Injury Prevention最新文献

{"title":"Acute work-related injuries among older adults in the USA on Medicare, 2016-2019: a national longitudinal study.","authors":"Matthew McFalls, Beth Virnig, Andrew D Ryan, Hyun Kim, Bruce H Alexander, Marizen Ramirez","doi":"10.1136/ip-2024-045363","DOIUrl":"https://doi.org/10.1136/ip-2024-045363","url":null,"abstract":"<p><strong>Objectives: </strong>Work-related injuries are only partially captured for older workers in the USA, likely due to low sensitivity of traditional data sources, such as workers' compensation, to capture non-fatal incidents. Using claims from Medicare, the primary health insurance of most US adults after age 65, we identified and described work-related injuries among Medicare enrollees aged 65 years and older.</p><p><strong>Methods: </strong>We identified injury claims from 2016 to 2019 Medicare inpatient and outpatient claims for aged 65+ Medicare fee-for-service enrollees. We then identified work-related injury claims using ICD-10-CM external cause codes and employment-related and workers' compensation codes used in Medicare claims processing. We calculated annual rates of work-related injuries among aged 65+ Medicare fee-for-service enrollees. We described demographics, injuries and their mechanisms, and healthcare encounter characteristics of Medicare enrollees with work-related injuries.</p><p><strong>Results: </strong>From 2016 to 2019, the average annual rate of work-related injuries was 27.6 per 100 000 Medicare fee-for-service enrollees aged 65+. Injury claims were most often for outpatient emergency department (ED) visits (58%), followed by non-ED outpatient visits (20%) and hospitalisations (19%). Falls, transportation and machinery-related mechanisms of injury each accounted for approximately 20% of injuries.</p><p><strong>Conclusions: </strong>Using the mechanism of injury, employment-related and workers' compensation codes, Medicare claims can be used to identify work-related injuries. Most work-related injuries appear in outpatient settings, although hospitalisations involve the most extensive care. Future research should validate and expand these methods, drawing on the depth of information in Medicare claims data to explore costs and health outcomes of work-related injuries in older populations.</p>","PeriodicalId":13682,"journal":{"name":"Injury Prevention","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do socioeconomic status, race and ethnicity modify the relationship between alcohol use and unintentional injury mortality?","authors":"Laura Llamosas-Falcón, Yachen Zhu, William C Kerr, Jürgen Rehm, Charlotte Probst","doi":"10.1136/ip-2024-045505","DOIUrl":"10.1136/ip-2024-045505","url":null,"abstract":"<p><strong>Background: </strong>There is a knowledge gap regarding the potential roles that socioeconomic status (SES), race and ethnicity may play in the associations between alcohol use and injury risk. This study aimed to examine these factors as potential effect modifiers in the relationship between heavy episodic drinking (HED) and unintentional injury mortality.</p><p><strong>Methods: </strong>We used mortality-linked data from the 1997-2018 US National Health Interview Survey. We performed survey-weighted Cox proportional hazards models to evaluate the effect modification of education, income, race and ethnicity on the relationship between the frequency of HED and motor vehicle and other unintentional injuries mortality.</p><p><strong>Results: </strong>559 442 participants were included, with 772 motor vehicle fatalities and 2003 other unintentional injury deaths. Our cohort study found no significant interaction effect between SES, race and ethnicity, and HED on motor vehicle fatalities. For other unintentional injury mortality, we identified a significant interaction effect between low education and HED once or more per month (HR 2.75, 95% CI 1.38 to 5.49). Similarly, we found a significant interaction effect between low income and HED once or more per month (HR 1.84, 95% CI 1.02 to 3.34). Finally, both Black and Hispanic participants exhibited a higher risk of other fatal unintentional injuries at varying frequencies of HED compared with White participants.</p><p><strong>Conclusions: </strong>Our results emphasise the importance of considering SES, race and ethnicity in understanding the complex interplay between alcohol consumption and unintentional injury mortality. Understanding subgroup-specific dynamics is crucial for formulating targeted interventions to address disparities and enhance public health outcomes.