Population Health Management[JOURNAL]
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200 papers
Improving Screening Rates for Social Determinants of Health in Pediatric Primary Care Practices.
Rao VS, Chamberlain C, Bernstein B … +2 more , Williams NT, Cooper MR
Popul Health Manag · 2026 Jun · PMID 41862289 · Publisher ↗
The COVID-19 pandemic highlighted pediatric health care disparities and disrupted routine care, including social needs assessments. The American Academy of Pediatrics recommends universal screening for Social Determinant...
The COVID-19 pandemic highlighted pediatric health care disparities and disrupted routine care, including social needs assessments. The American Academy of Pediatrics recommends universal screening for Social Determinants of Health (SDOH), yet implementation remains inconsistent in primary care settings. This quality improvement (QI) project aimed to implement a standardized, sustainable SDOH screening and referral process in pediatric primary care, hypothesizing that structured interventions would improve screening rates. This QI initiative was conducted from January to September 2023 across six practices within a large pediatric health system. Eligible patients (ages 0-19) included those attending their first well visit of the calendar year. The SMART aim targeted a 50% increase in SDOH screening compliance, from 28% at baseline to 42% over 9 months. Using the Consolidated Framework for Implementation Research and two Plan-Do-Study-Act cycles, the team addressed key implementation barriers and refined interventions. The primary measure was screening completion rate; the balancing measure was the number of refusals to screen. SDOH screening rates increased from 28% to 55%, with eligible patient volumes ranging from 2400 to 5500. All six practices demonstrated statistically significant improvements ( < 0.001). Positive screens ranged from 3.3% to 8% of patients screened. Screening refusals increased significantly ( < 0.001). Standardized SDOH screening, implemented through structured QI methods and stakeholder engagement, significantly improved screening rates in pediatric primary care. Future studies should assess referral effectiveness, clinical outcomes, cost-effectiveness, and strategies to mitigate patient discomfort and systemic barriers.
Population Health, Right: A Framework for Core Services, Bounded Risk, and Strategic Partnerships for Health Systems.
Stefanacci RG, Kaufman N
Popul Health Manag · 2026 Aug · PMID 41847823 · Publisher ↗
Abstract loading — click title to view on PubMed.
Trends in Cardiomyopathy and Atrial Fibrillation-Related Mortality Among US Adults, 1999-2024.
Mohamed Siraj H, Emmanuel Anyagwa O, Adalia Dairo O … +7 more , Alkhateeb M, Abdulkader A, Pant N, Joshi M, Babu A, Hussain A, Balasubramanian A
Popul Health Manag · 2026 Aug · PMID 41804959 · Publisher ↗
Atrial fibrillation (AF) is a highly prevalent comorbidity in patients with cardiomyopathy (CM), associated with worse cardiovascular outcomes. This study aims to provide a comprehensive, national-level analysis of AF an...
Atrial fibrillation (AF) is a highly prevalent comorbidity in patients with cardiomyopathy (CM), associated with worse cardiovascular outcomes. This study aims to provide a comprehensive, national-level analysis of AF and CM-related mortality in the United States. The Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database was utilized, using death certificates from 1999 to 2024. The study included patients aged ≥15 years with CM and AF. Statistical analyses were conducted to calculate age-adjusted mortality rates (AAMRs) per 100,000 individuals and annual percent changes with 95% confidence intervals (CIs). Between 1999 and 2024, CM with concomitant AF accounted for 134,470 deaths among individuals aged 15 years or older. The overall AAMR rose from 1.5 per 100,000 in 1999 to 2.3 in 2024. From 1999 to 2016, the AAMR rose modestly (1.5-1.8), followed by a pronounced rise from 2016 to 2022 (1.8-2.5), and a relative decline by 2024 (2.5-2.3). Compared with 2019, mortality in 2020 demonstrated a 15% relative increase (incidence rate ratio = 1.15; 95% CI: 1.11-1.19). Males had disproportionately higher AAMRs compared to females. By race, the highest AAMRs were observed in non-Hispanic (NH) Black and White populations (1.8 each). Regionally, the West and Midwest exhibited the highest AAMRs (1.9 each). Urban-rural stratification revealed higher AAMRs among rural areas (2.2) when compared with urban (1.8) areas. Targeted public-health interventions and resource allocation to address this growing cardiovascular mortality burden, particularly in high-risk demographic groups, are needed.
