American Journal of Preventive Medicine最新文献

{"title":"An RCT of front-of-package nutrition labels in Latino populations in the US.","authors":"Marissa G Hall, Cristina J Y Lee, Aline D'Angelo Campos, Natalicio Serrano, Lindsey Smith Taillie, Jennifer Falbe, Aviva Musicus, Callie Whitesell, Angela Viviana Martinez, Anna H Grummon","doi":"10.1016/j.amepre.2025.108122","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.108122","url":null,"abstract":"<p><strong>Introduction: </strong>The effects of front-of-package nutrition labels among Latino adults in the US, including those with limited English proficiency, remains largely unknown. The FDA has considered a high-in label stating when foods are high in nutrients of concern, but the design differs from Latin American high-in labels in several ways. This study examined the impact of FDA-style high-in labels among Latino consumers.</p><p><strong>Study design: </strong>Online randomized trial in 2024.</p><p><strong>Setting/participants: </strong>3,053 Latino US adults (49% limited English proficiency).</p><p><strong>Intervention: </strong>Participants viewed one of three labels: numerical labels displaying numerical information about added sugar, saturated fat, and sodium; text high-in labels; and icon high-in labels identical to the text labels plus a magnifying glass icon.</p><p><strong>Main outcome measures: </strong>Participants viewed three frozen pies, three frozen pizzas, and three frozen meals displaying randomly assigned labels and identified the healthiest and least healthy product within each group (based on nutrient content). Analyses were conducted in 2025.</p><p><strong>Results: </strong>Text high-in labels (49% correct) led to higher correct identification of the least healthy foods compared to the numerical labels (44%, p<.001), but the icon high-in labels did not (47%, p=.07). Neither the text high-in labels (46% correct) nor the icon high-in labels (46%) led to better identification of the healthiest food compared to the numerical labels (45%, all p≥.71). Neither high-in label led to more correct identification of foods high in nutrients of concern or higher selection of the healthiest food for purchase compared to the numerical labels (all p≥.09). English proficiency moderated the impact of label type on correct identification of the least healthy food (p-interaction=.003) such that the benefit of high-in labels was only present for participants with high English proficiency.</p><p><strong>Conclusions: </strong>High-in labels helped Latino consumers identify unhealthy foods more than numerical labels, but only among those with high English proficiency.</p><p><strong>Trial registration: </strong>NCT06293963.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108122"},"PeriodicalIF":4.5,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126494","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":"Associations between housing stability and food insecurity among U.S. low-wage workers.","authors":"Violeta Chacón, Curtis Antrum, Maria F Gombi Vaca, Ran Xu, Caitlin Caspi","doi":"10.1016/j.amepre.2025.108123","DOIUrl":"10.1016/j.amepre.2025.108123","url":null,"abstract":"<p><strong>Introduction: </strong>Housing instability and food insecurity are two social determinants of health with considerable overlap and complex dynamics among populations experiencing economic instability. This study sought to examine the magnitude and direction of the temporal associations between housing instability and food insecurity among low-wage workers in two U.S. cities.</p><p><strong>Methods: </strong>This study was a secondary analysis was conducted in 2024 using five years of data (2018-2022) collected from a cohort of low-wage workers in Minneapolis, MN, and Raleigh, NC. Annual measures included a 6-item food insecurity measure, a 3-item housing instability measure, and demographic characteristics. Four Dynamic Panel Models tested the effect of housing instability on food insecurity in the subsequent year and the effect of food insecurity on housing instability in the subsequent year.</p><p><strong>Results: </strong>At baseline, most participants experienced food insecurity (74.9%) and housing instability (70.8%), both of which declined in each subsequent year before increasing in 2022. Participants who experienced housing instability or food insecurity were more likely to experience the same hardship in the subsequent year. Overall, housing instability was negatively associated with subsequent food insecurity (b [95% CI], -0.082 [-0.136, -0.028]). Similarly, food insecurity had a negative association with subsequent housing instability (-0.125 [-0.189, -0.060]).</p><p><strong>Conclusion: </strong>Housing instability and food insecurity have a complex and dynamic relationship. Expansion of federal nutrition assistance programs coordinated with other safety net programs, such as eviction prevention or rental assistance, as was implemented during the COVID-19 pandemic, could provide critical protection from these hardships.