</p>","PeriodicalId":13682,"journal":{"name":"Injury Prevention","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moderating role of drowning risk perceptions in the relationship between adolescent and peer risk-taking behaviours: implications for drowning prevention.","authors":"Shi Luo, Zhengyang Mei","doi":"10.1136/ip-2024-045419","DOIUrl":"https://doi.org/10.1136/ip-2024-045419","url":null,"abstract":"<p><strong>Background: </strong>While previous studies have investigated the risk factors contributing to drowning risk-taking behaviours in adolescents, whether peer risk-taking behaviours influence this relationship remains uncertain. This study explored the potential relationship between peer risk-taking behaviours and adolescent drowning risk-taking behaviours while examining whether drowning risk perceptions play a moderating role in this relationship.</p><p><strong>Methods: </strong>A national survey of 7485 adolescents in China was conducted using three scales: the Drowning Risk-Taking Behaviours scale, the Peer Risk-Taking Behaviours scale and the Drowning Risk Perceptions scale. Pearson's analysis was employed to identify the correlations and hierarchical regression to examine the moderating role of drowning risk perceptions.</p><p><strong>Results: </strong>Peer risk-taking behaviours promoted adolescent drowning risk-taking behaviours (β=0.428, t=45.384, p<0.001). The interaction between peer risk-taking behaviours and susceptibility to drowning and seriousness of drowning reduced adolescent drowning risk-taking behaviours (β=-0.175, t=-18.576, p<0.001; β=-0.189, t=-20.802, p<0.001, respectively). The interaction between peer risk-taking behaviours and benefits of swimming skills also reduced adolescent drowning risk-taking behaviours (β=-0.227, t=-24.858, p<0.001), whereas the interaction between peer risk-taking behaviours and perceived barriers did not (β=0.012, t=1.242, p>0.05).</p><p><strong>Conclusions: </strong>Peer risk-taking behaviours are an important risk factor for adolescent drowning risk-taking behaviours, whereas an individual's drowning risk perceptions serve as a protective factor that negatively moderates the relationship between the two.</p>","PeriodicalId":13682,"journal":{"name":"Injury Prevention","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"State-wise economic burden of road traffic injuries in India.","authors":"Sajith Kumar S, Bhavani Shankara Bagepally, Akhil Sasidharan, Kayala Venkata Jagadeesh, Manickam Ponnaiah","doi":"10.1136/ip-2024-045429","DOIUrl":"https://doi.org/10.1136/ip-2024-045429","url":null,"abstract":"<p><strong>Background: </strong>Road traffic injuries (RTI) cause multifarious detrimental consequences, including fatality and serious injuries. RTIs cause considerable financial strain on healthcare systems with high costs of medical care, long-term care for the injured and lost productivity. To assess this economic burden, we estimated the state-wise economic costs of RTI in India.</p><p><strong>Methods: </strong>We followed the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) Checklist 2022 to present the methods and outcomes. Data were obtained from the Global Burden of Diseases, Injuries and Risk Factors Study, Government of India's budget documents, annual reports of the National Health Authority, Controller General of Accounts and Economic Surveys. Cost per disability-adjusted life years (DALY), direct costs, indirect costs and total costs associated with RTI burden were estimated for India and by its states.</p><p><strong>Results: </strong>The RTI burden declined in all Indian states except Jammu and Kashmir (with a minor increase from 1458 to 1564 DALYs per 100 000) and Rajasthan (from 1275 to 1394 DALYs per 100 000) during the 2010-2019 period. The estimated mean cost per DALY in India due to RTI was ₹1821 (95% CI 1606 to 2036) (US$22 (95% CI 19 to 24)), with a median (IQR) of ₹1609 (551) (US$19 (7)). As of 2019, the estimated mean total cost of RTI burden in India was ₹1017 billion (US$12 billion), with a median (IQR) of ₹731 billion (1220 billion) (US$9 billion (15 billion)).</p><p><strong>Conclusion: </strong>The burden of RTIs declined across the Indian states during 2010-2019, and the same was not observed with fiscal implications. The study reiterates the need for strategic road safety interventions to ameliorate the socioeconomic and health impacts of RTIs in India.