American Journal of Preventive Medicine最新文献

{"title":"Concentrated Affluence and Deprivation and Spatial Distribution of Firearm Violence: Racial/Ethnic Disparities across Urban Neighborhoods in the U.S.","authors":"Yi-Fang Lu, Mark T Berg","doi":"10.1016/j.amepre.2025.108103","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.108103","url":null,"abstract":"<p><strong>Introduction: </strong>This study examined whether neighborhood-level concentration of deprivation relative to affluence is associated with spatial variation in shootings and whether this association differs by the racial/ethnic composition of neighborhoods.</p><p><strong>Methods: </strong>Tract-level firearm violence data from 2020 to 2023 were obtained for 100 U.S. cities from the American Violence database. A modern measure of income inequality-Index of Concentration at the Extremes and negative binomial regression models were used to estimate the marginal effects of concentration at the extremes on shootings across Black, Hispanic, mixed minority, White, and racially integrated neighborhoods. Data analysis was conducted between December 2024 and July 2025.</p><p><strong>Results: </strong>A comparison of marginal effects revealed that the impact of concentration at the extremes on firearm violence was significantly greater in Black and mixed-minority neighborhoods than in predominantly Hispanic or White neighborhoods.</p><p><strong>Conclusions: </strong>This study highlights the differential effects of income inequality across neighborhoods with different population profiles. The concentration of affluence and deprivation has more pronounced effects on the burden of firearm violence in Black and mixed minority neighborhoods. Place-based interventions including investments in low-income Black and mix minority neighborhoods might be promising tools for firearm violence prevention.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108103"},"PeriodicalIF":4.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066267","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":"The intersection of tap water avoidance, food insecurity, and sugar-sweetened beverage intake among US 2-17-year-olds.","authors":"Asher Y Rosinger, Sera L Young","doi":"10.1016/j.amepre.2025.108104","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.108104","url":null,"abstract":"<p><strong>Objective: </strong>This study assessed how the intersection of water insecurity (WI) and food insecurity (FI) is associated with sugar-sweetened beverage (SSB) intake among US children and adolescents.</p><p><strong>Methods: </strong>Data from 18,251 children in the cross-sectional 2005-2020 National Health and Nutrition Examination Survey were analyzed in 2024-25. Differences in consumption of any SSB, mean SSB kcal, and percent of total kcals from SSBs on a given day across a validated four-category variable of WI (based on tap water avoidance) and FI (using the US Food Security Survey Module) were assessed with log-binomial and linear regressions.</p><p><strong>Results: </strong>Compared to children with water security (WS) and food security (FS), children with WI & FS had 13% (95% CI: 1.06-1.19; P<0.001) higher prevalence ratio of consuming any SSB, consumed 23.3 more kcals (SE=6.7; P=0.001), and 1.1% (SE=0.3; P<0.001) more total kcals from SSBs. Children with WS & FI had 7% (95% CI: 1.02-1.12; P=0.002) higher prevalence ratio of drinking any SSB, consumed 13.2 (SE=5.1; P=0.01) more kcals, and 0.8% (SE=0.2; P=0.001) more of their total kcals from SSBs. Children experiencing WI & FI had 15% (95% CI: 1.08-1.22; P<0.001) greater prevalence ratio of SSB intake, consumed 36.1 more kcals (SE=13.9; P=0.01), and 1.8% (SE=0.4; P<0.001) more of their total kcals from SSBs.</p><p><strong>Conclusion: </strong>Children experiencing WI or FI alone had higher SSB intake compared to children who were WS and FS; children experiencing both WI and FI had the highest SSB intake. Addressing the intersection of WI and FI may help reduce SSB intake.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108104"},"PeriodicalIF":4.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066262","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":"Global Burden of Non-Neoplastic Gynecological Diseases in Women: A 32-Year Analysis with Projections to 2100.","authors":"Dongqing Gu, Mengling Qi, Rui Gui, Dan Zhou, Chengying Su, Pan Hu, Lubin Liu","doi":"10.1016/j.amepre.2025.108099","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.108099","url":null,"abstract":"<p><strong>Introduction: </strong>Non-neoplastic gynecological diseases substantially affect women's health and quality of life worldwide, yet comprehensive analyses of their burden remain limited.