Public Health Rep
· 2026 Apr · PMID 42037404
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Veterans experiencing homelessness (hereinafter, homeless veterans), an important group in society, often have limited access to digital technologies, which may affect their ability to achieve social integration. Using d...Veterans experiencing homelessness (hereinafter, homeless veterans), an important group in society, often have limited access to digital technologies, which may affect their ability to achieve social integration. Using data from annual national surveys of homeless-experienced veterans (HEV) from 2022 through 2024 (1992 in 2022, 2596 in 2023, and 2860 in 2024), this study compared their ownership of cell phone devices and computers or laptops and their use of the internet during a 3-year period. While we found no significant change in ownership of cell phones, we found significant increases from 2022 through 2024 in ownership of smartphones (from 69.1% to 72.3%) and computers or laptops (from 36.7% to 38.5%), as well as use of the internet at least occasionally (from 75.8% to 79.0%) and often (from 71.9% to 77.3%). We observed increased internet use among currently and formerly homeless veterans when we analyzed the samples separately. Together, these findings provide updated prevalence rates of digital technology use among HEV and highlight opportunities for technology-based interventions. More HEV are using digital technologies, but we estimate that more than one-fifth of HEV still do not have a cell phone or smartphone or use the internet at all. Although access to digital technologies has increased in this population, some gaps remain, and further research is needed on how to increase the uptake of new technologies.
Abutalib NH, Wilkerson AH, Kim N
… +3 more, Chaney BH, Zingg T, Hernandez-Reif M
Public Health Rep
· 2026 Apr · PMID 42037399
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OBJECTIVE: Pregnant women are encouraged to engage in physical activity before and during pregnancy. However, few women in the United States engage in sufficient physical activity during pregnancy. We examined physical a...OBJECTIVE: Pregnant women are encouraged to engage in physical activity before and during pregnancy. However, few women in the United States engage in sufficient physical activity during pregnancy. We examined physical activity and factors associated with it before and during pregnancy. METHODS: We analyzed the most recent data from the Pregnancy Risk Assessment Monitoring System (PRAMS; 2016-2019) to describe physical activity among women in Alabama and Rhode Island. We used logistic regression models to assess factors associated with physical activity before and during pregnancy. RESULTS: Only 14.6% (n = 1178) of the sample (n = 7734; 3621 in Alabama, 4113 in Rhode Island) met physical activity guidelines before pregnancy and 8.8% (n = 666) during pregnancy. Identifying as White (adjusted odds ratio [AOR] = 1.46) or non-Hispanic ethnicity (AOR = 1.46), being underweight or normal weight (AOR = 1.98), and residing in Rhode Island (AOR = 1.30) were significantly associated with meeting physical activity guidelines before pregnancy. Being underweight or normal weight (AOR = 1.70) remained a significant variable associated with meeting physical activity guidelines during pregnancy. CONCLUSIONS: Public health professionals and health care providers may consider factors such as race, ethnicity, and body mass index when working to increase physical activity among women before and during pregnancy.
Pais KL, Bhatia KV, Zhang X
… +2 more, Lee JD, Lai M
Public Health Rep
· 2026 Apr · PMID 42037393
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OBJECTIVES: Alcohol-associated liver disease (AALD) is a leading cause of liver disease. Alcohol use disorder is a growing public health problem in the United States. TikTok is a growing source of public health informati...OBJECTIVES: Alcohol-associated liver disease (AALD) is a leading cause of liver disease. Alcohol use disorder is a growing public health problem in the United States. TikTok is a growing source of public health information; such information is not peer reviewed and often does not meet scientific standards. We assessed the quality of AALD information on TikTok. METHODS: We conducted a retrospective observational study of TikTok videos obtained on March 8, 2024, by searching the phrase "alcohol-associated liver disease." We analyzed video characteristics, engagement, and content. Three physicians independently assessed the reliability and quality of the videos by using the DISCERN tool and the Global Quality Score (GQS), scored from 1 to 5, with higher scores indicating better reliability and quality, respectively. RESULTS: We included 139 videos in the analysis. Video creators/publishers were health care professionals (39.6%), patients and family/friends (35.3%), wellness coaches (22.3%), and others (2.9%). The median (IQR) DISCERN score was 2.0 (1.3-2.7); the median (IQR) GQS score was 2.5 (1.5-3.3), indicating the videos were of low quality. Videos by health care professionals had higher DISCERN and GQS scores ( < .001) than videos by other creators/publishers. Video characteristics did not differ significantly between creator/publisher types. Regression results indicated that videos from health care professionals correlated positively with higher DISCERN and GQS scores, especially when videos were longer. CONCLUSION: The quality and reliability of TikTok videos on AALD are poor. The public should exercise caution when accessing AALD-related information on TikTok. Health care providers and public health officials should strongly investigate the quality of health information on social media platforms and seek to improve it.