</p>","PeriodicalId":13682,"journal":{"name":"Injury Prevention","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of question wording for self-reported traumatic brain injuries among adults: findings from the 2023 SummerStyles survey.","authors":"Dana Waltzman, Rashad Kuku, Alexis Peterson, Matthew Breiding, Jill Daugherty","doi":"10.1136/ip-2024-045282","DOIUrl":"https://doi.org/10.1136/ip-2024-045282","url":null,"abstract":"<p><strong>Background: </strong>Surveillance of traumatic brain injury (TBI) in the USA has historically relied on healthcare administrative datasets, but these methods likely undercount the true burden of TBI. Self-report measures may help obtain more comprehensive estimates. A fundamental question is whether TBI prevalence estimated through self-report varies by whether and how TBI signs and symptoms are ascertained in the survey question(s).</p><p><strong>Methods: </strong>Self-report data were collected from 4303 adults in the summer wave of Porter Novelli's 2023 ConsumerStyles survey. Respondents were randomised to receive a question about their 12-month experience of head injury and a grouped list of TBI signs/symptoms or a question about their 12-month experience of head injury and an option to select individual TBI signs and symptoms that resulted from the head injury. All respondents who indicated they experienced a head injury received a set of follow-up questions.</p><p><strong>Results: </strong>A significantly higher percentage of people who received the 'individual signs/symptoms' question self-reported a TBI (8.3%) than those who received the 'grouped signs/symptoms' question (4.3%) χ²=19.6, p<0.0001. Among TBI cases identified, there were no statistical differences between question type in relation to whether the respondent reported being evaluated for or diagnosed with a TBI, nor any demographic differences.</p><p><strong>Conclusions: </strong>These results demonstrate that how TBI is ascertained in a survey can meaningfully impact reporting of TBI prevalence and provides evidence that question wording and structure affect estimates on national surveys.</p>","PeriodicalId":13682,"journal":{"name":"Injury Prevention","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Oregon's extreme risk protection order law to address risk of firearm suicide.","authors":"Rebecca Valek, Rebecca Teichman, Shauna Rakshe, Susan DeFrancesco, Kathleen F Carlson","doi":"10.1136/ip-2024-045581","DOIUrl":"https://doi.org/10.1136/ip-2024-045581","url":null,"abstract":"<p><strong>Background: </strong>Extreme risk protection order (ERPO) laws may be effective tools for preventing firearm suicide. Oregon's ERPO law allows family/household members or law enforcement officers (LEOs) to petition a civil court for an order to temporarily restrict a person's access to firearms when at imminent risk of harming themselves or others. We analysed Oregon's ERPO petitions to describe the law's utilisation for the potential prevention of suicide.</p><p><strong>Methods: </strong>ERPO petitions were obtained from the Oregon Judicial Department. Data were abstracted for the 6-year period after the law took effect (2018-2023). A 20% random sample of records was double-coded. Inter-rater agreement was >80% for key variables. Descriptive analyses were conducted to examine petitions citing suicide risk; cross-tabulations compared suicide-related petitions to those unrelated to suicide.</p><p><strong>Results: </strong>There were 835 petitions filed and 650 (78%) initially granted. Suicide risk was identified in 516 petitions (62%), 421 of which were initially granted (82%). Suicide-related petitions were more likely to be granted than non-suicide-related petitions (72%; p=0.001). Threats to others were also cited in 80% of suicide-related petitions. LEOs filed 60% and family/household members filed 29% of suicide-related petitions. Concerns cited in suicide-related petitions included substance use (56%) and mental health diagnoses (27%). Respondents were hospitalised or referred for services in 41% of suicide-related petitions.</p><p><strong>Conclusions: </strong>Oregon's ERPO law is being used to address firearm suicide risk, but implementation gaps may exist, including missed opportunities for healthcare or other services. Further research examining barriers and facilitators to ERPO use for suicide prevention is needed.