Epidemiology最新文献

{"title":"Be Wary of Age-stratum Aging in Early-onset Cancer Trends.","authors":"Axelle Braggion, Stéphane Cullati, Arnaud Chiolero","doi":"10.1097/EDE.0000000000001998","DOIUrl":"10.1097/EDE.0000000000001998","url":null,"abstract":"","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":" ","pages":"e14-e16"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Estimators in Partially Identified Models.","authors":"Richard F MacLehose, Timothy L Lash, Lindsay J Collin, Thomas P Ahern, Paul Gustafson","doi":"10.1097/EDE.0000000000002014","DOIUrl":"10.1097/EDE.0000000000002014","url":null,"abstract":"","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":" ","pages":"575-577"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148197849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying Demographic Predictors of Increased Nonfatal Opioid Overdose Risk Among New York State Medicaid Enrollees After the COVID-19 Pandemic: An Analysis of Heterogeneous Treatment Effects.","authors":"John R Pamplin, Katherine Wheeler-Martin, Allison Perry, Zachary Mannes, Noa Krawczyk, Stephen Crystal, Deborah S Hasin, Silvia S Martins, Ravi Shroff, Magdalena Cerdá, Daniel B Neill","doi":"10.1097/EDE.0000000000001992","DOIUrl":"10.1097/EDE.0000000000001992","url":null,"abstract":"<p><strong>Background: </strong>Overdose rates in the United States rose dramatically during the coronavirus disease 2019 (COVID-19) pandemic. Well-documented racial and sociodemographic inequities in the impact of the pandemic suggest the potential for similar inequities for overdose. Our objective was to identify subgroups of New York State Medicaid enrollees who experienced the greatest increases in nonfatal opioid overdose risk after the onset of the COVID-19 pandemic.</p><p><strong>Methods: </strong>Data are from a retrospective cohort of 1,021,889 people enrolled in New York State Medicaid from 2019 to 2020. To identify subgroups with the greatest increased risk of nonfatal overdose after the onset of the COVID-19 pandemic, we used a Heterogeneous Treatment Effect-Scan, a novel machine learning method developed for accurate and computationally efficient discovery of heterogeneous treatment effects in complex data.</p><p><strong>Results: </strong>In the total sample, the risk of nonfatal opioid overdose increased 22% after the onset of the pandemic. We also identified two subgroups with elevated risk relative to the total sample: subgroup 1 (Black and Hispanic males aged 45-64 years old with no baseline documentation of opioid use disorder (OUD); N = 53,065) and subgroup 2 (people aged 45-64 years old with documented aged/blind/disabled status and no baseline documentation of OUD; N = 73,694). These subgroups experienced a 54% and 57% increase in nonfatal overdose risk, respectively.</p><p><strong>Conclusion: </strong>We estimated heterogeneous effects of the onset of the COVID-19 pandemic on nonfatal overdose, with elevated risks estimated for older working-aged, structurally disadvantaged adults without documented OUD. These findings illustrate the importance of structural factors in driving heterogeneous risk of overdose after complex social events.</p>","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":" ","pages":"640-650"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13308939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147671523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Excess Adiposity among US and Canadian Adults with and without BMI-defined Obesity.","authors":"Laura N Anderson, Nuha Anver Mohamed Rizan, Rachel A Lipson, Alexandra J Mayhew, Lauren E Griffith","doi":"10.1097/EDE.0000000000002010","DOIUrl":"10.1097/EDE.0000000000002010","url":null,"abstract":"","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":" ","pages":"e16-e18"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147986995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Transitions Between Internalizing and Externalizing Symptoms and Associations with Substance Use among US Young Adults, 2016-2023.","authors":"Dae-Hee Han, Katherine M Keyes","doi":"10.1097/EDE.0000000000002009","DOIUrl":"10.1097/EDE.0000000000002009","url":null,"abstract":"<p><strong>Background: </strong>Internalizing and externalizing symptoms are key mental health indicators that frequently co-occur in young populations. This study examined transition probabilities between none/low-symptom, exclusive internalizing (e.g., depression, anxiety), exclusive externalizing (e.g., aggression, impulsivity), and co-occurring states in young adulthood and assessed associations with substance use.</p><p><strong>Methods: </strong>Using four waves (Waves 4-7) of the Population Assessment of Tobacco and Health Study (2016-2023), this prospective cohort study applied Markov multistate transition modeling to estimate transition probabilities across four mental health states based on self-reported past 12-month symptoms. We then examined how current (daily, nondaily) nicotine use, past 30-day binge drinking, cannabis use, prescription drug misuse, and sociodemographic characteristics were associated with transitions between mental health states among baseline young adults (18-24 years).