American Journal of Preventive Medicine最新文献

{"title":"Universal Strategies to End Appeal of Firearms in America.","authors":"Daniel Romer","doi":"10.1016/j.amepre.2026.108587","DOIUrl":"https://doi.org/10.1016/j.amepre.2026.108587","url":null,"abstract":"<p><p>Efforts to reduce firearm violence and injury in the US focus mainly on policies that deter persons at risk of unjustified firearm use. These programs attempt to prevent those who might use firearms from harming others or themselves. What has been overlooked are more universal strategies to reduce the demand for firearms, especially handguns, which are the most frequently used weapon for violent purposes. It is also the weapon that is cited by the Supreme Court as sufficiently popular to justify its protection under the Second Amendment. Here it is argued that the widespread portrayal of firearms in entertainment is closely related to the increase in the sales of handguns and their use specifically for assaults rather than for suicide, especially in young people. The public health approach to the reduction of demand for cigarettes provides a useful model for reducing the appeal of handguns. Such a universal strategy can add to the selective and indicated strategies that are currently highlighted in efforts to control firearm use.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108587"},"PeriodicalIF":4.7,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AREA-LEVEL SOCIAL AND STRUCTURAL DETERMINANTS OF HEALTH AND CERVICAL CANCER STAGE AT DIAGNOSIS.","authors":"Abigail M Girgis, Karla Radillo, Melinda Irwin, Sangini S Sheth, Linda M Niccolai","doi":"10.1016/j.amepre.2026.108589","DOIUrl":"https://doi.org/10.1016/j.amepre.2026.108589","url":null,"abstract":"<p><strong>Introduction: </strong>Cervical cancer is highly preventable, yet disparities in stage at diagnosis persist. While individual-level factors affect access to screening and diagnostic care, less is known about how area-level social and structural determinants shape stage at diagnosis. Area-based measures offer a multidimensional approach to capturing structural disadvantage but remain underutilized in cervical cancer research.</p><p><strong>Methods: </strong>A retrospective cohort study of 352 patients diagnosed with cervical cancer between 2015 and 2023 at Smilow Cancer Hospital Network at Yale was conducted. Residential addresses at diagnosis were geocoded to census tracts and linked to area-level datasets, including ACS poverty estimates, NCI Social Determinants of Health measures, and CDC Social Vulnerability Index. Stage was categorized as early (I-IIA) or advanced (IIB-IVB). Bivariate analyses assessed associations between individual- and area-level characteristics and stage at diagnosis. Multivariable logistic regression models were fit separately for each area-level measure, adjusting for individual-level covariates.</p><p><strong>Results: </strong>Overall, 51.7% of patients were diagnosed with advanced-stage disease. Higher area-level poverty was associated with higher odds of advanced-stage diagnosis (global p = 0.01). Compared with the lowest-poverty neighborhoods, patients in moderate-poverty areas had over twice the odds of advanced disease (aOR 2.19, 95% CI 1.05-4.58), while those in highest-poverty neighborhoods had nearly threefold higher odds (aOR 2.99, 95% CI 1.43-6.24). Higher household composition and disability vulnerability was also independently associated with advanced-stage diagnosis (global p = 0.04).</p><p><strong>Conclusions: </strong>Neighborhood social and structural disadvantage is independently associated with advanced cervical cancer stage, underscoring the importance of incorporating area-level context into strategies to reduce cervical cancer disparities.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108589"},"PeriodicalIF":4.7,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disability, Intersectionality, and Diagnostic Overshadowing: Implications for Preventive Medicine - A Commentary.","authors":"Leslie Heller","doi":"10.1016/j.amepre.2026.108590","DOIUrl":"https://doi.org/10.1016/j.amepre.2026.108590","url":null,"abstract":"<p><p>Healthcare encounters involving patients with disabilities are shaped not only by symptoms and clinical information but also by assumptions regarding credibility, competence, and social identity. Drawing on concepts of intersectionality, diagnostic overshadowing, and patient credibility, this commentary examines how ableism, intersectionality, and