Public Health Reports[JOURNAL]
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200 papers
Corrigendum to "When Stigma, Disclosure, and Access to Care Collide: An Ethical Reflection of mpox Vaccination Outreach".
Public Health Rep · 2026 Mar · PMID 41776944 · Full text
Abstract loading — click title to view on PubMed.
Trends in Active Tuberculosis Cases Diagnosed in New York City During the COVID-19 Pandemic.
Bamforth EG, Jordan HT, Trieu L
Public Health Rep · 2026 Feb · PMID 41761719 · Full text
OBJECTIVES: The number of active tuberculosis (TB) cases reported in New York City in 2020 declined 20% from 2019. To describe this decrease, we examined the characteristics of TB patients before and during the COVID-19...
OBJECTIVES: The number of active tuberculosis (TB) cases reported in New York City in 2020 declined 20% from 2019. To describe this decrease, we examined the characteristics of TB patients before and during the COVID-19 pandemic. METHODS: We compared the characteristics of 2 groups of TB cases: (1) cases in New York City's TB surveillance registry diagnosed during the pandemic (March 1, 2020-February 28, 2022) and the stay-at-home order PAUSE (Policies that Assure Uniform Safety for Everyone) (March 23-June 7, 2020) and (2) cases diagnosed before the pandemic (March 1, 2018-February 29, 2020). RESULTS: We identified 1088 patients with TB before the pandemic and 945 patients with TB during the pandemic; 62 patients were diagnosed with TB during PAUSE (53% fewer compared with the same dates in 2019). During the pandemic versus before the pandemic, a significantly higher proportion of patients were hospitalized at diagnosis (66.3% vs 60.1%; < .001). During PAUSE versus before the pandemic, a higher (but not significantly higher) proportion of patients with pulmonary TB had a positive respiratory acid-fast bacilli smear result (63.5% vs 57.8%; = .42) and cavitation on chest imaging (48.1% vs 39.0%; = .19). The median duration of TB symptoms before diagnosis was 58 days during the pandemic and 45 days before the pandemic ( = .02). During the pandemic, a higher (but not significantly higher) proportion of patients died before treatment start (3.3% vs 2.0%; = .08) and before treatment completion (9.0% vs 6.8%; = .07) compared with before the pandemic. CONCLUSIONS: TB diagnoses precipitously declined during PAUSE. Disease severity and symptom duration increased among patients during the COVID-19 pandemic, indicating that TB diagnoses may have been delayed and that TB may have been underdiagnosed during the pandemic in New York City.
Evaluation of Generative Artificial Intelligence Safeguards Against the Creation of Images and Videos Harmful to Public Health.
Chu B, Modi ND, Menz BD … +9 more , Cornelisse E, Bacchi S, Bulamu N, Ullah S, McKinnon RA, Gradon K, Rowland A, Sorich MJ, Hopkins AM
Public Health Rep · 2026 · PMID 41747768 · Full text
OBJECTIVES: As generative artificial intelligence (AI) continues to advance, an environment that lacks strong safeguards could create opportunities for misuse by malicious actors. This study aimed to evaluate the safegua...
OBJECTIVES: As generative artificial intelligence (AI) continues to advance, an environment that lacks strong safeguards could create opportunities for misuse by malicious actors. This study aimed to evaluate the safeguards of publicly accessible generative AI applications against the creation of image and video content potentially harmful to public health. METHODS: We assessed the safeguards of 10 leading text-to-image models and 2 text-to-video models across 5 public health themes: promoting solariums as safe, stigmatizing overweight people, promoting alcohol use as safe during pregnancy, depicting vaping as healthy, and depicting smoking cigarettes as cool for teenagers. For each theme, we submitted 10 paraphrased prompts in duplicate to the image models and once to each video model. Two independent reviewers categorized outputs as potentially harmful or not, with a third reviewer responsible for resolving discrepancies. We used χ² tests to determine significant differences in outputs. RESULTS: Among 1000 image prompt submissions, we judged 521 (52%) of the generated images to be potentially harmful to public health. Image generation rates varied significantly by public health theme-from 43% (85 of 200) of prompts promoting alcohol use as safe during pregnancy to 64% (128 of 200) of prompts depicting vaping as healthy ( < .001)-and across models, from 0% for ChatGPT to 98% for Reve ( < .001). Of 100 video prompt submissions, we classified 52% of outputs from Sora and 30% from Flow as potentially harmful. CONCLUSIONS: Generative AI applications varied significantly in safeguards, with several systems often generating images that could be harmful to public health. The findings underscore the urgent need for greater transparency, safety, and oversight of generative AI to mitigate public health harms.