</p><p><strong>Results: </strong>In the sample (N = 5,575), the baseline prevalences of none/low-symptom, exclusive internalizing, exclusive externalizing, and co-occurring states were 62.5%, 12.1%, 10.4%, and 13.9%, respectively. Sizable transition probabilities from internalizing or externalizing symptoms to co-occurring symptoms were observed in both short-term (21.6% and 19.7% at Wave 2) and long-term (14.7% and 14.4% at Wave 4) analyses. Co-occurring states demonstrated greater stability (43.9% short-term; 16.4% long-term) than internalizing or externalizing symptom states. Nicotine use was associated with transitions from none/low to internalizing symptoms; binge drinking and prescription drug misuse with transitions to externalizing symptoms; and cannabis use with transitions to both internalizing and externalizing symptoms.</p><p><strong>Conclusion: </strong>Transitions to co-occurring symptoms are frequent in young adulthood and may be associated with patterns of substance use.</p>","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":" ","pages":"679-687"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13281706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147987018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why Should We Scan for Heterogeneous Treatment Effects?","authors":"Stephen J Mooney","doi":"10.1097/EDE.0000000000002001","DOIUrl":"10.1097/EDE.0000000000002001","url":null,"abstract":"","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":" ","pages":"651-653"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147971488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pooled Multinomial Logistic Regression for Parametric G-computation in the Presence of Competing Events.","authors":"Lucas M Neuroth, Monica E Swilley-Martinez, Paul N Zivich, Jessie K Edwards","doi":"10.1097/EDE.0000000000001995","DOIUrl":"10.1097/EDE.0000000000001995","url":null,"abstract":"<p><strong>Background: </strong>Parametric g-computation with competing events typically involves fitting multiple pooled logistic regression models. We outline an alternative approach based on fitting a single pooled multinomial logistic model.</p><p><strong>Methods: </strong>Data from the Women's Interagency HIV Study (n = 1,164) were used to estimate the marginal 2-year risk of highly active antiretroviral therapy (HAART) initiation and AIDS/death before HAART initiation with two parametric g-computation approaches: multiple pooled logistic regression and pooled multinomial logistic regression. The total effect of historical injection drug use was estimated for both event types using the multinomial approach.</p><p><strong>Results: </strong>Both g-computation implementations produced identical results. The 2-year risk difference comparing a scenario where all participants had historical injection drug use to one with no historical injection drug use was -12.5% (-18.0%, -7.0%) for HAART initiation and 13.2% (6.8%, 19.7%) for AIDS/death.</p><p><strong>Conclusions: </strong>Incorporating a pooled multinomial logit nuisance model for parametric g-computation simplifies estimation of total effects while accounting for right-censoring and competing events.</p>","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":"37 5","pages":"591-595"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stratification and Accumulation?: Explaining Changing Mortality Inequities Between Business Owners and Non-owners in the United States (1984-2022).","authors":"Jerzy Eisenberg-Guyot, Seth J Prins, Anita Minh, Anjum Hajat, Audrey Renson","doi":"10.1097/EDE.0000000000002013","DOIUrl":"10.1097/EDE.0000000000002013","url":null,"abstract":"<p><strong>Background: </strong>Given established relationships between social class and mortality, the growing concentration of income, wealth, and power among business owners in the United States may have increased mortality inequities across classes. To investigate this hypothesis, we analyzed temporal changes in mortality inequities between owners and non-owners.</p><p><strong>Methods: </strong>Our sample included respondents ages 25-64 in the 1984, 1989, 1994, and 1999-2013 Panel Study of Income Dynamics with mortality follow-up through 2022 (respondents: 22,103; observations: 103,965). Business owners were individuals with personal or family ownership of, or direct financial interest in, a business in the prior year. Using g-computation, we estimated how inequities between owners and non-owners in 10-year age-adjusted mortality risks changed from 1984 to 2013. Next, we analyzed whether any changes were attributable to shifting social stratification. Finally, we analyzed whether growing income and wealth disparities between owners and non-owners exacerbated inequities.</p><p><strong>Results: </strong>In 1984, non-owners had 1.4 times (95% confidence interval [CI]: 1.1, 1.8) greater 10-year age-adjusted mortality risks than owners. In 2013, the figure was 2.3 (95% CI: 1.8, 3.0), yielding a ratio of risk ratios of 1.7 (95% CI: 1.1, 2.5). After social-stratification adjustment, within-year inequities lessened; however, increases across years attenuated only somewhat (2013 vs. 1984 ratio of risk ratios: 1.5 [95% CI: 0.99, 2.2]). Finally, we did not find that increases in inequities across years would have lessened if income and wealth distributions had remained at 1984 levels.