diagnostic overshadowing interact to shape diagnostic reasoning, preventive care, and health equity. These intersecting mechanisms may contribute to delayed diagnosis, missed diagnosis, reduced access to preventive services, and preventable morbidity and mortality. Disability-related inequities may also affect participation in preventive screening, opportunities for early detection, and other core goals of preventive medicine. Recognizing disability as a critical component of health equity and preventive medicine may help healthcare systems improve preventive service delivery, diagnostic accuracy, patient safety, and population health outcomes. Structural safeguards, disability-informed education, and healthcare system reforms are needed to reduce preventable harms associated with disability-related bias.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108590"},"PeriodicalIF":4.7,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"County-Level Healthcare and Social Spending and Health Outcomes by Race/Ethnicity and Sex in the U.S.","authors":"Gunah Kim, Joseph L Dieleman, Arturo Vargas Bustamante, S V Subramanian, Sungchul Park","doi":"10.1016/j.amepre.2026.108577","DOIUrl":"https://doi.org/10.1016/j.amepre.2026.108577","url":null,"abstract":"<p><strong>Introduction: </strong>Healthcare and social spending are associated with improved population health, but whether these associations differ by race/ethnicity and sex remains unclear. This study examines heterogeneity in county-level spending-health associations in the United States.</p><p><strong>Methods: </strong>A county-level panel study used 2010-2019 data from the Institute for Health Metrics and Evaluation and the Government Finance Database. Outcomes included life expectancy, health-adjusted life expectancy (HALE), age-standardized mortality (ASMR), and infant mortality, stratified by race/ethnicity and sex. Primary exposures were per capita healthcare and social spending. Fixed-effects models adjusted for time-varying covariates. Data analysis was conducted in 2026.</p><p><strong>Results: </strong>Each additional $1,000 in healthcare spending was associated with higher life expectancy (0.073 years), higher HALE (0.057 years), and lower ASMR (-7.299 per 100,000). Associations were strongest among White populations (life expectancy: 0.092; HALE: 0.070; ASMR: -8.776) and consistent across sex. However, healthcare spending was not significantly associated with life expectancy, HALE, or ASMR among Black or Hispanic populations. In contrast, social spending was consistently associated with higher life expectancy (0.148), higher HALE (0.116), and lower ASMR (-5.837) among Hispanic populations. Social spending was most consistently associated with lower infant mortality among Black and Hispanic populations.</p><p><strong>Conclusions: </strong>Healthcare and social spending were associated with improved population health, but associations varied by spending type, outcome, and racial/ethnic group. Public spending alone may be insufficient to reduce health inequities without addressing structural barriers to access and utilization. Equity-focused policies are needed to ensure public investments reach populations with the greatest unmet needs.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108577"},"PeriodicalIF":4.7,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency Department Visits for Gambling Disorders After the Legalization of Single-Event Sports Betting and Rapid Expansion of Online Gambling.","authors":"Ryan Forrest, Natalie Doan, Rachael MacDonald-Spracklin, Michael Pugliese, Nigel E Turner, Daniel T Myran","doi":"10.1016/j.amepre.2026.108551","DOIUrl":"https://doi.org/10.1016/j.amepre.2026.108551","url":null,"abstract":"<p><strong>Introduction: </strong>Online gambling and single-event sports betting have been legalized and expanded in North America. Although these changes have raised concerns over increased gambling-related harms, the impacts of gambling expansion are not well understood. This study examined changes in gambling-related emergency department visits after the legalization of single-event sports betting and privatized online gambling in Ontario, Canada.</p><p><strong>Methods: </strong>This was a population-based study of all individuals in Ontario, Canada, aged ≥10 years, who were eligible for universal health coverage (N=17,353,640) between January 2012 and June 2025. An interrupted time series design estimated changes in the rates of emergency department visits for gambling disorders after online gambling liberalization in April 2022, overall and by age and sex.