</p><p><strong>Methods: </strong>Using data from the Global Burden of Disease 2021 study, the prevalence, incidence and disability-adjusted life years (DALYs) of seven gynecological conditions across 204 countries and territories from 1990 to 2021 were estimated. Temporal trends were assessed using joinpoint regression, and decomposition analysis quantified contributions of population growth, aging, and epidemiological changes. Bayesian age-period-cohort models projected future trends to 2100.</p><p><strong>Results: </strong>The global age-standardized prevalence declined slightly from 38.5% in 1990 to 37.8% in 2021 (AAPC: -0.058), but the absolute number of cases rose by 55.3% to 1.53 billion. Decomposition analysis attributed this increase mainly to population growth (92.0%) and aging (14.2%), partially offset by epidemiological improvements (-6.2%). Premenstrual syndrome was the most prevalent condition (24.7%), while female infertility and polycystic ovarian syndrome (PCOS) showed the fastest growth (AAPC: 0.697 and 0.796). Disease burden varied widely: DALYs were highest in North Africa and the Middle East (1112.1 per 100,000) and lowest in high-income Asia Pacific (456.2 per 100,000). Women aged 20-49 years accounted for 68% of DALYs. By 2100, prevalent cases are projected to rise by 9.5%, with infertility and PCOS increasing by 61.6% and 85.2%, respectively.</p><p><strong>Conclusions: </strong>Non-neoplastic gynecological diseases pose major public health challenges in low-resource settings, necessitating targeted interventions for rising infertility and PCOS. Population growth served as the primary driver of the increased burden of gynecological diseases.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108099"},"PeriodicalIF":4.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066241","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":"Getting at the Root: Structural Racism, Policing, and Youth Firearm Homicide.","authors":"Julia M Fleckman, Ethan Smith, Julie Ford, Paul Hutchinson, Lolita Moss, Lexie M Contreras, Samantha Francois, Joseph Constans, Sharven Taghavi, Katherine P Theall","doi":"10.1016/j.amepre.2025.108098","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.108098","url":null,"abstract":"<p><strong>Introduction: </strong>While recent studies have shown that structural racism impacts violent injury, how it impacts youth violence is poorly defined. The objective of the current study was to examine the relationships between two markers of structural racism-neighborhood racial-income residential segregation and police stop and search encounters on youth firearm homicide.</p><p><strong>Methods: </strong>A longitudinal ecologic study was conducted among New Orleans neighborhoods with publicly historical data (2018-2023) from the New Orleans Police Department (NOPD), and the American Community Survey (ACS), as well as contractually approved data from the Louisiana Department of Health, New Orleans Coroner's Office, and NOPD. The outcome measure included the number of youth firearm homicide victims for any given census tract. Exposures included racialized economic polarization as measured by the Index of Concentration at the Extremes and the count of police stop and search encounters within a census tract.</p><p><strong>Results: </strong>Neighborhood racial-income segregation was significantly and positively associated with youth homicides, with the relationship remaining in most models even after accounting for other neighborhood covariates and with both random and correlated fixed effects. There was no significant association between total police stop and search encounters, nor youth stop and search encounters, and youth firearm homicide victimization.</p><p><strong>Conclusions: </strong>Interventions that strongly consider structural racism at the neighborhood level may help mitigate the crisis of youth violence and racial inequities in youth violence.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108098"},"PeriodicalIF":4.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066217","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":"Biological indicators of cardiovascular health by foster care history in adults.","authors":"Darlynn M Rojo-Wissar, Sean R Womack, Tomas Baka, Adam P Spira, Ryan D Davidson, Eric S Zhou, Candice A Alfano, Chandra L Jackson, Michael A Grandner, Stephanie H Parade","doi":"10.1016/j.amepre.2025.108097","DOIUrl":"10.1016/j.amepre.2025.108097","url":null,"abstract":"<p><strong>Introduction: </strong>Childhood adversity contributes to adult cardiovascular health (CVH) disparities, but CVH in foster care alumni, experience unique compounded stressors like attachment disruption and environmental upheaval, is understudied. In this study, biological CVH indicators were described among US adults with and without a foster care placement history.