American Journal of Preventive Medicine最新文献

{"title":"Paternal Depression at Kindergarten Entry and Teacher-Reported Behavior at Age 9 Years.","authors":"Kristine Schmitz, Kelly Noonan, Hope Corman, Jenny M Nguyen, Manuel E Jimenez, Nancy E Reichman","doi":"10.1016/j.amepre.2025.01.017","DOIUrl":"10.1016/j.amepre.2025.01.017","url":null,"abstract":"<p><strong>Introduction: </strong>This study investigated associations between paternal depression when children were age 5 years and teacher-reported behavioral problems at age 9 years.</p><p><strong>Methods: </strong>1,422 children in a U.S. cohort study of mostly nonmarital births were studied. Data collection, which is ongoing, began in 1998-2000. Behavioral outcomes were measured in 2009-2010, when the children transitioned to middle school. Analysis was conducted in 2023-2024. Negative binomial regression models of associations between paternal depression and children's behavior and social skill scores and logistic regression models of associations between paternal depression and high (≥1 sSD above mean) or low (≥1 SD below mean) scores were estimated.</p><p><strong>Results: </strong>Adjusting for child/paternal/family characteristics and maternal depression, paternal depression was associated with a 36% higher oppositional score (IRR=1.36; 95% CI=1.02, 1.82), 37% higher hyperactive score (IRR=1.37; 95% CI=1.11, 1.69) and 25% higher ADHD score (IRR=1.25; 95% CI=1.08, 1.46) but not associated with cognitive problem/inattention score. A similar pattern was apparent for high behavior problem scores, with AORs from 1.78 to 1.85. Paternal depression was associated with an 11% lower positive social skills score and a 25% higher problematic behavior score with similar associations across subscales. Similar patterns were apparent for some high problematic and low positive social skills.</p><p><strong>Conclusions: </strong>Paternal depression when children transitioned to kindergarten was associated with poorer teacher ratings of behaviors and social skills at age 9 years. These findings suggest a need for interventions that identify and support fathers with depressive symptoms and their children.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082009","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":"Children's Cereal Purchases by U.S. Households: Associations With Child Versus Adult TV Ad Exposure","authors":"Jennifer L. Harris PhD, MBA ,&nbsp;Binod Khanal PhD ,&nbsp;Frances Fleming-Milici PhD ,&nbsp;Tatiana Andreyeva PhD","doi":"10.1016/j.amepre.2024.11.022","DOIUrl":"10.1016/j.amepre.2024.11.022","url":null,"abstract":"<div><h3>Introduction</h3><div>Research is needed to demonstrate the impact of child-directed advertising on household purchases of nutrient-poor children's foods to support mandatory government regulations. This study examines the relationship between total TV advertising to children versus adults and U.S. household purchases of high-sugar children's cereals. Posthoc analyses examine potential differential marginal effects of advertising on households experiencing health disparities.</div></div><div><h3>Methods</h3><div>Longitudinal NielsenIQ U.S. Consumer Panel Data (2009–2017) provided monthly volume (oz) of ready-to-eat cereal purchases by households with children (&lt;12 years) (<em>N</em>=76,926). Nielsen gross ratings point data measured monthly TV advertising to children (6–11 years) and adults (18–49 years) (2008–2017). A 2-part Cragg hurdle model assessed associations between child versus adult advertising for children's cereal brands (<em>n</em>=9) and subsequent household cereal purchases, including differences by household sociodemographic characteristics. Data were collected in 2021 and analyzed in 2023.</div></div><div><h3>Results</h3><div>Advertising to children, but not adults, was positively related to household purchases of children's cereals (<em>p</em>&lt;0.01) across all sample households. Lower price (<em>p</em>&lt;0.05) and greater household size (<em>p</em>&lt;0.01) also predicted higher purchases. Marginal effects of advertising to children were higher for Black versus non-Black households (<em>p</em>&lt;0.01), and positively related to purchases by middle/high-income (<em>p</em>&lt;0.01) but not low-income households. Advertising to adults only predicted greater children's cereal purchases by low-income households (<em>p</em>&lt;0.01).