American Journal of Preventive Medicine最新文献

{"title":"Gaps in Care Among Adolescents and Young Adults in The United States.","authors":"Samhita M Ilango, Robert Hest, Annie Schmidt, Margaret A McManus, Kathleen Call, Patience H White","doi":"10.1016/j.amepre.2025.107957","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.107957","url":null,"abstract":"<p><strong>Introduction: </strong>Adolescents and young adults (AYAs) face several challenges to their wellbeing as they move into adulthood and assume a larger role in navigating their health, health care, and health insurance. This study examines gaps in care that may result in missed opportunities for health promotion and maintenance, early intervention, and acute and chronic care management.</p><p><strong>Methods: </strong>This study used the 2022-2023 National Health Interview Survey data of individuals 10-25 years old to understand which AYA age groups (10-14, 15-18, and 19-25 years) experience gaps in care and which sociodemographic, health status, and health care access variables are associated with increased odds of care gaps. The analysis was conducted in 2025.</p><p><strong>Results: </strong>More than 1 in 4 young adults (YAs) experienced a gap in care of 1 or more years, a rate twice that of adolescents. Measures of health care access-namely, being uninsured and without a usual source of care-were predictive of gaps in care across all 3 age groups. The sociodemographic factors of citizenship, region, and poverty level were also associated with care gaps across all 3 age groups.</p><p><strong>Conclusions: </strong>Policymakers, payers, public agencies, and health care providers can play an important role in AYA health. There should be increased attention to identifying and assisting AYAs with (and at risk for) lapses in coverage and care, prioritizing those without a medical home, transitioning from pediatric to adult care, losing childhood Medicaid or CHIP eligibility status, and residing in states not expanding Medicaid.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"107957"},"PeriodicalIF":4.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512679","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":"Postpartum Readmission in People with Intellectual and Developmental Disability.","authors":"Jessica E Rast, Jennifer Bromberg, Arina Chesnokova, Molly Sadowsky, Jonas Ventimiglia, Lindsay L Shea","doi":"10.1016/j.amepre.2025.107959","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.107959","url":null,"abstract":"<p><strong>Introduction: </strong>Postpartum readmission (PPR) and severe maternal morbidity have been increasing in recent years in the U.S., but little is known about the risk of either for people with intellectual and developmental disabilities (IDD), including the autism spectrum. The purpose of the study is to establish an estimate of PPR in a nationally representative sample of people with IDD.</p><p><strong>Methods: </strong>this study used the National Readmission Database to examine the deliveries of people with IDD (n=5721), people on the autism spectrum (n=1099) and deliveries in people without IDD or autism (n=3,890,553) in 2019 and 2020. Log-binomial regression was used to examine person and delivery characteristics associated with PPR in all deliveries.</p><p><strong>Results: </strong>PPR was more common in people with IDD (6.6%) and people on the autism spectrum (3.3%) than in all other deliveries (1.5%). In adjusted analyses, people with IDD (aRR 3.50, 95% CI 3.15, 3.90) and people on the autism spectrum (aRR 2.06, 95% CI 1.42, 2.97) had increased risk of PPR compared to people without these conditions. Other characteristics were also associated with increased risk of PPR, including 2.80 times the risk of PPR in people with severe maternal morbidity compared to those without (95% CI 2.66, 2.94).</p><p><strong>Conclusions: </strong>High rates of PPR in people with IDD point to the need for a better understanding of the drivers of such high rates in these populations. These drivers could include population differences in co-occurring health and mental health conditions, social and community support, and accessible health care.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"107959"},"PeriodicalIF":4.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512681","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":"Sex Differences in Life Course Suicide Rates by State Firearm Policy Environment.","authors":"Nathaniel J Glasser, Jacob C Jameson, Nabil Abou Baker, Harold A Pollack, Elizabeth L Tung","doi":"10.1016/j.amepre.2025.107961","DOIUrl":"10.1016/j.amepre.2025.107961","url":null,"abstract":"<p><strong>Introduction: </strong>Male sex and permissive state firearm policy environments have been independently associated with suicide mortality. Few recent studies quantify how these factors interact, or how interactions vary across the life course. This study investigates how state firearm policy environments moderate sex differences in firearm, non-firearm, and overall suicide rates across the life course.