Informed Consent in Molecular HIV Epidemiology: A Rapid Review of the Literature to Identify Concerns and Recommendations.
Onyeama U, Rennie S, Day S … +1 more , Dennis AM
Public Health Rep · 2026 Feb · PMID 41736659 · Full text
In the United States, molecular HIV epidemiology (MHE) is a key part of the National HIV/AIDS Strategy, which incorporates the evaluation of HIV genetic sequences for cluster detection and response. Data collection for M...
In the United States, molecular HIV epidemiology (MHE) is a key part of the National HIV/AIDS Strategy, which incorporates the evaluation of HIV genetic sequences for cluster detection and response. Data collection for MHE occurs without any requirement for formal consent from patients, which has sparked ethical concerns among community members, ethicists, and advocates. We conducted a rapid review of the current literature on informed consent and MHE to understand the key concerns and recommendations. We searched 4 academic databases and included articles that examined the issue of informed consent in MHE practices. We screened a total of 119 articles and selected 30 articles for inclusion. From these, we extracted data pertaining to concerns and recommendations related to informed consent in MHE, including MHE in the context of both research and surveillance. Our findings revealed 2 main categories of concerns: (1) challenges in obtaining valid informed consent and (2) concerns related to the current lack of consent such as risks of data misuse, privacy violations, and potential stigma. We identified 3 main categories of recommendations: establishing stronger data governance, developing ethical consent practices, and increasing community engagement. A key theme identified was an unresolved contestation about the ethics of using MHE without consent and whether the potential public health benefits of MHE justify concerns about autonomy, privacy, and potential harm. Future directions include the need for empirical research to evaluate the risks and benefits of MHE and the development of practices for meaningful community engagement to ensure ethical and context-sensitive approaches.
Parental Underestimation of Their Child's Overweight and Obesity: Influence of Feedback From a Health Care Provider in a Nationally Representative Sample.
Moss BG
Public Health Rep · 2026 Feb · PMID 41736653 · Full text
OBJECTIVES: Parental misperception of a child's weight status is common and may delay recognition and intervention for overweight and obesity. This study estimated the prevalence of parental underestimation of their chil...
OBJECTIVES: Parental misperception of a child's weight status is common and may delay recognition and intervention for overweight and obesity. This study estimated the prevalence of parental underestimation of their child's weight status among US children and adolescents with overweight or obesity and assessed whether health care provider (hereinafter, provider) feedback was associated with this underestimation. METHODS: Data came from the 2012 National Youth Fitness Survey (n = 1571), a nationally representative cross-sectional survey of US children and adolescents aged 3 to 15 years. Parent-reported weight perception was compared with measured body mass index. Inaccurate parental perception (underestimation) was defined as a parent perceiving a child with measured overweight or obesity as "about the right weight" or "underweight." Survey-weighted logistic regression was used to estimate the odds of underestimation by child sex, age group, and parental recall of provider feedback. Predicted probabilities were calculated using marginal standardization. RESULTS: Most parents of children with overweight (82%) and nearly half of parents of children with obesity (44%) underestimated their child's weight status. Parents who did not recall receiving provider feedback were substantially more likely to underestimate their child's weight status than parents who recalled receiving feedback (78% vs 31%). The odds of underestimation were nearly 10 times higher among parents without provider feedback than among parents who received feedback (adjusted odds ratio = 9.65; 95% CI, 5.57-16.70). Underestimation was more common among younger children and among boys. CONCLUSIONS: Parental underestimation of their child's overweight and obesity is widespread and strongly associated with the absence of provider feedback. Clinical communication may represent a low-cost, scalable strategy to improve parental perception of unhealthy weight and support early intervention.