Association Between Social Vulnerability and Postoperative Complications and Readmission Among Cardiovascular Surgery Patients.
Tilve R, Zhou G, Maigrot JA … +3 more , Koroukian SM, Soltesz EG, Bensken WP
Popul Health Manag · 2026 Jun · PMID 41804948 · Publisher ↗
Despite the well-established importance of health-related social needs in shaping patient outcomes, gaps remain in the literature examining these relationships at the individual level among patients undergoing cardiac su...
Despite the well-established importance of health-related social needs in shaping patient outcomes, gaps remain in the literature examining these relationships at the individual level among patients undergoing cardiac surgery. This retrospective study used data from the 2016-2018 Nationwide Readmission Database to evaluate postoperative complications and readmissions in patients undergoing cardiac surgery (coronary artery bypass grafting, aortic surgery, valve surgery, or a combination) using individual-level social vulnerability clinically acknowledged using ICD-10 Z-codes. Six domains of ICD-10 Z-codes (employment, family, housing, psychosocial needs, socioeconomic status, dependence) were considered social vulnerabilities. Data were analyzed using stratification by social vulnerability status and multivariable logistic regression. Among the 846,837 included patients, dependence-related needs were the most documented domain. Patients with social vulnerability at any point were younger, had a longer length of stay, and had a higher prevalence of comorbid conditions, readmissions, and complications. For patients with social vulnerability, the odds ratio of complications was 1.12 (1.03-1.22), and the odds ratio of 90-day readmissions was 1.15 (1.03-1.27). Clinically acknowledged social vulnerability at any point was associated with higher odds of complications or readmissions after cardiac surgery. Z-codes may be useful for identifying nonmedical factors that can affect patient outcomes, but further standardization and assessment are needed.
Association Between Relative Fat Mass and New-Onset Arthritis Among Middle-Aged and Older Chinese Females.
Zhang M, Jiang L, Wang Q … +1 more , Meng J
Popul Health Manag · 2026 Apr · PMID 41700721 · Publisher ↗
Arthritis is a major health concern in middle-aged and older people. In females, estrogen decline after midlife may exacerbate abnormal adiposity and thereby heighten arthritis risk. Given China's large population, clari...
Arthritis is a major health concern in middle-aged and older people. In females, estrogen decline after midlife may exacerbate abnormal adiposity and thereby heighten arthritis risk. Given China's large population, clarifying the relationship between fat mass and arthritis in middle-aged and older Chinese females is of great public-health importance. To explore the relationship between relative fat mass (RFM) and incident arthritis in middle-aged and older Chinese females. This population-based longitudinal study included 3874 females from the China Health and Retirement Longitudinal Study. Logistic regression and restricted cubic splines (RCS) evaluated the relationship between RFM and arthritis. Subgroup and interaction analyses explored potential heterogeneity across age groups and subgroups defined by chronic disease status. After full adjustment, females in the third (Q3 OR = 1.70, 95% CI: 1.24-2.33, < 0.001) and fourth (Q4 OR = 1.67, 95% CI: 1.13-2.47, = 0.010) RFM quartiles exhibited significantly higher odds of incident arthritis compared with those in the lowest quartile (Q1). Across the full study population and within the stratum of women below 60 years, RCS disclosed a statistically significant association between arthritis risk and RFM ( < 0.05), with no indication of nonlinearity ( > 0.05). Subgroup analyses revealed no evidence of effect modification ( > 0.05). Higher levels of RFM are associated with increased risk of new-onset arthritis in middle-aged and older Chinese females, providing a crucial indicator for the early screening of female arthritis and indicating a potential for controlling arthritis incidence by targeted body fat management.
Comparing Clinician Impression of Cognition with Standardized Screening in Medicare Annual Wellness Visits.
Hersh LR, Salzman B, Cunningham AT … +5 more , Flink L, Hovern D, Ng B, Azzolino C, Parks S
Popul Health Manag · 2026 Jun · PMID 41688865 · Publisher ↗
Early identification of cognitive changes is crucial for accessing timely interventions, implementing care planning, and optimizing quality of life for patients. Underdiagnosis of cognitive changes, particularly the subt...
