American Journal of Preventive Medicine最新文献

{"title":"Patterns of cigarette and electronic nicotine delivery system transitions in U.S. adults, 2021-2024.","authors":"Andrew F Brouwer, Olivia K Roberts, Jihyoun Jeon, Evelyn Jimenez-Mendoza, Stephanie R Land, Neal D Freedman, Rossana Torres-Alvarez, Ritesh Mistry, David T Levy, Rafael Meza","doi":"10.1016/j.amepre.2026.108576","DOIUrl":"10.1016/j.amepre.2026.108576","url":null,"abstract":"<p><strong>Introduction: </strong>Electronic nicotine delivery systems (ENDS) continue to evolve, and so ongoing analysis of transition rates over time is important for tracking real-world associations between ENDS and cigarette use.</p><p><strong>Methods: </strong>A Markov multistate transition model was applied to adults in the Population Assessment of Tobacco and Health Study Waves 6-7 and 7-8 (collected 2021-2024; analyzed 2026), estimating product transition rates and per-year transition probabilities by age group (18-24, 25-34, 35-54, or 55-90 years). These results were compared to estimates from each wave pair in Waves 1-6 (2014-2021).</p><p><strong>Results: </strong>ENDS initiation from never use increased from 0.3% (95% confidence intervals [CI]: 0.3, 0.4%) per year in 2019-22 to 0.5% (95%: 0.4, 0.6%) in 2021-22, before returning to 0.3% (95% CI: 0.3, 0.4%) in 2022-24. Similarly, ENDS initiation from cigarette-only to dual use changed from 4.0% (95% CI: 3.6, 4.5%) to 6.8% (95% CI: 6.1, 7.6%) to 5.9% (95% CI: 5.0, 6.7%), respectively. ENDS adoption remained driven by young adults, with respective transition fractions of 1.7% (95% CI: 1.4, 2.0%) and 16.2% (95% CI: 10.6, 21.7%) per year in 2022-24. Persistence of dual use increased, as transitions from dual to cigarette-only and to ENDS-only use each decreased from 26.2% (95% CI: 21.7, 30.7%) and 24.2% (95%CI: 20.5, 27.9%) in 2021-22 to 17.3% (95% CI: 14.3, 20.3%) and 17.9% (95% CI: 15.2, 20.7%), respectively, in 2022-24.</p><p><strong>Conclusion: </strong>Public health efforts are needed to reduce persistent dual use and to promote cigarette cessation among older adults.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108576"},"PeriodicalIF":4.7,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148971949","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":"Leisure-time and occupational physical activity and risk of long-term sickness absence from mental disorders: a prospective cohort study.","authors":"Keisuke Kuwahara, Tohru Nakagawa, Shuichiro Yamamoto, Toru Honda, Atsushi Goto, Maki Konishi, Tetsuya Mizoue","doi":"10.1016/j.amepre.2026.108563","DOIUrl":"https://doi.org/10.1016/j.amepre.2026.108563","url":null,"abstract":"<p><strong>Introduction: </strong>This study examined whether leisure-time physical activity (LTPA), occupational physical activity (OPA), and their combination are associated with risk of mental disorder-related long-term sickness absence (LSA).</p><p><strong>Methods: </strong>This cohort study included 38,120 Japanese employees aged 20-59 years from the Japan Epidemiology Collaboration on Occupational Health Study. Baseline assessments were conducted primarily in 2011, with follow-up from 2012 through 2024. LTPA and OPA levels were self-reported at baseline. LSA (≥30 consecutive days) due to mental disorders was medically certified by physicians. Cox regression estimated hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for demographic, lifestyle, occupational, and health-related factors including depressive symptoms.</p><p><strong>Results: </strong>During a mean follow-up of 9.2 years, 1,032 participants (2.7%) experienced LSA from mental disorders. LTPA showed an inverse but non-linear association with LSA risk (p for non-linearity=0.042) with lower risk apparent at low activity; activity below recommended levels was associated with reduced risk (HR 0.72, 95% CI 0.55-0.93). The inverse association of LTPA was evident when restricted to depressive disorders as the outcome (p for trend=0.029) and among sedentary workers (p for trend=0.027), although the interaction by OPA was non-significant (p=0.14). Higher OPA was linearly associated with lower risk (HR for physically active vs sedentary work = 0.50, 95% CI 0.37-0.69; p for linear trend<0.001).</p><p><strong>Conclusions: </strong>LTPA showed inverse associations with mental disorder-related LSA, most evident for depressive disorders. Higher OPA was associated with reduced risk of mental disorder-related LSA, not clearly supporting the physical activity paradox.