</p>","PeriodicalId":13682,"journal":{"name":"Injury Prevention","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ambulance services for road traffic injury (RTI) victims in Bangladesh: a cross-sectional study on the ground realities and the way forward.","authors":"Zarin Tasnim, Samiun Nazrin Bente Kamal Tune, Bushra Zarin Islam, Nahitun Naher, Syed Masud Ahmed","doi":"10.1136/ip-2024-045302","DOIUrl":"https://doi.org/10.1136/ip-2024-045302","url":null,"abstract":"<p><strong>Introduction: </strong>Swift and safe transport of road traffic injury patients for life-saving interventions requires a functioning ambulance system which is largely lacking in the low- and middle-income countries. This study explored the current situation of ambulance-based prehospital care services in Bangladesh to inform the development of an evidence-based national ambulance system.</p><p><strong>Methods: </strong>A cross-sectional study conducted in five selected districts of Bangladesh, employing qualitative and quantitative approaches, elicited data on the 29 ambulances and the knowledge and skills of their operators. Findings were validated through 32 key informant interviews with relevant stakeholders on their experiences and insights towards developing a national ambulance system in the country.</p><p><strong>Results: </strong>Most of the ambulances were 'makeshift ambulances' (converted microbus) and commonly lacked the necessary supplies and equipment, including a Global Positioning System tracker or location identifier system. Around 20 drivers had 10+years of work experience, but none were trained in first-aid. Some drivers developed a few life-saving skills like removing foreign bodies from the airway or immobilising fractured limbs, etc from work experiences. The public sector ambulances were mostly used for transporting referral patients and, quite frequently, for transporting staff. Public ambulances had government-determined fixed rates, whereas private ambulances did not. The responsible authority/operator for the public sector ambulances was ambiguous and not coordinated by any local/central authority.</p><p><strong>Conclusion: </strong>The 'ambulance' service in the country is rudimentary, fragmented and poorly resourced, lacking any central/regional level coordination. A recommendation is made to develop a national ambulance service, integrating public and private sectors and operating under a central/regional authority.</p>","PeriodicalId":13682,"journal":{"name":"Injury Prevention","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short note on economic connectedness, social connection and fatal injury.","authors":"Richard Stansfield","doi":"10.1136/ip-2024-045608","DOIUrl":"https://doi.org/10.1136/ip-2024-045608","url":null,"abstract":"<p><strong>Objectives: </strong>To offer a brief assessment of the association between economic connectedness and violence.</p><p><strong>Methods: </strong>Using data from Facebook's Social Connectedness Index (SCI), I assess the relationship between social connectivity and homicide and suicide rates, relative to other traditional structural estimates of violence. I further assess whether social connectivity mediates the relationship between economic disadvantages and violence.</p><p><strong>Results: </strong>Economic connectedness is associated with county-level homicide and suicide rates and has the strongest connection with violence of any of the social connection measures examined. Traditional measures of economic disadvantage explained 57% of the county-level variation in economic connectedness. Economic connectedness in turn mediated a significant proportion of the association between economic disadvantages and both homicide and suicide. Including other control variables, higher economic connectedness was consistently associated with lower rates of violence, irrespective of county rurality, economic disadvantage or firearm availability.</p><p><strong>Conclusions: </strong>Violence researchers can incorporate a much-needed focus on social capital and cohesiveness into large-scale national studies using SCI data. Economic connectedness specifically may be a significant protective factor for violence, thus incorporating economic connectedness and social connection into violence research may provide support for new violence prevention efforts.