Annals of Epidemiology最新文献

{"title":"Systemic inflammation-based refinement of triglyceride glucose index for predicting new-onset cardiovascular disease: A nationwide multicenter cohort study","authors":"Liangyu Yin ,&nbsp;Lan Zhong ,&nbsp;Yinghui Huang ,&nbsp;Jinghong Zhao","doi":"10.1016/j.annepidem.2025.08.022","DOIUrl":"10.1016/j.annepidem.2025.08.022","url":null,"abstract":"<div><h3>Background</h3><div>Triglyceride glucose (TyG) index is a surrogate marker of insulin resistance, which has been related to cardiovascular disease (CVD) risk. However, the predictive rationale for incorporating triglyceride and glucose is not well established. Furthermore, whether inflammatory information adds prognostic value to TyG remains largely unknown.</div></div><div><h3>Methods</h3><div>This cohort study involved 7456 participants without pre-existing CVD. CVD events were defined as physician-diagnosed coronary heart disease (CHD) and/or stroke during follow-up. The predictive abilities of TyG, triglycerides, glucose, C-reactive protein (CRP), a TyC index (triglycerides [mg/dL]+60 ×CRP [mg/L]) and a TyG-C index (TyG+CRP [mg/L]) were compared. Using multivariable Cox models, hazard ratios (HR) of any and type-specific CVD according to TyG-C tertiles (T) were estimated.</div></div><div><h3>Results</h3><div>The median age of participants was 57.0 years. There were 3448 (46.2 %) men and 4008 (53.8 %) women. During the follow-up of up to 6 years, 1470 CVD, 1114 CHD and 487 stroke incidents occurred. TyG showed comparable discrimination to triglycerides in predicting new-onset CVD and CHD, and similar performance to glucose in predicting stroke (all <em>P</em> &gt; 0.05). TyG-C was superior to TyG and other investigated indices for predicting CVD (Harrell’s C-index [95 %CI]=0.557 [0.541–0.573], all <em>P</em> &lt; 0.05). TyG-C tertiles were monotonically associated with CVD risk (HR [95 %CI]: T2 vs T1, 1.200 [1.050–1.372]; T3 vs T1, 1.282 [1.121–1.468], <em>P</em> trend&lt;0.001). Similar patterns were observed for CHD and stroke. These associations attenuated with age (all <em>P</em> interaction&lt;0.001).</div></div><div><h3>Conclusion</h3><div>TyG does not outperform its components in predicting new-onset CVD. TyG-C might serve as a better biomarker of CVD risk.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"110 ","pages":"Pages 114-121"},"PeriodicalIF":3.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144879266","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":"The association between metabolic syndrome and risk of severe infection: A population-based cohort study","authors":"Ming Zhao ,&nbsp;Jiayi Huang ,&nbsp;Luojia Dai ,&nbsp;Chenyu Liang ,&nbsp;Yankun Liu ,&nbsp;Haili Wang ,&nbsp;Xin Zhang ,&nbsp;Shuzhen Zhao ,&nbsp;Chengnan Guo ,&nbsp;Zhenqiu Liu ,&nbsp;Tiejun Zhang","doi":"10.1016/j.annepidem.2025.08.015","DOIUrl":"10.1016/j.annepidem.2025.08.015","url":null,"abstract":"<div><h3>Purpose</h3><div>The association between metabolic syndrome (MetS) and severe infection remains inconclusive. We investigated the potential associations between MetS and its components and severe infection in a large population-based cohort.</div></div><div><h3>Methods</h3><div>We used data from Shanghai Suburban Adult Cohort and Biobank which includes 35,193 participants who were enrolled in 2016 and 2017 with follow-up until March 2024. Severe infections, defined as those requiring hospital admission or resulting in mortality, were identified through medical records. Cox proportional hazards models were used to analyze the associations between MetS and its components with incident severe infection.</div></div><div><h3>Results</h3><div>During a median of 6.96 years of follow-up, a total of 1143 (11.78 %) severe infections occurred in participants with MetS and 2337 (9.18 %) in No MetS group. MetS was associated with an increased risk of severe infection compared to the No MetS group (HR, 1.19; 95 % CI, 1.11–1.28). Among the individual components, elevated waist circumference, fasting blood glucose, and reduced HDL cholesterol were associated with increased severe infection risk, whereas elevated blood pressure alone was associated with reduced severe infection risk (HR, 0.91; 95 % CI, 0.85–0.98). The risk of severe infection also increased with increasing number of MetS components, with the highest risk found in the presence of all 5 components (HR, 1.70; 95 % CI, 1.39–2.07).</div></div><div><h3>Conclusions</h3><div>MetS was associated with an increased risk of severe infection. Further studies are warranted to elucidate the association between MetS and severe infection.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"110 ","pages":"Pages 107-113"},"PeriodicalIF":3.