Predictors of Breast Cancer Screening Variability Among National Breast and Cervical Cancer Early Detection Program Awardees: Provider Shortages and Nurse Practitioner Autonomy.
Bermudez Y, Miller J, Kenney K … +2 more , Schlueter D, Fairley T
Public Health Rep · 2026 Feb · PMID 41724668 · Full text
OBJECTIVE: The percentage of eligible women screened for breast cancer varies among National Breast and Cervical Cancer Early Detection Program (NBCCEDP) awardees. We assessed the effect of awardee- and state-level facto...
OBJECTIVE: The percentage of eligible women screened for breast cancer varies among National Breast and Cervical Cancer Early Detection Program (NBCCEDP) awardees. We assessed the effect of awardee- and state-level factors on the percentage of eligible women screened for breast cancer among NBCCEDP awardees. We focused on primary care-health professional shortage areas (PC-HPSAs) and nurse practitioner scope of practice. METHODS: First, we calculated the study outcome, defined as the percentage of eligible women screened among NBCCEDP state awardees during July 2022-June 2024. Next, we gathered data on awardee- and state-level predictors from multiple sources and estimated 2 general linear multilevel models. Models differed only by the inclusion of an interaction term between PC-HPSA and nurse practitioner autonomy. Finally, we calculated marginal and partial to determine combined and individual contributions of predictors on variability in the study outcome. RESULTS: The average percentage of eligible women screened for breast cancer among awardees was 9.6% (range, 0.5%-78.0%). Awardees in states with (1) full nurse practitioner autonomy or (2) a larger percentage of their population living in PC-HPSAs screened larger percentages of eligible women as compared with awardees in states without full autonomy or with smaller PC-HPSA populations. Awardees in states with full nurse practitioner autonomy and larger PC-HPSA populations screened even higher percentages of eligible women (β = 0.46; = .02). Interaction model predictors explained 59% (marginal = 0.59) of the variability in the percentage of eligible women screened among awardees, with PC-HPSA being the largest contributor, explaining 27% of the variability (partial = 0.27). CONCLUSIONS: NBCCEDP awardees can encourage their clinical partners to reach women in PC-HPSAs and encourage strategic partnerships with nurse practitioners to address differences in screening.
Prevalence of Nonfatal Opioid Overdoses and Interactions With the Health Care System Prior to Death Among Opioid Overdose Decedents, Rhode Island, 2023.
Hallowell BD, Shin J, Weidele H … +2 more , Omari J, Wightman RS
Public Health Rep · 2026 Feb · PMID 41724663 · Full text
OBJECTIVES: Most people who experience a fatal opioid overdose have never received medical care for a prior nonfatal overdose. Because minimal health care interaction could limit the effect of postoverdose interventions...
OBJECTIVES: Most people who experience a fatal opioid overdose have never received medical care for a prior nonfatal overdose. Because minimal health care interaction could limit the effect of postoverdose interventions on preventing overdose fatalities, we evaluated the percentage of opioid overdose decedents who experienced a nonfatal opioid overdose prior to death. METHODS: We identified accidental fatal opioid overdoses that occurred in Rhode Island in 2023. To identify prior nonfatal opioid overdoses and prior health care use, we used emergency medical services (EMS) run data from 2016-2023 and emergency department (ED) discharge data from October 1, 2020, through December 31, 2023. Each date range represents the earliest date for which identifiable data were available. We excluded from analysis health care interactions that occurred within 1 day of the date of death. RESULTS: In 2023, a total of 318 Rhode Island residents who met inclusion criteria died of an opioid overdose. In the 6 months, 1 year, 2 years, 3 years, and 5 years before death, 12.3%, 16.4%, 22.6%, 26.7%, and 29.2% of decedents, respectively, had a prior nonfatal opioid overdose. The likelihood of having a prior nonfatal opioid overdose did not vary by age group, sex, race and ethnicity, or county of residence. The proportion of decedents who had at least 1 interaction with EMS or ED services increased from 45.9% at 6 months to 58.5% at 1 year, 67.0% at 2 years, 72.3% at 3 years, and 75.8% at 5 years before death. CONCLUSION: Our findings have important implications for overdose prevention efforts focused on connecting people experiencing nonfatal opioid overdoses to care, as these efforts would miss up to 71% of overdose decedents.
