Brendan Saloner, Daliah Heller, Corey S Davis, Susan G Sherman
{"title":"Harm Reduction: The Neglected Pillar of US Drug Policy.","authors":"Brendan Saloner, Daliah Heller, Corey S Davis, Susan G Sherman","doi":"10.1146/annurev-publhealth-071723-112620","DOIUrl":"10.1146/annurev-publhealth-071723-112620","url":null,"abstract":"<p><p>Harm reduction programs provide tools that enable people who use drugs to do so more safely in a nonstigmatizing environment without the goal of them necessarily seeking treatment or abstinence. Most harm reduction programs in the United States distribute sterile syringes and naloxone and safely dispose of used syringes and other drug use supplies. Many also provide drug checking services, and other safer use supplies. These programs exist on a limited scale and often face restrictions on their funding and scope of operations. While research demonstrates the effectiveness of existing programs in preventing infectious disease transmission and fatal overdose, there is less evidence about conditions that support the effective expansion and sustainment of existing models. Other harm reduction interventions such as overdose prevention centers and safer supply programs have promising international evidence but are prohibited or severely restricted under US law. In this review, we summarize the evidence for harm reduction interventions, describe the policy environment in which they exist, and provide recommendations to better align drug policy with existing and emerging evidence in the US context.</p>","PeriodicalId":50752,"journal":{"name":"Annual Review of Public Health","volume":" ","pages":"369-387"},"PeriodicalIF":21.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yuilyn A Chang Chusan, Ihuoma Eneli, Erin Hennessy, Nicolaas P Pronk, Christina D Economos
{"title":"Next Steps in Efforts to Address the Obesity Epidemic.","authors":"Yuilyn A Chang Chusan, Ihuoma Eneli, Erin Hennessy, Nicolaas P Pronk, Christina D Economos","doi":"10.1146/annurev-publhealth-060922-044108","DOIUrl":"10.1146/annurev-publhealth-060922-044108","url":null,"abstract":"<p><p>Obesity prevalence continues to rise globally at alarming rates, with adverse health and economic implications. In this state-of-the-art review, we provide an analysis of selected evidence about the current knowledge in the obesity literature, including a synthesis of current challenges in obesity and its determinants. In addition, we review past and current efforts to combat the obesity epidemic, highlighting both successful efforts and areas for further development. Last, we offer insights into the next steps to address the obesity epidemic and advance the field of obesity through both research and practice by (<i>a</i>) adopting a systems perspective, (<i>b</i>) fostering cross-sector and community collaborations, (<i>c</i>) advancing health equity, (<i>d</i>) narrowing the research-to-practice and research-to-policy gaps with multidisciplinary approaches, and (<i>e</i>) embracing complementary approaches for concurrent obesity prevention and treatment.</p>","PeriodicalId":50752,"journal":{"name":"Annual Review of Public Health","volume":" ","pages":"171-191"},"PeriodicalIF":21.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maura Kepper, Callie Walsh-Bailey, Constance Owens-Jasey, Rose Gunn, Rachel Gold
{"title":"Integrating Social Needs into Health Care: An Implementation Science Perspective.","authors":"Maura Kepper, Callie Walsh-Bailey, Constance Owens-Jasey, Rose Gunn, Rachel Gold","doi":"10.1146/annurev-publhealth-071823-111332","DOIUrl":"10.1146/annurev-publhealth-071823-111332","url":null,"abstract":"<p><p>Unmet social needs (e.g., housing instability, food insecurity, transportation barriers) impact a patient's ability to participate in health-seeking behaviors (e.g., physical activity, routine preventive care) and to achieve optimal health. A rapidly growing number of health care systems are incorporating social needs screening and assistance into clinical workflows, yet many implementation and sustainability challenges exist and require collaboration with social service organizations. This review highlights implementation approaches used within this rapidly changing US landscape and uses implementation science frameworks to systematically identify multilevel barriers to and facilitators of implementing and sustaining social needs care. Policies and economic investments are necessary as they determine critical barriers and facilitators within the clinical and social service contexts. Implementation may be further strengthened by cross-sector engagement, evidence-based implementation strategies, and capacity building within clinical and social service organizations. Successful, sustained implementation of social needs care may improve the quality of health care, population health, and health equity.</p>","PeriodicalId":50752,"journal":{"name":"Annual Review of Public Health","volume":" ","pages":"151-170"},"PeriodicalIF":21.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jamie F Chriqui, Elizabeth Piekarz-Porter, Rebecca M Schermbeck, Abhery Das
