Public Health Reports最新文献

{"title":"Excess Deaths in California During the COVID-19 Pandemic, by Healthy Places Index Quartile, February 2020-April 2022.","authors":"Celeste J Romano, Tiffany N Tsukuda, Rui Zhao, Joshua Quint, Seema Jain, Erin L Murray","doi":"10.1177/00333549251314409","DOIUrl":"https://doi.org/10.1177/00333549251314409","url":null,"abstract":"<p><strong>Objectives: </strong>Place-based disadvantage indices have been used to assess health disparities and allocate funding and health resources. We assessed excess mortality in California during the COVID-19 pandemic by Healthy Places Index (HPI) quartile, a disadvantage index used by the California Department of Public Health to structure COVID-19 response efforts.</p><p><strong>Methods: </strong>We estimated expected deaths from all causes during the COVID-19 pandemic by fitting a quasi-Poisson regression model to actual deaths that occurred from 2014 through 2019. We estimated ranges of excess deaths by calculating differences between actual deaths and (1) the average expected number of deaths and (2) the upper bound of the 95% prediction interval. The percentage of excess deaths equaled the number of excess deaths divided by the corresponding threshold. We reported estimates overall and across demographic groups, stratified by HPI quartile; quartile 4 indicated communities with the most advantaged social and environmental conditions.</p><p><strong>Results: </strong>From February 2020 through April 2022, the number of excess deaths in California ranged from 81 245 to 107 806, with 93 309 deaths attributed to COVID-19. The number of excess deaths decreased across quartiles, from 27 924 to 35 615 (20.5%-28.0%) in HPI quartile 1 to 7757 to 14 477 (4.6%-9.2%) in HPI quartile 4. The Hispanic or Latine population had a disproportionate percentage of excess deaths across all quartiles, whereas American Indian or Alaska Native, Asian, Black or African American, Native Hawaiian or Pacific Islander, and White (all non-Hispanic) populations had percentage excess death estimates in quartile 2 that were similar to or higher than in quartile 1.</p><p><strong>Conclusions: </strong>Health policies should supplement the use of place-based disparity measures with other measures that support groups at high risk for adverse health outcomes residing in more socially and environmentally advantaged communities.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":" ","pages":"333549251314409"},"PeriodicalIF":3.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of a Vaccine Mandate in Nonessential Public Spaces in New Orleans, Louisiana, on COVID-19 Vaccine Uptake, 2021-2022.","authors":"Aneeka Ratnayake, Charles Stoecker, Patricia J Kissinger","doi":"10.1177/00333549251315073","DOIUrl":"https://doi.org/10.1177/00333549251315073","url":null,"abstract":"<p><strong>Objectives: </strong>During the height of the COVID-19 pandemic, vaccine hesitancy in the United States was a key driver of continued COVID-19 transmission and the emergence of new variants. We examined the effect of a mandate that required patrons at nonessential venues (eg, restaurants, bars) in New Orleans, Louisiana, to be vaccinated to enter these establishments from August 2021 through March 2022.</p><p><strong>Methods: </strong>We implemented a parish-level synthetic control model that compared vaccination trends in Orleans Parish (county) (the boundaries of Orleans Parish are equivalent to the city of New Orleans) with a synthetic composite of other parishes in Louisiana that had similar vaccination trends before the mandate. We used permutation testing (ie, shuffle testing) to determine the significance of differences in vaccination rates between Orleans Parish and other parishes.</p><p><strong>Results: </strong>Individuals in Orleans Parish initiated an average of 760 more vaccines weekly during the 31 weeks in which the mandate was in place, which was significantly higher than expected based on the synthetic control (<i>P</i> = .03).</p><p><strong>Conclusions: </strong>The rate of vaccine initiation increased during the vaccine mandate for nonessential venues. Implementing such mandates may be an effective intervention in overcoming COVID-19 vaccine hesitancy during a future pandemic.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":" ","pages":"333549251315073"},"PeriodicalIF":3.