</p><p><strong>Methods: </strong>Cross-sectional data from 4,625 adults (representing 17,226,361 US adults) approaching and in early midlife (2016-18) from The National Longitudinal Study of Adolescent to Adult Health was used. Biological indicators of CVH included body mass index, blood lipids, blood glucose, and blood pressure, which were each scored on a standardized scale of 0-100, with higher scores indicating better CVH. An unweighted average of these standardized scores was also computed. Incorporating sampling weights nationally representative estimates of CVH by foster care history were generated in 2024-25.</p><p><strong>Results: </strong>There were 113 participants who reported a foster care placement history (1.8% [weighted]), representing 313,604 adults. Foster care alumni had poorer overall CVH scores (Mean=61.8, 95% CI=56.6, 66.9) and blood pressure health scores (Mean=48.7 [indicates hypertension], 95% CI=39.8, 57.5) compared to those without a foster care history (CVH: Mean=70.2, 95% CI=69.1, 71.4; blood pressure: Mean=61.6, 95% CI=59.9, 63.2). Notably, common protective factors (e.g., female sex, higher income) did not mitigate CVH risk in the foster care group.</p><p><strong>Conclusions: </strong>Childhood foster care placement is associated with poorer CVH, particularly hypertension, even in groups generally at lower risk. Research and clinical initiatives are needed to better understand and address CVH inequities and promote cardiovascular wellness in this population.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108097"},"PeriodicalIF":4.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066625","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":"Translated Educational Infographics Increase Colorectal Cancer Screening Rates in Non-Native English Speakers.","authors":"Alex Zhornitskiy, Bao Sean Nguyen, Christine Shieh, Aida Nasirishargh, Lindsay Valenti, Jose Leonel Martinez Perez, Felicia Zhornitsky, Timothy Do, Johnny Trung Nguyen, Sujin Jeong, Ronald Hsu","doi":"10.1016/j.amepre.2025.108101","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.108101","url":null,"abstract":"<p><strong>Introduction: </strong>Language barriers hinder colorectal cancer (CRC) screening in underserved populations of non- native English speakers, particularly in Asian American Pacific Islander (AAPI) communities; yet, patient educational materials are not readily available in languages other than English and Spanish.</p><p><strong>Methods: </strong>In this pilot study, American College of Gastroenterology (ACG) infographics were translated into Chinese (traditional/simplified), Hmong, and Vietnamese, and distributed along with a translated pre-post survey to average-risk patients between 45-75 years old at a safety-net clinic. Primary outcomes were CRC screening rates and secondary outcomes were patients' perceptions of CRC screening.</p><p><strong>Results: </strong>CRC screening rates increased from 19.5% to 54.3% (p-value <0.01), while more than 80.0% noted increased understanding of CRC and plans to pursue screening.</p><p><strong>Discussion: </strong>These findings demonstrate that providing translated, language-concordant infographics significantly increased CRC screening rates and patient understanding among non-native English speakers. Creating and integrating the use of culturally and linguistically tailored educational materials in resource-limited clinics can help eliminate disparities and narrow the colorectal cancer screening gap in AAPI communities.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108101"},"PeriodicalIF":4.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066212","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":"Spatial Association of Area-Level Credit Scores and Firearm Violence: A Novel Measure of Socioeconomic Position for Violence and Injury Research.","authors":"Mudia Uzzi, Pilar Ocampo, William Wical, Kyle Aune, Mac McComas, Lorraine T Dean","doi":"10.1016/j.amepre.2025.108100","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.108100","url":null,"abstract":"<p><strong>Introduction: </strong>Scholars use socioeconomic position measures to describe the relationship of social inequities with violence and injury. Area-level credit scores are a novel measure of socioeconomic position that reflect elements of a geographic area's social and economic structure beyond what traditional measures capture. This study assessed the spatial association between area-level credit scores and firearm violence.