Early identification of cognitive changes is crucial for accessing timely interventions, implementing care planning, and optimizing quality of life for patients. Underdiagnosis of cognitive changes, particularly the subtle findings associated with mild cognitive impairment, is a significant issue in primary care. This pilot study compared provider's impression of a patient's cognitive status (provider gestalt) with a standardized screening tool (Mini-Cog) during the Medicare Annual Wellness Visit (AWV). During patient encounters, medical assistants administered the Mini-Cog in addition to the standard AWV. Clinicians were blinded to the Mini-Cog test result and provided an independent impression of cognitive status. Cohen's kappa was calculated to determine rates of agreement between providers' impression and Mini-Cog findings. Statistical analysis with Cohen's kappa indicated only fair agreement between the provider's impression of cognitive impairment and the Mini-Cog result ( = 76, k = 0.315). When discordance occurred between provider impression and Mini-Cog results, providers were more likely to document "no concern" for cognitive impairment in the presence of an abnormal Mini-Cog. Specifically, 19.7% of patients demonstrated a positive Mini-Cog when providers identified no cognitive concerns versus 5.3% of patients who demonstrated a negative Mini-Cog when providers documented concerns for cognitive impairment. Our study suggests under-identification of patients with cognitive impairment when provider impression alone is used to guide the diagnosis. Utilization of a standardized screening tool, such as the Mini-Cog, may minimize the risk of missing early signs of cognitive change.
Identifying and Measuring Caregiver Burdens: A Scoping Review.
Poehler D, Giombi K, Shenkar E … +3 more , Tayebali Z, Dempsey M, Khavjou O
Popul Health Manag · 2026 Apr · PMID 41661154 · Publisher ↗
Unpaid caregiving is associated with significant burdens, including financial strain, time constraints, diminished quality of life, and elevated stress levels. Despite these challenges, existing literature on disease bur...
Unpaid caregiving is associated with significant burdens, including financial strain, time constraints, diminished quality of life, and elevated stress levels. Despite these challenges, existing literature on disease burdens devotes limited attention to caregiver experiences. The aim of this scoping literature review was to identify instruments used to measure caregiver burden to better inform future studies of caregiver costs. This study included articles that estimated the costs or burdens associated with unpaid caregiving to patients in the United States and used a survey or cohort study design to conduct primary or secondary quantitative data analysis. Across the 46 articles abstracted, 27 unique survey instruments were identified; 23 (89%) instruments were validated, 12 (46%) were publicly available, and 14 (54%) were designed for or validated among caregivers. Among studies included in this review, 18 (39%) studies designed their own questionnaires to assess caregiver burden. This review additionally identified six nonsurvey data sources, such as medical claims data, used to estimate caregiver costs. The heterogeneity across measurement tools limits comparability across studies. Standardized, validated, and accessible instruments are essential for understanding caregiver burdens and advancing research to improve outcomes for patients and their caregivers.
Mental Health Service Use and Equity in a Comprehensive Employer-Sponsored Benefit Program: A Retrospective Cohort Study.
Baum G, Hawrilenko M, Cascalheira C … +4 more , Ward EJ, Graupensperger S, Brown M, Chekroud A
Popul Health Manag · 2026 Apr · PMID 41660826 · Publisher ↗
Geographic and socioeconomic disparities in access to mental health care contribute to overall health inequity. Identifying scalable interventions that expand access to affordable and effective care remains a critical pr...
Geographic and socioeconomic disparities in access to mental health care contribute to overall health inequity. Identifying scalable interventions that expand access to affordable and effective care remains a critical priority. This retrospective cohort study analyzed medical claims and census-level socioeconomic data from 742,658 individuals representing 90.9% of all US counties who were eligible for an employer-sponsored mental health benefit. Mental health service utilization was compared between individuals who accessed care through the benefit program and those who used the traditional health plan, across levels of socioeconomic disadvantage as measured by the area deprivation index. Program implementation was associated with a 36% relative increase in mental health care use overall compared to health plan utilization in the prior year. Following program implementation, care initiation increased equitably among program users, while disparities by area deprivation persisted among health plan users. Program users also had more equitable care retention and therapy duration across deprivation levels, whereas disparities increased among health plan users. Program initiation was positively associated with the number of employer-sponsored sessions, with a stronger association observed among individuals in high-deprivation areas. Lastly, program use was associated with significant reductions in anxiety and depression symptoms, with comparable treatment effects across deprivation levels. The benefit program was associated with more equitable care initiation and reduced socioeconomic disparities in engagement relative to traditional plans. Program users also experienced significant clinical improvements across deprivation levels. These findings highlight opportunities to reduce systemic barriers and promote equitable access to mental health care through scalable, real-world interventions.
