American Journal of Preventive Medicine最新文献

{"title":"Mediating role of health behaviors in income-related health inequalities: evidence from socioeconomically deprived rural areas of China.","authors":"Daopeng Duan, Wenning Sun, Jin Hao, Shuwen Bi, Siqian Zhang, Longrui Zou, Zexuan Yu, Shiju Dong, Jiajia Li","doi":"10.1016/j.amepre.2025.107658","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.107658","url":null,"abstract":"<p><strong>Introduction: </strong>Existing evidence from high-income countries suggests that higher income is associated with better health outcomes through health-promoting behaviors. However, limited evidence exists regarding income-related health inequalities mediated by health behaviors in low- and middle-income countries. This study focuses on socioeconomically deprived rural areas of China and examines how health behaviors contribute to the association between income and health.</p><p><strong>Methods: </strong>In 2023, a cross-sectional study comprising 6,674 participants was conducted in rural Shandong, China, using a stratified cluster random sampling method. Income was measured using annual per capita net household income. Health behaviors included smoking, overdrinking, teeth brushing, fruit and vegetable consumption, and physical activity. Health status was assessed using the self-rated health (SRH) scale, the activities of daily living (ADLs) scale and EuroQol-5 Dimension (EQ5D). The ordinary least squares (OLS) method was adopted to examine the associations among income, health behaviors and health status after controlling for confounding factors. The non-parametric bootstrapping method was employed to further explore the mediating role of health behaviors in income-related health inequalities.</p><p><strong>Results: </strong>Income was positively associated with SRH, ADLs, EQ5D, and three positive behaviors including teeth brushing, fruit consumption, and physical activity, but was also positively correlated with overdrinking. Mediation analysis revealed that health behaviors mediated 35.05% (SRH), 67.90% (ADLs), and 72.08% (EQ5D) of the association between income and health status.</p><p><strong>Conclusion: </strong>This study has shown income-related inequalities in both health and health behaviors in socioeconomically deprived rural areas of China. The health behaviors mediated the association between income and health status.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"107658"},"PeriodicalIF":4.3,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121449","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":"Health Outcomes and Hormone Therapy Source in Transgender Adults","authors":"Rishub K. Das MD,&nbsp;Brian C. Drolet MD","doi":"10.1016/j.amepre.2025.107657","DOIUrl":"10.1016/j.amepre.2025.107657","url":null,"abstract":"","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 2","pages":"Article 107657"},"PeriodicalIF":4.3,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121444","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":"Multi-Target Stool DNA and the Fecal Immunochemical Test: A Systematic Review and Meta-Analysis on Test Performances","authors":"Derek W. Ebner MD ,&nbsp;Heather A. Johnson MLIS, MSc ,&nbsp;Chris Estes MPH ,&nbsp;William K. Johnson PhD ,&nbsp;Rukaiyya S. Khan PhD ,&nbsp;Gina Thompson PharmD, MPH ,&nbsp;Joyce Kong ,&nbsp;Mark Camardo MS ,&nbsp;Michael Dore MD ,&nbsp;Vahab Vahdat PhD ,&nbsp;A. Mark Fendrick MD ,&nbsp;Paul J. Limburg MD ,&nbsp;John B. Kisiel MD","doi":"10.1016/j.amepre.2025.107654","DOIUrl":"10.1016/j.amepre.2025.107654","url":null,"abstract":"<div><h3>Introduction</h3><div>Colorectal cancer remains a leading cause of cancer death in the U.S. Since the latest U.S. Preventive Services Task Force update, additional studies examining the performance of the multi-target stool DNA and the fecal immunochemical test have been published. This analysis builds upon the U.S. Preventive Serices Task Force analysis by including recent studies on test performance.</div></div><div><h3>Methods</h3><div>PubMed and Embase were searched for manuscripts published between December 4, 2019, and July 9, 2024, using colonoscopy as the reference standard. Double-blinded reviewers screened articles. Primary outcomes were test sensitivity and specificity for colorectal cancer, advanced neoplasia, advanced precancerous lesions, and nonadvanced precancerous lesions.