</p>","PeriodicalId":13682,"journal":{"name":"Injury Prevention","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of bicycle collisions and 'safety in numbers': a natural experiment using the local introduction of e-scooters in England.","authors":"Hannah B Edwards, Frank de Vocht, Russell Jago, Miranda Elaine Glynis Armstrong, Edward Carlton, Yoav Ben-Shlomo","doi":"10.1136/ip-2024-045569","DOIUrl":"https://doi.org/10.1136/ip-2024-045569","url":null,"abstract":"<p><strong>Background: </strong>Ecological studies hypothesise a 'safety in numbers' (SiN) effect whereby road safety for bicycles and other micromobility users improves as their numbers increase, due to behavioural changes of motorists. Causal interpretation of these studies is difficult due to confounding and reverse causation. The introduction of electric scooter (e-scooter) rental schemes in selected districts in England meant an increase in micromobility users in these areas, which presented an opportunity to test the SiN hypothesis using a natural experiment.</p><p><strong>Methods: </strong>Time-series analysis of police data on road collisions in local authorities (LAs) in Great Britain, 2015-2023. Random-effects Poisson regression time-series models compared collision rates in LA districts with an e-scooter trial (n=41) versus matched control districts (n=41). Primary outcomes were all road collisions and bicycle collisions. Models adjusted for time; seasonality; baseline collision rate; COVID-19 period; and preintervention/postintervention period (proxied by intervention group/COVID-19 period interaction).</p><p><strong>Results: </strong>The rate of bicycle collisions reduced following the introduction of the schemes, compared with control districts (incidence rate ratio (IRR) 0.78, 95% CI 0.68 to 0.89 during peak COVID-19; IRR 0.87, 95% CI 0.77 to 0.99 in the post-COVID-19 period). This effect was specific to bicycle collisions and strongest in the subgroup of serious/fatal collisions.</p><p><strong>Conclusions: </strong>Findings suggest that the increase of a new and sustainable mode of transport, e-scooters, may have reduced bicycle collisions. This could have far-reaching benefits including reduced injuries, safer environments, and public health and environmental benefits if more people choose bicycles and micromobility over car transport. Findings should be verified in further work.</p>","PeriodicalId":13682,"journal":{"name":"Injury Prevention","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining contextual differences in suicide by rural-urban designation and military status, 2009-2019: a cross-sectional analysis of the National Violent Death Reporting System.","authors":"J Priyanka Vakkalanka, Eliezer Santos Leon, Jon Davis, Cameron Williams, Carri Casteel","doi":"10.1136/ip-2024-045430","DOIUrl":"10.1136/ip-2024-045430","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate differences in mental health and substance use circumstances by rurality and military affiliations among suicide decedents.</p><p><strong>Methods: </strong>Multiyear (2009-2019) cross-sectional study of adult suicide decedents reported to the National Violent Death Reporting System. We classified suicide decedents into a four-level variable by geography (urban/rural) and military status and evaluated the prevalence of current and past alcohol and substance use problems, mental health problem recognition and mental illness treatment. We estimated prevalence ratios using multiple imputation chain equations to account for missing data and log-binomial regression models and present stratified estimates by military and rural classification.</p><p><strong>Findings: </strong>There was no significant relationship between rural-military classification and alcohol use problem. Compared with urban civilians, other groups had a lower risk identified of having a substance use problem: urban military (adjusted prevalence ratio (aPR): 0.65; 95% CI: 0.60 to 0.71), rural military (aPR: 0.57; 95% CI: 0.50 to 0.66) and rural civilians (aPR: 0.95; 95% CI: 0.90 to 1.00). Recognition of a mental health problem was lower among both rural military (aPR: 0.88; 95% CI: 0.81 to 0.96) and rural civilians (aPR: 0.89; 95% CI: 0.86 to 0.92). The likelihood of current mental treatment was lower in other groups (urban military (aPR: 0.93; 95% CI: 0.89 to 0.96); rural military (aPR: 0.87; 95% CI: 0.81 to 0.94); and rural civilian (aPR: 0.89; 95% CI: 0.85 to 0.92)). There was no evidence of effect modification by military and rural classification for any outcome.</p><p><strong>Conclusions: </strong>Mental health outcomes by military affiliation and urbanicity/rurality may need to be independently assessed as social determinants of health.</p>","PeriodicalId":13682,"journal":{"name":"Injury Prevention","volume":" ","pages":"121-127"},"PeriodicalIF":2.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}