American journal of public health最新文献

We explored gaming elements as a tool to promote engagement in HIV prevention services among Latino men who have sex with men. We conducted thematic content analysis of semistructured interview data that we collected from 12 Latino men who have sex with men (April-August 2022) in South Florida. Themes emerged related to intervention delivery, components, and perceptions. Our findings will guide the development of a game-based intervention to improve preexposure prophylaxis and HIV prevention engagement among Latino men who have sex with men. (Am J Public Health. 2026;116(S1):S10-S15. https://doi.org/10.2105/AJPH.2025.308353).

Objectives. To estimate the population size of people who inject drugs (PWID) in the United States in 2022. Methods. We constructed a hybrid estimator, which applied the ratio of nonfatal to fatal overdose among PWID to convert estimated injection-involved overdose deaths to the number of nonfatal overdoses. We divided the number of nonfatal overdose events by the prevalence of nonfatal overdose to generate PWID population size estimates. Results. There were an estimated 2 392 100 (95% confidence interval = 1 323 300, 4 648 100) PWID in 2022, which was 35% lower than the 2018 estimate. Most PWID were male and non-Hispanic White. The US South had the highest number of PWID. Conclusions. Reduced PWID population size may reflect improved data inputs or a true decline in the number of PWID because of high levels of overdose fatality or shifts in routes of drug consumption. These data are essential for determining needs for prevention services and rates of morbidity and mortality among PWID. (Am J Public Health. 2026;116(3):376-379. https://doi.org/10.2105/AJPH.2025.308310).

South Florida is the domestic epicenter of the HIV epidemic. However, awareness of and access to preexposure prophylaxis (PrEP) remain low. This report outlines lessons learned from the development and implementation of the PrEParados model-a spatially explicit, social network-based approach designed to engage adults in PrEP. Informed by social contagion theory, the PrEParados model integrates social network and geospatial methodologies to examine participant characteristics and gather information on their friendship, sexual, and substance use networks. (Am J Public Health. 2026;116(S1):S16-S21. https://doi.org/10.2105/AJPH.2025.308333).

Objectives. To determine the longitudinal relationships between economic hardship in 2020 and self-rated health (SRH) in 2022, and whether monetary stimulus payments offset negative health consequences of economic hardship among older adults living in the United States. Methods. We used data from 7549 adults aged 50 years or older from all US states in the longitudinal Health and Retirement Study cohort. Using Poisson regression models, we evaluated the relationship between economic hardship in 2020 and "fair or poor" SRH in 2022, and whether receipt of stimulus payments modified this relationship, controlling for covariates. Results. In stratified analysis, among persons who did not receive a stimulus payment, economic hardship was associated with higher risk of "fair or poor" SRH (risk ratio [RR] = 1.50; 95% confidence interval [CI] = 1.22, 1.85). Among persons who received a stimulus payment, the relationship between economic hardship and "fair or poor" SRH was nonsignificant (RR = 1.06; 95% CI = 0.96, 1.17). Conclusions. Receipt of a stimulus payment may have offset the negative consequences of economic hardship on SRH among persons aged 50 years and older. Public Health Implications. Monetary payments may be an effective health intervention for persons experiencing economic hardship. (Am J Public Health. Published online ahead of print February 26, 2026:e1-e9. https://doi.org/10.2105/AJPH.2025.308414).

Objectives. To determine differences in reasons for choosing telehealth abortion based on food insecurity status. Methods. We analyzed data from the California Home Abortion by Telehealth (CHAT) Study, which included survey responses from patients who received medication abortion care between 2021 and 2022 from 1 of 3 virtual US clinics. Based on responses from 1726 survey participants, we used multivariable logistic regression to analyze differences in reported reasons for choosing telehealth abortion among individuals who experienced food insecurity versus those who did not. Results. Compared with individuals in food-secure households, individuals who experienced food insecurity were more likely to choose telehealth abortion because of cost, challenges in finding transportation, challenges in finding child or dependent care, and concerns related to fear, judgment, and discrimination regarding care at an in-person clinic. Conclusions. When seeking an abortion, individuals in food-insecure households consider many factors relevant to their abortion care preferences and reproductive health. Telehealth abortion, with its lower cost, may be particularly appealing to individuals who experience economic constraints. (Am J Public Health. Published online ahead of print February 26, 2026:e1-e9. https://doi.org/10.2105/AJPH.2025.308372).