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy and Birth Outcomes Among Middle Eastern or North African Infants and Mothers in Quebec, Canada, 2008-2020.","authors":"Gabriel Côté-Corriveau, Nicole Silva-Lavigne, Méloë Maigné, Aimina Ayoub, Thuy Mai Luu, Olivier Drouin, Nathalie Auger","doi":"10.1177/00333549251314304","DOIUrl":"https://doi.org/10.1177/00333549251314304","url":null,"abstract":"<p><strong>Objectives: </strong>The health status of Middle Eastern or North African (MENA) populations in Western countries is poorly understood. We assessed whether MENA infants and mothers have a greater risk of adverse pregnancy and birth outcomes than non-MENA infants and mothers in Quebec, Canada.</p><p><strong>Methods: </strong>We conducted a population-based observational study of 809 172 infants born to pregnant women in Quebec from 2008 through 2020. We identified infants in the MENA group based on self-reported mother tongue (Arabic or Turkish) and parents' country of birth (North African or Middle Eastern country). We compared infant and maternal outcomes, including gestational diabetes, cesarean delivery, preterm birth, severe maternal or neonatal morbidity, and other pregnancy and birth complications between the MENA and non-MENA groups. Using log-binomial regression models, we calculated risk ratios (RRs) and 95% CIs to measure the risk of adverse pregnancy and birth outcomes for the MENA group compared with the non-MENA group, adjusting for maternal age, comorbidity, and other patient characteristics.</p><p><strong>Results: </strong>Compared with the non-MENA group (n = 716 387), the MENA group (n = 92 785) had an elevated risk of gestational diabetes (RR = 1.51; 95% CI, 1.48-1.55), postterm birth (RR = 1.24; 95% CI, 1.08-1.42), and short-stay neonatal intensive care unit admission (RR = 1.91; 95% CI, 1.82-1.99). However, MENA infants were 15% to 50% less likely than non-MENA infants to be born preterm, have severe neonatal morbidity, and have a mother with preeclampsia or severe maternal morbidity.</p><p><strong>Conclusions: </strong>Although findings among MENA infants and mothers in Quebec were reassuring overall, MENA infants and mothers may benefit from closer perinatal follow-up to improve complications of gestational diabetes.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":" ","pages":"333549251314304"},"PeriodicalIF":3.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measuring Whether Gratitude and Loneliness Mediate the Link Between Non-organizational Religiosity and Suicidal Ideation: Evidence From Black Adults During COVID-19.","authors":"Janelle R Goodwill, Harry O Taylor","doi":"10.1177/00333549251314665","DOIUrl":"https://doi.org/10.1177/00333549251314665","url":null,"abstract":"<p><strong>Objectives: </strong>Suicides among Black adults in the United States increased nationally during the COVID-19 pandemic, although limited empirical evidence documents the pathways that explain how suicide risk may develop in this population. We examined experiences of non-organizational religious involvement, gratitude, and loneliness and their relation to suicidal ideation among Black adults in the United States.</p><p><strong>Methods: </strong>We analyzed data from a probability-based sample of 995 Black adults in the United States who completed online surveys from April through June 2022. We recruited participants from the AmeriSpeak panel at the National Opinion Research Center. We applied structural equation modeling techniques to measure direct and indirect associations among religiosity, positive psychology, and mental health variables. We tested whether non-organizational religiosity was indirectly associated with suicidal ideation via feelings of gratitude and COVID-19-specific forms of loneliness during the pandemic.</p><p><strong>Results: </strong>The measurement model demonstrated a good fit to the data. Structural model results indicated that non-organizational religious involvement was positively related to gratitude (β = 0.51; <i>P</i> < .001); in turn, feelings of gratitude were associated with reduced suicidal ideation (β = -0.12; <i>P</i> = .02). Moreover, COVID-19-specific forms of loneliness were positively associated with past-year suicidal ideation (β = 0.11; <i>P</i> = .01). Non-organizational religious involvement, however, was not directly associated with feelings of COVID-19-related loneliness or suicidal ideation.</p><p><strong>Conclusions: </strong>Public health officials should account for feelings of gratitude and loneliness as mechanisms that can be leveraged to inform the development of evidence-based suicide prevention interventions for Black adults during public health emergencies such as the COVID-19 pandemic and beyond.