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144863280","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":"Seasonal variations in child mortality during the 2014–2015 Ebola epidemic in Sierra Leone","authors":"Joseph Sam Kanu ,&nbsp;Mohamed A. Vandi ,&nbsp;Caleb L. Ward ,&nbsp;Yelena Gorina ,&nbsp;Eric Ikoona ,&nbsp;Daphne Moffett ,&nbsp;Tushar Singh ,&nbsp;Amara Jambai ,&nbsp;John Redd ,&nbsp;Monique Foster ,&nbsp;Brima Bangura ,&nbsp;Jadnah D. Harding ,&nbsp;Mohamed A.M. Kamara ,&nbsp;Reinhard Kaiser","doi":"10.1016/j.annepidem.2025.08.010","DOIUrl":"10.1016/j.annepidem.2025.08.010","url":null,"abstract":"<div><h3>Purpose</h3><div>Under-five mortality is a key indicator of child health, and a measure of the quality of healthcare in a country. Seasonality affecting under-five deaths is not well understood. We reviewed seasonal variations of mortality among infants under one year, children under five years, and stillbirths in Sierra Leone using data collected continuously during the 2014–2015 Ebola outbreak in Sierra Leone.</div></div><div><h3>Methods</h3><div>We used Ebola and non-Ebola death data from the 117 Call Centers, laboratory testing records, burial team records, and the Viral Hemorrhagic Fever module divided into dry and rainy seasons. Difference by sex was assessed by the Cochran-Mantel-Haenszel test. All trends were verified by the Joinpoint Regression Program, and the seasonal differences in monthly number of deaths were evaluated using Student’s t-test.</div></div><div><h3>Results</h3><div>The percentage of EVD-positive deaths significantly decreased from about 35 % in November-December 2014 to less than 2 % in April-June 2015 among children under five years, and from 47 % in January to less than 2 % in May 2015 among children under one year. Less than 5 % of EVD-positive deaths occurred during the rainy season. Our analysis showed a significant increase in non-Ebola deaths during the rainy season. About 60 % of deaths among children under one year and under five years, and 68 % of stillbirths, occurred during the rainy season. The trend analysis of monthly aggregated percentages showed an increase from about 5 % in months of November 2014 through February 2015 to more than 10 % in each month from May through August 2015. Seasonal differences in the monthly number of deaths records for children under one year were statistically significant in each data source.</div></div><div><h3>Conclusions</h3><div>Compared to the dry season, more child deaths and stillbirths occurred during the rainy season. This finding suggests the need to strengthen the healthcare system for children in consideration of the effects of seasonality on child mortality. Targeted interventions, such as improved healthcare access, seasonal malaria chemoprevention, and strengthening vaccination programs, may assist with efforts to mitigate the health effects of the rainy season in Sierra Leone.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"109 ","pages":"Pages 119-124"},"PeriodicalIF":3.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876646","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":"Commentary on community-engaged epidemiology and abolitional possibility with a case study on aluminum worker health","authors":"Elizabeth S. McClure ,&nbsp;Pavithra Vasudevan ,&nbsp;Cherrel K. Manley ,&nbsp;Elizabeth Teka","doi":"10.1016/j.annepidem.2025.08.009","DOIUrl":"10.1016/j.annepidem.2025.08.009","url":null,"abstract":"<div><div>This collaborative project addresses the possibilities and limits of occupational epidemiology in supporting struggles for environmental justice through a case study of aluminum smelting. We focus on illness and toxic exposure among Black workers and their families in Badin, North Carolina, a primary aluminum smelting plant site for Alcoa, in operation from 1915 to 2007. We conducted two quantitative analyses—one documenting disparities in work exposure trajectories, and one comparing mortality rates among workers to those in the general population. Supplementing these conventional epidemiological methods, we developed a third approach in collaboration with community members: an open-ended household survey designed to gather qualitative data regarding former workers’ job histories, medical histories, and concerns related to toxic exposures and discrimination at the smelting plant. This approach was conceived in response to residents’ questions about disparate health outcomes of toxic exposure in the workplace. The current occupational epidemiology literature published about aluminum smelting does not reflect concerns voiced by community collaborators regarding the extent of harm caused by occupational exposure to toxins, nor does it include analyses of race or gender disparities due to discriminate labor divisions. We argue that despite the discipline’s history of efforts to address health inequities, contemporary occupational epidemiology is limited in its methodological capacity eliminate health disparities rooted in structural racism. We illustrate how such a method may both broaden the scientific knowledge base and support organizing towards developing an abolitional approach to epidemiology.