Objectives. To describe health care‒related educational divides in 2 dimensions-outpatient care utilization and medically preventable deaths-over the past 25 years. Methods. We examined education-based disparities in ambulatory care utilization by analyzing data on 476 277 respondents aged 25 years or older to the 1996-2022 US Medical Expenditure Panel Survey, and in deaths potentially preventable by medical care (defined by International Classification of Diseases, 10th Revision, code) from 26 092 720 death certificates of individuals aged 25 to 74 years in the United States from 2001 to 2023. Results. In 1996, the share of adults with zero provider visits was higher among those without (26.4%; 95% confidence interval [CI] = 25.3, 27.5) than with (20.2%; 95% CI = 18.5, 22.0) a bachelor's degree, a gap that widened to a nearly 2-fold difference by 2022; the gap in the proportion with no doctor visit also widened. Disparities in health care use were larger after adjustment for health factors. Separately, we observed large and growing education-based gaps in age-adjusted health care‒amenable mortality. Conclusions. Education-based disparities in ambulatory health care utilization have grown since 1996, as have medically preventable deaths. Public Health Implications. Improved health care access for less-educated Americans might help address widening disparities in ambulatory health care use and, potentially, health outcomes. (Am J Public Health. Published online ahead of print February 19, 2026:e1-e10. https://doi.org/10.2105/AJPH.2025.308373).

Objectives. To examine whether there are reduced or elevated risks for all-cause, overdose, and suicide mortality after moving into supported housing. Methods. A national retrospective cohort study compared a census of 60 888 veterans experiencing homelessness in the US Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) program with a 1:1 propensity-score matched group of veterans experiencing homelessness from 2017 to 2021. Results. Rates for all-cause mortality in the matched HUD-VASH group significantly increased after 6 months, and risk of all-cause mortality was slightly higher in the HUD-VASH group than the matched comparison cohort at 24-month follow-up. Overdose mortality risk was twice as high among the HUD-VASH cohort across all time points, and there was no significant group difference in suicide mortality risk across time. Conclusions. Supported housing was associated with an initial lower risk of all-cause mortality that was not sustained over the course of 2 years. Veterans in supported housing were consistently more likely to die from drug overdose than were other veterans experiencing homelessness. Public Health Implications. The timely provision of substance use treatment in supported housing could be important to prevent drug overdose deaths. (Am J Public Health. Published online ahead of print February 12, 2026:e1-e9. https://doi.org/10.2105/AJPH.2025.308371).

Violence is preventable, and the United Nations' Sustainable Development Goals set out violence prevention as a global priority-calling for countries to halve their violent death rates by 2030. Despite action since then, there has been limited progress in reducing violence globally. In this essay, we argue that current violence prevention efforts are being heavily shaped by reductionism-the now-dominant research paradigm across the sciences. We make the case that this reductionist philosophy has prematurely misguided violence research away from studying populations as a whole. We further argue that the mainstream statistical methods in violence research are reinforcing this reductionist bias by oversimplifying cause-effect relationships. After revisiting foundational principles in sociology and public health, and drawing on advances in social epidemiology and complexity science, we suggest that violence-at any level-is better understood as an emergent property of a complex system. We call on the field of violence research to return to a holistic lens to maximize gains in explanatory theory and better position the evidence to directly inform effective intervention strategies for reducing violence at scale. (Am J Public Health. Published online ahead of print February 12, 2026:e1-e10. https://doi.org/10.2105/AJPH.2025.308366).