Comparison of e-Cigarette and Cigarette Use and Dual Use Associations With Disease: Updated Systematic Review and Meta-Analysis.
Glantz SA, Oliveira da Silva AL
Public Health Rep · 2026 · PMID 41702869 · Full text
OBJECTIVE: Electronic cigarettes (e-cigarettes) are often presented as a less harmful alternative to combustible cigarettes (hereinafter, cigarettes). This study updates an earlier meta-analysis of 107 population studies...
OBJECTIVE: Electronic cigarettes (e-cigarettes) are often presented as a less harmful alternative to combustible cigarettes (hereinafter, cigarettes). This study updates an earlier meta-analysis of 107 population studies of e-cigarette disease risks. METHODS: We pooled data from studies in PubMed, EMBASE, Web of Science, and PsychINFO from January 1, 2005, through January 1, 2025, in a random-effects meta-analysis if we identified ≥5 studies for a disease outcome. RESULTS: We identified 142 odds ratios (ORs) (107 [75%] from cross-sectional studies and 35 [25%] from longitudinal studies) from 124 articles, including 18 new articles. Comparing e-cigarette use with cigarette use, the ORs (95% CIs) for metabolic dysfunction (1.00 [0.91-1.09]) and oral disease (0.89 [0.78-1.02]) were not different from 1.0. The ORs (95% CIs) for cardiovascular disease (0.76 [0.58-0.99]), stroke (0.62 [0.47-0.82]), asthma (0.84 [0.74-0.95]), chronic obstructive pulmonary disease (0.55 [0.40-0.76]), and fetal growth (0.64 [0.44-0.92]) were ≤1.0. Pooled ORs for dual use versus cigarette use were increased for all outcomes (range, 1.22-1.42) except fetal growth (0.99). Pooled ORs for e-cigarette use, compared with nonuse of e-cigarettes, were increased for all outcomes (e-cigarette range, 1.24-1.53) except fetal growth (1.20). Dual use was associated with increased ORs for all outcomes (1.49-3.17). Studies had a low risk of bias. Results were generally not sensitive to study characteristics. Confidence in conclusions was mostly moderate to high except for stroke, where confidence was low for some outcomes, and fetal growth, for which confidence was very low for all outcomes. CONCLUSION: The growing literature increases confidence that e-cigarette use is associated with disease outcomes indistinguishable from or approaching cigarette use, with dual use associated with higher ORs. E-cigarettes should not be promoted as a safer alternative to cigarettes.
Differences in Hospitalization and Inpatient Death Patterns by Incarceration Status in 31 US Jurisdictions, 2021.
Kennedy BS, Richeson RP, Houde AJ
Public Health Rep · 2026 Feb · PMID 41699843 · Full text
OBJECTIVE: Population-based studies that examine both hospitalization and inpatient death patterns by incarceration status are sparse. We sought to compare hospitalization and inpatient death patterns by incarceration st...
OBJECTIVE: Population-based studies that examine both hospitalization and inpatient death patterns by incarceration status are sparse. We sought to compare hospitalization and inpatient death patterns by incarceration status in the United States. METHODS: In this retrospective study of adults aged 18 to 64 years, we used the 2021 State Inpatient Database files from 31 US jurisdictions, which included discharges from general acute care hospitals. We compared hospitalization and inpatient death patterns among incarcerated adults versus nonincarcerated adults using adjusted rate ratios (ARRs) and 95% CIs, estimated with negative binomial regression. We examined discharges overall and discharges by nonoverlapping hospital service line. RESULTS: The study population included 6.3 million hospital discharges (incarcerated, 1.1%; mean [SD] age, 47.5 [12.7] y; women, 46.8%; non-Hispanic White race and ethnicity, 36.6%), with 2.2% inpatient deaths. For discharges overall, incarcerated adults had higher rates of hospitalization (ARR = 2.9; 95% CI, 2.2-3.8) than nonincarcerated adults, which was driven mainly by higher rates of inpatient admissions classified as mental health/substance use (ARR = 11.8; 95% CI, 8.5-16.8) and injury (ARR = 1.9; 95% CI, 1.6-2.2) among incarcerated adults than among nonincarcerated adults. However, surgical (ARR = 0.6; 95% CI, 0.5-0.6) and medical (ARR = 0.8; 95% CI, 0.7-0.9) admissions were lower among incarcerated adults than among nonincarcerated adults. Overall, incarcerated adults had lower inpatient mortality during their length of stay (ARR = 0.4; 95% CI, 0.4-0.5) than nonincarcerated adults, which was consistent by hospital service line. CONCLUSIONS: Considering hospitalization and mortality together offers a clear view of health care use among incarcerated adults and underscores the need for integrated correctional-hospital data systems to inform public health practice and policy.