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":" ","pages":"333549251314665"},"PeriodicalIF":3.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traumatic Brain Injury, Alaska, 2016-2021.","authors":"Katherine Newell, Jared Parrish, Joseph McLaughlin","doi":"10.1177/00333549241309802","DOIUrl":"https://doi.org/10.1177/00333549241309802","url":null,"abstract":"<p><strong>Objectives: </strong>Alaska has among the highest traumatic brain injury (TBI) mortality rates in the United States. We characterized the epidemiology of TBIs in the country's largest and most sparsely populated state to guide prevention efforts.</p><p><strong>Methods: </strong>This cross-sectional study analyzed TBI-associated hospitalization and mortality rates in Alaska from 2016 through 2021. Data included people with TBI-associated hospitalization or death in Alaska. We compared age-adjusted rates using national data, with analysis by age, sex, race and ethnicity, and injury mechanism. Logistic regression explored factors influencing mortality among hospitalized patients with TBI.</p><p><strong>Results: </strong>TBI-associated hospitalization rates per 100 000 population in Alaska were highest among adults aged ≥75 years (310.4), by sex among males (123.3), and by race among American Indian and Alaska Native (AI/AN) people (186.7). Patients with TBI-associated hospitalizations due to self-harm were approximately 8.6 times as likely to die as patients with unintentional injuries. Alaska's age-adjusted TBI-associated mortality rate per 100 000 population was twice the national rate (36.2 vs 17.3). TBI-associated mortality rates in Alaska exceeded national averages across all demographic characteristics and injury mechanisms. Adults aged ≥75 years, males, and AI/AN people in Alaska had TBI-associated death rates that were 1.3, 1.9, and 2.0 times higher, respectively, than national rates. Alaska's TBI-associated mortality rate from suicide was 2.6 times the national average, with notable racial disparities for AI/AN people.</p><p><strong>Conclusions: </strong>TBIs are a considerable source of morbidity and mortality in Alaska, with disproportionate effects observed among population groups. These findings underscore the need for increased focus on mechanism-specific TBI prevention activities, particularly for older adults and AI/AN people.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":" ","pages":"333549241309802"},"PeriodicalIF":3.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12037538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral Nicotine Pouches: Rising Popularity and State of the Science.","authors":"Nicholas J Felicione, Jenny E Ozga, Alisha Eversole, Joy L Hart, Alayna Tackett, Mary Hrywna, Matthew Halquist, Cassandra A Stanton","doi":"10.1177/00333549251313668","DOIUrl":"https://doi.org/10.1177/00333549251313668","url":null,"abstract":"<p><p>Nicotine pouches are noncombustible products that contain nicotine but no tobacco plant material. With rising popularity and increased media attention surrounding ZYN and other nicotine pouch brands, questions remain about whether empirical evidence exists on the public health effects of these products. This review highlights how nicotine pouches, including ZYN, are rising in appeal and prevalence of use, particularly among adolescents and young adults. The use of nicotine pouches is also more prevalent among people who use other tobacco products (vs those who do not), including electronic cigarettes (e-cigarettes), and some people report using nicotine pouches to help reduce or quit the use of e-cigarettes or combustible tobacco products. Nicotine pouches deliver amounts of nicotine similar to other tobacco products and do so at a rate similar to other oral nicotine products, including some US Food and Drug Administration (FDA)-approved nicotine replacement therapies. In addition, nicotine pouches have the potential to be tobacco harm-reduction products if unintended harms can be minimized, although more research is needed to determine the health effect profile of nicotine pouches under naturalistic use conditions. Overall, additional research is needed to verify the results from industry-funded studies, further understand product characteristics that influence nicotine delivery and health effects, and translate findings to real-world use behaviors. This additional research could help determine whether nicotine pouches have a robust evidence base to meet the public health standard by which FDA evaluates new tobacco products.