Current Epidemiology Reports, Год журнала: 2024, Номер 12(1)
Опубликована: Дек. 27, 2024
Язык: Английский
JAMA Health Forum, Год журнала: 2025, Номер 6(1), С. e244699 - e244699
Опубликована: Янв. 3, 2025
Importance 2021 Advance child tax credit (ACTC) monthly payments were associated with reduced US poverty rates; however, policymakers have expressed concerns that permanent adoption would increase parental substance use. Objective To assess whether ACTC temporally changes in use among parents compared adults without children. Design, Setting, and Participants The primary sample included aged 18 to 64 years who responded the National Survey on Drug Use Health 2021. Difference-in-differences models used test changed for children after went into effect. Additional data from 2018 2020 pretrends Analyses survey weighted conducted September 2023 November 2024. treatment group was defined as dependent home been eligible July December Adults children, not credit, comprised comparison group. Main Outcomes Measures binary measures of any self-reported tobacco, alcohol, cannabis, illicit substances (eg, cocaine, opioids, or other stimulants sedatives) during previous 30 days; counts number days people these substances; cigarettes alcoholic beverages consumed substances. Results Of 41 853 adults, 17 308 24 545 payment implementation a −4.3–percentage point (95% CI, −6.6 −2.0) decline probability using tobacco Among smoked, −46.8–percentage −93.1 −0.5) smoked days. Estimated probability, frequency, quantity (alcohol, substances) null significant. Conclusions study results suggest increased
Язык: Английский
Процитировано
1
Emergency Medicine Journal, Год журнала: 2025, Номер 42(2), С. 141 - 142
Опубликована: Янв. 21, 2025
Язык: Английский
Процитировано
0
Social Science & Medicine, Год журнала: 2025, Номер 370, С. 117813 - 117813
Опубликована: Фев. 6, 2025
Язык: Английский
Процитировано
0
JAMA, Год журнала: 2025, Номер unknown
Опубликована: Фев. 27, 2025
Importance Health-related social needs are drivers of worse health and high care spending. In North Carolina Medicaid’s 1115 waiver, the Healthy Opportunities Pilots (HOP) program allows for nonmedical services to address health-related needs, such as healthy food boxes housing navigation, financed by Medicaid, in 3 regions Carolina. Objective To determine whether individual participation HOP is associated with lower Medicaid Design, Setting, Participants Comparative interrupted time series evaluation using data from March 2021 through November 2023. The 13 227 enrollees were compared 73 469 beneficiaries reporting a need (a eligibility criterion), but who ineligible due county residence. Exposure Participation HOP. Main Outcomes Measures primary outcome was sum spending on medical per beneficiary month. Secondary outcomes included use (emergency department visits, inpatient admissions, outpatient visits). Results Among comparison group members, mean age 23.4 (SD, 18.8) years, 63.9% female, 42.4% Black, 57.4% White (participants could report >1 race). Mean monthly preindex $828 $5105). Of enrollees, 89% received at least 1 service, 85% services. comparative analysis estimated that increased month enrollment (change level, $687; 95% CI, $420-$954). However, trend participants differentially trend, −$85 month; −$122 −$48; P < .001) relative counterfactual scenario without Taken together, these findings indicated equivalent expenditures 8 after starting thereafter. Emergency visit (−6 1000 person-months; −8 −4). There no statistically significant differential hospitalizations (−1 −2 0) or visits (1 −7 9). Conclusions Relevance this study suggest enrollment, followed subsequently trend.
Язык: Английский
Процитировано
0
Cancer Medicine, Год журнала: 2025, Номер 14(5)
Опубликована: Март 1, 2025
Black patients with non-small cell lung cancer (NSCLC) are more often diagnosed at a later stage and receive inadequate evaluation treatment compared to White patients. We aimed identify factors representing exposure structural racism that mediate the association between race NSCLC care. queried Surveillance, Epidemiology, End Results-Medicare for non-Hispanic ≥ 67 years from 2013 2019. Our outcomes were localized diagnosis stage, receipt of stage-appropriate evaluation, treatment, two-year survival, "optimal" care, an aggregate metric comprising first three listed outcomes. estimated indirect effects mediators on Of 69,130 patients, 8.2% Black. Medicare-Medicaid dual eligibility, marker individual-level socioeconomic status (SES), accounted largest proportion mediating most outcomes, ranging 13.6% (p < 0.001) 25.0% survival. Receipt influenza vaccine, health care access, had second associations (9.5%, p 0.001), (15.3%, optimal (11.4%, 0.001). Neighborhood-level SES third each outcome, explaining 9% 16% racial inequities phase (all Individual- neighborhood-level partly explain in their vary based Interventions should be adapted
Язык: Английский
Процитировано
0
Health Affairs Scholar, Год журнала: 2025, Номер 3(3)
Опубликована: Март 1, 2025
Abstract People need to consume goods and services that support health, such as nutritious food, medical care, quality housing, throughout their lives. Many of these are allocated using markets, which means people income provide purchasing power for services. However, everyone has times when supporting themselves through paid labor is not possible, so many individuals will receive the needed a healthy life if distribution tied solely economic production. Therefore, key political economy health goal put in place income-support policy gets those unable engage labor. The 3 main forms policy—social assistance, social insurance, guaranteed income—offer different strengths limitations. I argue because its focus on getting situations they cannot or should labor, fundamental part supports everyone's health.