</p><p><strong>Results: </strong>Over 14 years, there were 952 emergency department visits for gambling disorders from 757 unique individuals (mean [SD] age=41.8 [14.9] years; 72.0% male). The mean quarterly rates of emergency department visits for gambling disorders were 31.3% higher during the period after liberalization than before (1.28-1.68 per 1,000,000 individuals), with increases observed in males (1.81-2.63 per 1,000,000) but not in females (0.77-0.74 per 1,000,000). Visits were stable before liberalization, showed no immediate change on implementation, but began to increase by 7% per quarter (incidence rate ratio=1.07, 95% CI=1.04, 1.10). By the end of the study period (in April-June 2025), the rate of emergency department visits for gambling disorders was estimated to be 99.0% (incidence rate ratio=1.99, 95% CI=1.48, 2.67) higher overall and 154.0% (incidence rate ratio=2.54, 95% CI=1.15, 5.63) and 116.0% (incidence rate ratio=2.16, 95% CI=1.18, 3.95) higher in males aged 10-29 years and 30-44 years, respectively, than the expected rates without gambling market liberalization.</p><p><strong>Conclusions: </strong>Online gambling expansion with legal single-event sports betting was associated with a doubling of the rates of severe cases of gambling disorders, with increases occurring only in young men. Although such visits were rare, they may reflect broader population increases in gambling harms.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108551"},"PeriodicalIF":4.7,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevention Research on Extreme Weather and Health: A Portfolio Analysis of NIH Funded Studies, 2015-2024.","authors":"Jaime Madrigano, Liberty Walton, Jacqueline Lloyd","doi":"10.1016/j.amepre.2026.108578","DOIUrl":"https://doi.org/10.1016/j.amepre.2026.108578","url":null,"abstract":"<p><strong>Introduction: </strong>The public health burden from extreme weather is significant and research to prevent related adverse health impacts is needed. This study's objective was to characterize the portfolio of extreme weather and prevention research funded by NIH for fiscal years (FY) 2015-2024 and identify research gaps and opportunities.</p><p><strong>Methods: </strong>Within a broad portfolio of NIH-funded extreme weather-related grants, a coding schema was developed to identify prevention projects focused on six extreme weather hazards. A prevention research taxonomy was applied to categorize projects according to several study variables.</p><p><strong>Results: </strong>A total of 243 projects focused on specific extreme weather hazards. Among these, 78% (n=189) were considered prevention research, primarily consisting of primary prevention. Of these, the largest proportion of projects focused on heat (39.4%), followed by hurricanes/floods/precipitation (31.7%). Projects assessed a range of health outcomes, and approximately 30% of the projects within the portfolio included a focus on one of the ten leading causes of death in the United States. The majority of projects were observational studies, compared to interventional. Children, the elderly, or low-income populations were each represented in about 20-25% of funded projects. However, some vulnerable populations, such as populations experiencing homelessness, were not represented in the portfolio.</p><p><strong>Conclusions: </strong>A large portion of the research funded by the NIH in FY 2015-2024 addressing extreme weather and health focused on prevention. An increased focus on longitudinal research, as well as interventional research to mitigate the health impacts from extreme weather, with attention to highly vulnerable populations, is needed.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108578"},"PeriodicalIF":4.7,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variation in toxicology testing for violent deaths and suicides by geography and medicolegal death investigation system type - National Violent Death Reporting System, 2023.","authors":"Marissa Zwald, Daniel A Bowen, Kristin Holland, Katherine Fowler, Steven Sumner, M Carri R Cottengim, M Allison Arwady","doi":"10.1016/j.amepre.2026.108579","DOIUrl":"https://doi.org/10.1016/j.amepre.2026.108579","url":null,"abstract":"<p><strong>Introduction: </strong>Although toxicology testing is critical for identifying substance involvement in violent deaths and suicides, testing is not standardized and varies across states and medicolegal death investigation (MDI) systems in the United States. This study examined geographic and system-level variation in toxicology testing among violent deaths and suicides.