Melkonian SC, Jim MA, Haverkamp D
… +9 more, McCollum J, Apostolou A, Rodriguez JL, Warren-Mears V, Tolentino N, Morris J, Foley D, Balzer E, Lenz K
Public Health Rep
· 2026 Apr · PMID 42035359
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OBJECTIVES: Accurate mortality data for American Indian and Alaska Native (AI/AN) people are critical for describing health disparities and program planning needs. We describe the rates of leading causes of death among n...OBJECTIVES: Accurate mortality data for American Indian and Alaska Native (AI/AN) people are critical for describing health disparities and program planning needs. We describe the rates of leading causes of death among non-Hispanic AI/AN as compared with non-Hispanic White populations living in the same area, by sex and Indian Health Service (IHS) Area in 2020. METHODS: We used the 2020 US Cancer Statistics AI/AN Mortality Database and SEER*Stat software to calculate sex-specific age-adjusted death rates (per 100 000 population) for the 15 leading causes of death among non-Hispanic AI/AN and non-Hispanic White people in the United States overall (all areas combined), by IHS Area, and by age group. We restricted analyses to non-Hispanic AI/AN and non-Hispanic White people living in Purchased/Referred Care Delivery Area counties. RESULTS: Death rates were higher among non-Hispanic AI/AN people than among non-Hispanic White people in the United States overall (rate ratio = 1.90) and in every IHS Area (rate ratio range = 1.11-2.78). Death rates also varied by sex and age. Death rates were nearly 4 times higher among non-Hispanic AI/AN people than among non-Hispanic White people in the 25- to 44-year age group. Leading causes of death among non-Hispanic AI/AN males and females included COVID-19, heart disease, unintentional injury, cancer, and chronic liver disease. CONCLUSIONS: Death rates differed between non-Hispanic AI/AN and non-Hispanic White people by IHS Area, sex, and age when data corrected for racial misclassification were used. Our findings have important implications for guiding future public health practice to address disparities in mortality, particularly in the context of public health emergencies.
Solnick RE, Cortes R, Chang E
… +8 more, Dudas P, Cetkovic A, Londoño-Barreras R, Munawar M, Pendell C, Zhao AS, Kocher KE, Merchant RC
Public Health Rep
· 2026 Apr · PMID 42035357
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OBJECTIVES: Expedited partner therapy (EPT) provides treatment or prescriptions for the sexual partners of patients with sexually transmitted infections (STIs) without requiring a clinical visit, and it is recommended fo...OBJECTIVES: Expedited partner therapy (EPT) provides treatment or prescriptions for the sexual partners of patients with sexually transmitted infections (STIs) without requiring a clinical visit, and it is recommended for partners who might not seek care otherwise. Despite its public health importance, EPT has had limited uptake in emergency departments (EDs). We assessed barriers to and facilitators of EPT that could assist in increasing its use in EDs. METHODS: From July 2020 through February 2021, we conducted semistructured virtual interviews with 18 ED medical directors and key medical personnel from US institutions that offer or were interested in offering EPT, as identified through previous research. We developed and piloted an interview guide based on the Consolidated Framework for Implementation Research. We recorded, transcribed, and analyzed interviews using thematic analysis. We developed themes through iterative coding and team discussion. RESULTS: Participant-reported barriers to implementing EPT included perceived legal liability, unclear clinical workflows, electronic health record challenges when prescribing for a nonpatient, ambiguity about duty to the sexual partner, concerns about patient safety, and sexual health stigma. Facilitators were defined as task sharing, streamlined electronic health record processes, and leadership support. Participants emphasized the ED's potential to expand access to care for populations at high risk for STIs, provided that EPT implementation did not disrupt clinical operations. CONCLUSIONS: Understanding barriers to and facilitators of EPT in EDs can inform the development of effective implementation strategies. While nontraditional prescribing processes pose challenges to routine adoption of EPT, experiences from EDs with established protocols suggest that these obstacles can be overcome.
