American Journal of Preventive Medicine最新文献

{"title":"Optimal Design of an Added-Sugar Menu Warning Label: A Randomized Experiment.","authors":"Brittany Lemmon, Andrea Gil, Aviva A Musicus, Marissa G Hall, Christina A Roberto, Jennifer Falbe","doi":"10.1016/j.amepre.2025.108038","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.108038","url":null,"abstract":"<p><strong>Introduction: </strong>Restaurant menu added-sugar warning labels have the potential to reduce added-sugar consumption. Label efficacy depends on noticeability. This study aimed to assess which design elements improve noticeability and recognizability and also assessed behavioral response to the labels.</p><p><strong>Study design: </strong>An online randomized experiment was used.</p><p><strong>Setting/participants: </strong>A national sample of adults (N=4,083) was recruited to approximate U.S. distributions of sex, age, race, ethnicity, and education.</p><p><strong>Intervention: </strong>A pretest-determined triangle shape was used for the label icon in the main experiment. The main experiment used a 3 × 2 × 2 × 2 factorial design to test label type (icon-plus-text versus boxed icon-only versus icon-only label), color (red versus black), size (150% vs 100% of menu text height), and placement (right versus left side of item name). Participants viewed fast-food and full-service restaurant menus displaying the assigned label next to high-added-sugar items (containing >50% of the daily recommended limit).</p><p><strong>Main outcome measures: </strong>Noticing a high-added-sugar label and recognizing one's assigned label among other labels were assessed and analyzed in 2024. Menu-ordering behaviors were also examined.</p><p><strong>Results: </strong>Compared with icon-only labels, icon-plus-text labels increased the probability of noticing and recognizing high-added-sugar labels by 508% (7% vs 44%) and 263% (23% vs 82%) (ps<0.001), respectively. Red color increased noticing by 16% (p=0.020) and recognition by 20% (p<0.001) compared with black color. Larger height increased recognition by 13% (p=0.001). For icon-only labels, right placement increased noticing by 59% (p=0.020). Icon-plus-text labels reduced the probability of ordering a high-added-sugar item by 11% and the amount of added sugar ordered by 10.5 g (ps<0.001) compared with icon-only labels.</p><p><strong>Conclusions: </strong>Icon-plus-text labels were substantially more noticeable as high-added-sugar labels, recognizable, and efficacious at reducing the amount of added sugar ordered than icon-only labels. To a lesser extent, red color, larger labels, and right placement additionally improved performance, especially for icon-only designs, although they did not improve efficacy to a level similar to that of icon-plus-text labels.</p><p><strong>Trial registration: </strong>This trial is registered at AsPredicted.org (Number 156625) and ClinicalTrials.gov (NCT0620491).</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108038"},"PeriodicalIF":4.5,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114962","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":"Changes in Price, Consumption, Prevalence, and State Revenue of Transitioning Cigarette Sales to State-Controlled Outlets","authors":"Megan C. Diaz PhD ,&nbsp;Jidong Huang PhD ,&nbsp;Sarah D. Mills PhD, MPH ,&nbsp;Shelley D. Golden PhD, MPH ,&nbsp;Kurt M. Ribisl PhD","doi":"10.1016/j.amepre.2025.108078","DOIUrl":"10.1016/j.amepre.2025.108078","url":null,"abstract":"<div><h3>Introduction</h3><div>Policies that phase out the retail sale of tobacco products have been recommended to accelerate the tobacco endgame and reach negligible tobacco use rates. Using simulation modeling, this study assessed how a policy that transitions cigarette sales to state-controlled outlets may change prices and thus affect state revenue, cigarette pack sales, and smoking prevalence.</div></div><div><h3>Methods</h3><div>Using data from the Behavioral Risk Factor Surveillance System and Tax Burden On Tobacco, models were developed to examine 3 potential scenarios resulting from a policy that transitions the sales of cigarette products to state-controlled outlets in Oregon, Pennsylvania, Vermont, and Virginia. In Model 1, each state would keep cigarette pack prices at their current retail price but retain markup; in Model 2, cigarette pack prices would increase by 7%; and in Model 3, each state would increase prices to meet a consumption target reduction of 5%. For each price scenario, additional models that also considered changes to consumer travel and time costs were run.