</div></div><div><h3>Results</h3><div>Of 4,320 citations screened, 41 new studies were identified. After combining with 14 studies from the previous U.S. Preventive Services Task Force evidence review, 55 studies were analyzed. Forty-one studies reported the performance of fecal immunochemical test alone, 10 of multi-target stool DNA alone, and 4 reported fecal immunochemical test and multi-target stool DNA. Of 14 studies evaluating multi-target stool DNA, 2 considered the next-generation multi-target stool DNA test’s colorectal cancer sensitivity was 93.6% (95% CI=89.0, 97.1) for next-generation multi-target stool DNA and 71.6% (95% CI=64.3, 77.9) for fecal immunochemical test. Specificity was 91.6% (95% CI=89.2, 93.7) for next-generation multi-target stool DNA and 96.3% (95% CI=95.4, 97.0) for fecal immunochemical test. Advanced precancerous lesion sensitivity was 22.2% (95% CI=20.6, 24.0) for fecal immunochemical test and 45.6% (95% CI=40.8, 50.4) for next-generation multi-target stool DNA.</div></div><div><h3>Discussion</h3><div>This meta-analysis revealed that multi-target stool DNA has high sensitivity for detecting colorectal cancer and is more than twice as sensitive than fecal immunochemical test for detecting advanced precancerous lesions. The lifetime benefit and effectiveness of these tests should be further analyzed.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 2","pages":"Article 107654"},"PeriodicalIF":4.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating School-Based Interventions for Preventing and Reducing Tobacco Use Among Adolescents in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis","authors":"Sahadat Hossain PhD ,&nbsp;Harry Tattan-Birch PhD ,&nbsp;Emma Beard PhD ,&nbsp;Lion Shahab PhD","doi":"10.1016/j.amepre.2025.107656","DOIUrl":"10.1016/j.amepre.2025.107656","url":null,"abstract":"<div><h3>Introduction</h3><div>Tobacco-related disease and death remain high in many low- and middle-income countries, and most people start using tobacco during adolescence. This study evaluated the effectiveness of school-based interventions in preventing and reducing tobacco use among adolescents in low- and middle-income countries.</div></div><div><h3>Methods</h3><div>Seven databases were searched until 20 April 2024. The primary outcome was tobacco use prevalence (ever or point prevalence) at the longest follow-up. Risk of bias was assessed, and random-effects meta-analyses were conducted, exploring heterogeneity via meta-regression (PROSPERO registration CRD42022330329).</div></div><div><h3>Results</h3><div>Twenty-seven studies (N=57,292) were summarized descriptively, and 20 were meta-analyzed. Most studies were from Brazil (<em>n</em>=5, 18.5%), India (<em>n</em>=5, 18.5%), China (<em>n</em>=3, 11.1%), and Pakistan (<em>n</em>=2, 7.4%); 12 (44.4%) assessed newly developed and 15 (55.6%) culturally adapted existing interventions; and over half (<em>n</em>=14, 51.9%) focused solely on preventing and reducing tobacco use while the rest addressed multiple behaviors. Overall, interventions reduced adolescent tobacco use (OR=0.76, 95% CI=0.64, 0.91; I²=47%; <em>n</em>=20; 50,056 participants). Stratification by outcome measure showed significant reductions in point prevalence (OR=0.69, 95% CI=0.57, 0.85; I²=32.4%). After adjusting for study duration, interventions with higher contact time had lower effectiveness than shorter interventions (AOR=1.36, 95% CI=1.01, 1.84; <em>p</em>=0.045; I²=22%). Low risk of bias studies demonstrated lower odds of tobacco use among participants (OR=0.66, 95% CI=0.50, 0.87; I²=14%; n=6).</div></div><div><h3>Discussion</h3><div>School-based interventions in low- and middle-income countries effectively reduce the proportion of adolescents who use tobacco. Shorter interventions appeared to be effective, suggesting that brief yet engaging interventions may offer practical advantages and could contribute to addressing the tobacco epidemic in low- and middle-income countries. Further research is needed to determine optimal intervention duration and intensity for sustained effectiveness.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 2","pages":"Article 107656"},"PeriodicalIF":4.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086782","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 Impact of Extreme Risk Protective Orders on Firearm Fatalities","authors":"Wenying Gu MS ,&nbsp;Brad N. Greenwood PhD, MBA ,&nbsp;Ritu Agarwal PhD, MS, MBA ,&nbsp;Paul S. Nestadt MD","doi":"10.1016/j.amepre.2025.107652","DOIUrl":"10.1016/j.amepre.2025.107652","url":null,"abstract":"<div><h3>Introduction</h3><div>Although a growing number of states have implemented extreme risk protective orders to curb gun violence, existing studies on extreme risk protective orders have been limited in scope, focusing on a few states, and often lacking robust methodologies to identify their effects. This work estimates the effect of extreme risk protective order codification on firearm fatalities (homicides and suicides). Further, the study examines heterogeneity in fatalities across racial subpopulations and those who can petition for such restrictions (viz. law enforcement, family members, healthcare professionals).