Implementation and Outcomes from a Post-Discharge Intervention Program in a Medicare ACO Population.
Schiavoni KH, Chang Y, Hall C … +6 more , Garalis D, Teng C, Eliopoulos M, Chaudhry A, Chan H, Mendu ML
Popul Health Manag · 2026 Apr · PMID 41645920 · Publisher ↗
Preventable readmissions represent a significant opportunity to improve quality and reduce healthcare costs, with approximately 26% of Medicare medicine readmissions considered preventable. However, evidence on the effec...
Preventable readmissions represent a significant opportunity to improve quality and reduce healthcare costs, with approximately 26% of Medicare medicine readmissions considered preventable. However, evidence on the effectiveness of post-discharge interventions at scale remains mixed, and implementing evidence-based practices consistently across large, diverse health systems is a challenge. To address these concerns, the Mass General Brigham Population Health Services Organization (MGB PHSO) developed and implemented a novel, multidisciplinary, system-wide post-discharge intervention aimed at reducing 30-day readmissions within its Medicare Shared Savings Program (MSSP) Accountable Care Organization (ACO). It was hypothesized that standardizing delivery through a high-fidelity workflow would reduce readmissions. A standardized, multidisciplinary program was created involving: (1) a coordinator conducting chart review and obtaining records; (2) a pharmacist performing medication reconciliation; and (3) a registered nurse completing a post-discharge assessment. A prospective cohort study was conducted comparing the outcomes of patients at pilot intervention sites with those of a propensity-matched control group. The intervention cohort showed a directional reduction in 30-day readmission rates compared to the matched controls (13.5% vs. 16.3%, = 0.07) but no significant difference in 30-day emergency department presentations. The intervention group also had a significantly higher rate of 14-day follow-up appointments (70.0% vs. 65.3%, = 0.025). These findings support the effectiveness of a centralized, standardized post-discharge strategy for reducing readmissions within an ACO setting. This study demonstrates that structured, system-level interventions can improve care transitions and outcomes in value-based care models.
Cost-Effectiveness of Screening and Early Diagnosis Strategies for Cancer in the General Adult Population in Low- and Middle-Income Countries: A Systematic Review.
Hernández-Vásquez A, Villar Bernaola L, Vargas-Fernández R … +1 more , Timaná Ruiz R
Popul Health Manag · 2026 Jun · PMID 41468182 · Publisher ↗
Cancer is one of the leading causes of morbidity and mortality worldwide, disproportionately affecting low- and middle-income countries (LMICs) due to barriers to obtaining access to health care services and screening pr...
Cancer is one of the leading causes of morbidity and mortality worldwide, disproportionately affecting low- and middle-income countries (LMICs) due to barriers to obtaining access to health care services and screening programs. The current study aimed to synthesize evidence on cost-effective strategies for cancer screening and early diagnosis in adults (≥18 years) in LMICs. The literature search was conducted in PubMed, the Cochrane Library, Embase, EconLit, CINAHL, LILACS, Global Health, and the Web of Science Core Collection databases. The review included cost-effectiveness studies compared with standard practices in LMICs. Two reviewers independently assessed eligibility, extracted data, and evaluated methodological quality using the Drummond and Jefferson guidelines. Twelve studies conducted in nine countries across four global regions were included. The results identified that the most cost-effective strategies for cervical cancer were human papillomavirus DNA testing, visual inspection with acetic acid, and combined tests. For breast and prostate cancer, digital breast tomosynthesis and the Prostate Health Index were promising options, repectively. However, limitations were noted in the studies, such as the lack of analysis on productivity changes and the justification of variables in sensitivity analyses. Population-based cancer screening strategies exist but must be adapted to the implementation context to maximize their cost-effectiveness in LMICs.