</div></div><div><h3>Results</h3><div>Across all models, state revenue increased in each state. Results suggest that the policy would increase revenue by at least 16% in Oregon to 302% in Virginia. In models that assumed that the cigarette pack price would increase, cigarette pack consumption and smoking prevalence declined. Declines in pack consumption and smoking prevalence ranged from 1% to 5% across states. Findings were robust to different assumptions about total own-price elasticities in sensitivity analyses.</div></div><div><h3>Conclusions</h3><div>Transitioning cigarette sales to state-controlled outlets may increase state revenue while reducing cigarette consumption and smoking prevalence.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 6","pages":"Article 108078"},"PeriodicalIF":4.5,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977385","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":"How State Factors Moderated the Impacts of the 2021 Child Tax Credit on Mental Health and Financial Hardship","authors":"Akansha Batra PhD ,&nbsp;Jacqueline M. Torres PhD, MPH ,&nbsp;Kaitlyn E. Jackson MPH ,&nbsp;Rita Hamad MD, PhD","doi":"10.1016/j.amepre.2025.108077","DOIUrl":"10.1016/j.amepre.2025.108077","url":null,"abstract":"<div><h3>Introduction</h3><div>Mental health problems during the COVID-19 pandemic in the U.S. were partly alleviated by economic policies. For example, the 2021 expansion of the child tax credit provided cash support to many families and improved mental health. Although the child tax credit was a federal policy, there may be geographic disparities in policy impacts depending on state contexts. This study examined how state factors modified the child tax credit’s effects.</div></div><div><h3>Methods</h3><div>This study used April 2021–January 2022 individual-level data from the Census Household Pulse Survey (N=944,189). Outcomes included depressive symptoms, anxiety symptoms, recent utilization of mental health counseling, and financial hardship. State-level modifiers included (1) social safety net policy context (as a composite measure and for individual policies) and (2) racial equity. This study examined whether state-level factors moderated the effects of the child tax credit expansion using a quasi-experimental difference-in-difference-in-differences approach, comparing pre–post differences among child tax credit–eligible versus ineligible individuals. Analyses were conducted during 2023–2025.</div></div><div><h3>Results</h3><div>There was no effect modification of the child tax credit by the composite state safety net policy measure or racial equity index. However, when examining individual policy measures, in states with higher Special Supplemental Nutrition Program for Women, Infants, and Children caseloads, the child tax credit expansion was associated with improved confidence in the ability to pay rent/mortgage. In states with higher Supplemental Nutrition Assistance Program accessibility, the child tax credit expansion was associated with reduced food insufficiency and lower utilization of mental health services.</div></div><div><h3>Conclusion</h3><div>The 2021 federal child tax credit’s effects were modestly moderated by local state policy contexts, potentially contributing to geographic health disparities. This informs policymaking and research on multilevel policy interactions.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 6","pages":"Article 108077"},"PeriodicalIF":4.5,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977429","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":"Preventing Intimate Partner Murder–Suicide: A Case-Control Study of Suicidal Males in Abusive Relationships","authors":"Julie M. Kafka PhD, MPD ,&nbsp;Vivian H. Lyons PhD, MPH ,&nbsp;Angel Cheung MPH ,&nbsp;Laurie M. Graham PhD, MSW ,&nbsp;Millan A. AbiNader PhD, LMSW ,&nbsp;Avanti Adhia ScD ,&nbsp;Ayah Mustafah BS ,&nbsp;Frederick P. Rivara MD, MPH","doi":"10.1016/j.amepre.2025.108076","DOIUrl":"10.1016/j.amepre.2025.108076","url":null,"abstract":"<div><h3>Introduction</h3><div>Murder–suicide is a rare but serious public health problem. It often occurs in the context of intimate partner violence; 62% of murder–suicides in the U.S. involve killing an intimate partner. The goal of this study was to identify the risk indicators for intimate partner murder–suicide among suicidal males with a history of perpetrating intimate partner violence.