Association Between Soda or Sports Drink Consumption and a Past-Year Dentist Visit: National Survey Among American Indian or Alaska Native High School Students, 2023.
Molinari AHW, Satter DE, Merlo CL … +4 more , Lin M, Mauritson E, Saelee R, Reece J
Public Health Rep · 2026 · PMID 41652670 · Full text
OBJECTIVES: Sugar-sweetened beverages (SSBs) are the leading contributor of added sugars in the diets of children, adolescents, and young adults aged 2 to 19 years and are associated with chronic diseases, including oral...
OBJECTIVES: Sugar-sweetened beverages (SSBs) are the leading contributor of added sugars in the diets of children, adolescents, and young adults aged 2 to 19 years and are associated with chronic diseases, including oral health conditions such as dental caries. We assessed the possible association between the consumption of soda or sports drinks (SSDs), 2 types of SSBs, and past-year dentist visits among American Indian or Alaska Native (AI/AN) high school students because this population has unique challenges related to oral health (eg, barriers to access to care) that might increase SSD consumption and decrease the frequency of dentist visits. METHODS: We analyzed data from the 2023 national Youth Risk Behavior Survey and used a 3-stage cluster sampling design to produce a nationally representative sample of students in grades 9 through 12 attending public and private schools. We examined the association between consumption of SSDs or water and having seen a dentist during the past 12 months for a dental check-up, examination, teeth cleaning, or other dental work among 2770 AI/AN students. RESULTS: Among 2770 AI/AN students, the weighted prevalence of having a dentist visit during the past 12 months was 67.6%. Students who consumed SSDs more frequently were less likely to have had a past-year dentist visit (adjusted prevalence ratio = 0.7; 95% CI, 0.5-0.9), whereas students who drank water ≥3 times per day were more likely to have had a past-year dentist visit (adjusted prevalence ratio = 1.3; 95% CI, 1.0-1.7). CONCLUSIONS: Community efforts to reduce consumption of SSBs such as SSDs, encourage healthier beverages such as water, and promote oral health visits in AI/AN communities could improve oral health outcomes.
Simplifying Public Health Recommendations: Use of a Public CDC Chatbot During the COVID-19 Pandemic, 2022-2024.
Castonguay FM, Boyette MH, Katz D … +6 more , Lee TF, McDaniel R, Patel P, Smith WF, Way PD, Meltzer MI
Public Health Rep · 2026 Feb · PMID 41635214 · Full text
To help people with COVID-19 and their contacts quickly understand guidelines to prevent transmission, the Centers for Disease Control and Prevention (CDC) developed an interactive calculator that indicated whether and h...
To help people with COVID-19 and their contacts quickly understand guidelines to prevent transmission, the Centers for Disease Control and Prevention (CDC) developed an interactive calculator that indicated whether and how long to stay home, get tested, wear face masks, and adopt other precautions. The CDC COVID-19 Calculator used a web-based chatbot format that mimicked a 2-person conversation. The calculator had the following design specifications: (1) reach an audience of people with COVID-19 (who tested positive or were symptomatic for COVID-19) and their close contacts and (2) provide an answer to the question "When can I leave home?" in less than 1 minute. To measure the use of the calculator, we analyzed the number of anonymous unique visitors and median visit time. The calculator had approximately 13.6 million visitors by March 1, 2024. The median visit time was 38 seconds, and approximately 65% of visits were via smartphones. The millions of unique visitors to the CDC COVID-19 Calculator demonstrated the usefulness of a conversational chatbot format to provide public health guidance. Future research should assess whether such tools influence behavior.