Feasibility of an Adaptive Food Insecurity Intervention for Patients with Uncontrolled Hypertension: A Pilot SMART.
Palakshappa D, Quinones S, Elashker AL … +7 more , Hodge LD, Caudill N, Bundy R, Martin H, Eaton K, Atwater S, Rosenthal GE
Popul Health Manag · 2026 Apr · PMID 41468111 · Full text
Health systems are integrating interventions to assist patients with food insecurity; however, people need varying levels of support. Rather than using a single intervention, adaptively providing interventions may be a m...
Health systems are integrating interventions to assist patients with food insecurity; however, people need varying levels of support. Rather than using a single intervention, adaptively providing interventions may be a more effective approach. The authors conducted a pilot, sequential, multiple-assignment randomized trial to determine the feasibility of an adaptive food insecurity intervention. Adults with uncontrolled hypertension who reported food insecurity were randomized to one of two interventions for 3 months in Stage 1: information about community resources or community health worker (CHW) support. Participants who did not have ≥10 mmHg improvement in systolic blood pressure at 3 months were re-randomized to CHW support or the delivery of medically tailored meals (MTM) in Stage 2 for an additional 3 months. We evaluated the proportion who enrolled, completed follow-up, and had an improvement in blood pressure. Sixty of 61 (98.3%) eligible patients enrolled. Four withdrew, 46 of 56 (82.1%) completed the 3-month follow-up, and 40 of 56 (71.4%) completed the 6-month follow-up. Of 27 randomized to resource information, 15 (55.6%) did not have ≥10 mmHg improvement and were re-randomized. Of 29 randomized to CHW support, 14 (48.3%) were re-randomized. The adaptive intervention that provided CHW support in Stage 1 and additional CHW support in Stage 2 resulted in 46.7% of participants with ≥10 mmHg improvement in systolic blood pressure at 6 months. The adaptive intervention that provided CHW support in Stage 1 and MTM in Stage 2 resulted in 66.7% of participants with ≥10 mmHg improvement. This study found that an adaptive food insecurity intervention was feasible to utilize.
Progression to the Mean: Reconciling Traditional and Modern Professional Values in Medicine.
Hull SC, Law A, Dudzinski DM … +5 more , Mullen JB, Zaidi D, Anderson L, Kornberg R, Kirkpatrick JN
Popul Health Manag · 2026 Feb · PMID 41457702 · Publisher ↗
Medicine has historically been conceptualized as not simply an occupation but rather as a profession, one that entails both substantial privileges as well as significant responsibilities. In this article, the majority of...
Medicine has historically been conceptualized as not simply an occupation but rather as a profession, one that entails both substantial privileges as well as significant responsibilities. In this article, the majority of whose authors are cardiologists serving on the American College of Cardiology Ethics Committee, we observe the evolution of professional values in Western medicine along a continuum shaped by both intrinsic and extrinsic forces with respect to the physician and the medical profession. Though a historically reactive process, we argue for a more proactive and anticipatory approach moving forward that reframes professionalism and what it means to be part of a profession, aiming to reconcile cross-generational professional values in the interest of advancing health and human flourishing. Rather than rejecting the power and privilege of our profession, thus leaving a vacuum to be filled by administrators and politicians, we should reclaim and repurpose it to provide better care and promote better outcomes.
Development of Digital Algorithms for the Early Identification of Rare Clinical Outcomes Using Electronic Medical Records: A Case Study of Hidradenitis Suppurativa.
Pham H, McMeniman E, Liu T … +3 more , Eva J, Khosrotehrani K, Pole JD
Popul Health Manag · 2026 Feb · PMID 41449535 · Publisher ↗
Hidradenitis suppurativa (HS) is a painful, progressive, and disfiguring rare inflammatory skin condition with significant diagnostic delays due to limited awareness. This study aims to develop and validate digital algor...
