Journal of Medicine, Surgery, and Public Health最新文献

{"title":"Unifying and linking data sources in medical and public health research","authors":"Kavita Batra,&nbsp;Vidhani S. Goel,&nbsp;Ana L. Reyes,&nbsp;Bertille Assoumou,&nbsp;Dodds P. Simangan,&nbsp;Farooq Abdulla,&nbsp;Deborah A. Kuhls","doi":"10.1016/j.glmedi.2024.100164","DOIUrl":"10.1016/j.glmedi.2024.100164","url":null,"abstract":"<div><div>Data linkage methods, including probabilistic, deterministic, and hybrid are critical for linking medical and public health records, expanding data scope, and improving research outcomes. These methods differ in accuracy, efficiency, and scalability. This letter seeks to identify best practices for enhancing data quality and linkage rates in healthcare and public health research using these techniques. Data linkage enhances data quality by removing duplicates and correcting artifacts, facilitates cost-effective longitudinal studies by integrating existing data, and supports public health through person-oriented statistics and disease registries. Tools like \"RecordLinkage\" in R and EpiLink have advanced linkage accuracy, particularly in epidemiological studies. A PubMed search in November 2023 identified 176 studies, with 29 meeting inclusion criteria. Hybrid methods showed superior accuracy, with some studies achieving over 90 % linkage rates. Emerging AI-driven methods can further improved scalability, efficiency, and automation, employing privacy-preserving techniques like federated learning to address confidentiality concerns. However, challenges such as inconsistent data, incomplete identifiers, and technical complexities remain, emphasizing the need for standardized protocols and robust ethical frameworks. In low- and middle-income countries (LMICs), tailored strategies such as enhancing health information systems, adopting open-source tools, and fostering regional collaborations are essential to address resource constraints. Initiatives like the Western Australian Data Linkage System exemplify the potential impact of linkage on healthcare and public health. Future research should focus on refining methods, integrating diverse datasets, and leveraging AI to improve linkage efficiency and reliability. By adopting best practices, data linkage can enhance decision-making, optimize interventions, and advance global health research.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"5 ","pages":"Article 100164"},"PeriodicalIF":0.0,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143092872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multilevel determinants of linkage to care among pregnant women with opioid use disorder","authors":"Olajumoke Olarewaju,&nbsp;Samuel Tundealao","doi":"10.1016/j.glmedi.2024.100162","DOIUrl":"10.1016/j.glmedi.2024.100162","url":null,"abstract":"<div><div>Opioid use disorder (OUD) in pregnancy poses considerable risks for both the mother and the child, with rising opioid use among women of reproductive age in the United States. Although OUD is treatable, pregnant individuals frequently encounter obstacles like stigma, legal issues, and inadequate access to healthcare. This commentary examines the factors influencing access to treatment services for pregnant individuals with OUD. The proposed conceptual framework using the socioecological model emphasizes the intricate relationships among these multi-level determinants. At the individual level, social expectations of motherhood, internalized stigma, previous healthcare experiences, insufficient understanding of treatment alternatives, and absence of health insurance frequently establish substantial obstacles to care. At the interpersonal level, healthcare personnel's attitudes, training, and communication are crucial in establishing trust and promoting treatment adherence, while supportive social networks and family involvement enhance care engagement and resilience. Structurally, the systemic constraints, including the variability in Medicaid coverage, geographic inequities, and inadequate integration of prenatal and addiction care, impede access, exacerbated by punitive policies that stigmatize substance use during pregnancy. Comprehending these dynamics can guide treatments designed to enhance treatment linkage and results. Advocating for a compassionate, patient-centered methodology within healthcare systems is crucial for tackling this escalating public health epidemic and mitigating the stigma associated with opioid use during pregnancy.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"5 ","pages":"Article 100162"},"PeriodicalIF":0.