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108123"},"PeriodicalIF":4.5,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12520739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126541","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":"Systematic Review of Dementia Risk Screening Tools in Primary Care Settings.","authors":"Diana Matovic, Xiaojing Lei, Gabrielle Picard, Malene Ahern, Olivia R Maurice, Simon Willcock, Viviana M Wuthrich","doi":"10.1016/j.amepre.2025.108124","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.108124","url":null,"abstract":"<p><strong>Introduction: </strong>This preregistered (PROSPERO ID: 272529) systematic review analyzed the reliability, validity, acceptability, and feasibility of methods to screen and identify primary care patients at increased risk for dementia.</p><p><strong>Methods: </strong>Inclusion criteria were studies of dementia risk screening methods applied, or designed for use, in primary care, or derived or validated with primary care data for use with community-dwelling adults (≥18 years) without dementia/cognitive impairment. Articles were limited to full text peer-reviewed studies published in English. Searches were conducted from database inception until 09.21.21/09.22.21 (updated 09.04.22, 09.16.24) in PubMed, MEDLINE, EMBASE, PsycINFO and COCHRANE with backwards snowballing. Risk Of Bias (ROB) was assessed using the Newcastle-Ottawa Scale for non-randomized studies, the Cochrane ROB tool for randomized trials-V2, and the Critical Appraisal Skills Program qualitative checklist.</p><p><strong>Results: </strong>Eleven validated tools and scores were investigated in 34 studies. Participant numbers ranged from 100-94,000,000. Tools and scores were used or validated in one (six tools) to 13 studies (one tool). Most studies were from higher-income countries. ROB was low in most studies. C-statistics were most commonly used (range = .52-.86). Tools and scores generally had acceptable prediction but performed poorly in samples differing from the derivation sample. The CAIDE and LIBRA demonstrated acceptable validity in midlife samples, and the LIBRA in older samples <80 years of age.</p><p><strong>Discussion: </strong>The CAIDE and LIBRA are recommended for midlife and older adults <80 years, but further research is needed for adults ≥80 and lower-middle income countries.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108124"},"PeriodicalIF":4.5,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126537","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":"A Call to Action: Meeting the Needs of Autistic Adolescents with a history of Adverse Childhood Experiences.","authors":"Zahra Ladhani, Sonali Rajan","doi":"10.1016/j.amepre.2025.108125","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.108125","url":null,"abstract":"<p><p>Autistic adolescents who have a history of adverse childhood experiences (ACEs) may face unique health, developmental, and learning challenges that require targeted support, care, and urgent attention. In this work, we highlight the prevalence of this issue in the United States (U.S.), the need for an interdisciplinary approach to addressing the unique needs of this population, and present a call to action for policymakers and key stakeholders to invest in trauma-informed care in schools. Specific gaps in research and intervention efforts are also presented.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108125"},"PeriodicalIF":4.5,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126485","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":"A Multilevel Analysis of Social Environmental Factors Related to Substance Use, Tobacco Use, and Binge Drinking Behaviors Among Older Adults","authors":"Xue Zhang PhD ,&nbsp;Braden K. Linn PhD, LMSW ,&nbsp;Jennifer L. Moss PhD","doi":"10.1016/j.amepre.2025.108115","DOIUrl":"10.1016/j.amepre.2025.108115","url":null,"abstract":"<div><h3>Introduction</h3><div>Social environmental factors are associated with risky health behaviors. However, limited research examines these relationships among older adults and across multiple levels of the social environment.</div></div><div><h3>Methods</h3><div>This study analyzed data from a 2021 survey of older adults (aged ≥50 years, <em>n</em>=2,774) in the mid-Atlantic region of the U.S. Using a socioecologic framework, the social environment was measured at the levels of the individual (loneliness, resilience, perceived discrimination), interpersonal (emotional social support), neighborhood (attraction to neighborhood, acts of neighboring, sense of belonging), and community (crime, area deprivation, racial residential segregation). Generalized structural equation models were used to examine the pathways from multilevel social environmental factors to risk behaviors (substance misuse, tobacco use, binge drinking), controlling for age, sex (male or female), race/ethnicity, marital status, educational level, household income, and metropolitan status. Analyses were conducted in 2024.</div></div><div><h3>Results</h3><div>Individual characteristics, including higher loneliness and discrimination and lower resilience, were associated with a higher likelihood of risk behaviors. Attraction to neighborhood, acts of neighboring, and sense of belonging were indirectly, negatively associated with risk behaviors through their relationships with individual characteristics and social support. However, acts of neighboring and sense of belonging were directly, positively associated with tobacco use and binge drinking. Racial segregation was indirectly, positively associated with risk behaviors through discrimination and neighborhood factors.