</p><p><strong>Methods: </strong>Centers for Disease Control and Prevention's National Violent Death Reporting System (NVDRS) data from 2023 was analyzed. Decedents were classified as having toxicology testing if any substance was indicated as tested. Percentages of decedents with toxicology testing overall and by manner of death, state, and MDI system type were calculated.</p><p><strong>Results: </strong>Toxicology testing varied across geography and MDI system type. State-level overall testing rates varied widely, ranging from a low of 15.1% to a high of 99.0%. Centralized systems consistently reported the highest percentage of toxicology testing across all manners of death (overall: 79.5%; homicide: 88.7%; legal intervention deaths: 91.5%; suicide: 72.2%; undetermined intent: 94.9%; unintentional firearm injury: 85.1%). Local mixed systems generally exhibited the lowest frequency of testing (overall: 48.1%; homicide: 52.4%; legal intervention: 67.7%; suicide: 44.9%; undetermined intent: 58.4%; unintentional firearm injury: 41.7%).</p><p><strong>Conclusions: </strong>Toxicology testing rates for violent deaths and suicides varied substantially by state/jurisdiction and MDI system. These findings highlight opportunities to standardize testing protocols and address gaps in lower-testing states/jurisdictions, which could strengthen violent death and suicide surveillance, enhance the accuracy and completeness of substance-related data, and support prevention efforts at state and national levels.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108579"},"PeriodicalIF":4.7,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary Guideline Adherence and All-Cause Mortality: A Target Trial Emulation of Universal and Equity-Targeted Strategies Among Canadian Adults.","authors":"Saba Jalali, Xiao Hu, Boris Sobolev, Mahsa Jessri","doi":"10.1016/j.amepre.2026.108575","DOIUrl":"https://doi.org/10.1016/j.amepre.2026.108575","url":null,"abstract":"<p><strong>Introduction: </strong>National dietary guidelines are key tools for chronic disease prevention, yet the mortality and life-expectancy benefits of greater guideline alignment remain insufficiently quantified overall and among socially disadvantaged groups.</p><p><strong>Methods: </strong>A target trial was emulated in 2025 among adults ≥20 years using the Canadian Community Health Survey-Nutrition 2004 linked to mortality records through 2017. Alignment with Canada's Food Guide 2019 was retrospectively assessed using the Healthy Eating Food Index-2019 (HEFI-2019). Under prespecified target-trial assumptions of exchangeability, positivity, consistency, and approximation of random assignment, inverse-probability-weighted pooled logistic regression models estimated 5- and 13-year mortality risks under counterfactual scenarios shifting population diet to prespecified adherence levels. Targeted improvements were simulated among adults aged 45-80 years in equity-relevant subgroups defined by educational attainment, household income, food insecurity, or neighborhood deprivation.</p><p><strong>Results: </strong>Among 15,835 adults, shifting the population to optimal adherence yielded lower estimated 5-year (RR:0.55; 95% CI:0.39-0.77) and 13-year mortality (RR:0.79; 95% CI:0.70-0.89), corresponding to 13-year life-expectancy gains of 1.7 years (women) to 3.0 years (men). Targeting adults with less than secondary education lowered population-level 5-year mortality by 28% (RR_optimal:0.72; 95% CI: 0.56-0.93), comparable to universal high adherence among all adults aged 45-80 years (RR_high:0.64; 95% CI:0.47-0.87). Low-income targeting showed short-term within-group benefit only; estimates for food-insecurity and neighborhood-deprivation were near null.</p><p><strong>Conclusions: </strong>Higher adherence to a national food-based dietary guideline yielded lower estimated mortality and longer life expectancy in this target trial emulation. Targeted improvement among adults with lower educational attainment showed clear short-term population-level benefit, comparable to universal approaches.