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143092771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large language models for improving cancer diagnosis and management in primary health care settings","authors":"Albert Andrew,&nbsp;Ethan Tizzard","doi":"10.1016/j.glmedi.2024.100157","DOIUrl":"10.1016/j.glmedi.2024.100157","url":null,"abstract":"<div><div>Cancer remains a leading cause of death globally, but diagnosing and treating it is often challenging. Barriers such as multiple consultations, overburdened healthcare systems, and limited cancer-specific training among primary health care clinicians significantly delay diagnoses and worsen outcomes. To address these challenges, health care must enhance patient and clinician knowledge while minimizing diagnostic and treatment delays. Emerging technologies, particularly artificial intelligence (AI), hold great promise in revolutionising cancer care by improving diagnosis, education, and patient management. Large language models (LLMs) such as ChatGPT offer exciting potential to enhance cancer care in three key areas: clinical decision-making, patient education and engagement, and access to oncology research. Studies suggest that ChatGPT-4's oncology-related performance approaches that of medical professionals, enabling it to assist in decision-making, improve outcomes, and streamline cancer care. These tools can help clinicians rule out potential cancer diagnoses based on symptoms and history, reducing unnecessary tests and consultations. Additionally, specialised LLMs can provide accessible, understandable information for patients while disseminating cutting-edge research to clinicians. Despite their potential, LLMs face notable limitations. Output quality varies based on the type of cancer or treatment, the specificity of questions, and phrasing. Many LLMs produce responses requiring advanced literacy, limiting accessibility. Moreover, AI bias remains a concern; training on biased data could perpetuate healthcare inequalities, leading to harmful recommendations. Accountability is another critical issue—the ability for LLMs to produce errors in its outputs raise questions about responsibility, highlighting the need for safeguards and clear frameworks to ensure equitable and reliable AI integration into cancer care.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"4 ","pages":"Article 100157"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143170298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diet fads and supplements: Navigating the allure, risks, and reality","authors":"Jagdish Khubchandani,&nbsp;Kavita Batra","doi":"10.1016/j.glmedi.2024.100168","DOIUrl":"10.1016/j.glmedi.2024.100168","url":null,"abstract":"<div><div>Diet fads and supplements have become an integral part of modern health culture, growing steadily in popularity over the years. What started as relatively simple practices has now evolved into a booming industry, driven by societal pressures, technological advancements, and changing cultural ideals. From promises of quick weight loss to claims of improved health and longevity, these products and practices often come with bold assertions. However, many of these claims lack the support of strong scientific evidence, leaving consumers vulnerable to misinformation, unrealistic expectations, and potential health risks. This editorial dives into the several pertinent questions and issues associated with the use of diet fads and supplements and their growing popularity. Consumers must approach these products and fads with a critical mindset, healthcare providers need to offer evidence-based and culturally sensitive guidance, and regulators should enforce stricter measures to combat false advertising and ensure consumer safety. Collaborative research is vital to uncover long-term effects, address gaps in knowledge, and shape public policies that protect consumers as it relates to diet supplements and fads. The global public health community of scholars and practitioners has to address with urgency the challenges posed by diet fads and supplements to safeguard consumer public health in an ever-evolving marketplace of health-related products and trends.