Hidradenitis suppurativa (HS) is a painful, progressive, and disfiguring rare inflammatory skin condition with significant diagnostic delays due to limited awareness. This study aims to develop and validate digital algorithms using integrated electronic medical records (ieMR) to identify undiagnosed HS patients. A test cohort of 121 HS cases (patients who visited a dermatologist-led HS clinic and received treatment) and 187,106 controls (emergency department patients) were identified from patients attending a Queensland tertiary hospital from 2018 to 2022. Using demographics, structured ieMR data and free-text flags, we developed one logistic regression and two random forest algorithms (with and without class weighting) to predict HS. A clinical chart audit of 200 randomly selected patients helped refine the best-performing algorithm, which was then validated using data from another tertiary hospital. Logistic regression performed best at a threshold of 0.4 (sensitivity: 0.66 [0.58, 0.74], positive predictive value [PPV]: 0.71 [0.64, 0.80]). Strong predictors included dermatology clinic visits, free-text diagnostic notes, lesion location terms, antibiotic and isotretinoin use, and elevated inflammatory markers. Internal validation showed high agreement, and the refined model improved sensitivity to 0.89 (0.83, 0.94) and PPV to 0.87 (0.81, 0.92). This model performed relatively well in the validation cohort, with sensitivity and specificity (at threshold 0.4) both >0.70 and a PPV of 0.45, supporting clinical utility. Validated digital algorithms incorporating key diagnostic indicators may help identify undiagnosed HS patients, reducing diagnostic delays and improving prevalence assessment.
A Multi-Intervention Approach to Blood Pressure Control: A Description of How a Large University Based Primary Care Clinic Tackled Hypertension.
Lobo I, Koon K, Potthast K … +2 more , Ozmina K, Billups SJ
Popul Health Manag · 2026 Feb · PMID 41433141 · Publisher ↗
Uncontrolled hypertension remains a leading modifiable risk factor for cardiovascular disease. Numerous quality improvement initiatives have aimed to address health care challenges associated with uncontrolled hypertensi...
Uncontrolled hypertension remains a leading modifiable risk factor for cardiovascular disease. Numerous quality improvement initiatives have aimed to address health care challenges associated with uncontrolled hypertension, many of which have been organized around the American Medical Association Measure Accurately, Act Rapidly, and Partner with Patients (AMA MAP) hypertension quality improvement framework. This paper describes a multifaceted hypertension quality improvement program initiated within a large university-based internal medicine clinic. Key interventions targeted at "Measure Accurately" included staff retraining on blood pressure (BP) measurement, implementation of BP recheck protocols, and a structured home BP monitor validation process. To combat clinical inertia and "Act Rapidly," the clinic introduced a visual BP alert system, promoted clinical pharmacist comanagement, and distributed monthly provider performance reports. Lastly, to "Partner with Patients," patient engagement was enhanced via targeted outreach, a care team approach focused on holistic patient care, and increased patient education. One year after implementation, the clinic's hypertension control rate had increased from 66% to 72% ( = 0.047), while control rates across other system clinics remained unchanged. During this time, 343 patients had staff visits for BP checks, 287 patients had validated home BP monitors documented in their electronic health record, 302 patients engaged with a clinical pharmacist for hypertension comanagement, and 575 received individualized outreach from the care manager to increase engagement. This multifaceted quality improvement program improved patient care and increased hypertension control rates. These interventions have demonstrated sustainability and have been adopted by other primary care clinics in this system.
Adopting Health Technologies in Israel and England.
Finkelshtein-Zloof D, Tal O
Popul Health Manag · 2026 Apr · PMID 41433043 · Publisher ↗
Health systems worldwide are challenged by the need to prioritize and fund rapidly evolving health technologies. The methodology of health technology assessment (HTA) incorporates benefits, costs, and social implications...
Health systems worldwide are challenged by the need to prioritize and fund rapidly evolving health technologies. The methodology of health technology assessment (HTA) incorporates benefits, costs, and social implications, supporting prioritization of public coverage regarding national health policy. The aim of this study is to identify, analyze, and compare key considerations in the adoption of medical technologies reflecting the national health policies in Israel and England. All Israeli pharmaceuticals approved for public funding during 2020-2022 (287) were analyzed and compared with England recommendations concerned clinical effectiveness, economic considerations, and social values. Both health systems demonstrated 49% agreement regarding approval of funding recommendations policy, while in oncology, diabetes, and hematology, this reached 60%-65%. In both health systems, adoption was determined by clinical impact considering the disease burden and regarding the added value of the innovative technology compared with existing treatments, followed by social considerations. Budget considerations prevail in England. This relatively high resemblance in adoption decisions between England and Israel may emerge from similar principles of accountability for public coverage of medical care. In addition, it may also be driven by the forefront of innovative technological research worldwide and global interest. Nevertheless, economic considerations differ between the 2 health systems, introducing policy discrepancies or tactical diversity.