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":" ","pages":"333549251313668"},"PeriodicalIF":3.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12037535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dental Services Use Among Adults With Disabilities: Results From the 2015-2016 and 2017-2018 National Health and Nutrition Examination Survey.","authors":"Huabin Luo, Hua Daniel Xu, Missy Stancil, Vanessa Pardi, Mark E Moss","doi":"10.1177/00333549251314315","DOIUrl":"https://doi.org/10.1177/00333549251314315","url":null,"abstract":"<p><strong>Objectives: </strong>People with disabilities face many challenges in accessing dental care. We compared disparities in dental care patterns (ie, dental visits for preventive care or treatment) between adults with and without hearing, seeing, mobility, self-care, cognition, or independent living disabilities.</p><p><strong>Methods: </strong>We analyzed data from the 2015-2016 and 2017-2018 National Health and Nutrition Examination Survey (NHANES). For outcome variables, we included self-reported dental visit (yes/no) and preventive dental visit (yes/no) within the past year. NHANES asked participants whether they had serious difficulty in conducting any of the following 6 activities: hearing, seeing, mobility, self-care, cognition, or independent living; participants who answered yes to any of these activities were classified as disabled. Our analytic sample included 11 288 adult respondents aged ≥20 years. We used multiple logistic regression to assess the association between disability status-measured by any disability (yes/no), the 6 types of disabilities (yes/no), and the number of disabilities-and the outcome variables, with <i>P</i> ≤ .05 indicating significance.</p><p><strong>Results: </strong>Respondents with disabilities were less likely than those without a disability to have a preventive dental visit (adjusted odds ratio = 0.67; 95% CI, 0.59-0.77). Respondents with disabilities in mobility, self-care, or independent living were significantly less likely than those without any disability to have a dental visit. In addition, adults with more disabilities were significantly less likely than those without a disability to have a dental visit.</p><p><strong>Conclusions: </strong>Access to preventive dental care was limited among people with disabilities. Further assistance, including providing dental insurance coverage, is needed to increase access to dental care among people with disabilities, especially those with mobility, self-care, and independent living disabilities.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":" ","pages":"333549251314315"},"PeriodicalIF":3.0,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Experiences of Black Men Who Survived a Gunshot Wound and Were Treated With a Colostomy.","authors":"William Wical, Bethany Strong, Joseph B Richardson","doi":"10.1177/00333549251316808","DOIUrl":"https://doi.org/10.1177/00333549251316808","url":null,"abstract":"<p><p>In the United States, rates of fatal and nonfatal firearm injuries differ substantially by race and sex, with Black men being more likely than any other group to be shot. Many people who survive a gunshot wound have complex physical, psychological, and social challenges during their recovery. Public health programs, including hospital-based violence intervention programs (HVIPs), have been designed to reduce the likelihood of reinjury for their participants and to support their well-being. However, little is known about how Black men who survive a gunshot wound and receive care from these programs conceptualize the best ways to support their healing and the barriers they experience in achieving their health-related goals. This case study, drawing from ethnographic research conducted during 2013-2023 at the second busiest HVIP in Maryland, examines the experiences of 6 Black men who were treated with a colostomy after surviving a gunshot wound. Emergent themes included increased psychological stress from being treated with a colostomy and wearing a waste collection pouch, disruptions to everyday life, and insufficient access to colostomy care and education. The findings from this case study highlight the importance of providing access to psychological services, colostomy education, and health care supplies to meet the needs of HVIP participants and improve health outcomes for this population.