American journal of preventive medicine
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Over 40,000 people die by suicide annually in the U.S., and firearms are the most lethal suicide method. There is limited evidence on the effectiveness of many state-level policies on reducing firearm suicide. The objective of this study was to identify public policies that best predict state-level firearm suicide rates. ⋯ On average, firearm suicide rates were lower in state-years that had each influential policy active. Notably, these analyses were ecological and noncausal. However, this study was able to use a supervised machine learning approach with inherent feature selection and many policy types to make predictions using unseen data (i.e., balancing Lasso and Ridge regularization penalties).
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Since 2020, many types of intoxicating cannabis products have entered the U.S. market. Hemp-derived intoxicating cannabis products, including hexahydrocannabinol and delta-8 tetrahydrocannabinol, pose concerns regarding their youth-oriented marketing, potency, and health effects. Some states have attempted to ban, restrict, or regulate their sale. However, the effectiveness of these laws and their enforcement is unclear. This study provides insights into the retail landscape of intoxicating cannabis products sold across the U.S. ⋯ Taking licensed dispensaries into consideration, intoxicating cannabis products can be purchased in retail stores located in all 50 states; Washington, District of Columbia; and Puerto Rico. Intoxicating cannabis products are widely available in vape shops, even in most states with relevant bans/restrictions. Enhanced laws, surveillance, and enforcement are needed. The 2024 Farm Bill and state laws should explicitly prohibit hemp-derived intoxicating cannabis products.
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Men who have sex with men (MSM) and are engaged in transactional sex (MSM-TS) experience complex social and structural vulnerabilities that increase their HIV risk. This study aimed to estimate the prevalence of TS and associations between TS and sexually transmitted infection (STI) outcomes among cisgender MSM in the U.S. ⋯ Structural and behavioral risks converged among U.S. MSM engaging in TS leading to greater HIV and bacterial STI prevalence in this group. HIV interventions for U.S. MSM-TS should address individual as well as structural risks, including poverty and housing instability.
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Quantifying the impact of smoking on life expectancy and the potential benefits of smoking cessation is crucial for motivating people who smoke to quit. While previous studies have attempted to estimate these effects, they were conducted more than a decade ago and did not include a significant demographic, people over 65 years old who smoke. ⋯ Quitting smoking early will avoid most years otherwise lost due to smoking. Even those who quit at ages 65 and above can still meaningfully increase their life expectancy.
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The American Lung Association's "State of the Air" 2023 report reveals almost 36% of Americans live with unhealthy levels of air pollution. Studies link air pollution with acute respiratory symptoms and exacerbation of respiratory and cardiovascular diseases. Differential air pollution exposures between white and nonwhite communities are significant components of environmental injustices. ⋯ We also recommend physicians utilize social determinants of health Z-Codes to capture environmental factors. Private payers should incorporate pollution exposure data into social determinants of health risk adjustments for Medicare Advantage programs. Medicaid agencies should develop provider recommendations for pediatric populations, and states should finance in-home interventions for asthma.