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108563"},"PeriodicalIF":4.7,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842040","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":"Suicide death following a crisis line contact: The importance of treatment initiation and continuation.","authors":"Peter C Britton, Ahmed Mohamed, Tracy Stecker, Wilfred R Pigeon","doi":"10.1016/j.amepre.2026.108564","DOIUrl":"https://doi.org/10.1016/j.amepre.2026.108564","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of this study was to determine whether initiating or connecting with behavioral health care (BHC; mental health and substance use) following a Veterans Crisis Line (VCL) contact was associated with reduced likelihood of suicide.</p><p><strong>Methods: </strong>A retrospective cohort design was used to examine the association of BHC in the month (0-30 days) following a crisis line contact (i.e., calls, texts, and chats) with suicide death over a year (days 31-365) among 317,515 VCL contacts from 2015-2019. Contacts were divided into 1) non-BHC users, 2) BHC initiators, 3) BHC continuers, and 4) BHC discontinuers. Logistic regression was used with BHC discontinuers as reference. Secondary analyses were conducted with any health care (HC).</p><p><strong>Results: </strong>Non-BHC users, adjusted odds ratio (AOR) (95% CI) = 0.29 (0.23-0.38), BHC initiators, AOR (95%CI) = 0.46 (0.35-0.61), and BHC continuers, AOR = 0.63 (0.47-0.83), were less likely to die by suicide than those who discontinued BHC. Non-HC users, AOR (95% CI) = 0.22 (0.16-0.29), HC initiators, AOR (95%CI) = 0.34 (0.25-0.45), and HC continuers, AOR = 0.48 (0.36-0.64), were also less likely to die by suicide than HC discontinuers.</p><p><strong>Conclusions: </strong>Initiating and continuing with BHC following a crisis line contact was associated with a lower likelihood of suicide than discontinuing with BHC. Veterans who never used BHC may include one or more subpopulations at low suicide risk. Those who discontinue BHC may be at high suicide risk, suggesting a need for additional research and possible intervention. Similar associations were found for any HC.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108564"},"PeriodicalIF":4.7,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842029","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":"Handgrip strength across generations: An analysis of 1,158,069 Japanese children and adolescents from 57 years of national surveillance (1967-2023).","authors":"Tetsuhiro Kidokoro, Naruki Kitano, Natsuko Imai, Tomoko Aoyama, Koya Suzuki, Costan G Magnussen, Justin J Lang, Grant R Tomkinson","doi":"10.1016/j.amepre.2026.108566","DOIUrl":"https://doi.org/10.1016/j.amepre.2026.108566","url":null,"abstract":"<p><strong>Introduction: </strong>Handgrip strength (HGS) is a widely used indicator of muscular strength that offers important insights into population health. While the literature has examined period effects-year-by-year changes in HGS- the authors are unaware of any study that has systematically investigated cohort effects, which may offer a more nuanced understanding of the generational shifts in HGS. This study aimed to examine the generational differences in the development of HGS among Japanese children and adolescents.</p><p><strong>Methods: </strong>Repeated, nationally-representative, annual, cross-sectional data on HGS were obtained from the Japan Sports Agency, covering 1,158,069 Japanese children and adolescents aged 10-17 years between 1967 and 2023. Temporal trends in absolute and relative HGS were estimated using sample-weighted regression models relating the year of testing to the mean HGS. To assess generational differences in HGS development, 10 synthetic birth cohorts were constructed at 5-year intervals from 1960 to 2005. Each cohort was tracked longitudinally in a repeated cross-sectional manner from age 10 to 17, allowing comparisons of both the annual strength velocity and the age at peak strength velocity across cohorts.</p><p><strong>Results: </strong>A small but consistent decline in both absolute and relative HGS was observed over the 57-year period, with more pronounced declines observed since the 1990s (mean change per decade: boys, -1.6% [95% CI: -1.9%, -1.3%]; girls, -1.4% [95% CI: -1.7%, -1.2%]). Cohort analyses further revealed that the annual strength velocity was consistently lower at all ages in more recent cohorts (e.g., 2005 birth cohort) than in earlier cohorts (e.g., 1960 birth cohort), although the age at peak strength velocity remained steady.</p><p><strong>Conclusions: </strong>These findings suggest that children's HGS has progressively declined across generations, with more recent cohorts showing smaller age-related improvement. Given the well-established associations between HGS and multiple health outcomes, the observed decrease in HGS suggests a corresponding decline in population health.