</div></div><div><h3>Conclusions</h3><div>Advertising children's cereals directly to children may increase household purchases and children's consumption of these high-sugar products. Child-directed advertising may also disproportionately influence purchases by Black households. This study supports further restrictions on advertising of nutrient-poor foods directly to children.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"68 3","pages":"Pages 598-606"},"PeriodicalIF":4.3,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076187","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":"Physical Activity and Falls From Midlife: Patterns and Bidirectional Associations.","authors":"Wing S Kwok, Saman Khalatbari-Soltani, Xenia Dolja-Gore, Julie Byles, Juliana S Oliveira, Catherine Sherrington","doi":"10.1016/j.amepre.2025.01.020","DOIUrl":"10.1016/j.amepre.2025.01.020","url":null,"abstract":"<p><strong>Introduction: </strong>The relationship between physical activity behavior and subsequent falls in adults from midlife to older age is unclear. Falls and fall-related injuries could lessen physical activity participation. This study examined patterns and bidirectional associations between physical activity and falls from midlife to older age.</p><p><strong>Methods: </strong>In the Australian Longitudinal Study on Women's Health, women born 1946-1951 (n=11,759, mean age: 56 years at baseline in 2004) self-reported weekly physical activity amounts (0, 1-<150, 150-<300, ≥300 minutes/week) and noninjurious and injurious falls every 3 years between 2004 survey and 2019 survey. Bidirectional prospective 3-year associations between physical activity and falls were examined using generalized estimating equations to estimate ORs and 95% CIs, adjusting for directed acyclic graph-informed covariates. Analyses were conducted in 2023.</p><p><strong>Results: </strong>Participation in any amount of physical activity was associated with a reduced risk of injurious falls (OR_{1-<150 min}₌0.87; 95% CI=0.80, 0.96; OR_{150-<300 min}₌0.87; 95% CI= 0.79, 0.96; OR_{≥300 min}₌0.85; 95% CI=0.78, 0.93) in the next 3 years, compared with women with no physical activity. Women who reported noninjurious falls had lower odds of undertaking ≥300 minutes/week of physical activity 3 years later (OR=0.84; 95% CI=0.77, 0.92), compared with women without falls. Women who reported injurious falls had lower odds of subsequently undertaking various amounts of physical activity (OR=0.83, 95% CI=0.75, 0.91 for 1-<150; OR=0.82, 95% CI=0.74, 0.90 for 150-<300; OR=0.83, 95% CI=0.76, 0.90 for ≥300 minutes/week).</p><p><strong>Conclusions: </strong>The prospective bidirectional association between physical activity and falls supports addressing falls by promoting activity and highlighting the impact of injurious falls on reduced physical activity participation.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076288","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":"Use of Medications for Opioid Use Disorder in Older Adults.","authors":"Yong-Fang Kuo, Jordan Westra, Edythe P Harvey, Mukaila A Raji","doi":"10.1016/j.amepre.2025.01.019","DOIUrl":"10.1016/j.amepre.2025.01.019","url":null,"abstract":"<p><strong>Introduction: </strong>The American population diagnosed with opioid use disorder is growing, particularly those aged ≥65 years. Less than 30% of opioid use disorder patients receive medication for opioid use disorder, and even fewer older adults.</p><p><strong>Methods: </strong>Using 20% national Medicare data, beneficiaries aged over 65 years diagnosed with opioid use disorder in 2017-2022 were selected to assess the trend and types of medication for opioid use disorder use, including methadone, buprenorphine, or naltrexone. In the 2022 cohort (n=69,380), a multivariable logistic regression model was constructed to examine the factors associated with use of medication for opioid use disorder. Analyses were performed in 2024.</p><p><strong>Results: </strong>Use of medications for opioid use disorder among older adults increased from 4.8% in 2017 to 7.5% in 2019 and 15.0% in 2022. The larger increase coincided with implementation of a new Medicare payment policy covering methadone for opioid use disorder. About 79% of opioid use disorder patients had chronic pain and arthritis; 50% had anemia, depression, or anxiety. Males, Black patients, Hispanic patients, older patients, and rural residents had lower odds of receiving medication for opioid use disorder. Enrollees with dual coverage from Medicaid had higher odds of receiving medication for opioid use disorder. Patients with alcohol or tobacco use disorders, anxiety, depression, hypothyroidism, or liver disease were more likely to receive medication for opioid use disorder; conversely, those with non-Alzheimer's dementia, cancer, chronic kidney disease, stroke, chronic pain, or arthritis were less likely to receive medication for opioid use disorder.