American journal of preventive medicine
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State policies and programs affect population health; yet, little is known about the connections between health and the political institutions and actors that prescribe and execute those policies and programs. ⋯ Findings support the proposition that the social determinants of health are constructed, at least in part, by the power vested in governments.
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Observational Study
Association Between Acute Exposure to Crime and Individual Systolic Blood Pressure.
Hypertension is associated with adverse cardiovascular outcomes and is geographically concentrated in urban underserved neighborhoods. This study examines the temporal-spatial association between individual exposure to violent crime and blood pressure. ⋯ Exposure to a violent crime event was associated with increased blood pressure, with gradient effects by both distance and time from exposure.
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Childhood physical, sexual, and emotional abuse are linked to adult obesity, and little is known about what protective factors might mitigate this association. ⋯ Factors previously found to promote resilience to mental health sequelae after abuse did not modify the association of severe child abuse with higher weight status.
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Little is known about the possible impacts of recreational marijuana legalization on alcohol and marijuana co-use among underage youth. This study examines the association between recreational marijuana legalization in California in 2016 and alcohol and marijuana co-use among adolescents. Additional analyses investigate the associations between recreational marijuana legalization and co-use among past 30-day drinkers and marijuana users and the frequency of alcohol and marijuana use among co-users. ⋯ Recreational marijuana legalization may increase the risk of alcohol and marijuana co-use among adolescents. Greater restrictions on the numbers of alcohol and marijuana retail outlets and hours of operation and advertising and higher taxes on alcohol and marijuana products may help reduce the availability of these substances to adolescents.
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Opioid-related overdose risks are elevated after incarceration. The rates of opioid-related overdose mortality have risen in recent years, including among Veterans Health Administration patients. To inform Veteran overdose prevention, this study evaluates whether opioid-related overdose risks differ for Veterans Health Administration patients with versus those without indicators of legal system involvement. ⋯ Among Veterans receiving Veterans Health Administration care in 2012, documented legal system involvement was associated with an increased risk of opioid-related overdose mortality. Targeting overdose education and naloxone distribution programs and integrating opioid overdose prevention efforts into mental health care may reduce opioid overdose deaths among Veterans with legal involvement.