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108566"},"PeriodicalIF":4.7,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842010","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":"Association between the food environment and the risk of ischemic stroke.","authors":"Christopher J Becker, Mohanad Ahmad, Jocelyn Ra, Madeline Kwicklis, Jiacong Du, Chen Chen, Hely D Nanavati, Leanna Delhey, Lynda D Lisabeth, Lewis B Morgenstern","doi":"10.1016/j.amepre.2026.108567","DOIUrl":"10.1016/j.amepre.2026.108567","url":null,"abstract":"<p><strong>Introduction: </strong>A healthy diet is critical for stroke prevention. The role of the food environment is less clear. This study evaluated the association between the food environment and incident ischemic stroke in a large population-based study.</p><p><strong>Methods: </strong>All first-ever ischemic strokes among residents of Nueces County, Texas from 2000-2023 were identified and geocoded by patient home address. The primary exposure was the modified retail food environment index (mRFEI), reflecting the mix of healthy and unhealthy food sources in each census tract (range 0-1, higher=healthier, modeled continuously), obtained from the National Neighborhood Data Archive. Population data were obtained from the US Census and American Community Survey. Stroke incidence rates were estimated using Poisson regression on cross-classified aggregate data. Covariates included age, sex, ethnicity, and neighborhood socioeconomic status (nSES).</p><p><strong>Results: </strong>A total of 6,716 first-ever ischemic strokes occurred in the study region from 2000-2023. Unexpectedly, higher (healthier) mRFEI values were associated with lower (poorer) nSES. Before adjustment, there was a marginal association between higher mRFEI scores and greater stroke incidence (incidence rate ratio [IRR] of 75^th vs 25^th percentile=1.07; 95%CI=0.99, 1.15; p=0.07). After adjustment, this association was attenuated and not statistically significant (IRR=1.00, 95%CI=0.95, 1.06; p=0.91). Post-hoc analyses evaluated healthy and unhealthy food sources separately and expanded the neighborhood to include adjacent tracts, yielding similar results.</p><p><strong>Conclusions: </strong>No association was observed between the food environment and stroke incidence. These results add to a growing literature suggesting that improved access to healthy food sources alone may not be sufficient to reduce incidence of stroke and other cardiovascular events.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108567"},"PeriodicalIF":4.7,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842023","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":"Physical Activity and Recreation for Kids Study (PARKS): Park-intensive community outreach for child physical activity group-randomized controlled trial.","authors":"Simone A French, Susan M Mason, Katherine R Hendel, Daheia J Barr-Anderson, Natalie Scholz, Dawn Nederhoff","doi":"10.1016/j.amepre.2026.108565","DOIUrl":"10.1016/j.amepre.2026.108565","url":null,"abstract":"<p><strong>Background: </strong>Park use among urban children can contribute to higher child physical activity (PA), yet most children do not use parks or park sports programs. The PARKS (Physical Activity and Recreation for Kids Study) group randomized controlled trial evaluated the effect of park-level intensive community outreach on change in child MVPA, light and sedentary activity. It was hypothesized that children in the intervention parks would increase their MVPA and decrease their sedentary activity compared to children in the usual parks.</p><p><strong>Methods: </strong>Twenty urban parks were randomized to intensive park outreach or usual outreach. Intervention included monthly meetings with park managers and community partner organizations to support existing and create new community marketing efforts. An evaluation cohort of 430 parent-child dyads who resided near these parks completed PA measures at baseline and 12 months. Generalized linear mixed models estimated mean differences (95% confidence intervals) between treatment groups on child and parent PA outcomes at 12 months.</p><p><strong>Results: </strong>Cohort retention was 90% at 12 months. No significant intervention effects were observed on child MVPA or sedentary time. Children in the intervention parks showed significantly less decline in their accelerometry-based light PA on average by 9.6 mins/day (95% Confidence Interval: 1.4, 17.7) compared with children in the control group. Parents in the intervention parks showed significantly less increase in accelerometry-based sedentary activity on average -27.3 mins/day (95% Confidence Interval: -52.9, -1.6) compared with parents in the control group.