Язык: Английский
Процитировано
0
Health Affairs, Год журнала: 2025, Номер 44(4), С. 384 - 390
Опубликована: Апрель 1, 2025
Income distribution, food and nutrition insecurity, poor diet quality contribute to diet-related disease, which is a major threat population health equity. Based on our review synthesis of the empirical evidence, we provide new conceptual model for understanding interrelationships among income, security, quality, health. We identify directions future research discuss policy program implications model. Overall, interventions that address income security can facilitate, but do not ensure, better although they improve in other ways. Importantly, even people who are secure have adequate frequently unhealthy diets. Addressing these challenges will require innovative policies Such should include efforts increase availability accessibility Food Is Medicine care. Health insurance coverage evidence-based, clinically indicated programs critical success efforts.
Язык: Английский
Процитировано
0
Health Affairs Scholar, Год журнала: 2024, Номер 2(12)
Опубликована: Ноя. 27, 2024
Our descriptive study examined current associations (2022-2024) between US state-level health outcomes and 4 political metrics: 2 rarely used in public research (political ideology of elected representatives based on voting records; trifectas, where 1 party controls the executive legislative branches) more commonly (state policies enacted; voter lean). The 8 spanned life course: infant mortality, premature mortality (death at age <65), insurance (adults aged 35-64), vaccination for children persons ≥65 (flu; COVID-19 booster), maternity care deserts, food insecurity. For first 3 outcomes, we also trends (2012-2024). all metrics, higher conservatism was associated with worse especially metrics state trifectas. example, 2016, rate states Republican vs Democratic trifectas by 55.4 deaths per 100 000 person-years (95% CI: 7.7, 103.1), slope increase to 2021 higher, 27.0 24.4, 29.7). These results suggest elections, ideology, concentrations power matter population health.
Язык: Английский
Процитировано
3
JAMA Network Open, Год журнала: 2024, Номер 7(10), С. e2440810 - e2440810
Опубликована: Окт. 23, 2024
Importance Mental health disorders are increasing for children and adolescents in the US, with those poverty having especially high rates. More evidence is needed about association between economic policies, such as minimum wage, children’s mental health. Objective To test wages of adolescents. Design, Setting, Participants This repeated cross-sectional, population-based US study used data from 2001 to 2022. included state-representative, stratified random samples National Survey Children’s Health Youth Risk Behavior Surveillance System. Data analysis was performed January 2023 August 2024. Exposure State wage policies. Main Outcomes Measures A total 15 outcomes reported by caregivers or survey were evaluated: depression, anxiety, attention deficit disorder and/or attention-deficit/hyperactivity disorder, behavior disorders, mood symptoms, gastrointestinal considered attempted suicide, any unmet care care, alcohol marijuana use, physical fights, school absenteeism, paid employment. The associations policies tested using 2-way fixed-effects models, lifetime difference-in-differences models event studies, all state, year, birth cohort fixed effects. Additional controls individual-level demographics state-level insurance welfare Results Analyses 239 534 (aged 3-17 years; 117 111 girls [48.9%]) 2016 2022 Health, 1 453 043 12-18 711 380 [49.0%]) 2021 Across diverse modeling approaches, increases not associated clear, consistent improvements For example, a $1 increase changes rates depression (0.06 percentage points [pp]; 95% CI, –0.11 0.23 pp; P = .48), (0.13 –0.04 0.30 .14), suicide (–0.17 –0.47 0.13 .26). There also no clear when stratifying household income, parental education, race ethnicity, nativity, urbanicity. Conclusions Relevance In this cross-sectional study, over past 2 decades accompanied adolescents’ on policy approaches improve well-being children, particularly economically disadvantaged families.
Язык: Английский
Процитировано
0
Current Epidemiology Reports, Год журнала: 2024, Номер 12(1)
Опубликована: Дек. 27, 2024
Язык: Английский
Процитировано
0