</div></div><div><h3>Methods</h3><div>Using a difference in difference approach, the authors estimate changes in outcomes across 19 treated states and the District of Columbia, which implemented ERPOs, and 31 control states. The sample runs from 1998 to 2020, including 288,250 homicides and 450,956 suicides involving firearms. Data are drawn from National Center for Health Statistics death certificates.</div></div><div><h3>Results</h3><div>Empowering health professional petitioners significantly reduces suicides overall, most prominently among White victims (−14.79%; 95% CI= −19.18%, −10.24%]; 7–16 state yearly net effect). Including family members as petitioners significantly decreases homicides overall, and most prominently among Black victims to varying degrees in most models.</div></div><div><h3>Conclusions</h3><div>Results indicate significant differences in the efficacy of extreme risk protection orders implementation on firearm-related homicides and suicides across petitioners and subpopulations. This study underscores the benefits of diversified petitioners and their role in ending violence across different communities.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 2","pages":"Article 107652"},"PeriodicalIF":4.3,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057480","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":"Sexual Minority Identity and Physical Illnesses: Role of Life-Course Victimization and Gender Differences","authors":"Aura Ankita Mishra PhD ,&nbsp;Ainsley Yanz BA ,&nbsp;Laura M. Schwab-Reese PhD ,&nbsp;Carolyn T. Halpern PhD ,&nbsp;Kathleen Mullan Harris PhD","doi":"10.1016/j.amepre.2025.107650","DOIUrl":"10.1016/j.amepre.2025.107650","url":null,"abstract":"<div><h3>Introduction</h3><div>Sexual minority individuals experience higher rates of victimization and chronic physical health conditions. There are also known differences by gender in both victimization rates and victimization-linked chronic physical health conditions. However, few studies have examined gender differences regarding the association between sexual minority identity and chronic physical health conditions through cumulative life-course victimization, cumulative childhood victimization, and cumulative adult victimization.</div></div><div><h3>Methods</h3><div>This research uses a nationally representative dataset—the National Longitudinal Study of Adolescent to Adult Health (data collected from 1994 to 2018)—to examine (1) cumulative violence victimization across the life course and (2) the relative importance of violence victimization in childhood and adulthood as pathways between sexual minority identity and chronic physical health conditions while estimating differences by gender. Data processing and analysis were conducted between August 2021 and December 2024.</div></div><div><h3>Results</h3><div>Women who identified as mostly heterosexual and bisexual were more likely to experience chronic physical health disparities through indirect associations through victimization accumulation across the life course and violence victimization both in childhood and adulthood. Among lesbian women, there was an indirect association between sexual orientation and chronic physical health conditions through cumulative life-course victimization and childhood victimization.</div></div><div><h3>Conclusions</h3><div>Findings demonstrate that for women who identify as mostly heterosexual and bisexual, victimization-related chronic physical health vulnerabilities may manifest even before midlife, and both childhood and adult exposures are critical for physical health disparities in these groups. In contrast, childhood victimization maybe a more pervasive factor for chronic physical health conditions among lesbian women.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 2","pages":"Article 107650"},"PeriodicalIF":4.3,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048170","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":"Perceived difficulty of flavored tobacco purchase: Early effects of a statewide flavor policy among young people.","authors":"Jennifer M Kreslake, Elizabeth L Seaman, Stephanie N Yoon, Jamie Cordova, Barbara A Schillo, Kristy Marynak","doi":"10.1016/j.amepre.2025.107651","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.107651","url":null,"abstract":"<p><strong>Introduction: </strong>In December 2022, California enacted a policy restricting the sale of flavored tobacco products. This study tested whether perceived difficulty of purchasing flavored tobacco products from retailers changed among youth and young adults following the enactment of California's policy.