</p><p><strong>Methods: </strong>An ecological cross-sectional study was performed of 1324 census block groups in Philadelphia, Pennsylvania. A quasi-Poisson spatial regression analysis was conducted to determine the association between area-level credit scores in 2017 and block group-level firearm violence in 2018. The regression model included several socioeconomic position and structural factors as control variables and eigenvector spatial filtering accounted for residual spatial autocorrelation.</p><p><strong>Results: </strong>Census block groups with subprime area-level credit scores had a firearm violence incidence rate that was over four times higher (IRR= 4.74; 95% CI: (2.60, 8.96; p <0.001)) compared to block groups with prime scores; even after controlling for other social and economic factors. For every one standard deviation increase in credit scores, the rate of firearm violence decreased by 63%.</p><p><strong>Conclusions: </strong>There is a significant spatial association between area-level credit scores and firearm violence. This association is notably stronger than other measures of socioeconomic position, including education and poverty. Area-level credit scores are a novel measure of socioeconomic position that can provide critical insights into the socioeconomic environment of a geographic area and could be a valuable target for reparative social and economic policies to reduce violence and injury.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108100"},"PeriodicalIF":4.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066215","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":"Bullying, Sexual Assault, and E-Cigarette Use Among High School Students in the United States.","authors":"Olayemi Timothy Adekeye, Thomas P McCoy, Evans Kyei, Godwin Gonyoe, Mercy N Mumba","doi":"10.1016/j.amepre.2025.108106","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.108106","url":null,"abstract":"<p><strong>Introduction: </strong>Adolescent e-cigarette use is a growing public health concern. Emerging evidence suggests that adverse experiences such as bullying and forced sexual intercourse may contribute to its initiation and continuation. This study investigates the associations between these experiences and e-cigarette use, with attention to demographic differences.</p><p><strong>Methods: </strong>Data from the 2023 Youth Risk Behavior Surveillance System (YRBS) were analyzed using statistical methods in 2025. Logistic regression models examined associations between school-based bullying, electronic bullying, forced sexual intercourse, and e-cigarette use (ever use and past 30-day use), adjusting for demographics. Interaction terms were tested to assess sex-based differences.</p><p><strong>Results: </strong>Among respondents, 31.1% reported ever using e-cigarettes, and 16.7% reported past 30-day use. School-based bullying was associated with higher odds of ever use (AOR=1.28, 95% CI=1.06-1.54), while electronic bullying showed stronger associations (AOR=2.22, 95% CI=1.85-2.66). Forced sexual intercourse was linked to both ever use (AOR=2.04, 95% CI=1.56-2.66) and past 30-day use (AOR=3.27, 95% CI=2.69-3.97). A significant sex interaction (p=0.011) indicated higher predicted probabilities of ever use for females (62.2%) than males (44.3%) who had experienced forced sexual intercourse. Race/ethnicity and grade level were also significant predictors, with Asian students reporting lower odds of use compared to White students (AOR=0.38, 95% CI=0.25-0.58).</p><p><strong>Conclusions: </strong>Bullying and forced sexual intercourse are significantly associated with adolescent e-cigarette use, with electronic bullying and forced sexual intercourse showing particularly strong effects. Findings underscore the need for trauma-informed, school-based prevention strategies tailored to demographic risk factors.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108106"},"PeriodicalIF":4.5,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058765","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":"Does home COVID-19 testing bias COVID-19 vaccine effectiveness estimates?","authors":"Mary Patricia Nowalk, G K Balasubramani, Helen D'Agostino, Richard K Zimmerman, Arnold S Monto, Emily T Martin, Huong Q Nguyen, Manjusha Gaglani, Mufaddal Mamwala, Sara Tartof, Bruno J Lewin, Karen Wernli, Brianna Wickersham, H Keipp Talbot, Carlos G Grijalva, Jessie R Chung, Brendan Flannery","doi":"10.1016/j.amepre.2025.108096","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.108096","url":null,"abstract":"<p><strong>Introduction: </strong>COVID-19 home testing became widely available in early 2021. Care seeking for acute respiratory illness (ARI), and COVID-19 vaccine effectiveness (VE) estimates may be affected by home testing.