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108575"},"PeriodicalIF":4.7,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148971834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occupational Access to Pharmaceuticals and Drug Poisoning-related Suicides among US Workers.","authors":"Victor A Soupene, J Priyanka Vakkalanka, Jonathan Davis","doi":"10.1016/j.amepre.2026.108580","DOIUrl":"https://doi.org/10.1016/j.amepre.2026.108580","url":null,"abstract":"<p><strong>Introduction: </strong>Healthcare practitioners and technical workers have the highest rates of poisoning-related suicide among major occupational groups, potentially due to their occupational access to and familiarity with pharmaceuticals. However, the role of occupation-specific pharmaceutical access in suicide method choice remains poorly understood. This study examined whether occupational access to pharmaceuticals is associated with an increased likelihood of suicide by drug poisoning versus other methods.</p><p><strong>Methods: </strong>In this mortality case-control study, suicides involving drug poisonings were compared with non-drug poisonings (e.g., firearms) using data from the National Violent Death Reporting System between 2013 and 2023. Occupational access to pharmaceuticals was defined as having job-related access to medications and professional-level knowledge of medication use. Adjusted odds ratios with 95% confidence intervals were estimated using multivariable logistic regression models, stratified by biological sex, and adjusted for age, race/ethnicity, education level, and rurality.</p><p><strong>Results: </strong>Among decedents with occupational access to pharmaceuticals (n = 4,123), most were registered nurses (63.4%), physicians (15.8%), or pharmacists (6.3%). Compared with those without occupational pharmaceutical access, male and female decedents had higher odds of dying by drug poisoning suicide (males: OR = 1.7, 95% CI: 1.3-2.1; females: OR = 1.4, 95% CI: 1.2-1.6).</p><p><strong>Conclusions: </strong>Occupational access to pharmaceuticals may influence suicide method choice among healthcare workers. These findings underscore the need for targeted prevention strategies that address access to and familiarity with medications in high-risk occupations.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108580"},"PeriodicalIF":4.7,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148971856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family Composition as a Moderator of PTSD and Suicidal Ideation-Related Risk for Non-Secure Firearm Storage Among U.S. Army Soldiers and Veterans.","authors":"Alexander J Rice, Louis N Lachman, Jing Zhou, Ian H Stanley, Stephen J Cozza","doi":"10.1016/j.amepre.2026.108574","DOIUrl":"https://doi.org/10.1016/j.amepre.2026.108574","url":null,"abstract":"<p><strong>Introduction: </strong>Non-secure firearm storage is a key suicide risk factor among U.S. Army soldiers and veterans. Though PTSD and suicidal ideation correlate with storage practices, the role of household context remains unclear. This study examined whether family composition moderates associations of PTSD and suicidal ideation with non-secure storage of personal firearms.</p><p><strong>Methods: </strong>Data were drawn from the Army Study to Assess Risk and Resilience in Service Members-Longitudinal Study (STARRS-LS; collected April 2018-July 2019; analyzed August 2025-May 2026). Analyses included soldiers and veterans with household firearms (N = 5,583). Logistic regressions assessed associations of lifetime PTSD, suicidal ideation, and family composition (partner status, child presence) with non-secure storage (≥1 loaded and unlocked firearm), controlling for demographics, firearm count, and military status.</p><p><strong>Results: </strong>Overall, 26.5% reported non-secure storage. Lifetime PTSD (adjusted OR = 1.38, 95% CI: 1.13, 1.70) and suicidal ideation (unadjusted OR = 1.39, 95% CI: 1.13, 1.72) were associated with non-secure storage. Family composition moderated the PTSD-storage relationship (p = .015), but not suicidal ideation. Among those with PTSD, single individuals without children had the highest odds of non-secure storage, whereas partnered parents had the lowest.</p><p><strong>Conclusions: </strong>Risk for non-secure firearm storage among personnel with PTSD varies by family composition. Interventions should consider combining clinical risk assessment with household context, specifically targeting single, childless individuals.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108574"},"PeriodicalIF":4.7,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148971881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}