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"110 ","pages":"Pages 102-106"},"PeriodicalIF":3.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859798","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":"Family incarceration and barriers to mental health care among low-income US veterans","authors":"Alexander Testa PhD ,&nbsp;Luis Mijares MS ,&nbsp;Jack Tsai PhD","doi":"10.1016/j.annepidem.2025.08.006","DOIUrl":"10.1016/j.annepidem.2025.08.006","url":null,"abstract":"<div><h3>Background</h3><div>Family member incarceration is a risk factor for mental health challenges. However, less research has investigated the relationship between family member incarceration and barriers to mental health services.</div></div><div><h3>Methods</h3><div>Data were drawn from the 2023 National Veteran Homeless and Other Poverty Experiences (NV-HOPE) Survey, a nationally representative sample of US veterans living at or below 300 % of the federal poverty level (N = 978). Logistic regression models were used to examine the association between family member incarceration and self-reported barriers to mental health care, adjusting for demographic, socioeconomic, and military service characteristics.</div></div><div><h3>Results</h3><div>Overall, 42.1 % of veterans reported that a family member had been incarcerated. Veterans with an incarcerated family member had 1.63 times greater odds of reporting any barrier to mental health care (95 % CI: 1.13–2.33). Specific barriers to mental health care reported by these veterans included embarrassment (OR = 2.25, 95 % CI = 1.18, 4.29), being treated differently by peers (OR = 2.51, 95 % CI = 1.24, 5.08), not knowing where to seek help (OR = 2.25, 95 % CI = 1.23, 4.10), inadequate transportation (OR = 7.01, 95 % CI = 2.99, 16.41), difficulty scheduling appointments (OR = 2.84, 95 % CI = 1.65, 4.89), and treatment cost (OR = 1.72, 95 % CI = 1.14, 2.60).</div></div><div><h3>Conclusions</h3><div>Family member incarceration is associated with increased barriers to mental health care among low-income US veterans. These findings highlight the potential value of programs within veteran healthcare that address the barriers to mental health access, especially among those with a history of family member incarceration.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"110 ","pages":"Pages 89-94"},"PeriodicalIF":3.0,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144841606","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":"Gestational weight change patterns in pregnant people with obesity class I, II, and III receiving care from community-based health care centers","authors":"Sarah-Truclinh T. Tran ,&nbsp;Anna Booman ,&nbsp;Miguel Marino ,&nbsp;Jean O’Malley ,&nbsp;Amy Palma ,&nbsp;Teresa Schmidt ,&nbsp;Kristin Lyon-Scott ,&nbsp;Jonathan M. Snowden ,&nbsp;Rachel Springer ,&nbsp;Kalera Stratton ,&nbsp;Kimberly K. Vesco ,&nbsp;Janne Boone-Heinonen","doi":"10.1016/j.annepidem.2025.08.005","DOIUrl":"10.1016/j.annepidem.2025.08.005","url":null,"abstract":"<div><h3>Purpose</h3><div>To identify pregnancy weight patterns among people with obesity class I, II, and III, and how they lead to total gestational weight change (GWC) relative to Institute of Medicine (IOM) recommendations.</div></div><div><h3>Methods</h3><div>We examined clinically measured pregnancy weights from 7196 individuals with pre-pregnancy obesity receiving care from a national network of community-based health care organizations (2004–2020). We conducted obesity class-stratified, group-based trajectory modeling, then characterized identified GWC patterns with respect to sociodemographic and clinical characteristics.</div></div><div><h3>Results</h3><div>GWC trajectories included two patterns exhibiting early weight loss that was later regained (n = 4113), two with consistent weight gain (n = 3026), and, among individuals with class III obesity, a fifth pattern (n = 57) exhibiting weight loss that was not regained by delivery. Trajectories that met the total GWC IOM recommendations exhibited 1st trimester weight loss followed by at/above-IOM recommended 2nd and 3rd trimester GWC. Trajectories with 1st trimester weight gain exceeded the total GWC recommendation. Public health insurance, tobacco use, and Black race were generally more common in trajectories with the highest rates of weight loss or gain.