</p><p><strong>Conclusion: </strong>Park-based intensive community outreach may prevent age-related declines in children's light PA and may reduce increases in parents' sedentary activity. Future park-based interventions must amplify community outreach efforts to strengthen their impact on child PA.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108565"},"PeriodicalIF":4.7,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842027","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":"Age and Stage Trends in Early-Onset Colorectal Cancer Incidence Before and After the USPSTF 2021 Update.","authors":"Todd Burus, Jason Semprini","doi":"10.1016/j.amepre.2026.108568","DOIUrl":"https://doi.org/10.1016/j.amepre.2026.108568","url":null,"abstract":"<p><strong>Introduction: </strong>Early-onset colorectal cancer (CRC) incidence has increased in the US, raising concern about changing risk among adults aged 20-49 years. In 2021, the US Preventive Services Task Force lowered the recommended starting age for average-risk CRC screening from 50 to 45 years. This study examined whether CRC incidence trends were concentrated among adults newly eligible for screening.</p><p><strong>Methods: </strong>Analyzing the latest SEER data for malignant CRCs from 2004-2023, the study estimated annual percentage changes (APCs) using log-linear regression for adults aged 20-49 years overall and for age groups 20-44, 45-49, and 50-54 years, further stratified by early-stage and late-stage diagnosis. Joint-Point analyses were performed as a sensitivity check.</p><p><strong>Results: </strong>In 2023, there were 10,395 early-onset CRC diagnoses, corresponding to an incidence rate of 18.1 per 100,000. Overall early-onset CRC incidence increased by 1.95% per year in 2004-2019 and 8.41% per year in 2021-2023. The largest recent increase occurred among adults aged 45-49 years, whose all-stage APC rose from 1.31% in 2004-2019 to 14.38% in 2021-2023. Among adults aged 45-49 years, early-stage CRC increased by 32.14% per year in 2021-2023, compared with 0.12% per year in 2004-2019; late-stage CRC increased by 3.29% per year in 2021-2023. Trends among adults aged 20-44 and 50-54 years were comparatively stable, but rising.</p><p><strong>Conclusions: </strong>Recent acceleration in early-onset CRC incidence was concentrated among adults aged 45-49 years, especially early-stage diagnoses, suggesting increased detection after expanded screening eligibility.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108568"},"PeriodicalIF":4.7,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820121","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":"Medical Financial Burdens and Later Risks of Adult Psychological Distress (2014-2023).","authors":"Michael Caniglia, Laura J Chavez","doi":"10.1016/j.amepre.2026.108555","DOIUrl":"https://doi.org/10.1016/j.amepre.2026.108555","url":null,"abstract":"<p><strong>Introduction: </strong>Research suggests that medical debt and difficulty paying medical bills are associated with worse mental health. However, limited research examines the longitudinal association between medical spending as a proportion of income and later mental health.</p><p><strong>Methods: </strong>Using a series of two-year panels from the US Medical Expenditure Panel Survey-Household Components (2014-2023) (N=60,391 adults), this study employed longitudinal logistic regression models to examine the relationship between out-of-pocket and premium burdens in Year 1 and mental health outcomes in Year 2. Symptoms of severe psychological distress and probable major depression were measured using the Kessler-6 Severe Psychological Distress Scale and the Patient Health Questionnaire-2, respectively.</p><p><strong>Results: </strong>Among the study population, 63% of adults identified as non-Hispanic White, 16% as Hispanic, 12% as non-Hispanic Black, 6% as non-Hispanic Asian and Pacific Islander, 2% as non-Hispanic Multiracial and 1% as non-Hispanic American Indian or Alaska Native. The sample was 52% female. After controlling for covariates, adults with out-of-pocket burdens in Year 1 faced increased odds of both severe psychological distress [OR 1.405; 95% CI=1.182, 1.670] and probable major depression [OR 1.293, 95% CI 1.114, 1.500] at Year 2 compared to their peers a year later. Premium burdens were not associated with either outcome in Year 2.</p><p><strong>Conclusions: </strong>Out-of-pocket medical financial burdens in Year 1 were associated with worse mental health outcomes in Year 2. No association existed between premium burdens and mental health outcomes. Policymakers should consider how to address the nation's healthcare affordability crisis.