</div></div><div><h3>Methods</h3><div>This case-control study used National Violent Death Reporting System data, 2019–2020. Cases were intimate partner murder–suicides committed by males. Controls were males who perpetrated intimate partner violence but who died by suicide without killing their partner. The research team reviewed text summaries from the National Violent Death Reporting System to code detailed information about each event. Analyses estimated the adjusted odds of intimate partner murder–suicide using generalized estimating equations and were completed in November 2024.</div></div><div><h3>Results</h3><div>Among 478 matched case/control pairs, firearm use (AOR=5.3) and decedent military history (AOR=1.8) were associated with increased odds of perpetrating intimate partner murder–suicide. Prior involvement in a domestic violence protection order (AOR=0.4) and previously established suicide risk indicators (e.g., appearing depressed [AOR=0.4], prior suicide attempts [AOR=0.2], disclosed suicidal intent [AOR=0.2]) were associated with decreased odds of intimate partner murder–suicide.</div></div><div><h3>Conclusions</h3><div>Among suicidal males perpetrating intimate partner violence, several factors differentiated the risk for murder–suicide relative to that of suicide only. Improving accessibility and implementation of domestic violence protection orders while removing firearms from people who are perpetrating intimate partner violence may prevent intimate partner murder–suicide. There may also be opportunities to screen for and jointly address suicidality and intimate partner violence perpetration across military, healthcare, legal, and child welfare settings.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 6","pages":"Article 108076"},"PeriodicalIF":4.5,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977433","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":"U.S. State Marijuana and Delta-8-Tetrahydrocannabinol Laws and Delta-8-Tetrahydrocannabinol Use.","authors":"Nora Satybaldiyeva, Kevin H Yang, Wayne E Kepner, Eric C Leas","doi":"10.1016/j.amepre.2025.108026","DOIUrl":"10.1016/j.amepre.2025.108026","url":null,"abstract":"<p><strong>Introduction: </strong>Delta-8-tetrahydrocannabinol has gained popularity since the passage of the 2018 U.S. Farm Bill. The absence of federal laws and varying state regulations governing delta-8-tetrahydrocannabinol have allowed manufacturers to evade restrictions placed on marijuana products. This study examined delta-8-tetrahydrocannabinol use across different state marijuana and delta-8-tetrahydrocannabinol policies.</p><p><strong>Methods: </strong>A cross-sectional, web-based survey of 1,523 U.S. adults was conducted in October-November 2023. Responses were weighted to represent the national adult population. Inverse-probability-of-treatment weights balanced covariates across policy groups; adjusted risk ratios and 95% CIs were estimated in 2025 for state (1) marijuana policy (prohibited, medical only, recreational) and (2) delta-8-tetrahydrocannabinol policy (prohibited, regulated, unregulated).</p><p><strong>Results: </strong>Approximately 7.7% (95% CI=6.5, 9.1) of U.S. adults reported using delta-8-tetrahydrocannabinol in their lifetime. The prevalence of delta-8-tetrahydrocannabinol use was lower among adults in states permitting recreational marijuana use (5.5%; adjusted risk ratio=0.48, 95% CI=0.33, 0.70) and lower in states permitting medical use only (8.5%; adjusted risk ratio=0.73, 95% CI=0.46, 1.14) than in states prohibiting all marijuana use (10.9%). Adults in states that regulated (3.9%; adjusted risk ratio=0.33, 95% CI=0.20, 0.55) or prohibited (4.5%; adjusted risk ratio=0.47, 95% CI=0.28, 0.78) delta-8-tetrahydrocannabinol sales reported lower rates of delta-8-tetrahydrocannabinol use than adults in states with unregulated markets for delta-8-tetrahydrocannabinol (10.5%).