</p><p><strong>Methods: </strong>Data were from the Tobacco Epidemic Evaluation Network (TEEN+) study, a probability-based national longitudinal cohort (aged 13-24 years) survey which fielded pre-policy (W1: July-October 2022) and post-policy (W2: March-June 2023). Respondents reported perceived difficulty (0=somewhat/very easy, 1=somewhat/very hard) at both waves. The analysis was restricted to respondents who had ever used tobacco by W1 (California n=527; rest of US n=2,220). Weighted GEE analyses tested for differences in PD at W2 versus W1.</p><p><strong>Results: </strong>California respondents were significantly more likely to perceive difficulty in purchasing: flavored e-cigarettes (aOR: 2.12, P<0.001); menthol cigarettes (aOR: 2.16, P=0.007); and flavored cigars (aOR: 2.76, P=0.012) at W2 versus W1. Among the rest of US sample, no significant increases in perceived difficulty were observed for any product type at W2 versus W1. At W2, most California respondents perceived flavored products to be easy to purchase (flavored e-cigarettes: 73.8%; menthol cigarettes: 72.9%; flavored cigars: 83.2%).</p><p><strong>Conclusions: </strong>California youth and young adults who had ever used tobacco were more likely to perceive difficulty in purchasing flavored tobacco products following California's policy, compared to pre-policy. Increases in perceived difficulty were not observed among other US respondents. Nonetheless, most perceive the purchase of flavored tobacco products to be somewhat or very easy following the California policy. Monitoring and enforcement are needed to ensure compliance with the statewide policy.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"107651"},"PeriodicalIF":4.3,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023731","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":"Healthcare Utilization and Preventive Cardiovascular Health Screening Among Adults With Disabilities Amid COVID-19 Phases","authors":"Annaliese Pena BA ,&nbsp;Palma Bauman BS ,&nbsp;Peyton Free BS, BA ,&nbsp;Rochelle Brittingham PhD ,&nbsp;Dana Holz PhD ,&nbsp;Daniel Harris PhD ,&nbsp;Tarang Parekh PhD, MBBS","doi":"10.1016/j.amepre.2025.107648","DOIUrl":"10.1016/j.amepre.2025.107648","url":null,"abstract":"<div><h3>Introduction</h3><div>This study examines healthcare utilization and preventive cardiovascular health screening among U.S. adults in 2021–2023 compared with those in prepandemic Year 2019 by disability status.</div></div><div><h3>Methods</h3><div>This repeated cross-sectional analysis conducted in 2024 used data from National Health Interview Survey for years 2019–2023, including 150,198 adults. Disabilities were categorized as sensory, cognitive, physical, multiple, or none. Healthcare utilization measures (usual care source, wellness visits, and delayed/unmet care due to cost) and preventive screenings (blood pressure, cholesterol, glucose, flu-shot) were analyzed using descriptive methods and Poisson regression, reporting adjusted rate ratios with 95% CIs.</div></div><div><h3>Results</h3><div>During the COVID-19 pandemic, cardiovascular health screening rates decreased across all disability types except for sensory disability. Blood pressure screening for adults with cognitive disabilities dropped from 89% in 2019 to 83% in 2021, whereas blood glucose screening for those with multiple disabilities declined from 83.9% to 78.4%. Cholesterol screenings decreased across all disability types in 2021 but increased among adults with sensory disabilities in 2023 (adjusted rate ratio=1.07, 95% CI=1.03, 1.09). Notably, adults with cognitive (adjusted rate ratio=1.23, 95% CI=1.03, 1.43) and physical (adjusted rate ratio=1.13, 95% CI=1.01, 1.27) disabilities reported higher unmet medical needs due to cost than those without disabilities. Such differences persisted even after adjusting for pandemic-related socioeconomic changes (income, citizenship, employment, insurance).</div></div><div><h3>Conclusions</h3><div>U.S. adults with disabilities experienced increased delays in medical care and declines in cardiovascular screenings during the COVID-19 pandemic, highlighting ongoing disparities in healthcare utilization. These findings underscore the urgent need for public health initiatives to enhance preventive health screening uptake among adults with disabilities.