Tsai RJ, Kalennyy I, Marovich S
… +1 more, Mobley A
Public Health Rep
· 2026 Apr · PMID 42026992
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OBJECTIVE: It is crucial for public health professionals to have easy and timely access to occupational safety and health (OSH) data to monitor adverse outcomes and identify risk factors that may harm our nation's workfo...OBJECTIVE: It is crucial for public health professionals to have easy and timely access to occupational safety and health (OSH) data to monitor adverse outcomes and identify risk factors that may harm our nation's workforce. The National Institute for Occupational Safety and Health created Worker Health Charts (WHC), a data query and visualization tool, to provide quick and easy access to multiple occupational data sources. However, user feedback indicated that the 2016 WHC navigational menu was difficult to use and did not fully meet user needs. Because access to occupational data is critical in many contexts, we sought to design a menu that would be suitable for various types of users. METHODS: The 2016 WHC navigational menu lists 7 high-level OSH topics and 18 OSH subtopics. To gain insight into how users organize and categorize OSH information, we conducted a series of user experience tests using a method known as card sorting. During the process, participants were given a web link that contained occupational health topics, and they were tasked with grouping or combining similar topics. RESULTS: The card-sorting techniques identified opportunities to reorganize (eg, create, delete, merge, split) or rename topics for clarity. The final proposed WHC menu was restructured into 4 high-level OSH topics and 14 OSH subtopics. CONCLUSIONS: This study details how card sorting can be used to guide and improve the navigation and content structure of OSH information and the acceptability of the user interface to facilitate access to public health data. Future steps for WHC include validating the proposed menu through task-based testing.
Public Health Rep
· 2026 Apr · PMID 42026988
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Overdose deaths have steadily decreased in the United States from 105 000 deaths in 2023 to 79 384 deaths in 2024. To better understand emerging trends in overdose deaths, we conducted a pilot epidemiological study of fa...Overdose deaths have steadily decreased in the United States from 105 000 deaths in 2023 to 79 384 deaths in 2024. To better understand emerging trends in overdose deaths, we conducted a pilot epidemiological study of fatal drug overdose data from the Cuyahoga County Medical Examiner's Office (Cleveland, Ohio) from 2023 through mid-2025 (all accidental drug overdose deaths from January through June). During the study period, all fentanyl-related accidental drug overdose deaths decreased from 75.8% to 45.6% ( < .001). During the same period, all cocaine deaths that included fentanyl decreased from 69.8% to 40.7% ( = .004), and all cocaine deaths that excluded fentanyl increased from 17.6% to 39.2% ( < .001). Drug overdose deaths decreased among White males but increased by 9% among Black males, largely driven by Black men aged ≥55 years. Percentages of overdoses among Black men aged ≥55 years in the all-fentanyl group ( < .001) decreased from 53.4% (47 of 88) to 34.1% (15 of 44) but remained steady in the all-cocaine group ( < .001) from 85.2% (75 of 88) to 84.1% (37 of 44). Overdoses increased in the cocaine-without-fentanyl group ( < .001) from 46.6% (41 of 88) to 63.6% (28 of 44) but decreased in the cocaine-only group ( < .001) from 31.8% (28 of 88) to 27.3% (12 of 44). Our results showed a shift in demographic characteristics with regard to decreases in fentanyl-related overdose deaths and increases in cocaine-related overdose deaths. Because no stimulant antidote analogous to naloxone for opioids is available, public health policy will need to pivot in response to the increase in stimulant-involved overdose deaths.