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"4 ","pages":"Article 100168"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143170297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revised clinical standards for assessing sepsis: Serum iron level as an emerging biomarker","authors":"Maham Bilal,&nbsp;Ali Ait Hssain,&nbsp;Abdulqadir J. Nashwan","doi":"10.1016/j.glmedi.2024.100161","DOIUrl":"10.1016/j.glmedi.2024.100161","url":null,"abstract":"<div><div>Iron is a vital trace element for basic human and bacteria processes. Iron metabolism is altered in sepsis, decreasing iron export and increasing iron transport and cell uptake. As a defense against circulating infections, intracellular iron sequestration restricts their availability. Although iron retention has been shown to have protective effects, an upsurge in labile iron may result in oxidative injury and cell death (e.g., pyroptosis and ferroptosis) as the condition worsens. A recent meta-analysis has revealed a correlation between high serum iron levels and intensive care unit mortality. However, low serum iron levels have traditionally been associated with increased mortality rates. This letter highlights the need for further research to re-evaluate this contradictory finding and comprehend sepsis's pathophysiological mechanisms. We emphasize the need for additional knowledge to make serum iron levels a valuable prognostic and diagnostic marker.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"4 ","pages":"Article 100161"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between women’s autonomy and reproductive health outcomes in India","authors":"Charu Tayal ,&nbsp;Rajesh Sharma ,&nbsp;Kusum Lata","doi":"10.1016/j.glmedi.2024.100156","DOIUrl":"10.1016/j.glmedi.2024.100156","url":null,"abstract":"<div><h3>Background</h3><div>In India, limited autonomy in maternal reproductive healthcare decision-making remains a persistent issue. This study investigates the impact of women’s autonomy in managing their healthcare on abortion history, knowledge of contraceptive methods, wanted pregnancy, and delivery via caesarean section in India.</div></div><div><h3>Data and methods</h3><div>The data for this study were extracted from two rounds of the Indian Demographic and Health Survey [DHS (2015–16) and DHS (2019–21)]. Descriptive statistics, logistic regression and time interaction regression model were employed to investigate the association between women’s autonomy in managing their healthcare and access to reproductive healthcare services.</div></div><div><h3>Results</h3><div>Women whose healthcare decisions were jointly managed with their husband/partner had higher odds of having a wanted pregnancy [OR = 1.64; p&lt;0.01] in 2015–16 and [OR = 1.29; p&lt;0.10] in 2019–21 compared to women who managed healthcare decisions alone. However, the significance of shared healthcare decision-making in predicting a wanted pregnancy diminished between 2015–16 and 2019–21. In 2015–16, the odds of delivery via caesarean section were lower for women who managed their healthcare jointly with their husband/partner [OR = 0.79; p&lt;0.05] and for those whose healthcare decisions were made by someone else [OR = 0.57; p&lt;0.01] compared to women who managed healthcare decisions alone. Additionally, in 2015–16 when healthcare decisions were made by the husband/partner alone, women had significantly lower odds of knowing contraceptive methods [OR = 0.48; p&lt;0.05] compared to when women managed healthcare decisions alone. Furthermore, in each round, women with higher levels of education, health insurance coverage, from wealthier households, and those whose husbands were educated and older at the time of childbirth, had higher odds of having contraceptive knowledge and a wanted pregnancy in India.</div></div><div><h3>Conclusion</h3><div>In summary, we found that when healthcare decisions were made solely by the husband or partner, women had significantly lower odds of being knowledgeable about contraceptive methods. Furthermore, we found that the odds of delivery via caesarean section were lower when women jointly managed their healthcare with their partner. To achieve Sustainable Development Goal 3.7, which calls for universal access to sexual and reproductive healthcare services, it is crucial to promote informed reproductive choices, enhance contraceptive knowledge, and increase access to reproductive healthcare services in India.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"4 ","pages":"Article 100156"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistent blepharospasm and bradyphrenia following Artery of Percheron infarction","authors":"Hazim Muhammad Yousuf Brohi,&nbsp;Muhammad Luqman,&nbsp;Syeda Zainab Fatima Rizvi ,&nbsp;Syed Muhammad Sinaan Ali ,&nbsp;Mohammad Bilal Abbasi","doi":"10.1016/j.glmedi.2024.100160","DOIUrl":"10.1016/j.glmedi.2024.100160","url":null,"abstract":"<div><div>Infarctions of the artery of Percheron are a rare clinical event, primarily presenting as bilateral thalamic infarcts with varying manifestations. We report an unusual case of a 50-year-old male who presented with sudden loss of consciousness, afebrile hypertension, and a Glasgow Coma Scale (GCS) score of 7/15. Initial laboratory findings were unremarkable, but further investigations revealed bilateral thalamic infarcts on MRI. The patient was managed