</p><p><strong>Methods: </strong>Employing Center for Disease Control and Prevention data, linear regression was used to model sex differences in firearm, non-firearm, and total suicide mortality rates per 100,000 across the life course and interactions with state firearm policy environments (categorized \"permissive\" versus \"strict\" using Giffords Gun Law Scorecard Grades). Data were collected in 2018-2022 and analyzed in 2024-2025.</p><p><strong>Results: </strong>Across all ages and state policy environments, male sex was associated with higher firearm (18.95; 95%CI, 16.97,20.92), non-firearm (7.07; 95%CI, 6.63,7.14), and total (26.02; 95%CI, 23.94,28.10) suicide rates. Compared to strict state policy environments, permissive environments were associated with increased firearm (5.84; 95%CI, 3.84,7.84) and total suicide rates (5.96; 95%CI, 3.32,8.60). In interacted models, permissive environments augmented associations of male sex with higher firearm (9.02; 95%CI, 5.75,12.29) and total (9.24; 95%CI, 5.96,12.52) suicide rates. Sex also moderated associations of age with suicide rates.</p><p><strong>Conclusions: </strong>Males die from suicide at higher rates than females across the life course, exhibiting particularly high rates within states that implement permissive firearm policies. At older ages, dramatically higher male suicide rates are seen in both permissive and strict state environments, suggesting that males face unique challenges associated with aging that require focused clinical attention.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"107961"},"PeriodicalIF":4.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12248068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistent cannabis use and ocular health in midlife.","authors":"Kirsten Cheyne, Rachael L Niederer, Antony Ambler, Ashleigh Barrett-Young, Hayley Guiney, Richie Poulton, Sandhya Ramrakha, Tien Yin Wong, Graham A Wilson","doi":"10.1016/j.amepre.2025.107955","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.107955","url":null,"abstract":"<p><strong>Introduction: </strong>Cannabis is widely used and becoming legal in many countries. While some acute ocular effects of cannabis are well-known (e.g., reduced intraocular pressure, vasodilation), little is known about the consequences of long-term cannabis use for ocular health. The aim of this study was to examine the association between persistent cannabis use across adulthood and measures of ocular health in midlife.</p><p><strong>Methods: </strong>Participants were members of the Dunedin Study (n=1037), a longitudinal cohort followed since birth. Cannabis use has been measured by self-report at every assessment from age 18 to 45. Ocular health data were collected as part of a larger assessment at age 45 (2017-2019). Statistical analysis was performed in 2022.</p><p><strong>Results: </strong>Cannabis use and ocular health data were obtained from 887 Study members. Generalised estimating equation analysis showed higher cannabis use was associated with poorer visual acuity, wider retinal arterioles and venules, and a thicker inferior hemifield of the ganglion cell-inner plexiform layer (GC-IPL). However, when controlling for tobacco smoking and socioeconomic status (known to be associated with these ocular health domains), the associations with visual acuity, arterioles, and venules were no longer significant. The association with GC-IPL remained significant in this adjusted model.</p><p><strong>Conclusions: </strong>Persistent cannabis use appears to be neither harmful nor beneficial to the eye at age 45, although the thicker inferior GC-IPL hemifield in users of cannabis suggests biologically plausible neuroprotection. Further assessments as this cohort ages will illuminate the relationship between persistent cannabis use and ocular neuroprotection.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"107955"},"PeriodicalIF":4.3,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509277","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":"Publisher’s Note: Introducing article numbering to American Journal of Preventive Medicine","authors":"","doi":"10.1016/j.amepre.2025.107737","DOIUrl":"10.1016/j.amepre.2025.107737","url":null,"abstract":"","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 1","pages":"Article 107737"},"PeriodicalIF":4.3,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322210","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":"Sex-Specific Hypertension Deaths From Excessive Alcohol Use","authors":"Gregory Leung PhD ,&nbsp;Marissa B. Esser PhD ,&nbsp;Janet Wright MD","doi":"10.1016/j.amepre.2025.03.003","DOIUrl":"10.1016/j.amepre.2025.03.003","url":null,"abstract":"","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 1","pages":"Article 107623"},"PeriodicalIF":4.3,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322211","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":"Longitudinal Association Between Walkability and Physical Activity in Twins","authors":"Glen E. Duncan PhD ,&nbsp;Ally R. Avery MS ,&nbsp;Matthew J.D. Pilgrim MS ,&nbsp;Ofer Amram PhD ,&nbsp;Stephen J. Mooney PhD ,&nbsp;Andrew G. Rundle PhD","doi":"10.1016/j.amepre.2025.107950","DOIUrl":"10.1016/j.amepre.2025.107950","url":null,"abstract":"<div><h3>Introduction</h3><div>Research has focused on the built environment (e.g., neighborhood walkability) that supports or hinders physical activity because it is potentially modifiable. This study investigated the associations between changes in neighborhood walkability and changes in physical activity in an adult twin cohort.