{"title":"Assessing Policy Impacts on Chronic Disease Risk Reduction: The Science and Art of Policy Measurement and Rating Systems.","authors":"Jamie F Chriqui, Elizabeth Piekarz-Porter, Rebecca M Schermbeck, Abhery Das","doi":"10.1146/annurev-publhealth-071723-113826","DOIUrl":"10.1146/annurev-publhealth-071723-113826","url":null,"abstract":"<p><p>Public policies have been instrumental in influencing population health, and the desire to study their impact led to the development of the fields of policy surveillance and legal epidemiology. The standardized practice of creating policy measurement systems allows researchers to track and evaluate policy impacts across jurisdictions and over time. Policy measures may take many forms, including dichotomous measures, ordinal ratings, composite measures, or scale measures. The policy measures are determined largely based on the research question but should also consider factors impacting policy implementation and equity. Many sources of evidence, including expert input, national standards, scientific evidence, and existing policies, can be used in the development of policy measurement and rating systems. Any system must be tested, reliable, and clearly documented to create a robust and rigorous dataset. This article reviews key considerations for the development of policy measurement and rating systems for use in public health research.</p>","PeriodicalId":50752,"journal":{"name":"Annual Review of Public Health","volume":" ","pages":"331-348"},"PeriodicalIF":21.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anurima Baidya, Victoria Willens, Chizoba Wonodi, William J Moss
{"title":"Maintaining Immunizations for Vaccine-Preventable Diseases in a Changing World.","authors":"Anurima Baidya, Victoria Willens, Chizoba Wonodi, William J Moss","doi":"10.1146/annurev-publhealth-071723-111427","DOIUrl":"10.1146/annurev-publhealth-071723-111427","url":null,"abstract":"<p><p>Immunization has saved an estimated 154 million lives over the past 50 years since the launch of the Essential (formerly Expanded) Program on Immunization in 1974, representing 6 lives saved every minute, every year, for 50 years. But achieving and maintaining high immunization coverage have required sustained political and public commitment, financial resources, strong partnerships, research and innovation, and communication and advocacy. New and evolving challenges to maintaining high immunization coverage have emerged alongside long-standing stubborn obstacles. We review some of these key challenges to immunization in this dynamic, changing world and summarize some promising solutions. Success in some regions of the world in eliminating polio, measles, and rubella, and reducing morbidity and mortality from other vaccine-preventable diseases, should provide hope that progress can be made in achieving and maintaining high immunization coverage. We cannot afford to do otherwise.</p>","PeriodicalId":50752,"journal":{"name":"Annual Review of Public Health","volume":" ","pages":"389-409"},"PeriodicalIF":21.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Micah R Lattanner, Sarah McKetta, John E Pachankis, Mark L Hatzenbuehler
{"title":"State of the Science of Structural Stigma and LGBTQ+ Health: Meta-Analytic Evidence, Research Gaps, and Future Directions.","authors":"Micah R Lattanner, Sarah McKetta, John E Pachankis, Mark L Hatzenbuehler","doi":"10.1146/annurev-publhealth-071723-013336","DOIUrl":"10.1146/annurev-publhealth-071723-013336","url":null,"abstract":"<p><p>While public health practitioners and scholars have long theorized that structural forms of stigma shape the health of disadvantaged groups, they have frequently bemoaned the lack of research on this topic. A unique opportunity to address this lacuna occurred in the past two decades, with the advent of dramatic changes in laws, social attitudes, and other structural manifestations of stigma surrounding LGBTQ+ individuals. In a review of this literature, we conducted a meta-analysis of LGBTQ+ structural stigma and health, finding an effect size comparable to several other well-established macrolevel risk factors for poor health (e.g., income inequality, racial residential segregation, neighborhood socioeconomic status). In addition, we enumerated a range of established methodological strategies that studies have used to strengthen inferences; these strategies include documenting result specificity (i.e., structural stigma is unrelated to the health of cisgender heterosexuals), addressing alternative explanations (e.g., social selection), and triangulating evidence across multiple methods, measures, and health outcomes. We offer suggestions for future research to advance this rapidly expanding field, including identifying sources of unexplained heterogeneity in the structural stigma-health association. Finally, we discuss implications for other marginalized groups and for public health interventions and policies to reduce LGBTQ+ health disparities.</p>","PeriodicalId":50752,"journal":{"name":"Annual Review of Public Health","volume":" ","pages":"213-231"},"PeriodicalIF":21.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Madison Coots, Kristin A Linn, Sharad Goel, Amol S Navathe, Ravi B Parikh
