linear models controlling for staff vacancies and the characteristics of incarcerated people. Because of the prevalence of COVID-19-specific dynamics in prisons in 2020-2021, baseline models included data up to December 2019; data from January 2022 through May 2023 were added as a robustness check. Results. Reductions in prison occupancy rates were associated with increased access to care. Associations were more pronounced when postpandemic data were added. However, decreasing occupancy rates were not associated with declines in health care grievances or mortality. Conclusions. Lowering prison occupancy rates could help ensure better access to care, but it is not a panacea for alleviating varied health-related problems and dangers inside carceral facilities. (Am J Public Health. Published online ahead of print February 27, 2025:e1-e9. https://doi.org/10.2105/AJPH.2025.308011).

Objectives. To determine if de facto postpartum Medicaid extension during the Families First Coronavirus Response Act (FFCRA) reduced immigrant versus US-born inequities in uninsurance. Methods. We assessed self-reported uninsurance at 2 to 6 months postpartum among people with Medicaid-paid births using the New York City Pregnancy Risk Assessment Monitoring System (PRAMS), comparing immigrant and US-born people. We created a pre-FFCRA cohort of 2611 births from 2016 to 2019 and a post-FFCRA implementation cohort of 1197 births from 2020 to 2021. We calculated risk differences using log binomial regression. Results. Self-reported postpartum uninsurance among immigrants decreased from 13.6% to 9.3% after FFCRA (adjusted risk difference = -4.9%; 95% confidence interval = -7.8%, -2.0%). Immigrant versus US-born inequities in postpartum uninsurance decreased except among Hispanic birthing people, among whom 1 in 6 reported they were uninsured during FFCRA, despite continued eligibility. Conclusions. De facto postpartum Medicaid extension decreased immigrant inequities in insurance coverage, but Hispanic immigrants may have been unaware of continued coverage. Public Health Implications. Postpartum Medicaid extension policies that are inclusive of all immigrants may decrease inequities, but community-integrated implementation is needed to raise awareness of coverage and advance postpartum maternal health equity. (Am J Public Health. Published online ahead of print February 27, 2025:e1-e4. https://doi.org/10.2105/AJPH.2024.307968).

Objectives. To examine whether the state-level LGBT+ (lesbian, gay, bisexual, transgender, and other identities) legal protections where LGBT+ youths and young adults reside are associated with cigarette and e-cigarette use. Methods. We drew LGBT+ respondents (aged 15-31 years; n = 1255) from a national, probability-based survey conducted from August to December 2023. We scored each state for LGBT+ equality on a scale from restrictive to protective based on the Movement Advancement Project's 2023 policy environment. Using weighted logistic regression models, we examined the relationship between current (past 30-day) cigarette and e-cigarette use and state LGBT+ equality protections, controlling for demographics and state tobacco control expenditure. Results. LGBT+ individuals in protective policy states had 65% lower odds (odds ratio [OR] = 0.35; 95% confidence interval [CI] = 0.16, 0.78) of current cigarette use, and 56% lower odds (OR = 0.44; 95% CI = 0.25, 0.79) of current e-cigarette use compared with those in restrictive policy states. Conclusions. LGBT+ individuals living in protective policy environments had lower odds of current cigarette and e-cigarette use, consistent with theoretical relationships between stress, discrimination, and harmful health behaviors. Public Health Implications. Protective policies may alleviate tobacco use disparities among the LGBT+ community. (Am J Public Health. Published online ahead of print February 27, 2025:e1-e9. https://doi.org/10.2105/AJPH.2025.308008).

Objectives. To develop a national, tract-level measure of neighborhood housing quality and test its validity by examining associations with population health metrics. Methods. Using microdata from the 2021 American Housing Survey postfit to the 2018-2022 American Community Survey, we developed the Housing Quality Metric (HQM), which predicts the likelihood that a US census tract contains a large share of poor-quality housing units across 3 domains: physical inadequacy, housing cost burden, and poor neighborhood perception. We then used regression models to assess the ecological association between HQM and area-level measures of adult population health (fair or poor general health, poor mental health, and poor physical health) from the PLACES data set. Results. Census tract HQM score was significantly associated with a higher predicted proportion of adults self-reporting all 3 examined negative health status outcomes in both unadjusted and adjusted models. Conclusions. HQM presents the first national, tract-level measure of poor housing quality that has significant associations with adult population health status. Public Health Implications. HQM can be used to target resources and interventions in ways that may better capture the complex relationship between housing quality and population health than existing measures of housing quality. (Am J Public Health. Published online ahead of print February 21, 2025:e1-e9. https://doi.org/10.2105/AJPH.2024.307962).