for stroke with antiplatelet therapy and supportive treatment. He was discharged after improvement in his clinical status; however, he continued to experience persistent bradyphrenia and blepharospasm. During a follow-up visit, the patient was administered a Botox injection, which improved the blepharospasm, emphasizing on the importance of palliative care in addressing long-term sequelae of stroke. This patient exhibited the rare combination of bradyphrenia and blepharospasm. MRI is the investigation of choice in diagnosing AOP infarcts, but timely clinical evaluation is essential to minimize the risk of persistent long-term symptoms. This case of an atypical presentation of blepharospasm and bradyphrenia associated with an AOP infarct highlights the need for further research into the diverse clinical manifestations and underlying mechanisms of these infarctions.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"4 ","pages":"Article 100160"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethical Challenges in the Integration of Artificial Intelligence in Palliative Care","authors":"Abiodun Adegbesan ,&nbsp;Adewunmi Akingbola ,&nbsp;Olajide Ojo ,&nbsp;Otumara Urowoli Jessica ,&nbsp;Uthman Hassan Alao ,&nbsp;Uchechukwu Shagaya ,&nbsp;Olajumoke Adewole ,&nbsp;Owolabi Abdullahi","doi":"10.1016/j.glmedi.2024.100158","DOIUrl":"10.1016/j.glmedi.2024.100158","url":null,"abstract":"<div><div>The integration of artificial intelligence (AI) into palliative care offers the possibility of improved patient outcomes through enhanced decision-making, personalized care, and reduced healthcare provider burden. However, the use of AI in this sensitive area presents significant ethical challenges which require serious consideration to ensure that technology serves the best interests of patients without compromising their rights or well-being. This narrative review explores the key ethical issues associated with AI in palliative care, with a focus on low-resource settings where these challenges are often intensified. The review examines essential ethical principles such as autonomy, beneficence, non-maleficence, and justice, and identifies critical concerns including data privacy, informed consent, algorithmic bias, and the risk of depersonalizing care. It also highlights the unique difficulties faced in low-resource environments, where the lack of infrastructure and regulatory frameworks can exacerbate these ethical risks. To address these challenges, the review offers actionable recommendations, such as developing context-specific guidelines, promoting transparency and accountability through explainable AI (XAI), and conducting regular ethical audits. Interdisciplinary collaboration is emphasized to ensure that AI systems are ethically designed and implemented, respecting cultural contexts and upholding patient dignity. This study contributes to the ongoing discourse on ethical AI integration in healthcare, indicating the need for careful consideration of ethical principles to ensure that AI enhances rather than undermines the compassionate care at the heart of palliative care. These findings serve as a foundation for future research and policy development in this emerging field.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"4 ","pages":"Article 100158"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer screening among sexual minority groups in the United States","authors":"Samuel Tundealao ,&nbsp;Anusha Sajja ,&nbsp;Tolulope Titiloye ,&nbsp;Praise Okunlola ,&nbsp;Adedayo Ogunware ,&nbsp;Olajumoke Olarewaju","doi":"10.1016/j.glmedi.2024.100159","DOIUrl":"10.1016/j.glmedi.2024.100159","url":null,"abstract":"<div><div>This study assessed the prevalence and likelihood of being up-to-date with cancer screening tests based on sexual orientation among United States (US) adults. It is a secondary analysis of the Health Information National Trends Survey 6, a nationally representative survey of civilian, non-institutionalized adults aged 18 or older living in the United States. A descriptive analysis of the sociodemographic characteristics based on cancer screening was done with a survey-weighted Chi-Squared test. Survey-weighted binomial multivariable logistic regression was used to assess the relationship between sexual orientation and being up-to-date with cancer screening tests. In addition, logistic regression using the backward selection method was also used to evaluate factors associated with not being up-to-date with cancer screening among the sexual minority (SM) population alone. There were 5209 heterosexual individuals (non-SM) and 439 SM individuals (58 lesbian women, 93 gay men, 148 bisexual women, 35 bisexual men, and 105 other SM groups). Approximately 