Staples L, Gonzalez G, Yeh A
… +2 more, Rubin R, Phillippi S
Public Health Rep
· 2026 Apr · PMID 42026968
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The Center for Evidence to Practice at Louisiana State University Health Sciences School of Public Health (hereinafter, the Center) is committed to strengthening the capacity of Medicaid providers to implement and sustai...The Center for Evidence to Practice at Louisiana State University Health Sciences School of Public Health (hereinafter, the Center) is committed to strengthening the capacity of Medicaid providers to implement and sustain evidence-based practices (EBPs) for behavioral health services. With funding from the Louisiana Department of Health-Office of Behavioral Health, the Center conducted the EBP Capacity and Sustainability Funding Initiative to expand the use and accessibility of EBPs in Louisiana. This case study examined how targeted financial incentives and technical assistance supported clinicians in qualifying for, billing, and delivering 7 EBPs within Louisiana's Medicaid behavioral health system. Thirty EBP-qualified clinicians delivered 361 sessions to 93 clients during a 5-month funding period (March-July 2022) and earned $167 500 in incentives across 25 entities. A survey of these clinicians found that 96% (24 of 25) would recommend this type of incentive, reporting increased motivation, professional recognition, and capacity to grow their practices. However, Medicaid claims data showed that the use of EBP tracking codes decreased after the incentive period ended, suggesting that short-term funding alone was insufficient for long-term sustainability. Clinicians identified administrative and technical barriers, including inconsistent managed care organization requirements and nonstandardized billing processes. A simplified billing infrastructure and ongoing funding incentives are needed to reduce the administrative burden of billing and promote EBP implementation. Findings highlight the strengths and limitations of short-term incentive programs for advancing EBP delivery within a Medicaid system.
Holman DM, Mallen ES, Reza A
… +2 more, Townsend JS, Kava CM
Public Health Rep
· 2026 Apr · PMID 41933898
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Public health efforts to reduce cancer risk often include strategies intended to create community spaces that support healthy behaviors (eg, physical activity, healthy eating) and reduce harmful exposures (eg, tobacco sm...Public health efforts to reduce cancer risk often include strategies intended to create community spaces that support healthy behaviors (eg, physical activity, healthy eating) and reduce harmful exposures (eg, tobacco smoke), all of which can help to reduce the risk of cancer and other chronic diseases. Meanwhile, a growing body of literature has quantified the health, social, and economic benefits that trees bring to communities, including benefits directly related to cancer risk and prevention. However, in the field of cancer prevention and control, little attention has been given to the health benefits that tree shade can bring to communities. In the context of skin cancer prevention, efforts have been made to increase the availability of shade in outdoor community spaces to support sun safety. However, these efforts have often focused on built shade and rarely highlighted the additional health benefits that shade trees can provide. In addition, the larger body of literature documenting the health benefits that trees bring to communities rarely frames this information in the context of cancer types beyond skin cancer. In this topical review, we discuss the benefits of community-level efforts to increase tree shade availability for cancer prevention and control, including reductions in exposure to ultraviolet radiation and heat, improved air quality, and increased physical activity in outdoor community spaces. We then discuss the implications of these benefits, including the value of multisectoral partnerships, the importance of strategic communication about the benefits of tree shade, best practices for increasing and maintaining tree shade, and opportunities for future research to further quantify such benefits in cancer-related health outcomes.