</div></div><div><h3>Conclusions</h3><div>A multilevel approach is essential for understanding risk behaviors among older adults. Enhancing the built environment to improve neighborhood attractiveness and addressing structural factors that contribute to racial segregation could help reduce risk behaviors in this population.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"70 1","pages":"Article 108115"},"PeriodicalIF":4.5,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114976","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":"Trends in Mortality Rates for Cardiovascular Disease Subtypes Among Adults, 2010-2023.","authors":"Rebecca C Woodruff, Xin Tong, Adam S Vaughan, Nilay S Shah, Sadiya S Khan, Omoye Imoisili, Fleetwood Loustalot, Essi Havor, Susan Carlson","doi":"10.1016/j.amepre.2025.108119","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.108119","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiovascular disease (CVD) mortality rates, which had been declining in the decade before the COVID-19 pandemic, increased in 2020 and remained elevated through 2022. Understanding whether trends in mortality rates from 2010 to 2023 varied by CVD subtypes could help focus prevention and clinical management.</p><p><strong>Methods: </strong>Annual age-standardized mortality rates (ASMR) per 100,000 for U.S. adults were calculated in 2025 using National Vital Statistics System death counts from 2010 to 2023. Deaths with CVD listed as the underlying cause of death were classified into 8 major CVD subtypes. Temporal trends from 2010 to 2023 were evaluated using average annual percent change (AAPC).</p><p><strong>Results: </strong>In 2023, ASMR for CVD subtypes were highest for ischemic heart disease (117.9 deaths per 100,000), followed by hypertensive disease (111.2), heart failure (82.1), cerebrovascular disease (65.7), arrhythmia (48.4), valvular heart disease (13.0), pulmonary heart disease (11.9), and cardiomyopathy (9.4). From 2010 to 2023, mortality rates significantly declined for ischemic heart disease (AAPC: -2.21) and cardiomyopathy (AAPC: -3.00) and increased for hypertensive disease (AAPC: 2.52), arrhythmia (AAPC: 1.14), and pulmonary heart disease (AAPC: 1.38). Although the overall trend was not significant, ASMR were higher in 2023 than 2010 for heart failure and lower for cerebrovascular disease and valvular heart disease.</p><p><strong>Conclusions: </strong>From 2010 to 2023, mortality rates improved for ischemic heart disease and cardiomyopathy but worsened for hypertensive disease, arrhythmia, and pulmonary heart disease. These results signal a need to focus prevention and clinical management efforts to target the growing burden of leading causes of death.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108119"},"PeriodicalIF":4.5,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115013","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":"Federal Calorie Menu Labeling Policy and Calories Purchased in Restaurants in a National Fast Food Chain: A Quasi-Experimental Study","authors":"Pasquale E. Rummo PhD, MPH ,&nbsp;Emil Hafeez MS, MSPH ,&nbsp;Tod Mijanovich PhD ,&nbsp;Lloyd Heng MA ,&nbsp;Erilia Wu MPA ,&nbsp;Beth C. Weitzman PhD ,&nbsp;Marie A. Bragg PhD ,&nbsp;Simon A. Jones PhD ,&nbsp;Brian Elbel PhD, MPH","doi":"10.1016/j.amepre.2025.108113","DOIUrl":"10.1016/j.amepre.2025.108113","url":null,"abstract":"<div><h3>Introduction</h3><div>Menu labels were federally mandated in May 2018; however, to the authors’ knowledge, no study has evaluated the impact of the national rollout of this legislation in restaurants using a comparison group to account for potential bias.</div></div><div><h3>Methods</h3><div>Using synthetic control methods, Taco Bell restaurants that implemented menu labels after nationwide labeling (<em>n</em>=5,060 restaurants) were matched to restaurants that added calorie labels to menus after local labeling legislation (and before nationwide labeling). The effect of menu labeling on calories purchased per transaction after nationwide labeling between groups (i.e., “later-treated” and “early-treated” restaurants) was estimated using a 2-way fixed effects regression model, with time modeled as relative month from implementation and fixed effects for calendar month and restaurant.</div></div><div><h3>Results</h3><div>In the baseline period, average calories per transaction was 1,242 (SD=178) in the national menu labeling group and 1,245 (SD=183.9) in the comparison group, with parallel trends between groups. Difference-in-differences model results indicated that transactions from restaurants in the national menu labeling group included 7.4 (95% CI=7.3, 7.5) more calories than that was predicted based on the trend in the comparison group. The average number of total transactions per month decreased ∼2% more in the national menu labeling group than in the comparison group.</div></div><div><h3>Conclusions</h3><div>Negligible changes were observed in calories purchased and number of transactions in restaurants that added calorie labels because of national legislation, above and beyond secular changes. Other strategies may be necessary to promote meaningful decreases in daily calories purchased in restaurants in the future.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"70 1","pages":"Article 108113"},"PeriodicalIF":4.