</p><p><strong>Conclusions: </strong>The rate of medication for opioid use disorder use was low in older adults. The disparity in medication for opioid use disorder use underscores the need for improved access to comprehensive opioid treatment programs and increased medication for opioid use disorder coverage. Additional studies of treatment patterns are also warranted.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076293","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":"Lethal Means Among Veterans With Recent Experience of Housing Instability by Age","authors":"Ann Elizabeth Montgomery PhD ,&nbsp;Aerin J. DeRussy MPH ,&nbsp;Gala True PhD ,&nbsp;John R. Blosnich PhD","doi":"10.1016/j.amepre.2025.01.013","DOIUrl":"10.1016/j.amepre.2025.01.013","url":null,"abstract":"","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"68 4","pages":"Pages 821-823"},"PeriodicalIF":4.3,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069318","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 One Year Before Sudden Cardiac Death in Taiwan.","authors":"Ching-Yu Chen, Edward Pei-Chuan Huang, Cheng-Yi Fan, Chun-Hsiang Huang, Sih-Shiang Huang, Chi-Hsin Chen, Chien-Tai Huang, Yun-Chang Chen, Wen-Chu Chiang, Chien-Hua Huang, Chih-Wei Sung","doi":"10.1016/j.amepre.2025.01.014","DOIUrl":"10.1016/j.amepre.2025.01.014","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to investigate the patterns of healthcare system utilization before sudden cardiac death in Taiwan and compare the patterns between patients treated at medical centers and noncenter hospitals.</p><p><strong>Methods: </strong>This descriptive multicenter retrospective cohort study recruited adult, nontraumatic sudden cardiac death patients who were admitted to the National Taiwan University Hospital and its affiliated hospitals between January 2017 and December 2022. Healthcare utilization patterns, such as outpatient visits, emergency department visits, short-term emergency department returns, and hospitalizations, were analyzed during the weeks prior to SCD. The statistical analysis compared the above patterns between medical center and noncenter cohorts to identify potential differences in patient behavior and healthcare use.</p><p><strong>Results: </strong>Analysis of 3,649 eligible patients revealed a significant increase in healthcare utilization before sudden cardiac death. Outpatient visits began to rise sharply 5 weeks prior to sudden cardiac death, peaking at 16.5% in the overall cohort. The number of emergency department visits showed a notable increase starting 10 weeks prior, with a peak in the week immediately before the sudden cardiac death, reaching 3.7%. Hospitalization rates exhibited a distinct pattern, peaking at 2.5% 3 weeks before sudden cardiac death and then declining. The consistency between hospitalization diagnoses and the cause of sudden cardiac death was approximately 40% within 3 weeks prior to sudden cardiac death. The increases were consistent across both the medical center and noncenter cohorts, although noncenter patients generally exhibited higher utilization rates.</p><p><strong>Conclusions: </strong>Healthcare utilization significantly increased before sudden cardiac death, including outpatient visits, emergency department visits, and hospitalization. This pattern was consistent among patients treated at medical centers and nonmedical centers.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069317","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":"Beneficial and Harmful Tobacco-Use Transitions Associated With ENDS in the U.S.","authors":"Bekir Kaplan, Tuo-Yen Tseng, Jeffrey J Hardesty, Lauren Czaplicki, Joanna E Cohen","doi":"10.1016/j.amepre.2025.01.016","DOIUrl":"10.1016/j.amepre.2025.01.016","url":null,"abstract":"<p><strong>Introduction: </strong>ENDS can benefit those who use combustible tobacco if they transition completely to ENDS. ENDS can also result in nicotine addiction among nicotine-naïve people.