Objectives. To quantify the effects of 5 jurisdiction-level COVID-19 policies on chlamydia, gonorrhea, and syphilis rates in 22 US jurisdictions between January 2020 and December 2021. Methods. We applied a mixed-effects, negative binomial, interrupted time series model to estimate the impact that each policy of interest had on reported cases. Results. Mandatory stay-at-home periods were associated with a decrease in reported chlamydia (incident rate ratio [IRR] = 0.75; 95% confidence interval [CI] = 0.71, 0.80) and gonorrhea (IRR = 0.85; 95% CI = 0.78, 0.94) cases. We also observed decreased chlamydia case reporting when gatherings were restricted to 10 people (IRR = 0.88; 95% CI = 0.85, 0.92), masking was recommended (IRR = 0.90; 95% CI = 0.85, 0.97), or polymerase chain reaction testing was limited to symptomatic individuals (IRR = 0.72; 95% CI = 0.67, 0.77). Universal vaccine access corresponded to decreases in reported gonorrhea (IRR = 0.83; 95% CI = 0.75, 0.92) but increases in syphilis (IRR = 1.33; 95% CI = 1.04, 1.70) cases. We also observed effects by sex, race, and ethnicity. Conclusions. COVID-19 policies had disparate effects on sexually transmitted infection rates that varied across demographic groups. Overall results were attenuated after the first lockdown period (March-May 2020), but demographic variations persisted. (Am J Public Health. Published online ahead of print February 21, 2025:e1-e10. https://doi.org/10.2105/AJPH.2024.307957).

Millions of US workers are seriously injured on the job annually. These injuries have a significant and deleterious impact on injured workers, their families, and their communities. The limitations of the historical work injury surveillance systems have constrained research into the distribution and determinants of work injuries and efforts to improve allocation of limited injury prevention resources. Most work injury data sets suffer from significant limitations and fail to include a sizable proportion of work injuries. In recent years, the Occupational Safety and Health Administration has begun to collect and make available to the public more detailed data on work injuries at thousands of high hazard establishments. These data sets provide the opportunity to greatly improve our work injury surveillance system. Researchers are now using these data to investigate and compare injury risk in industries and high-hazard firms where workers are at increased risk of musculoskeletal disorders. However, these rich data sets are underused. Maintaining and facilitating access to accurate, current data can contribute to improved prevention of work-related injuries and deaths. (Am J Public Health. Published online ahead of print February 13, 2025:e1-e8. https://doi.org/10.2105/AJPH.2024.307934).

Objectives. To estimate the size of the US governmental public health nurse (PHN) workforce by setting and specialty, including those working outside of health departments. Methods. We used 2022 data from the National Council of State Boards of Nursing, representing 2846 registered nurses (RNs) in almost all states, with weights applied. We examined "setting" and "specialty" of PHNs according to broad and more restricted definitions. Results. Using a broad definition, PHNs in government settings made up 3.7% of the RN workforce, and 1.8% when specialty areas were narrowly defined. These percentages varied by state. PHNs working in public health, school health, and correctional health settings largely indicated their specialty practice areas as public health, school health, and "unspecified" rather than more narrow specialty areas. Conclusions. PHNs are a small proportion of the RN workforce. They consider themselves generalists and can be identified by specialty and when working in governmental settings outside of health departments. Public Health Implications. States with few PHNs may be underserving their communities. Better data are needed to understand specific functions and activities of the PHN workforce. (Am J Public Health. Published online ahead of print February 13, 2025:e1-e10. https://doi.org/10.2105/AJPH.2024.307950).

Objectives. To estimate the association of state policies that define prenatal substance use as child abuse and mandate that health care professionals report prenatal substance use to child protective services with congenital syphilis case rates. Methods. We used 2018 to 2022 US data on congenital syphilis case notifications to the National Notifiable Diseases Surveillance System. We conducted linear regression with a generalized estimating equation approach to compare congenital syphilis case rates in states with a child abuse policy only, a mandated reporting policy only, and both polices to rates in states with neither policy. Results. After adjustment for confounders, the rate of congenital syphilis cases was, on average, 23.5 (95% confidence interval = 2.2, 44.8) cases per 100 000 live births higher in states with both a child abuse policy and a mandated reporting policy for prenatal substance use than in states with neither policy. Rates were similar in states with a child abuse policy only and a mandated reporting policy only compared to states with neither policy. Conclusions. The combination of state child abuse policies and mandated reporting policies for prenatal substance use potentially contributes to higher congenital syphilis case rates. (Am J Public Health. Published online ahead of print February 13, 2025:e1-e9. https://doi.org/10.2105/AJPH.2024.307951).

Community members returning from incarceration experience serious health disparities, which intensified during the COVID-19 pandemic. In response, community health workers with lived experience of incarceration in the Transitions Clinic Network established a California reentry health care hotline to support time-sensitive linkages to postrelease medical care. From June 2020 to June 2023, the hotline supported 1276 people transitioning from incarceration. Lessons from this peer-led public health intervention are relevant for states utilizing Medicaid waivers to improve health equity for justice-involved populations. (Am J Public Health. Published online ahead of print February 13, 2025:e1-e4. https://doi.org/10.2105/AJPH.2024.307969).