{"title":"Racial Bias in Clinical and Population Health Algorithms: A Critical Review of Current Debates.","authors":"Madison Coots, Kristin A Linn, Sharad Goel, Amol S Navathe, Ravi B Parikh","doi":"10.1146/annurev-publhealth-071823-112058","DOIUrl":"10.1146/annurev-publhealth-071823-112058","url":null,"abstract":"<p><p>Among health care researchers, there is increasing debate over how best to assess and ensure the fairness of algorithms used for clinical decision support and population health, particularly concerning potential racial bias. Here we first distill concerns over the fairness of health care algorithms into four broad categories: (<i>a</i>) the explicit inclusion (or, conversely, the exclusion) of race and ethnicity in algorithms, (<i>b</i>) unequal algorithm decision rates across groups, (<i>c</i>) unequal error rates across groups, and (<i>d</i>) potential bias in the target variable used in prediction. With this taxonomy, we critically examine seven prominent and controversial health care algorithms. We show that popular approaches that aim to improve the fairness of health care algorithms can in fact worsen outcomes for individuals across all racial and ethnic groups. We conclude by offering an alternative, consequentialist framework for algorithm design that mitigates these harms by instead foregrounding outcomes and clarifying trade-offs in the pursuit of equitable decision-making.</p>","PeriodicalId":50752,"journal":{"name":"Annual Review of Public Health","volume":" ","pages":"507-523"},"PeriodicalIF":21.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Impact of Health Insurance on Mortality.","authors":"Helen Levy, Thomas C Buchmueller","doi":"10.1146/annurev-publhealth-061022-042335","DOIUrl":"10.1146/annurev-publhealth-061022-042335","url":null,"abstract":"<p><p>A 2008 review in the <i>Annual Review of Public Health</i> considered the question of whether health insurance improves health. The answer was a cautious yes because few studies provided convincing causal evidence. We revisit this question by focusing on a single outcome: mortality. Because of multiple high-quality studies published since 2008, which exploit new sources of quasi-experimental variation as well as new empirical approaches to evaluating older data, our answer is more definitive. Studies using different data sources and research designs provide credible evidence that health insurance coverage reduces mortality. The effects, which tend to be strongest for adults in middle age or older and for children, are generally evident shortly after coverage gains and grow over time. The evidence now unequivocally supports the conclusion that health insurance improves health.</p>","PeriodicalId":50752,"journal":{"name":"Annual Review of Public Health","volume":" ","pages":"541-550"},"PeriodicalIF":21.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Bridging Innovation and Equity: Advancing Public Health Through Just-in-Time Adaptive Interventions.","authors":"Nur Hani Zainal, Xueqing Liu, Utek Leong, Xiaoxi Yan, Bibhas Chakraborty","doi":"10.1146/annurev-publhealth-071723-103909","DOIUrl":"10.1146/annurev-publhealth-071723-103909","url":null,"abstract":"<p><p>This review explores the transformative potential of just-in-time adaptive interventions (JITAIs) as a scalable solution for addressing health disparities in underserved populations. JITAIs, delivered via mobile health technologies, could provide personalized, context-aware interventions based on real-time data to address public health challenges such as addiction treatment, chronic disease management, and mental health support. JITAIs can dynamically adjust intervention strategies, enhancing accessibility and engagement for marginalized communities. We highlight the utility of JITAIs in reducing opportunity costs associated with traditional in-person health interventions. Examples from various health domains demonstrate the adaptability of JITAIs in tailoring interventions to meet diverse needs. The review also emphasizes the need for community involvement, robust evaluation frameworks, and ethical considerations in implementing JITAIs, particularly in low- and middle-income countries. Sustainable funding models and technological innovations are necessary to ensure equitable access and effectively scale these interventions. By bridging the gap between research and practice, JITAIs could improve health outcomes and reduce disparities in vulnerable populations.</p>","PeriodicalId":50752,"journal":{"name":"Annual Review of Public Health","volume":" ","pages":"43-68"},"PeriodicalIF":21.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tyson H Brown, Hedwig E Lee, Margaret T Hicken, Eduardo Bonilla-Silva, Patricia Homan
{"title":"Conceptualizing and Measuring Systemic Racism.","authors":"Tyson H Brown, Hedwig E Lee, Margaret T Hicken, Eduardo Bonilla-Silva, Patricia Homan","doi":"10.1146/annurev-publhealth-060222-032022","DOIUrl":"10.1146/annurev-publhealth-060222-032022","url":null,"abstract":"<p><p>This article provides a guide for rigorous, theory-driven measurement approaches, proposing best practices for the scientific study of systemic racism in health research. We argue that the analytical crux of measuring systemic racism-a complex, interconnected, and dynamic system-lies in operationalizing the collective logics, properties, and mechanisms that undergird racial inequities. Misalignment between measurement tools and these fundamental features undermines research validity, as incongruent measures distort findings and obscure systemic racism's true impacts. To address this, we draw on interdisciplinary theories and evidence to dissect key features of systemic racism, emphasizing their implications for measurement. We further recommend incorporating temporal processes in health research by leveraging core principles of the life course perspective, which elucidate the intricate interplay of individual, historical, and societal trajectories. Our recommendations underscore the necessity of adopting robust, evidence-based methods to advance the understanding of how systemic racism operates and shapes public health.</p>","PeriodicalId":50752,"journal":{"name":"Annual Review of Public Health","volume":" ","pages":"69-90"},"PeriodicalIF":21.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}