American journal of preventive medicine
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Routine alcohol screening of people with chronic health conditions that are exacerbated by alcohol can help to prevent morbidity and mortality. The U.S. Affordable Care Act and other recent health reforms expanded insurance coverage and supported alcohol screening in primary care. This study assessed increases in alcohol screening following health reform and insurance-related and racial and ethnic disparities in screening. ⋯ Alcohol screening of primary care patients with chronic conditions increased following health reform, but persistent disparities among patients with private insurance and specific chronic conditions underscore the need to address drivers of unequal preventive care.
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Schools can support students' participation in physical activity by offering opportunities consistent with a Whole-of-School (WOS) approach; however, the extent to which physical activity opportunities are provided and how school-level characteristics associate with their use remains unclear. This study examined how elementary schools' use a WOS approach to promote physical activity, as well as associations between school-level characteristics and physical activity opportunities provided. ⋯ Studies are needed to examine disparities in physical activity practices consistent with a WOS approach to understand the implications on health, academic performance, and other key outcomes. This information can inform the development of strategies to address disparities and ensure youth have equitable access to school-based physical activity opportunities.
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Data on adverse childhood experiences are key to understanding their burden and informing prevention programs and strategies. Population-based surveys that collect adverse childhood experiences data may be affected by item nonresponse. This study examines differences in nonresponse to the optional Behavioral Risk Factor Surveillance System adverse childhood experiences module overall, by sociodemographic characteristics, by year, and by question. ⋯ Overall, findings demonstrate that individuals are willing to respond to the adverse childhood experiences module questions. Although low, nonresponse to the module increased from 2019 to 2021. Higher nonresponse for sexual abuse questions may be due to their sensitivity or potential survey fatigue due to placement at the end of the module. Higher nonresponse among racial/ethnic minorities and economically disadvantages groups highlights opportunities to improve existing surveillance systems.
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There is much concern that substance use treatment programs are rarely integrated with smoking cessation programs. Here, the first national statistics are presented on the connection between heavy vs. light smoking and the opioid epidemic. ⋯ As nations deal with the opioid epidemic, integrating smoking cessation programs into substance abuse treatment programs appears prudent.
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National-level data suggest that gun owners in the U.S. carry concealed weapons in public at growing rates. This research investigates whether these trends are associated with state adoption of more permissive concealed carry-licensing laws between 2002 and 2019. ⋯ State-level concealed carry licensing may inform public health and safety policies as large restrictive U.S. states transition to more permissive concealed carry-licensing laws.