Mortality Due to Opioid Overdose in the United States: Trends from a CDC WONDER Analysis (1999-2024).
Ahmed S, Javaid SS, Nasir A … +10 more , Manal I, Saleem K, Iqbal N, Irshad A, Hassan S, Harrison MA, Fatima S, Ul Abideen Z, Abbas F, Arshad A
Popul Health Manag · 2026 Feb · PMID 41371771 · Publisher ↗
The opioid epidemic in the United States has led to a sharp rise in overdose deaths over the past two decades. Although some progress was observed prior to the coronavirus disease 2019 pandemic, opioid-related mortality...
The opioid epidemic in the United States has led to a sharp rise in overdose deaths over the past two decades. Although some progress was observed prior to the coronavirus disease 2019 pandemic, opioid-related mortality has increased again in recent years, underscoring the need to re-examine national trends. A retrospective analysis of opioid overdose mortality among US adults aged 25 years and older from 1999 to 2024 was performed using data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiological Research (CDC WONDER) Multiple Cause-of-Death database. Opioid-related deaths were identified using the International Classification of Diseases, Tenth Revision, codes T40.0-T40.4 and T40.6. Mortality rates were calculated by year, sex, age, race/ethnicity, and US census region. Temporal trends were evaluated using Joinpoint regression to estimate annual percent changes. A total of 806,765 opioid overdose deaths occurred during the study period. The age-adjusted mortality rate (AAMR) increased from 4.41 to 22.84 per 100,000. Men consistently had higher AAMRs than women (men: 20.64; women: 9.52). Racial disparities were evident, with the highest rates observed among non-Hispanic American Indian/Alaska Native (21.79), non-Hispanic White (18.07), and non-Hispanic Black (15.97) populations. Adults aged 35-44 years had the highest crude mortality rates (20.52). Among US regions, the Northeast had the highest AAMR (18.09), followed by the Midwest (15.69), South (14.74), and West (13.09). These findings confirm that opioid overdose remains a major public health issue, with persistent demographic and regional disparities necessitating targeted strategies to reduce mortality.
Identification and Validation of a Machine Learning Predictive Model for Type 2 Diabetes Mellitus Based on Inflammation-Related Indicators.
Xia MH, Wu JX, Niu B … +4 more , Bo L, Wu HY, Deng FY, Lei SF
Popul Health Manag · 2026 Feb · PMID 41371754 · Publisher ↗
Type 2 diabetes mellitus (T2D) is a prevalent metabolic disorder with significant health and economic burdens worldwide. The relationship between inflammation-related indicators and the risk of developing new-onset T2D r...
Type 2 diabetes mellitus (T2D) is a prevalent metabolic disorder with significant health and economic burdens worldwide. The relationship between inflammation-related indicators and the risk of developing new-onset T2D remains underexplored. This study aims to identify and validate an interpretable predictive model for incident T2D using inflammation-related indicators. We analyzed data from 220,937 participants free of diabetes at baseline in the UK Biobank. Six machine learning algorithms were employed to construct predictive models. Feature selection was performed using Least Absolute Shrinkage and Selection Operator regression. SHapley Additive exPlanations (SHAP) were used to interpret the best-performing model. A genetic risk score (GRS, an aggregate measure of genetic susceptibility to T2D) was constructed, and multivariate Cox regression assessed the combined effects of genetic and inflammatory factors on T2D incidence. The Extreme Gradient Boosting model demonstrated the best performance (training set AUC = 0.863, testing set AUC = 0.838). Key predictors included body mass index, cholesterol, age, alanine aminotransferase, high-density lipoprotein, and Prognostic Nutritional Index (a marker predictive of inflammation and nutritional outcomes). SHAP analysis revealed significant contributions from these features. C-reactive protein and white blood cell count showed strong associations with future T2D risk. Integrating the GRS significantly improved the model's predictive performance (ΔAUC = +0.025, < 0.05 via DeLong's test). This study presents an interpretable machine learning model for new-onset T2D risk prediction, emphasizing the role of inflammation and genetic factors. The findings provide a valuable tool for early T2D prevention and intervention, offering insights into the complex interplay between inflammation and diabetes development.