</div></div><div><h3>Conclusions</h3><div>Obesity class-specific GWC recommendations should address safe levels of 1st trimester weight loss and dissonance between recommended total GWC and 2nd and 3rd trimester gain rates.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"110 ","pages":"Pages 95-101"},"PeriodicalIF":3.0,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823100","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":"Rising maternal obesity and persistent suboptimal gestational weight gain among women living with HIV in Kenya: A retrospective cohort study 2008–2017","authors":"Nazha M. Diwan ,&nbsp;Betty Mbithe ,&nbsp;John Kinuthia ,&nbsp;Tony J. Cagle ,&nbsp;Charles Kibaara ,&nbsp;Andrew Nagy Adly ,&nbsp;Michael H. Chung ,&nbsp;Angela M. Bengtson","doi":"10.1016/j.annepidem.2025.08.001","DOIUrl":"10.1016/j.annepidem.2025.08.001","url":null,"abstract":"<div><h3>Purpose</h3><div>To describe trends in pre-pregnancy BMI (ppBMI), gestational weight gain (GWG), and associations with birth outcomes among women living with HIV (WLWH) in Kenya.</div></div><div><h3>Methods</h3><div>WLWH who initiated antenatal care ≤ 14 weeks of gestation at the Coptic Hope Center in Nairobi and Maseno, Kenya between 2008 and 2017 were identified. PpBMI was defined using first-trimester BMI (Kg/m²); GWG was assessed using weekly GWG rate in the second-and-third trimesters per National Academy of Medicine (NAM) guidelines. Associations between GWG z-scores and birthweight, low/high birthweight, and emergency cesarean-section (c-section) were examined using mixed-effects models.</div></div><div><h3>Results</h3><div>We identified 1190 pregnancies, of which more than half had overweight (34.3 %) or obese (18.0 %) ppBMI, 45.1 % had normal ppBMI, and 2.6 % were underweight. From 2008–2017, obese ppBMI among WLWH doubled, while normal ppBMI decreased by 8.2 %. Suboptimal GWG rates, both above and below NAM-recommendations, were common across ppBMI categories. A one-unit increase in GWG z-score was associated with higher birthweight (+45.96, 95 % CI: 15.29–75.17) and increased risk of emergency c-section (aRR=1.35, 95 % CI: 1.03–1.82).</div></div><div><h3>Conclusion</h3><div>From 2008–2017, maternal obesity among WLWH in Kenya increased, while GWG rates remained suboptimal. Future studies should examine barriers and possible interventions to address rising ppBMI and promote healthy GWG among WLWH.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"110 ","pages":"Pages 81-88"},"PeriodicalIF":3.0,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805235","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":"Criminal justice intimate partner victimization before, during and after pregnancy among birthing parents screened postnatally by public health nurses","authors":"Monica Serena Perner ,&nbsp;Natalia Pacifico ,&nbsp;Maria Paula Godoy ,&nbsp;Marni Brownell ,&nbsp;Marcelo Luis Urquia","doi":"10.1016/j.annepidem.2025.07.063","DOIUrl":"10.1016/j.annepidem.2025.07.063","url":null,"abstract":"<div><h3>Background</h3><div>Intimate partner violence (IPV) is a global problem, disproportionately affecting women. Pregnancy offers a unique opportunity to identify IPV.</div></div><div><h3>Methods</h3><div>This population-based data linkage study includes residents of Manitoba, Canada who gave birth from 2006–2020 and were eligible for the Families First Screening (FFS) (n = 194,280). The FFS is a universal screening tool completed typically within one week postpartum by public-health nurses, which includes questions on current history of relationship violence and distress, including pregnancy. We assessed the associations of these responses with criminal justice identified IPV (JIIPV) two years before through two years after pregnancy (2004–2022) using logistic and multinomial regressions models.</div></div><div><h3>Results</h3><div>The prevalence of JIIPV at any time around pregnancy among birthing parents without distress/violence during pregnancy was 36.6 per 1000 pregnancies. Compared to them, those who reported both violence and relationship distress had a prevalence of 474.5/1000 [Odds Ratio (OR): 23.8; 95 %CI: 21.4, 26.4, and adjusted OR (AOR): 5.4; 95 %CI: 4.8, 6.1]. Those who did not respond to distress/violence questions and those who did not participate in the FFS had also higher prevalence of JIIPV. Observed patterns persisted before, during and after pregnancy.</div></div><div><h3>Conclusion</h3><div>Screening by public health nurses identifies families seriously affected by JIIPV around pregnancy.