Public Health Rep
· 2026 Mar · PMID 41889251
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The New York City Department of Health and Mental Hygiene conducts surveillance of hepatitis B virus (HBV) infection among pregnant/postpartum patients. Patients are identified by multiple methods, including reporting of...The New York City Department of Health and Mental Hygiene conducts surveillance of hepatitis B virus (HBV) infection among pregnant/postpartum patients. Patients are identified by multiple methods, including reporting of maternal hepatitis B surface antigen (HBsAg) status on the Newborn Metabolic Screening Form (NMSF) at the time of delivery. Health Department staff investigate reports received for HBV infection among pregnant/postpartum patients, including reports of positive HBsAg status on the NMSF, to confirm maternal HBV infection (ie, a confirmed case). We restricted this evaluation to confirmed cases that resulted in a live birth during January 2019 through June 2022 to patients with a residential address in New York City. We evaluated the utility of NMSF reports for (1) quality of demographic information, (2) the percentage of all confirmed cases that were recorded as HBsAg positive in the NMSF, (3) positive predictive value, and (4) timeliness. We received 6509 NMSF reports, of which 2575 indicated a positive HBsAg status, 1502 unknown, and 2432 missing. Among the HBsAg-positive NMSF reports, we matched 2196 to confirmed cases of HBV infection (positive predictive value, 85%). The 2196 confirmed cases with HBsAg-positive NMSF reports represented 77% of all 2864 confirmed cases of HBV infection. For 148 confirmed cases (5%), the HBsAg-positive NMSF report was the only source. Our evaluation demonstrates that the NMSF is an important supplementary reporting method for identifying pregnant/postpartum patients with HBV infection.
Branstetter B, Clelland-Goddard A, Sagar A
… +2 more, Miron E, Sacca L
Public Health Rep
· 2026 · PMID 41871907
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OBJECTIVES: Few analyses have differentiated locally acquired Lyme disease infection from travel-associated infection, limiting the ability to interpret whether case counts reflect true in-state transmission or increased...OBJECTIVES: Few analyses have differentiated locally acquired Lyme disease infection from travel-associated infection, limiting the ability to interpret whether case counts reflect true in-state transmission or increased detection among mobile populations. We analyzed and compared trends in Lyme disease incidence at the national level and in the state of Florida. METHODS: We primarily used Lyme disease surveillance data from the Centers for Disease Control and Prevention from 2010 through 2023. The data included total case numbers, demographic characteristics, and county-level distribution maps. We stratified data by age, sex, and county in Florida. We conducted a Pearson correlation analysis to examine the association between Florida's mean annual temperature and Lyme disease incidence from 2010 through 2023. RESULTS: Florida recorded 84 Lyme disease cases in 2010 and 271 cases in 2023; incidence per 100 000 residents rose from 0.4 in 2010 to 1.2 in 2023. Older adults had the highest incidence of reported Lyme disease in Florida. Lyme disease incidence was slightly higher among females than among males. North Florida was a hotspot for Lyme disease transmission, and the North Central region (roughly from Jacksonville to Tallahassee) consistently yielded most of the Florida-acquired tickborne disease cases. CONCLUSION: Early detection and timely action to reduce the spread of Lyme disease is important for several intertwined clinical, economic, and ecological reasons. Further research is needed to differentiate infections acquired outside the state to clarify their influence on state trends. Establishing proactive measures in Florida's public health and education sectors for tickborne disease prevention is necessary to reduce risk as Lyme disease cases continue to increase in Florida.
Naidu M, Shin J, St John K
… +4 more, Ledingham EM, McKee H, McKenzie M, Park JN
Public Health Rep
· 2026 · PMID 41807276
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OBJECTIVES: Fentanyl overdose deaths are a critical public health issue in the United States. Rhode Island, an early epicenter of the fentanyl crisis, has seen fentanyl overdose deaths increase 30-fold since 2009. In res...OBJECTIVES: Fentanyl overdose deaths are a critical public health issue in the United States. Rhode Island, an early epicenter of the fentanyl crisis, has seen fentanyl overdose deaths increase 30-fold since 2009. In response, harm reduction tools such as fentanyl test strips (FTSs) have been introduced to help people who use drugs (PWUD) detect fentanyl in their substances. We analyzed FTS use among PWUD in Rhode Island from 2021 through 2023 and identified characteristics associated with their use. METHODS: We conducted a pooled cross-sectional analysis using aggregate data from the Rhode Island Harm Reduction Surveillance System. We used bivariate Pearson χ tests to assess the relationship between past-month FTS use and demographic and behavioral characteristics. Because analyses were limited to unadjusted comparisons, these findings are exploratory and hypothesis generating. RESULTS: Of 498 survey respondents, most identified as male (n = 328; 65.9%), non-Hispanic White (n = 204; 41.0%), straight (n = 400; 80.3%), and aged 25 to 44 years (n = 288; 57.8%). The most frequently reported substances used were crack (n = 355; 71.3%), cocaine (n = 219; 44.0%), and fentanyl/heroin (n = 196; 39.4%). Only 31.7% of individuals reported FTS use in the past 30 days. FTS use was significantly associated with age, race and ethnicity, witnessing an overdose, possessing naloxone, and recent fentanyl/heroin use (all < .05). CONCLUSIONS: Despite FTS distribution efforts and overdose risk, FTS uptake in Rhode Island was low. Future research should assess barriers to FTS adoption and consider integrating FTS distribution within naloxone programs.