</p><p><strong>Methods: </strong>ENDS-related tobacco-use transitions were assessed among U.S. youth and adults using weighted Population Assessment of Tobacco and Health Study Waves 4 (2016-2017) and 5 (2018-2019) adult and youth data. A beneficial transition was defined as those who used combustible tobacco and transitioned exclusively to ENDS use or quit with the help of ENDS. A harmful transition was defined as (1) nonusers of any tobacco product who initiated ENDS (with or without combustible tobacco co-use) or (2) those who exclusively used ENDS and then added or transitioned to combustible tobacco use. Sensitivity analyses were conducted to examine modified definitions of beneficial and harmful transitions based on different assumptions. The analyses were conducted between August 2024 and November 2024.</p><p><strong>Results: </strong>Total sample size (N=31,733) represented ∼256 million people. For those using a combustible tobacco product in Wave 4, 2.1 million (∼4.6%) transitioned to exclusive ENDS use or to ENDS-assisted cessation of a combustible tobacco product (benefit). In addition, 4.6 million (∼%2.2) transitioned from nonuse to ENDS or, among people who use ENDS exclusively in Wave 4, added combustible or transitioned to combustible tobacco use in Wave 5 (harm).</p><p><strong>Conclusions: </strong>For every 1 beneficial transition, ENDS use was associated with 2.15 harmful transitions; this ratio ranged from 0.75 to 2.77 in sensitivity analyses. With effective restrictions on ENDS access and marketing for tobacco-naïve people, the population benefits of ENDS could outweigh population harms.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069315","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":"National Survey of Lung Cancer Screening Eligibility in United States Veterans.","authors":"Jennifer A Lewis, Allison Stranick, Jacquelyn Pennings, Lauren R Samuels, Susan Byerly, John Helton, Daniel Park, Robert Winter, Michael E Matheny, Claudia I Henschke, David F Yankelevitz, Fred Hendler, Sally J York, Carol Callaway-Lane, Hilary A Tindle, Robert S Dittus, Drew Moghanaki, Lucy B Spalluto, Christianne L Roumie","doi":"10.1016/j.amepre.2025.01.015","DOIUrl":"10.1016/j.amepre.2025.01.015","url":null,"abstract":"<p><strong>Introduction: </strong>Lung cancer screening is underutilized, especially in rural areas where lung cancer mortality is high. Approximately 11.2% of the U.S. population over age 50 years meet the U.S. Preventive Services Task Force (USPSTF) 2021 lung cancer screening eligibility criteria; the proportion of eligible Veterans is unknown. This study evaluated the proportion of Veterans who are USPSTF-eligible and tested the hypothesis that more USPSTF 2021-eligible Veterans reside in rural versus nonrural areas.</p><p><strong>Methods: </strong>Investigators cross-sectionally surveyed a national sample of Veterans aged 50 years and older January-November 2022. Oversampling ensured inclusion of minority groups and accounted for geographic variation in tobacco use. Analyses in 2023-2024 evaluated the proportion of USPSTF-eligible Veterans by year (2013 and 2021) and tested USPSTF-2021 eligibility by rural status (rural versus nonrural) using chi square tests. Weighting accounted for survey nonresponse and applied results to the whole Veteran population in a sensitivity analysis.</p><p><strong>Results: </strong>Of 2,000 surveyed, 754 responded (37.7% response rate); most respondents were White (74.4%), male (92.6%), and resided in nonrural areas (66.0%). Proportions meeting USPSTF criteria were 35.5% (95% CI=31.6%, 39.6%) in 2021 and 27.8% (95% CI=24.3%, 31.7%) in 2013. The proportion of USPSTF 2021-eligible rural Veterans (41.2%; 95% CI=34.8%, 48.0%) was higher compared with nonrural (32.5%; 95% CI=27.7%, 37.7%), p=0.037. A sensitivity analysis found the proportion of Veterans USPSTF 2021 eligible in the whole population was 33.0%.</p><p><strong>Conclusions: </strong>The proportion of Veterans USPSTF2021 eligible was nearly 3 times higher than the general U.S. population (11.2%), and a greater proportion of eligible Veterans resided in rural compared with nonrural areas. These findings are critical for policies aimed at fully implementing lung cancer screening at scale.