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"110 ","pages":"Pages 72-80"},"PeriodicalIF":3.0,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800869","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":"Incorporating longitudinal variability in prediction models: A comparison of machine learning and logistic regression in a cohort study with long follow-up.","authors":"L M de Groot, J W R Twisk, A A L Kok, M W Heymans","doi":"10.1016/j.annepidem.2025.07.060","DOIUrl":"10.1016/j.annepidem.2025.07.060","url":null,"abstract":"<p><strong>Purpose: </strong>Clinical prediction models benefit from longitudinal data. While the predictive value of a predictor's mean and change over time is well-established, the role of variability around this change is underexplored. Machine Learning methods can be effective in analyzing longitudinal data with long follow-up periods. This study evaluated the predictive value of mean, change, and variability, comparing Random Forest, Lasso regression, and logistic regression.</p><p><strong>Methods: </strong>We compared models including only mean and change to models also incorporating variability. Predictor selection, interpretability, and performance were compared across methods. Performance was assessed using AUC, sensitivity, specificity, PPV, NPV, and calibration. Data were drawn from the Longitudinal Aging Study Amsterdam to predict depression using 81 longitudinal parameters. Models were trained on 70 % and validated on 30 % of the data. To ensure robustness, analyses were repeated over 500 random splits, and aggregated results were reported.</p><p><strong>Results: </strong>Including variability improved AUCs for all methods. Predictor selection overlapped across models, and regression coefficients aligned with Random Forest partial dependence plots. Lasso showed the highest training AUC but poorer test performance, while logistic regression and Random Forest showed more stable results. Calibration was acceptable, though predicted risks remained below 0.6.</p><p><strong>Conclusion: </strong>Machine Learning methods did not outperform logistic regression. Nonetheless, incorporating variability in longitudinal predictors enhances prediction, especially with expected changes in predictors, e.g., ageing populations.</p>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":" ","pages":"51-65"},"PeriodicalIF":3.0,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735095","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":"Incarceration is a key driver of racial disparities in community-associated methicillin-resistant Staphylococcus aureus infections in Cook County, IL","authors":"Hannah Steinberg MPH ,&nbsp;William Trick MD ,&nbsp;Chad Zawitz MD ,&nbsp;Robert A. Weinstein MD ,&nbsp;Paul Won ,&nbsp;Alla Aroutcheva MD PhD ,&nbsp;Evan Snitkin PhD ,&nbsp;Kyle J. Popovich MD MS ,&nbsp;Jon Zelner PhD","doi":"10.1016/j.annepidem.2025.07.027","DOIUrl":"10.1016/j.annepidem.2025.07.027","url":null,"abstract":"<div><h3>Purpose</h3><div>Describe inequities in community-associated methicillin-resistant <em>Staphylococcus aureus</em> (CA-MRSA) infections and identify social factors contributing to these disparities.</div></div><div><h3>Methods</h3><div>We characterized census tract-level risk factors for CA-MRSA infections in the Cook County Health (CCH) catchment population in Cook County, IL from 2009 to 2022 using hierarchical Poisson regression models. We conducted mediation analyses to estimate a) the total risk attributable to and b) proportion of between-tract disparities in CA-MRSA accounted for by census tract-level inequities in risk factors.</div></div><div><h3>Results</h3><div>CCH patients living in majority Black census tracts in Cook County had double the rate of CA-MRSA infections as compared to CCH patients living in majority white census tracts. Socio-economic indicators such as public transportation use and the presence of homeless shelters in a census tract were associated with CA-MRSA rates in multivariate analyses. However, jail admission rates explained the largest proportion of CA-MRSA burden (30 %) and racial inequities in CA-MRSA incidence (69 %).</div></div><div><h3>Discussion</h3><div>High risks of MRSA infection and colonization have consistently been documented among incarcerated and recently incarcerated individuals. Our results suggest that incarceration may also drive infections among non-incarcerated individuals living in communities with high levels of indirect exposure to jails, especially in majority Black census tracts.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"109 ","pages":"Pages 96-102"},"PeriodicalIF":3.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735094","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}