</div></div><div><h3>Methods</h3><div>Longitudinal data (2009–2020) from 7,439 identical and fraternal twins comprising 2,800 complete pairs from a community-based registry were analyzed. Participants were free of mobility limitations and resided at their current residential location for at least 1 year. A series of phenotypic (nongenetically informed) models were used to test the effect of walkability change on change in physical activity. These were re-estimated in a series of quasi-causal models by leveraging the genetically informed nature of the twin design to test the effect of walkability change on change in physical activity while controlling for genetic and shared environmental confounds.</div></div><div><h3>Results</h3><div>Change in neighborhood walkability was associated with change in neighborhood walking but not in moderate-to-vigorous physical activity, which held after controlling for genetic and shared environmental confounding, plus standard demographic covariates, length of follow-up, and moving status. A 1-unit increased change in neighborhood walkability was associated with a 2.7-minute increased change in neighborhood walking per week, independent of familial confounds and covariates. Moving to a neighborhood that is 5.5 units greater in walkability could increase neighborhood walking by about 15 minutes per week.</div></div><div><h3>Conclusions</h3><div>This study supports a quasi-causal relationship between changes in neighborhood walkability and changes in neighborhood walking, extending previous cross-sectional findings in the same twin cohort by establishing temporality.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 3","pages":"Article 107950"},"PeriodicalIF":4.3,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327654","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":"Evaluating Equity in Universal Suicide Screening: Race/Ethnic Differences in Screening Acceptance and Results.","authors":"Richelle L Clifton, Kate Beemer, Marybelle Camacho, Molly C Adrian","doi":"10.1016/j.amepre.2025.107945","DOIUrl":"10.1016/j.amepre.2025.107945","url":null,"abstract":"<p><strong>Introduction: </strong>Youth suicide is a critical public health issue. Universal screening in healthcare settings can provide clinical pathways for early identification of suicide risk by assessing suicidal thoughts and behaviors and connection to care. This study aimed to examine whether participation in universal suicide risk screening varies by demographic factors, including race/ethnicity, given documented disparities in suicide rates across racial/ethnic groups.</p><p><strong>Methods: </strong>Patient responses on the Ask Suicide-Screening Questions (ASQ), demographics, and service use factor data were drawn from patient medical records for ambulatory and acute care visits within a large children's hospital system between 6/1/21, and 9/12/23, for patients aged 10 and above who presented for in-person visits in an eligible clinic and were asked to complete a suicide risk screening.</p><p><strong>Results: </strong>160,228 visits for patients between ages 10-25 (M_age=14.35) were included in final analyses. Screening was accepted in 76.95% of visits, and of those screens, 15.87% were positive. After controlling for within-patient correlations, race/ethnicity, sex, and age were significant predictors of screening acceptance and result. White and Latine youth were more likely to accept screening, whereas youth of other races/ethnicities, including Asian and Black youth, were less likely to accept screening. White and Multiracial youth were more likely to screen positive, whereas Latine, Asian, and Pacific Islander youth were less likely to screen positive.</p><p><strong>Conclusions: </strong>Racial/ethnic differences in screening acceptance and results indicate disparities in suicide risk identification among youth. More work is needed to understand factors impacting engagement in screening and to ensure equitable suicide risk identification.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"107945"},"PeriodicalIF":4.3,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12244196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incident Diabetes Diagnosis Among the Uninsured During COVID-19 Hospitalization","authors":"Anisha P. Ganguly MD, MPH ,&nbsp;Michael Harms MSBA ,&nbsp;Kavita P. Bhavan MD, MHS ,&nbsp;Michael E. Bowen MD, MPH, MSCS","doi":"10.1016/j.amepre.2025.107949","DOIUrl":"10.1016/j.amepre.2025.107949","url":null,"abstract":"<div><h3>Introduction</h3><div>Undiagnosed diabetes is associated with lack of insurance, which decreases access to preventive care. During the COVID-19 pandemic, uninsured patients previously unknown to health systems were hospitalized.