</p><p><strong>Conclusions: </strong>Delta-8-tetrahydrocannabinol use is more common where marijuana remains prohibited and less common where delta-8-tetrahydrocannabinol sales are regulated or prohibited. State-level restrictions targeting delta-8-tetrahydrocannabinol appear to reduce use, suggesting that closing regulatory gaps could limit consumption of these products.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108026"},"PeriodicalIF":4.5,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977410","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":"Injuries From Electric Bikes and Scooters: Illinois, U.S., 2021–2023","authors":"Brett Shannon MBBS, PhD ,&nbsp;Nan Ni MPH, MUP ,&nbsp;Johnathon Ehsani PhD ,&nbsp;Lee S. Friedman PhD","doi":"10.1016/j.amepre.2025.108065","DOIUrl":"10.1016/j.amepre.2025.108065","url":null,"abstract":"<div><h3>Introduction</h3><div>Micromobility device injuries and deaths continue to increase in the U.S., requiring public health input. The aim of this study was to describe injuries from micromobility devices in the state of Illinois and to determine whether there are differences in the patterns and severity of injuries from the use of electric devices (scooters/bikes) to inform future public health policy.</div></div><div><h3>Methods</h3><div>Outpatient and inpatient acute traumatic injuries related to micromobility device use that passed through the emergency room and were treated in Illinois hospitals from 2021 to 2023 were analyzed in 2024 using newly introduced ICD-10 codes for injuries resulting from electric scooters and other devices.</div></div><div><h3>Results</h3><div>Of 34,073 patients presenting with acute injuries from micromobility devices, the nature, severity, and mechanism of injuries differed for electric devices. Electric scooter injuries primarily occurred owing to falls (78.4%), whereas nearly half (45.4%) of electric bike injuries were caused by motor vehicle crashes (in traffic, nontraffic, or unspecified). Using cycling injuries as a reference group, users of electric devices were significantly more likely to be admitted to hospital (electric bikes AOR=1.62, <em>p</em>&lt;0.05; electric scooters AOR=1.61, <em>p</em>&lt;0.01), to be admitted to the intensive care unit (electric bikes AOR=2.39, <em>p</em>&lt;0.01; electric scooters AOR=2.04, <em>p</em>&lt;0.01), and to present with a traumatic brain injury (electric bikes AOR=1.3, <em>p</em>&lt;0.05; electric scooters AOR=1.23, <em>p</em>&lt;0.01).</div></div><div><h3>Conclusions</h3><div>Statewide hospital data demonstrate an increased likelihood of serious injuries associated with electric micromobility device use, relative to bicycles. These findings have implications for ongoing surveillance and safety promotion and further demonstrate the need for public health input into the use of personal electric micromobility devices in the U.S.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 6","pages":"Article 108065"},"PeriodicalIF":4.5,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977445","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":"Racial and Ethnic Disparities in Prehospital Restraint Use and Sedation","authors":"Thomas J. McAdam MPH ,&nbsp;Seth J. Prins PhD, MPH ,&nbsp;John R. Pamplin II PhD, MPH ,&nbsp;Pia M. Mauro PhD, MPH ,&nbsp;Sarah Gutkind PhD, MSPH ,&nbsp;Megan E. Marziali MPH ,&nbsp;Zachary L. Mannes PhD, MPH","doi":"10.1016/j.amepre.2025.108066","DOIUrl":"10.1016/j.amepre.2025.108066","url":null,"abstract":"<div><h3>Introduction</h3><div>Emergency medical service clinicians routinely encounter patients experiencing behavioral health emergencies, yet limited data describe the prehospital use of physical restraints or sedatives. Systemic racism and challenges in access to behavioral health care may contribute to disparities in restraint and sedation use among minoritized groups. This study examined whether race and ethnicity were associated with prehospital use of physical restraints and/or sedation among patients with behavioral health emergencies.</div></div><div><h3>Methods</h3><div>Using the 2022 ESO Data Collaborative consisting of ∼12,000,000 emergency medical service healthcare encounters, this study estimated the associations between race and ethnicity (non-Hispanic White, Black/African American, Hispanic any race, Asian, or American Indian/Alaskan Native) and physical restraint and/or sedation use (yes, no) among patients aged ≥15 years who had an emergency medical service encounter for a behavioral health emergency. AOR estimates with 95% CIs are presented.