17.5 % of non-SM individuals in the US are up-to-date with cancer screening tests, while 10.9 % of SM people are up-to-date with cancer screening. The prevalences of up-to-date cancer screening among the different SM populations include gay men (7.4 %), lesbian women (12.6 %), bisexual men (8.7 %), bisexual women (9.7 %), and other SM groups (15.5 %). SM people are 1.56 times (CI: 1.06 – 2.91, p&lt;0.03) more likely to not be up-to-date with cancer screening tests compared to non-SM individuals after adjusting for other sociodemographic characteristics. SM individuals who are less than 40 years old (aOR = 4.16, CI: 1.54–11.20, p=0.006), not married (aOR = 2.75, CI: 1.05–7.15, p=0.041), and currently smoke (aOR = 5.60, CI: 1.09–28.85, p=0.040) are more likely not to be up-date with cancer screening. This study provided crucial information that further bridged gaps in cancer disparities among the SM population and provided information that could help define SM-specific interventions to increase the rates of cancer screening among this population.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"4 ","pages":"Article 100159"},"PeriodicalIF":0.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social factors related to gun violence in urban United States","authors":"Joseph A. McMillan ,&nbsp;Sri Banerjee ,&nbsp;Rafael Gonzales-Lagos ,&nbsp;Wayne Harris","doi":"10.1016/j.glmedi.2024.100155","DOIUrl":"10.1016/j.glmedi.2024.100155","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Gun violence (GV), acknowledged as a public health crisis, disproportionately affects urban centers in the United States. However, the precise connections between social factors and GV are not fully understood. This study, leveraging the Cardiff Model approach, evaluates whether there is a statistical and geospatial relationship between social vulnerability index (SVI) and GV.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;In this cross-sectional study, we combined Gun Violence Archive (GVA), a dataset of firearm violence (2019–2023), with corresponding census tract level SVIs for three selected cities—Atlanta, GA; St. Louis, MO; and Washington, DC. The GVA was created, due to gaps in government-based data, from daily public records and media by an independent data collection group. Also, the SVI, derived from a place-based index from Centers for Disease Control (CDC), was originally used to evaluate the resiliency of communities to recover from socio-environmental stressors. GV data from these three cities, representative of major urban centers in the United States, were used to conduct various analyses. We used Poisson regression to assess whether nine of the sixteen SVI measures were statistically associated with GV incidents. Furthermore, we examined whether spatial relationships between SVI and GV differ by level of concentrated disadvantage in urban neighborhoods.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Out of all GV incidents (10,442), corresponding to 488 census tracts, teenagers ages 12–17 were found to have higher GV rates in St. Louis (12 %) than Atlanta (7.6 %) and Washington DC (10.5 %). Children, ages 0–11, in St. Louis (3.1 %) were involved in more GV incidents than the other two (Washington DC-1.2 % and Atlanta-2.3 %) cities. In the composite model, census tract-level SVIs were statistically significantly associated with GV. Some of the most prominent SVIs, viewed as predictors of GV, included racial-ethnic minority [Incidence Rate Ratio (IRR): 1.02, 95 % CI: 1.01–1.02, p&lt;0.001], 150 % of Federal Poverty Level (FPL) [IRR: 1.00, 95 % CI: 1.00–1.01, p&lt;0.001], and unemployment (IRR: 1.01, p&lt;0.001). Also, many of the SVI variables were found to be significantly associated with GV incidents in each of the three selected cities.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;In this original study, we found that there was a strong statistically significant association between SVI-related disadvantaged neighborhoods and increased GV incidents. Additionally, we found that the geospatial distribution of GV incidents were more concentrated in neighborhoods with increased vulnerability throughout the three (Atlanta, GA; St. Louis, MO; and Washington, DC) selected cities than those neighborhoods with decreased vulnerability. Unique approaches such as integration of the SVI with gun control legislation, which informs ownership, use, and access to firearms, provides a better strategy to inform the implementation of an inter","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"4 ","pages":"Article 100155"},"PeriodicalIF":0.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142705099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}