</div></div><div><h3>Methods</h3><div>This is a cross-sectional analysis of electronic health record data from patients with diabetes hospitalized with COVID-19 in a safety-net health system from June 2020 to December 2021, examining the association between payor status and incident diagnosis of diabetes. Incident diagnosis of diabetes was defined by excluding a prior known diagnosis of diabetes based on diagnosis codes, medications, and HgbA1c from the past 5 years. Regression analysis evaluated the association between payor status and incident diagnosis of diabetes. Data were analyzed in 2023.</div></div><div><h3>Results</h3><div>Among 872 patients with diabetes hospitalized with COVID-19, 24.0% were uninsured, 34.6% received county-funded charity coverage, 17.1% received Medicaid, and 24.3% received Medicare. The rate of incident diagnosis of diabetes in the total sample was 20.3%; incident diagnosis of diabetes was more common among the uninsured (30.1%) than among county-funded charity coverage (18.2%) and Medicare (11.3%) patients. After adjusting for age, gender, race/ethnicity, and BMI, uninsured patients had higher odds of incident diagnosis of diabetes (AOR=2.64; 95% CI=1.41, 4.92; <em>p</em>=0.002) than Medicare patients. Odds of incident diagnosis of diabetes were similar for county-funded charity coverage and Medicare patients.</div></div><div><h3>Conclusions</h3><div>Uninsured patients had higher odds of incident diagnosis of diabetes during COVID-19 hospitalization that may have gone undetected without hospitalization. These findings reflect decreased access to preventive care and missed opportunities to screen for diabetes among the uninsured.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 3","pages":"Article 107949"},"PeriodicalIF":4.3,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310777","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":"Social Safety Net Programs: The Relationship With Drug Treatment Among Women","authors":"Sam D. Gardner MPH, MSSW ,&nbsp;Shota W. Hasui MPH ,&nbsp;Sarah Gutkind PhD ,&nbsp;Emilie Bruzelius PhD ,&nbsp;Megan E. Marziali MPH, MPhil ,&nbsp;Nicole D. Fitzgerald PhD ,&nbsp;Pia M. Mauro PhD ,&nbsp;Morgan M. Philbin PhD ,&nbsp;Silvia S. Martins MD, PhD","doi":"10.1016/j.amepre.2025.107948","DOIUrl":"10.1016/j.amepre.2025.107948","url":null,"abstract":"<div><h3>Introduction</h3><div>Social safety net programs (e.g., Medicaid and government assistance) may facilitate drug use disorder treatment receipt. This study explored the associations of social safety net programs with drug treatment and medication for opioid use disorder receipt among women with drug use disorder and opioid use disorder, respectively.</div></div><div><h3>Methods</h3><div>Data were from the 2022 public-use National Survey on Drug Use and Health (analyzed in 2024) from women aged 18–64 years who met the criteria for past-year DSM-5 drug use disorder (<em>n</em>=2,784) and opioid use disorder (<em>n</em>=458). Odds of past-year drug use disorder treatment among women with drug use disorder and past-year medication for opioid use disorder treatment among women with opioid use disorder were estimated by government assistance and/or Medicaid receipt in primary analyses, followed by secondary categorizations of exposure (any government assistance, number of programs received), using separate logistic regressions, controlling for sociodemographics.</div></div><div><h3>Results</h3><div>In primary analyses, women with drug use disorder receiving both Medicaid and government assistance were more likely to report past-year drug use disorder treatment (AOR=2.91; 95% CI=1.60, 5.29) than women receiving neither. Women with past-year opioid use disorder receiving both Medicaid and government assistance were more likely to report medication for opioid use disorder (AOR=3.41; 95% CI=1.01, 11.61) than those receiving neither. Secondary analyses results were in the same direction.</div></div><div><h3>Conclusions</h3><div>Likelihood of drug treatment and medication for opioid use disorder receipt among women with drug use disorder and opioid use disorder, respectively, increased when Medicaid was combined with other forms of government assistance. Treatment costs and other barriers such as lack of insurance, childcare, and employment support are critical determinants of drug treatment; This study’s findings suggest that government support programs may help to buffer these known barriers.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 3","pages":"Article 107948"},"PeriodicalIF":4.3,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310778","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}