</p><p><strong>Methods: </strong>In a test-negative case-control study, between January-May 2022, U.S. Flu VE Network outpatients were asked about their home COVID-19 testing before seeking care for ARI and were laboratory tested for SARS-CoV-2. Associations among home testing, care seeking and COVID-19 VE were assessed using multivariable logistic regression.</p><p><strong>Results: </strong>Among 2,614 enrollees, home COVID-19 testing was significantly associated with current (≤6 months) COVID-19 vaccination (adjusted odds ratio (aOR=1.70; 95%CI=1.19-2.42); cough (aOR=1.69; 1.22-2.34) and having a college degree or higher (aOR=1.67; 1.37-2.03) and negatively associated with a prior positive COVID-19 test. COVID-19 illness was associated with cough (aOR=3.07; 2.04-4.61), contact with a COVID-19 case (aOR=2.41; 1.93-3.0), home testing (aOR=1.87; 1.53-2.29) and negatively associated with a prior positive COVID-19 test. In unadjusted modeling with only the association between current vaccination and COVID-19 infection, the OR was 0.77 (95% CI=0.66, 0.92); adjusting for patient race/ethnicity, age, days from onset to enrollment, prior COVID-19 illness and study site, the aOR was 0.65 (0.55, 0.78); estimated VE=35% (95%CI=22%-45%). Adding home testing to this adjusted model, VE was 37% (95%CI=13%-46%). Among patients who home tested, VE was 31% (13%-46%) versus 43% (24%-57%) among patients who did not.</p><p><strong>Conclusion: </strong>Patients reporting home testing for COVID-19 before seeking outpatient care for ARI differed from patients not using home tests, which could affect estimates of COVID-19 VE in some populations.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108096"},"PeriodicalIF":4.5,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058729","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":"Alcohol Consumption During Pregnancy and State Implementation of Legal Nonmedical Cannabis Retail Sales in the United States, 2011 to 2023.","authors":"Clark H Denny, Nicholas P Deputy, Rahi Abouk, Janae D Dunkley, Coleman Drake, Shin Y Kim, Michael Pella, Douglas R Roehler, Charles E Rose","doi":"10.1016/j.amepre.2025.108105","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.108105","url":null,"abstract":"<p><strong>Introduction: </strong>Alcohol consumption during pregnancy causes fetal alcohol spectrum disorders and may increase the risk of adverse pregnancy outcomes, such as miscarriage and stillbirth. It is unknown whether legalization of cannabis influences alcohol consumption during pregnancy. This analysis estimated the association between state implementation of legal nonmedical cannabis retail sales (NCRS) and alcohol consumption during pregnancy.</p><p><strong>Methods: </strong>Data from the 2011 to 2023 Behavioral Risk Factor Surveillance System were analyzed in 2023-2024. Adjusted prevalence ratios comparing current and binge drinking during pregnancy in states after implementation of legal NCRS to states before or without implementation were estimated, adjusting for demographic factors. Difference-in-difference analyses, that adjusted for state and time variability, estimated the association between the implementation of legal NCRS and the change in current and binge drinking during pregnancy, controlling for selected demographic and policy variables.</p><p><strong>Results: </strong>Prevalence of current and binge drinking during pregnancy were 1.43 (95% CI=1.18, 1.73) and 2.13 (95% CI=1.47, 3.09) times higher, respectively, among respondents in states with implementation of legal NCRS compared to respondents in states before or without implementation. Implementation of legal NCRS was significantly associated with a 4.96 (95% CI=1.22, 8.70) percentage point increase in binge drinking and a nonsignificant change in current drinking 3.18 (95% CI=-1.03, 7.39).</p><p><strong>Conclusions: </strong>Alcohol consumption among pregnant women may be higher where legal NCRS has been implemented, and implementation may be associated with an increase in binge drinking among pregnant women. Improving alcohol screening and counseling during pregnancy, and patient education, may be considered.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108105"},"PeriodicalIF":4.5,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058762","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}