JAMA Health Forum最新文献

{"title":"Support for Human and Civil Rights in Physical Disability, Mental Illness, and Substance Use Disorder.","authors":"Jessica Williams, Mia Kouveliotes, Nev Jones, Morgan C Shields","doi":"10.1001/jamahealthforum.2026.3431","DOIUrl":"https://doi.org/10.1001/jamahealthforum.2026.3431","url":null,"abstract":"<p><strong>Importance: </strong>While there is much research on stigma toward marginalized populations, public perceptions regarding deservingness of basic human and civil rights of these groups have not been examined in a nationwide sample of US adults.</p><p><strong>Objective: </strong>To understand the US public's perceptions regarding deservingness of basic human and contested civil rights for people with severe physical disabilities (SPDs), severe mental illness (SMI), and substance use disorders (SUDs).</p><p><strong>Design, setting, and participants: </strong>This cross-sectional study was a nationwide US internet-based quota panel survey of US adults (aged ≥18 years) who completed the survey. Responses were collected from January 17 to February 12, 2025.</p><p><strong>Main outcomes and measures: </strong>Participants rated their support for 5 human rights (adequate standard of living, high standards of health, legal capacity, freedom from torture, living independently) and 3 civil rights (being a parent, running for political office, owning a gun) for people with SPDs, SMI, and SUDs using a 5-point Likert scale, with marginalized subgroups presented to participants in randomized order. McNemar test for paired binary data was used to examine differences in mean support across subgroups, and linear probability regression models were used to identify demographic variables associated with support.</p><p><strong>Results: </strong>In this survey of 1442 US adult participants (849 female [58.9%]; 588 male [40.8%]; 3 nonbinary [0.2%]; and 2 preferred not to say [0.1%]), the SPD subgroup received significantly higher support across all 5 human rights and 3 civil rights compared with SMI and SUD subgroups. For example, 79.0% (95% CI, 76.9%-81.2%) of participants supported the right to live independently for people with SPDs, while 67.0% supported this right for those with SMI (95% CI, 64.6%-69.5%) and 68.4% supported this right for those with SUDs (95% CI, 66.0%-70.9%). Civil rights received lower support across all 3 subgroups; for example, 40.1% (95% CI, 37.5%-42.6%) supported the right to run for political office for those with SMI and 41.4% (95% CI, 38.8%-44.0%) for those with SUDs compared with 62.7% (95% CI, 60.1%-65.2%) for those with SPDs. Democratic affiliation and lived experience with behavioral health care were associated with higher support for human rights (eg, among those with SUDs, up to 17.1 and 14.2 percentage points higher support, respectively). Male sex and younger age (18-24 years) were associated with greater support for civil rights (eg, male sex with 17.9 percentage points higher support for gun ownership among those with SPDs and age 18-24 years with a 27.1 percentage-point difference among those with SMI).</p><p><strong>Conclusions and relevance: </strong>These findings contribute important evidence to the existing literature on stigma, highlighting discrepancies in public support for basic human and contested civil right","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"7 10","pages":"e263431"},"PeriodicalIF":12.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacy Benefit Manager Involvement in the US Opioid Crisis.","authors":"Amy Y Hwang, Vietvi Trinh, Tracy Zhen, Pamela M Ling, Dorie E Apollonio","doi":"10.1001/jamahealthforum.2026.3611","DOIUrl":"10.1001/jamahealthforum.2026.3611","url":null,"abstract":"<p><strong>Importance: </strong>The opioid crisis in the US has been attributed in part to the pharmaceutical industry's inappropriate marketing of opioid medications. How pharmaceutical companies work with pharmacy benefit managers (PBMs) to increase opioid dispensing has not been studied.</p><p><strong>Objective: </strong>To examine the potential role of PBMs and pharmaceutical companies in the opioid crisis.</p><p><strong>Design and setting: </strong>A qualitative study using retrospective data was conducted of opioid industry documents released in litigation that have been collected and preserved digitally at the University of California, San Francisco, and Johns Hopkins University Opioid Industry Documents Archive. Data collection was conducted from January to April 2026, with iterative keyword searches. Documents were identified in searches chronologically, then results were categorized by theme.</p><p><strong>Main outcomes and measures: </strong>Research of pharmaceutical industry documents to assess professional and financial relationships between PBMs and opioid manufacturers.</p><p><strong>Results: </strong>This study of 23 pharmaceutical industry documents dated from 1997 to 2018 identified 3 major themes in the coordinated activities of opioid manufacturers and PBMs: (1) both manufacturers and PBMs encouraged health care professionals to increase opioid prescribing, (2) PBMs expanded the allowed doses and durations of opioid prescriptions, and (3) opioid manufacturers paid PBMs when dispensing of branded opioids increased.</p><p><strong>Conclusions and relevance: </strong>These findings suggest that PBMs and opioid manufacturers had undisclosed financial relationships that may have exacerbated the opioid crisis. Regulatory restrictions on these relationships, including the elimination of rebates, could increase transparency and reduce the risks of public health harm due to misuse of addictive medications.</p>","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"7 10","pages":"e263611"},"PeriodicalIF":12.