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 2","pages":"Article 107648"},"PeriodicalIF":4.3,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042867","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":"Foregone Preventive Care and Unmet Mental Healthcare Needs Among U.S. Youth","authors":"Anthony L. Bui MD, MPH ,&nbsp;Alexis M. Ball MD, MPP ,&nbsp;Linda K. Ko PhD, MPH, MS ,&nbsp;Marie Ng PhD ,&nbsp;Frederick P. Rivara MD, MPH ,&nbsp;Tumaini R. Coker MD, MBA","doi":"10.1016/j.amepre.2025.107644","DOIUrl":"10.1016/j.amepre.2025.107644","url":null,"abstract":"<div><h3>Introduction</h3><div>Given the youth mental health crisis, this study examines racial and ethnic disparities of foregone preventive care, unmet mental healthcare needs, and difficulty accessing mental healthcare among youth with common mental health problems.</div></div><div><h3>Methods</h3><div>A cross-sectional analysis was conducted using the 2022 National Survey of Children’s Health (NSCH), examining U.S. youth aged 8–17 years with parent-reported anxiety, depression, or behavioral problems. NSCH survey weights were utilized, and ORs were estimated for each racial and ethnic group across foregone preventive care, unmet mental healthcare needs, and difficulty obtaining mental healthcare, adjusting for age, sex, language, income, parental education, and insurance.</div></div><div><h3>Results</h3><div>Among the weighted sample of 6,608 youth with common mental health problems, 14.2% of children with common mental health problems had forgone preventive care, 15.1% had unmet mental healthcare needs, and 59.2% had difficulty obtaining mental healthcare. Per parental report, Black children had 1.59 (95% CI=1.01, 2.51) times the odds of foregoing preventive care in the past year compared to White children. Asian children had 2.32 (1.18, 4.48) times the odds of unmet mental healthcare compared to White children. There were no significant differences in difficulty obtaining mental healthcare across race and ethnicity.</div></div><div><h3>Conclusions</h3><div>Racial and ethnic disparities exist in accessing preventive and mental healthcare among children with parent-reported mental health conditions. Black youth have higher rates of foregone preventive care, while Asian youth have higher unmet mental healthcare needs compared to White youth. Further research should explore barriers and facilitators of collaborative care to reduce youth mental healthcare disparities.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 2","pages":"Article 107644"},"PeriodicalIF":4.3,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039162","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 Unequal Geography of Recreational Cannabis Retailers in the U.S.","authors":"Lindsay L. Kephart PhD, MPH ,&nbsp;Vaughan W. Rees PhD ,&nbsp;Daniel P. Giovenco PhD, MPH ,&nbsp;Sankaran V. Subramanian PhD","doi":"10.1016/j.amepre.2025.107643","DOIUrl":"10.1016/j.amepre.2025.107643","url":null,"abstract":"<div><h3>Introduction</h3><div>Although more U.S. states continue to legalize the sale of cannabis for recreational adult-use, little is known about the spatial distribution of cannabis retailers in relation to neighborhood characteristics. The objective of this study is to examine the presence or absence of cannabis retailers in census tracts in relation to measures of neighborhood advantage and disadvantage.</div></div><div><h3>Methods</h3><div>Using 2023 U.S. state agency lists, we identified 5,586 recreational cannabis retailers and geocoded address data in 18 states with recreational cannabis legalization laws. Multilevel logistic and negative binomial regression were used to model the association between quintiles of the neighborhood deprivation index and index of concentration at the extremes with census tract cannabis retailer presence.</div></div><div><h3>Results</h3><div>Across the study states, 11% of census tracts had at least 1 recreational cannabis retailer. Census tracts with higher levels of socioeconomic deprivation, or racialized and economic disadvantage, had a significantly higher odds and rate of having cannabis retailers. In the adjusted analysis, tracts with the greatest concentration of low-income Black or Hispanic residents had 2.0–2.5 times the odds of cannabis retailer presence compared to more advantaged tracts.</div></div><div><h3>Conclusions</h3><div>In states with legalized nonmedical cannabis, there is a pattern of greater cannabis retailer presence in areas with the greatest neighborhood disadvantage. Public health agencies and policymakers should support the implementation of policies that reduce cannabis retailer clustering and enhance targeted prevention efforts in historically disadvantaged areas.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 2","pages":"Article 107643"},"PeriodicalIF":4.3,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023923","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}