</div></div><div><h3>Results</h3><div>Approximately 7.1% (<em>n</em>=3,799) of behavioral health encounters involved any restraint or sedation use. All racial and ethnic minoritized groups were more likely to receive physical restraints (AOR range=1.62–2.72, <em>p</em>&lt;0.05) than non-Hispanic White patients, whereas Black/African American, Hispanic, and American Indian/Alaskan Native patients were more likely to be sedated with antipsychotics or benzodiazepines (AOR range=1.27–3.21, <em>p</em>&lt;0.05). Black/African American patients were also more likely than non-Hispanic White patients to be concurrently restrained and sedated (AOR=1.30, 95% CI=1.09, 1.55).</div></div><div><h3>Conclusions</h3><div>Disparities in restraint and sedation use may perpetuate poor psychiatric outcomes for racially and ethnically minoritized groups, particularly Black/African American patients, in a system that already hinders their access to mental health treatment.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 6","pages":"Article 108066"},"PeriodicalIF":4.5,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977440","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 Support for Warning Label Policies on Social Media Among U.S. Adults in 2024","authors":"Jennifer Cornacchione Ross PhD ,&nbsp;Lynsie R. Ranker PhD ,&nbsp;Jessica L. Fetterman PhD ,&nbsp;Emelia J. Benjamin MD, ScM ,&nbsp;Traci Hong PhD","doi":"10.1016/j.amepre.2025.108067","DOIUrl":"10.1016/j.amepre.2025.108067","url":null,"abstract":"<div><h3>Introduction</h3><div>Health warning labels are used across several regulatory spaces to warn consumers about potentially harmful products. The study goal was to assess U.S. adults’ public opinions about health warning label policies on social media in general and for commercial tobacco/nicotine products specifically in response to a call from the U.S. Surgeon General on health warning label policies on social media. This study examined support by political party affiliation.</div></div><div><h3>Methods</h3><div>A nationally representative online survey was conducted in September 2024 among U.S. adults. Respondents indicated how much they strongly agreed (5) or strongly disagreed (1) with 5 statements about social media health warning labels, including mental health, influencer promotions, and tobacco/nicotine products. Log binomial regression models were constructed to estimate relative support prevalence by political affiliation. Analyses were conducted in 2024–2025.</div></div><div><h3>Results</h3><div>U.S. adults, regardless of political affiliation, generally supported social media health warning label policies, including agreeing/strongly agreeing that social media platforms should be required to have warning labels on posts promoting any tobacco product (81.2% of Democrats, 74.8% of Republicans). Democrats and Republicans were also closely aligned in support of influencer disclosures generally (82.9% and 80.5%, respectively) and in their support that social media platforms should do more to warn youth about the harms of vaping (82.4% and 77.2%, respectively). Democrats generally expressed the highest levels of support, whereas those who identified as independent or with no affiliation generally expressed the lowest levels of support.</div></div><div><h3>Conclusions</h3><div>Adding sponsored content disclosures and health warning labels to social media platforms and related posts is generally supported by U.S. adults, showing promise for policy adoption and implementation.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 6","pages":"Article 108067"},"PeriodicalIF":4.5,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977368","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":"Factors Associated with All-Cause Mortality in a Western State Prison System, 1999-2020.","authors":"Jillian J Turanovic, Nancy Rodriguez, Julie L Kuper","doi":"10.1016/j.amepre.2025.108063","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.108063","url":null,"abstract":"<p><strong>Introduction: </strong>Incarceration is linked to mortality, yet specific factors associated with death during imprisonment remain poorly understood, limiting efforts to identify vulnerable populations and develop effective prevention strategies in carceral settings.