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regulating Artificial Intelligence Design to Prevent Youth Mental Health Harms.","authors":"Ryan K McBain, Jonathan H Cantor, Li Ang Zhang, Benjamin A Barsky","doi":"10.1001/jamahealthforum.2026.3119","DOIUrl":"https://doi.org/10.1001/jamahealthforum.2026.3119","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"7 10","pages":"e263119"},"PeriodicalIF":12.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Challenges of Linking SNAP State Cost Sharing to Payment Error Rates.","authors":"Sara N Bleich, Rita Hamad, Gina Plata-Nino","doi":"10.1001/jamahealthforum.2026.4880","DOIUrl":"https://doi.org/10.1001/jamahealthforum.2026.4880","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"7 10","pages":"e264880"},"PeriodicalIF":12.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protecting LGBTQ+ Populations From Conversion Practices: Chiles v Salazar and Future Directions.","authors":"Gilbert Gonzales, Keyla Imbert Suarez, Tara McKay","doi":"10.1001/jamahealthforum.2026.3002","DOIUrl":"https://doi.org/10.1001/jamahealthforum.2026.3002","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"7 10","pages":"e263002"},"PeriodicalIF":12.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental Health Ghost Networks in Commercial Insurance Plans.","authors":"Simon Haeder, Yuqin Lou, Wendy Xu, Benjamin F Miller","doi":"10.1001/jamahealthforum.2026.3746","DOIUrl":"10.1001/jamahealthforum.2026.3746","url":null,"abstract":"<p><strong>Importance: </strong>Whether network directories in commercial insurance plans, which cover the majority of insured US residents, reliably connect patients to mental health care has only seen limited testing.</p><p><strong>Objective: </strong>To assess network directory accuracy, appointment availability, wait times, and travel burden for mental health clinicians listed in commercial insurance online plan directories.</p><p><strong>Design, setting, and participants: </strong>A cross-sectional study with a secret shopper design of 5822 calls to psychiatrists and psychologists listed in the online network directories of the largest commercial carrier in 5 diverse states (Delaware, Montana, New Jersey, Rhode Island, and Virginia), conducted between October 2025 and March 2026. Callers contacted the geographically closest listed clinician on behalf of a simulated patient assigned a standard preferred provider organization plan and a nonemergency mental health condition. Calls in which the caller could not obtain a definitive outcome were classified as nonevaluable.</p><p><strong>Main outcomes and measures: </strong>Appointment availability with the listed clinician and with alternate clinicians, network directory inaccuracy by error type (contact information, specialty, network status), capacity limitations, wait time to appointment, and travel time to appointment. Reported percentages and means are adjusted (predicted) values with 95% CIs.</p><p><strong>Results: </strong>Of 5822 calls, 3570 (61.3%) were nonevaluable, most commonly because callers reached only an answering machine or automated system. Among the 2252 evaluable calls, 23.6% (95% CI, 21.9%-25.4%) resulted in a scheduled appointment with the listed clinician, increasing to 32.1% (95% CI, 30.2%-34.1%) when alternate clinicians were included. Network directory inaccuracies affected 55.6% (95% CI, 53.6%-57.7%) of evaluable calls, with contact information errors (31.0%; 95% CI, 29.1%-32.9%) and specialty errors (22.2%; 95% CI, 20.6%-23.9%) being most prevalent. Capacity limitations prevented scheduling in 21.6% (95% CI, 19.9%-23.3%) of evaluable calls. Mean wait time was 20.5 days (95% CI, 18.0-23.0 days), with longer waits for psychiatry than psychology (22.5 vs 17.3 days). Mean travel time was 17.1 minutes (95% CI, 14.6-19.6 minutes) overall but 41.8 minutes (95% CI, 27.5-56.0 minutes) in Montana and 30.8 minutes (95% CI, 19.8-41.7 minutes) for rural residents. Across all initial call attempts, only 12.4% resulted in an appointment.</p><p><strong>Conclusions and relevance: </strong>In this study, access barriers previously documented in public insurance programs extend to the privately insured population, undermining the assumption that commercial coverage automatically translates into meaningful access to mental health care.</p>","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"7 10","pages":"e263746"},"PeriodicalIF":12.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Open Questions About the Next Phase of Telehealth Adoption.","authors":"Sandro Galea, Catherine K Ettman","doi":"10.1001/jamahealthforum.2026.2759","DOIUrl":"https://doi.org/10.1001/jamahealthforum.2026.2759","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"7 10","pages":"e262759"},"PeriodicalIF":12.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medicare for All Gets a Budget Check.","authors":"David M Cutler","doi":"10.1001/jamahealthforum.2026.4569","DOIUrl":"https://doi.org/10.1001/jamahealthforum.2026.4569","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"7 10","pages":"e264569"},"PeriodicalIF":12.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Essential Retail Pharmacies Under the Consolidated Appropriations Act of 2026.","authors":"Emily Gravlee, Qingrong Jessica Li, Jeffrey W Rozelle, Shyam Krishnan Ondanat Veetil, Dima M Qato","doi":"10.1001/jamahealthforum.2026.3527","DOIUrl":"10.1001/jamahealthforum.2026.3527","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"7 10","pages":"e263527"},"PeriodicalIF":12.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cuts to Medicaid Adult Dental Benefits and Savings for US States.","authors":"Hawazin W Elani, Ellen Meara","doi":"10.1001/jamahealthforum.2026.3848","DOIUrl":"10.1001/jamahealthforum.2026.3848","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"7 10","pages":"e263848"},"PeriodicalIF":12.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}