Digital Health Inequity in Italy: Unequal Access to the Electronic Health Record and Its Public Health and Medico-Legal Impacts.
Cioffi A, De Simone S, Orsini F … +2 more , Cipolloni L, Cecannecchia C
Popul Health Manag · 2026 Feb · PMID 41371723 · Publisher ↗
Abstract loading — click title to view on PubMed.
Disparities in Recombinant Zoster Vaccine Coverage in the United States.
Singer D, Stempniewicz N, Lee L … +3 more , Evans K, Huse S, Berger A
Popul Health Manag · 2025 Dec · PMID 41314972 · Publisher ↗
Recombinant zoster vaccine (RZV) was recommended in 2020 in the US for adults aged ≥50 years. This retrospective study used cross-sectional data from 2020 National Health Interview Survey respondents aged ≥50 years. Samp...
Recombinant zoster vaccine (RZV) was recommended in 2020 in the US for adults aged ≥50 years. This retrospective study used cross-sectional data from 2020 National Health Interview Survey respondents aged ≥50 years. Sample weights were applied to allow results to be representative of the non-institutionalized US population. Associations between respondent characteristics and coverage were explored using logistic regression. An estimated 14.1% of US adults aged ≥50 years had received ≥1 dose of RZV by 2020. Coverage varied by race and ethnicity (6.3% Hispanic, 6.9% Black/African American, 13.7% Asian, 16.6% White), education (6.9% for grade 1-11 to 24.1% with master's degrees), household income (8.8% for <$35,000 to 18.8% for ≥$100,000), age (7.3%, 14.6%, 19.9%, and 18.1% for ages 50-59, 60-64, 65-74, and ≥75 years, respectively), health insurance (2.2% without, 14.8% with), recency of last health visit (1.8% if >3 years prior to 15.1% if <1 year), and receipt of influenza vaccine in the past year (3.9% without, 21.1% with) (all < 0.001). In multivariable analysis, factors associated with lower RZV coverage included Black/African American race, Hispanic ethnicity, age 50-59 years, lower household income, less recent last health visit, and no influenza vaccination. In conclusion, only 1-in-7 non-institutionalized Americans aged ≥50 years reported RZV coverage by 2020, with significant disparities among subgroups defined by race and ethnicity, age, and levels of educational attainment, income, and insurance. These results highlight an opportunity to improve herpes zoster protection through increased vaccination, pursued in a more equitable manner. [Figure: see text].
Patient Engagement with General Bulk Outreach: Impact of Primary Care Provider vs. Care Team Signature in General Bulk Patient Outreach.
Matulis JC, Wingo M, Tobin K … +1 more , Chaudhry R
Popul Health Manag · 2025 Dec · PMID 41259074 · Publisher ↗
Bulk messaging is an important population health tool used to engage patients in preventive care and chronic disease management, yet little is known about optimal formatting of the communication. One factor to consider i...
Bulk messaging is an important population health tool used to engage patients in preventive care and chronic disease management, yet little is known about optimal formatting of the communication. One factor to consider is whether the signatory of the patient-facing communication is the patient's own Primary Care Provider (PCP) or a generic care team signature. In this quasi-randomized, non-blinded study we compared identical generic bulk outreach messages directed toward patients with an upcoming appointment and invited them to self-schedule a Medicare Annual wellness visit prior to their scheduled PCP appointment. Twenty-eight PCPs (1582 patients) were assigned to the PCP signature group, and 22 PCPs (1289 patients) to the care team signature group. The primary outcome was patient engagement, defined as a reply to the outreach message. Demographic, utilization, and rates of reading the bulk outreach message were similar between groups. Reply rates were significantly higher in the PCP signature group compared with the care team signature group (39.2% vs. 25.2%; odds ratio 1.86; < 0.001). These findings suggest that using a patient's own PCP signature in bulk outreach can meaningfully increase engagement, likely leveraging the trust inherent in established PCP-patient relationships. These results may inform health system leaders and population health teams seeking to optimize digital outreach strategies.
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