</p><p><strong>Conclusion: </strong>Mortality inequities between owners and non-owners have increased and cannot be fully explained by social stratification and individual-level income and wealth distributions.</p>","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":" ","pages":"629-639"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lagged and Nonlinear Effects of Temperature Extremes on Mortality in US Federal Prisons: A Case-Crossover Study, 2009-2021.","authors":"Kristen N Cowan, Jérémie Boudreault, Katherine LeMasters, Lauren Brinkley-Rubinstein","doi":"10.1097/EDE.0000000000002007","DOIUrl":"10.1097/EDE.0000000000002007","url":null,"abstract":"<p><strong>Background: </strong>Temperature extremes are becoming more common due to climate change. Due to infrastructural issues and the demographic characteristics of the incarcerated population, incarcerated people are at high risk of poor health outcomes during extreme temperature events. However, limited empirical evidence exists, with no prior studies on US federal prisons. Our goal was to estimate associations between ambient temperature and all-cause mortality in federal prisons.</p><p><strong>Methods: </strong>Data on mortality in federal prisons from 2009 to 2021 were linked with daily mean temperature data. We employed a case-crossover design and distributed lag nonlinear models to estimate the temperature-mortality relationship for deaths occurring during the hot (May-September) and cold (November-March) months throughout the United States. Odds ratios were estimated comparing the odds of mortality at extreme temperature percentiles (5th and 95th percentiles) to the median temperature at each prison during the study period from 2009 to 2021.</p><p><strong>Results: </strong>Of 5,182 deaths from 2009 to 2021, most were recorded during hot (42%) and cold (41%) months. The cumulative effect of extreme hot (95th percentile) and cold (5th percentile) temperatures was protective, yet imprecise. At a 2-day lag for extreme hot temperatures and a same-day lag for extreme cold temperatures, we observed increased odds of mortality in federal prison.</p><p><strong>Conclusions: </strong>Our analysis of mortality in federal prisons yielded different results from previous analyses of mortality in state prisons. Future studies are needed to improve exposure estimation of indoor temperatures and quantify air conditioning access in US prisons.</p>","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":" ","pages":"698-708"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147971444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Long Arm of Childhood Policy: Historical Schooling Laws and COVID-19 Pandemic-era Mortality.","authors":"Whitney Wells, Yea-Hung Chen, Rafeya V Raquib, Marie-Laure Charpignon, Ah-Reum Lee, Ruijia Chen, Andrew C Stokes, Mathew V Kiang, Jacqueline M Torres, M Maria Glymour","doi":"10.1097/EDE.0000000000002002","DOIUrl":"10.1097/EDE.0000000000002002","url":null,"abstract":"<p><strong>Background: </strong>Low educational attainment was strongly associated with higher coronavirus disease 2019 (COVID-19) mortality. Whether this association is causal remains controversial. We evaluated the impact of historical state-level compulsory schooling laws (CSLs) on older individuals' pandemic-era mortality via a natural experiment.</p><p><strong>Methods: </strong>We defined the US population of older adults using the 2019 American Community Survey and included all US death certificates from March 2019 to December 2021. We linked each individual to state-level CSLs at school age. We estimated effects of state-level CSLs on individual-level COVID-19 mortality and all-cause mortality pre-pandemic (March 2019-February 2020), pandemic year 1 (March 2020-February 2021), and pandemic year 2 (March 2021-December 2021), controlling for birth year, sex, race and ethnicity, state-level demographics, and state-of-birth fixed effects. We also examined the effect heterogeneity by sex and racial identity.</p><p><strong>Results: </strong>Each additional year of policy-mandated compulsory schooling was associated with lower odds of COVID-19 mortality (pandemic year 1 odds ratio [OR] for 8 vs. 9 years: 1.16 [95% confidence interval [CI]: 1.11, 1.20]; OR for 10 vs. 9 years 0.96 [95% CI: 0.93, 0.98]; similar estimates in year 2). The relationship between CSLs and COVID-19 mortality roughly mirrored the relationship with all-cause mortality immediately before and during the pandemic. The gradient was steepest among Black women.</p><p><strong>Conclusion: </strong>Older adults born into states requiring longer schooling experienced markedly lower mortality during the pandemic, suggesting historic investments in children's education reduced pandemic-era mortality decades later. Our findings support a causal relationship between population-level education policy and long-term population health.</p>","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":" ","pages":"654-661"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13435900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147971439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}