Kirkcaldy RD, Doyle H, Gusman S
… +3 more, Burke E, Bernstein KT, Leider JP
Public Health Rep
· 2026 · PMID 41807275
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OBJECTIVES: In 2024, the Centers for Disease Control and Prevention and the Council of State and Territorial Epidemiologists suggested approaches, including upskilling and recruitment/hiring, to strengthen the workforce...OBJECTIVES: In 2024, the Centers for Disease Control and Prevention and the Council of State and Territorial Epidemiologists suggested approaches, including upskilling and recruitment/hiring, to strengthen the workforce capacity in public health data science. We estimated the number of recently graduated data scientists who might be eligible for and potentially hirable into government public health jobs as a step toward filling data gaps in workforce planning. METHODS: We used data from the National Center for Education Statistics to calculate the number of data science graduates in 2023. As a proxy for interest in government public health among graduates, we used data from the Association of Schools and Programs of Public Health (graduation years 2015-2022). We multiplied the number of data science graduates from US academic institutions (from National Center for Education Statistics data) by the percentage of public health graduates who entered government public health employment (from Association of Schools and Programs of Public Health data) to estimate the number of data science graduates who might be eligible for and interested in government public health employment. RESULTS: In 2023, 467 435 graduates were awarded a data science degree from a US institution. Depending on the government employment criteria, 8.3% to 15.7% of 96 578 public health graduates reported first-destination employment in government public health. The total number of data science graduates who might be eligible for and interested in government public health employment ranged from nearly 29 000 to >57 000. CONCLUSIONS: These data contribute to the evidence base for public health workforce planning but are likely to be overestimates of supply. If the estimated supply of data scientists falls short of demand projections, staff data science upskilling and changes to academic curricula could be emphasized.
Vijayaraghavan M, Williams A, Bonniot C
… +6 more, Cheng C, Clark B, Safier J, Satterfield J, Pamatmat M, Schroeder SA
Public Health Rep
· 2026 · PMID 41797633
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From 2010 to 2023, the Smoking Cessation Leadership Center partnered with the Substance Abuse and Mental Health Services Administration to launch the State Leadership Academies (hereinafter, Leadership Academies) to addr...From 2010 to 2023, the Smoking Cessation Leadership Center partnered with the Substance Abuse and Mental Health Services Administration to launch the State Leadership Academies (hereinafter, Leadership Academies) to address tobacco use in populations with behavioral health conditions in the United States. The Leadership Academies were a facilitated convening of leaders in tobacco control, behavioral health, and public health who were tasked with creating action plans to reduce the high rates of tobacco use in populations with behavioral health conditions in their states. State partners convened for a 2-day summit between 2010 and 2023, created an action plan, and, in the subsequent 3 to 5 years, implemented and evaluated the action plan in the areas of data, systems, education, or policy. Using a multimethods evaluation approach, we describe short-term outcomes (collaborations), intermediate outcomes (examples of integration of tobacco treatment and policy), and long-term outcomes (decline in tobacco use prevalence) of the Leadership Academies, focusing on 4 state case studies. The case studies highlighted unique partnerships, impactful strategies, the harnessing of state-level infrastructure, and the importance of political will to achieve state-level reductions in tobacco use in populations with behavioral health conditions. The 4 states showed a mean decline of 5.2% in smoking prevalence among people with frequent poor mental health and 6.2% among people with heavy drinking during their Leadership Academy tenure. The case demonstrated the importance of cross-sector collaboration, leadership buy-in, and the creation of sustainable funding structures to support the scaling up of promising projects. Leadership Academies were an effective engagement model to reduce the prevalence of tobacco use in populations with behavioral health conditions.