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069320","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 Disparities of Type 2 Diabetes Through Exercise: The Multi-Ethnic Study of Atherosclerosis","authors":"Tong Xia PhD, MPH ,&nbsp;Roch A. Nianogo MD, PhD ,&nbsp;QingZhao Yu PhD ,&nbsp;Tamara Horwich MD, MS ,&nbsp;Preethi Srikanthan MD, MS ,&nbsp;Kosuke Inoue MD, PhD ,&nbsp;Matthew Allison MD, MPH ,&nbsp;Zuo-Feng Zhang MD, PhD ,&nbsp;Karol E. Watson MD, PhD ,&nbsp;Liwei Chen MD, PhD","doi":"10.1016/j.amepre.2025.01.009","DOIUrl":"10.1016/j.amepre.2025.01.009","url":null,"abstract":"<div><h3>Introduction</h3><div>Persistent racial and ethnic disparities exist for Type 2 diabetes in the U.S. Racial and ethnic minorities have a higher risk of Type 2 diabetes, and studies suggest that they engage in less exercise than White population. This study examined whether and to what degree racial differences in Type 2 diabetes were explained by exercise.</div></div><div><h3>Methods</h3><div>Adults aged 45–84 years without Type 2 diabetes at baseline (2000–2002) were included from the Multi-Ethnic Study of Atherosclerosis cohort and followed through 2020. Associations between race and Type 2 diabetes were examined using multivariable Cox proportional hazard regression. The effects of exercise were assessed using natural mediation effects. Analyses were conducted in 2023.</div></div><div><h3>Results</h3><div>Controlling for confounders, Hispanic (adjusted hazard ratio [95% CI]=2.02 [1.74, 2.34]), Chinese (1.50 [1.24, 1.82]), and Black (1.66 [1.44, 1.93]) participants had higher Type 2 diabetes risks than White participants. Hispanic (β [SE]= −0.29 [0.04] square root of MET-hour/day, <em>p</em>&lt;0.001) and Chinese (−0.25 [0.04], <em>p</em>&lt;0.001) participants had lower habitual intentional exercise than White participants; this was not true for Black participants (−0.01 [0.03], <em>p</em>=0.85). Habitual intentional exercise explained Type 2 diabetes excess risk by 13.6% for Hispanic and 13.2% for Chinese participants but not for Black participants, compared with that for White participants.</div></div><div><h3>Conclusions</h3><div>Habitual intentional exercise accounted for one tenth of the racial differences in Type 2 diabetes when comparing Hispanic or Chinese populations with White populations. Interventions promoting exercise are crucial to decrease Type 2 diabetes risk for all racial groups but may also narrow disparities in Type 2 diabetes among Hispanic and Chinese populations.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"68 4","pages":"Pages 794-803"},"PeriodicalIF":4.3,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015503","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":"Association of Residential Segregation with Mortality in the U.S., 2018-2022.","authors":"Lu Zhang, Nuo Nova Yang, Tianjiao Shen, Xiaoqian Sun, K Robin Yabroff, Xuesong Han","doi":"10.1016/j.amepre.2025.01.010","DOIUrl":"10.1016/j.amepre.2025.01.010","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to examine the association of county-level racial and economic residential segregation with mortality rates in the U.S. between 2018 and 2022.</p><p><strong>Methods: </strong>Residential segregation was measured by the Index of Concentration at the Extremes and categorized into quintiles. Outcomes included 2018-2022 county-level age-adjusted mortality rates from all causes and the top 10 causes. Multilevel linear mixed modeling was clustered at the state level and adjusted for county's poverty, metropolitan status, and racial composition.</p><p><strong>Results: </strong>A total of 3,129 counties were included. County-level age-adjusted mortality rates decreased as the segregation level decreased for all causes (from 1,078.8 deaths in the most segregated counties to 734.92 deaths in the least segregated counties per 100,000 persons per year) and for 10 leading causes. Adjusted rate ratios showed dose-response associations between segregation and mortality from all causes and 9 out of 10 leading causes. Using the least segregated counties as the reference group, the adjusted rate ratios (aRR) for all-cause mortality was 1.25 (95% CI=1.22, 1.28), 1.20 (1.17, 1.22), 1.13 (1.11, 1.15), and 1.09 (1.08, 1.10) for the first (most segregated) through the fourth quintile of segregation, respectively.</p><p><strong>Conclusions: </strong>Racial and economic residential segregation was positively associated with mortality rates at the county level in the contemporary U.S. Future studies should elucidate the mechanisms underlying associations to inform evidence-based interventions and improve the health of the entire population.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015282","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}