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108555"},"PeriodicalIF":4.7,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814756","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":"Public perceptions of the 2025-2030 Dietary Guidelines for Americans.","authors":"Julia A Wolfson, Cindy W Leung","doi":"10.1016/j.amepre.2026.108556","DOIUrl":"https://doi.org/10.1016/j.amepre.2026.108556","url":null,"abstract":"<p><strong>Introduction: </strong>The 2025-2030 Dietary Guidelines for Americans (DGAs), released in January 2026, generated substantial controversy among public health experts. However, little is known about public perceptions of the new DGAs.</p><p><strong>Methods: </strong>A nationally representative, web-based survey was fielded by Verasight from March 6-16, 2026. One-thousand US adults were randomized to complete the DGA perception questions. Respondents were asked four questions about their familiarity with the new DGAs, trust in the scientific basis of the DGAs, usefulness of the DGAs for decision-making, and support for incorporating environmental sustainability into future DGAs. Responses were analyzed overall using ordinal logistic regressions and chi-squared tests were used to assess differences across socio-demographic subgroups. All analyses were survey-weighted and were completed in 2026.</p><p><strong>Results: </strong>Overall, 50% of US adults did not trust that the recommendations in the new DGAs were based on sound scientific evidence; whereas, 35% did. Respondents were split between finding the DGAs useful (41%) versus not useful (44%), with 16% 'not sure'. Responses were significantly different (p's<0.01) based on education, household income, and political party affiliation with more unfavorable opinions about the new DGAs among those with higher education, higher income, and among Democrats and Independents. Support for including environmental sustainability into the DGAs (40%) was higher than opposition (24%), with 36.0% of adults being neutral.</p><p><strong>Conclusions: </strong>Results from this nationally representative survey showed US adults are divided about the trustworthiness and usefulness of the 2025-2030 DGAs, particularly along socio-economic and political lines which could have implications for dietary quality and health.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108556"},"PeriodicalIF":4.7,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800605","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":"Productivity losses from fatal drug overdoses in the United States.","authors":"Ramesh Ghimire, Cora Peterson, Gery Guy, Curtis Florence","doi":"10.1016/j.amepre.2026.108554","DOIUrl":"https://doi.org/10.1016/j.amepre.2026.108554","url":null,"abstract":"<p><strong>Introduction: </strong>Drug overdose remains a major public health challenge in the United States, yet contemporary national estimates of productivity losses from fatal drug overdoses are limited. This study estimated total and per-decedent life-years and productivity losses from fatal drug overdoses among U.S. adults in 2023.</p><p><strong>Methods: </strong>Drug overdose deaths were identified using 2023 National Vital Statistics System mortality file. Life-years lost were calculated by age and sex using U.S. life tables. Productivity losses were estimated from a societal perspective using human capital approach, valuing lost productivity as present value of expected lifetime productivity. Life-years and productivity losses were estimated for all overdose deaths, as well as opioid- and stimulant-involved overdose deaths.</p><p><strong>Results: </strong>In 2023, 103,936 overdose deaths occurred among U.S. adults, resulting in 3.79 million life-years lost and $194.51 billion in productivity losses. Opioid-involved overdoses resulted in 78,436 deaths, 2.95 million life-years lost, and $154.12 billion in productivity losses, and stimulant-involved overdoses accounted for 59,531 deaths, 2.13 million life-years lost, and $110.12 billion in productivity losses. Males accounted for most overdose deaths and associated losses. On average, 36.43 life-years were lost per overdose death, and per-decedent losses were greatest for opioid-involved overdoses (37.67 years). Synthetic opioids other than methadone (primarily illegally made fentanyl), psychostimulants, and cocaine were leading contributors to life-years and productivity losses.</p><p><strong>Conclusions: </strong>Fatal drug overdose imposes a substantial economic burden through lost life-years and productivity. Intervention efforts, particularly those addressing illegally made fentanyl, cocaine, and psychostimulants could potentially save lives and yield economic benefits.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108554"},"PeriodicalIF":4.7,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800392","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}