</p><p><strong>Methods: </strong>Administrative records were analyzed from 91,979 adults who served any portion of their sentence in a Western US state prison system between 1999 and 2020. Complementary log-log regression was used to identify demographic, criminal history, institutional, and behavioral health-related factors associated with all-cause mortality in prison.</p><p><strong>Results: </strong>Of incarcerated individuals (mean age 35.83 years at admission; 86.3% male), 839 (0.91%) died in prison. Self-harm incidents (HR 15.19; 95% CI 10.50-21.98) and sentences of 21+ years (HR 16.84; 95% CI 10.49-27.03 vs. ≤1 year) were most strongly associated with mortality. Variety of correctional programs completed was a protective factor (HR 0.78; 95% CI 0.74-0.82), and foreign-born status (HR 0.41; 95% CI 0.26-0.65), Black race (HR 0.73; 95% CI 0.59-0.91 vs. White), and violent infractions (HR 0.91; 95% CI 0.88-0.95) had inverse associations with mortality. Mortality risk increased substantially with age, with individuals aged 55+ years at admission having over 11 times the risk of death compared to those aged 24 and under (HR 11.79; 95% CI 8.75-15.88). Male sex, prior incarcerations, higher custody levels, drug infractions, mental health needs, academic needs, and criminogenic needs were also associated with increased mortality risk.</p><p><strong>Conclusions: </strong>This study identified new risk factors for mortality during imprisonment. The findings highlight directions for future research and actionable intervention points for reducing mortality in incarcerated populations.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108063"},"PeriodicalIF":4.5,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977391","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":"Precarious Employment Typologies and Psychotropic Medication Use and Misuse","authors":"Seong-Uk Baek MD ,&nbsp;Jin-Ha Yoon MD, PhD","doi":"10.1016/j.amepre.2025.108064","DOIUrl":"10.1016/j.amepre.2025.108064","url":null,"abstract":"<div><h3>Introduction</h3><div>Precarious employment has emerged as a significant social determinant of worker health. This cross-sectional study examined the association between precarious employment and psychotropic medication use and misuse using a typological approach.</div></div><div><h3>Methods</h3><div>A nationally representative sample of 8,993 young workers in Korea was analyzed. Data collection was conducted in 2022, and the analyses for this study were performed in 2025. Eight precarious employment indicators related to employment security, income adequacy, worker rights, and protection were included. Latent class analysis was employed to classify employment typologies. The associations between employment typologies, psychotropic medication use, and misuse were determined using ORs and 95% CIs.</div></div><div><h3>Results</h3><div>Three latent employment typologies were identified: standard employment relationship–like type (n=4,864; 59.7%), instrumental type (<em>n</em>=1,973; 20.3%), and precarious type (<em>n</em>=2,156; 19.9%). Psychotropic medication use was reported by 2.6%, 4.7%, and 6.5% of individuals in the standard employment relationship–like, instrumental, and precarious types, respectively. Psychotropic medication misuse was reported by 0.4%, 1.1%, and 1.4% of individuals in the standard employment relationship–like, instrumental, and precarious types, respectively. After adjusting for the sociodemographic factors, individuals in the precarious type had 6.16 times higher odds of psychotropic medication use (95% CI=3.10, 12.25) and 10.34 times higher odds of psychotropic medication misuse (95% CI=1.64, 65.39) than those in the standard employment relationship–like type.</div></div><div><h3>Conclusions</h3><div>Precarious employment experience is closely linked with psychotropic medication use and misuse among young Korean wage workers. Policy interventions are required to improve the employment quality and ensure appropriate psychotropic medication use in this population.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 6","pages":"Article 108064"},"PeriodicalIF":4.5,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977347","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}