Bakshi A, Zhao N, Kar S
… +2 more, Truong A, Sheikh F
Public Health Rep
· 2026 Mar · PMID 41797619
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OBJECTIVE: Routine childhood vaccination rates declined nationwide among children born during 2020-2021 compared with prior birth cohorts. We identified sociodemographic risk factors associated with incomplete 7-vaccine...OBJECTIVE: Routine childhood vaccination rates declined nationwide among children born during 2020-2021 compared with prior birth cohorts. We identified sociodemographic risk factors associated with incomplete 7-vaccine series among children born during widespread health care disruptions due to the COVID-19 pandemic. METHODS: We retrieved childhood vaccination data from Louisiana's Immunization Information System for children born from March 1, 2020, through July 1, 2021, to identify completion status of the 7-vaccine series by age 24 months. After geocoding home addresses, we used regression analyses and machine-learning models to identify social vulnerability factors at the individual and census-tract levels that were associated with 1 or more missing vaccine doses. RESULTS: Children residing a greater distance from the vaccinating facility (adjusted odds ratio [AOR] = 1.12; 95% CI, 1.05-1.19; = .002) and in a census tract with a larger low-income population than the statewide median (AOR = 1.14; 95% CI, 1.05-1.23; = .006) had significantly higher odds of being 1 dose short of 7-vaccine series completion by age 24 months. Similarly, children residing in areas with a larger low-income (AOR = 1.18. 95% CI, 1.14-1.23; < .001) and non-White (AOR = 1.07; 95% CI, 1.02-1.11; = .04) population than the statewide median had higher odds of missing multiple doses of the 7-vaccine series by age 24 months. CONCLUSION: We need further research to identify and implement best practices that help socially vulnerable communities retain access to routine health care, such as childhood immunizations, during future public health emergencies.
Public Health Rep
· 2026 Mar · PMID 41793175
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OBJECTIVE: Some refugee children in the United States have an elevated blood lead level (EBLL), which can result in neurologic disease and developmental delays. Little has been published on EBLLs in immigrant infants and...OBJECTIVE: Some refugee children in the United States have an elevated blood lead level (EBLL), which can result in neurologic disease and developmental delays. Little has been published on EBLLs in immigrant infants and children whose families are seeking humanitarian protections outside the refugee program. We evaluated lead testing and anemia in this population. METHODS: We performed a cross-sectional analysis of lead testing and anemia in infants and children whose families were seeking humanitarian protection (eg, asylum) and treated in clinics in Chelsea, Massachusetts (September 30, 2022-June 30, 2024) and New York City (January 1-November 30, 2023). We extracted demographic and clinical data from the medical records of clinics serving families who received emergency assistance with sheltering. We evaluated the proportion who completed lead testing and the prevalence of EBLL (≥3.5 µg/dL). We used Pearson χ and Kruskal-Wallis tests to determine factors significantly associated with EBLL. RESULTS: Among 882 children (most from Venezuela [29.5%], Ecuador [22.0%], Colombia [16.2%], and Peru [6.7%]), 693 (78.6%) completed testing for lead. Lead testing was more common among children aged <5 years than among older children ( < .001). Nine of 693 children (1.3%; 95% CI, 0.6%-2.5%) had EBLL; the mean blood lead level was 5.31 µg/dL. Eight of the 9 children with EBLL were boys ( = .06). Of 882 children, 146 (16.6%) had anemia; 2 children with EBLL had anemia. We did not find a statistically significant association between country of origin and EBLL ( = .23). CONCLUSION: Clinicians and public health professionals serving newcomer populations should enhance efforts to prevent and screen for EBLL and anemia.