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":" ","pages":"333549251316808"},"PeriodicalIF":3.0,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex- and Age-Specific Lyme Disease Testing Patterns in the United States, 2019 and 2022.","authors":"Yonghong Li, Fumika Matsushita, Zhen Chen, Robert S Jones, Lance A Bare, Jeannine M Petersen, Alison F Hinckley","doi":"10.1177/00333549251314419","DOIUrl":"10.1177/00333549251314419","url":null,"abstract":"<p><strong>Objectives: </strong>Serologic testing is a useful adjunct for the diagnosis of Lyme disease, a major public health problem in certain US regions. We aimed to determine whether Lyme disease serologic testing and results differed by sex and age group.</p><p><strong>Methods: </strong>We identified 2 cohorts of individuals across all ages who underwent serologic testing for Lyme disease at a national reference laboratory in 2019 (cohort 1) and 2022 (cohort 2). If an individual had multiple tests in the same year, we included only the first test. We excluded individuals who had been tested in the previous 5 years.</p><p><strong>Results: </strong>Cohorts 1 and 2 consisted of 578 052 and 550 674 people, respectively. Fewer males than females were tested in cohort 1 (42.7% vs 57.3%) and cohort 2 (42.3% vs 57.7%), although similar numbers were tested for both sexes among nonadults. More males than females had a positive test result in cohort 1 (53.9% more males) and cohort 2 (52.9% more males). The odds ratio of receiving a positive test result among males versus females was 2.09 (95% CI, 2.01-2.17) in cohort 1 and 2.12 (95% CI, 2.05-2.19) in cohort 2. Among people with positive test results, females (except children) were more likely than males to have positive immunoglobulin M and negative immunoglobulin G results, which can serve as a marker of early infection (odds ratio = 1.43 [95% CI, 1.31-1.55] in cohort 1 and 1.38 [95% CI, 1.29-1.47] in cohort 2).</p><p><strong>Conclusions: </strong>Further studies are needed to understand whether the observed differences in Lyme disease testing and positivity result from sex- and age-associated disparities in social behavior, health care seeking, clinical practice, or other factors.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":" ","pages":"333549251314419"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking Vulnerability: Using Factor Analysis to Assess Census Tract-Level Vulnerability.","authors":"Cole Jurecka, Eric Cavana, Yanjia Zhang, Elizabeth A Erdman, Pallavi Aytha Swathi, Joshua A Barocas, Laura F White","doi":"10.1177/00333549251313986","DOIUrl":"10.1177/00333549251313986","url":null,"abstract":"<p><strong>Objectives: </strong>The Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry (CDC/ATSDR) Social Vulnerability Index (SVI) is used to guide policy making and resource allocation for emergency responses. However, limited research has explored the extent to which each variable contributes to the overall calculation of the SVI. We used a factor analysis approach to determine whether specific drivers of vulnerability exist at the state and national levels.</p><p><strong>Methods: </strong>We used the 2020 CDC/ATSDR SVI dataset to perform factor analysis separately for each state and nationally. We determined factor weights and scores and conducted a comparative analysis with CDC/ATSDR SVI. The final SVI for each census tract ranged from 0 to 1, with higher values indicating greater vulnerability.</p><p><strong>Results: </strong>At the national level, our factor analysis approach identified 4 primary variables that affected vulnerability the most: the percentage of the population below 150% of the federal poverty level (weight, 0.262), with housing cost burden (ie, households that spend >30% of their income on housing-related costs; weight, 0.226), in a racial and ethnic minority group (weight, 0.232), and without a high school diploma (weight, 0.138). However, at the state level, some analyses assigned low weights to the primary national-level drivers.</p><p><strong>Conclusions: </strong>Our study highlights the need to consider context-specific vulnerability measures when characterizing community social vulnerability. The factor analysis SVI provides nuanced insight into vulnerability drivers at the national and state levels, laying the groundwork for more precise disaster response planning, resource allocation, and community resilience initiatives.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":" ","pages":"333549251313986"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}