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092978","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":"Implementing Care for Cannabis and Other Drug Use in Adult Primary Care: Outcomes of a Cluster-Randomized Implementation Trial.","authors":"Theresa E Matson, Eric Johnson, Jennifer F Bobb, Vina Graham, Linda Kiel, Amy K Lee, Gwen T Lapham, Ryan M Caldeiro, Katharine A Bradley, Julie E Angerhofer","doi":"10.1016/j.amepre.2025.108112","DOIUrl":"10.1016/j.amepre.2025.108112","url":null,"abstract":"<p><strong>Introduction: </strong>The US Preventive Services Task Force recommends substance use screening for adults when accurate diagnosis and follow-up treatment can be offered. This study evaluated whether implementation of population-based screening and symptom assessment increased treatment for cannabis and other drug use disorder (CUD/DUD) in a large primary care system.</p><p><strong>Methods: </strong>Nineteen randomized regional healthcare system sites implemented population-based screening and symptom assessment for cannabis and other drug use as part of a stepped-wedge trial to integrate mental health in adult primary care from 1/2016-7/2018. Implementation strategies included: practice facilitation, electronic health record (EHR) decision support, and performance feedback. Outcomes included treatment initiation and engagement rates among patients with any new DUD, and secondarily, rates for specific DUDs (e.g., CUD), using EHR and insurance claims data. Mixed-effect logistic regression modeled binary outcomes before and after implementation (1/2015-1/2019), adjusted for randomization stratification and time, accounting for person-level repeated outcomes. Monthly outcome rates (per 10,000 patient-visits) were estimated using marginal standardization. Analyses were conducted 2023-2024.</p><p><strong>Results: </strong>Pre-implementation, 244,542 patients had 942,400 visits; post-implementation, 287,696 patients had 1,087,565 visits. Implementation resulted in increased cannabis screening (9 to 153/10,000 patient-visits; p<0.001) and newly identified CUD (10 to 17/10,000 patient-visits, p<0.001). Treatment initiation for CUD increased 0.4 to 1/10,000 patient-visits (p=0.006), but treatment engagement did not change (p=0.147). Treatment initiation and engagement for any DUD did not change (p=0.777 and 0.584).</p><p><strong>Conclusion: </strong>Findings underscore potential value of integrating population-based cannabis screening/assessment in primary care for treatment initiation and highlight the need for improved engagement for CUD.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108112"},"PeriodicalIF":4.5,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12462408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087770","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":"Racial and Ethnic Disparities in Alcohol Consumption and Mortality in the U.S.","authors":"Timothy S. Naimi MD ,&nbsp;Adam Sherk PhD ,&nbsp;Keegan W. Lawrence MA ,&nbsp;Julianna Reece MD ,&nbsp;Marissa B. Esser PhD","doi":"10.1016/j.amepre.2025.107968","DOIUrl":"10.1016/j.amepre.2025.107968","url":null,"abstract":"<div><h3>Introduction</h3><div>Although there are racial/ethnic differences in alcohol use, there is little information about differences in mortality from all alcohol-related conditions or by cause of death. Furthermore, little is known about the degree to which racial/ethnic differences in mortality persist after adjusting for ethanol consumption. The purpose of this cross-sectional study was to comprehensively assess racial/ethnic differences in alcohol-attributable deaths and reduced life expectancy.</div></div><div><h3>Methods</h3><div>Alcohol prevalence data were from the Behavioral Risk Factor Surveillance System, and mortality data were from the National Vital Statistics System. Alcohol-attributable fractions and the Alcohol-Related Disease Impact application were used to assess alcohol-attributable deaths from 58 partially or wholly alcohol-attributable conditions in the U.S. during 2020–2021 (analyzed in 2024).</div></div><div><h3>Results</h3><div>White persons (60.9% of the population) accounted for 70.8% of all alcohol-attributable deaths and had the second-highest death rate (63.8 per 100,000) among racial/ethnic groups. American Indian/Alaska Native persons had the highest alcohol-attributable death rate (145.3) and the lowest average age of death (48.1 years). White and Asian, Native Hawaiian, or Pacific Islander persons tended to die of alcohol-attributable conditions from chronic diseases at relatively older ages, whereas people in other racial/ethnic groups tended to die at younger ages from alcohol-attributable acute causes of death. After adjusting for differences in per capita alcohol consumption, there remained fourfold differences in alcohol-attributable deaths by race/ethnicity.</div></div><div><h3>Conclusions</h3><div>Large differences in alcohol-attributable deaths across racial/ethnic groups were only partially explained by racial/ethnic differences in alcohol consumption. Implementing effective alcohol policies and addressing social determinants of health could reduce alcohol-related harms across race/ethnicities.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 6","pages":"Article 107968"},"PeriodicalIF":4.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145061195","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":"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}