Medicaid Expansion and Rural-Urban Disparities in Postpartum Medicaid Coverage.
Boggs E, Stefanescu A, Gritz M … +3 more , Lindrooth R, Admon L, Tipirneni R
Public Health Rep · 2026 Feb · PMID 41635169 · Full text
OBJECTIVE: Rural residents experience higher rates of postpartum uninsurance than their urban counterparts, contributing to rural-urban disparities in maternal health outcomes. We examined how Medicaid expansion under th...
OBJECTIVE: Rural residents experience higher rates of postpartum uninsurance than their urban counterparts, contributing to rural-urban disparities in maternal health outcomes. We examined how Medicaid expansion under the Affordable Care Act affected rural-urban disparities in the rates of postpartum health insurance coverage among low-income women. METHODS: We used nationally representative data from the 2010-2012 and 2015-2019 American Community Survey to compare rates of postpartum health insurance coverage among low-income women in states that expanded Medicaid and states that did not expand Medicaid (difference-in-differences analysis). We analyzed changes in disparities in postpartum health insurance coverage between women living in rural areas and women living in urban areas (difference-in-difference-in-differences analysis). RESULTS: Women living in rural areas had the greatest increases in postpartum health insurance coverage, with a 17.0 percentage-point increase in states that expanded Medicaid (95% CI, 13.9-20.2) and an 11.5 percentage-point increase in states that did not expand Medicaid (95% CI, 9.2-13.8). Any postpartum health insurance coverage among rural residents relative to urban residents increased by 4.8 percentage points (95% CI, 2.0-7.7) in states that expanded Medicaid compared with states that did not. We observed similar trends for Medicaid postpartum health insurance coverage specifically. CONCLUSIONS: Rural women had greater increases in postpartum health insurance coverage relative to urban women following Medicaid expansion, thereby reducing geographic disparities in health insurance coverage during the postpartum period. Future research should focus on whether disproportionate gains in health insurance coverage for rural communities led to increased access to care during the postpartum period.
Leveraging Syndromic Surveillance for Rabies Postexposure Prophylaxis Surveillance in Maine, 2018-2022.
Lamere L, Sohail H, Robinson S
Public Health Rep · 2026 · PMID 41635032 · Full text
OBJECTIVES: In Maine, rabies postexposure prophylaxis (PEP) administration is reportable to public health. We sought to determine the objectives of the Maine Center for Disease Control and Prevention's (Maine CDC's) PEP...
OBJECTIVES: In Maine, rabies postexposure prophylaxis (PEP) administration is reportable to public health. We sought to determine the objectives of the Maine Center for Disease Control and Prevention's (Maine CDC's) PEP administration surveillance system and whether the method of conducting surveillance through a manual health care provider (hereinafter, provider) reporting system meets these objectives. We also compared provider-reported PEP administrations with administrations identified in emergency department (ED) data. METHODS: During September 2022, we interviewed 8 Maine CDC epidemiologists to determine system objectives. We obtained and compared PEP administration data from provider reporting system and ED data and summarized each dataset by year, exposing animal, and facility. We assessed the ability of each source to address surveillance system objectives by comparing data elements with each objective. RESULTS: Maine CDC epidemiologists described the following objectives of the surveillance system: (1) track potential human exposures to rabid or potentially rabid animals, (2) document PEP administration trends, and (3) ensure PEP is correctly administered. They determined the third objective is not being achieved by the current system. During January 2018-June 2022, we identified 538 provider-reported PEP administrations and 1191 PEP administrations through ED data. ED data were more timely than provider reports and identified more PEP administrations, but 28% of ED records did not contain information on the exposing animal. CONCLUSIONS: Maine CDC can use ED data to document PEP administration trends in near-real time. ED data obtained from syndromic surveillance might be used in tandem with or in place of Maine CDC's traditional PEP surveillance system. We are building more complex queries that more fully capture PEP administrations to have a thorough understanding of PEP administered in Maine.
Compliance With England's Calorie Labeling Regulations 3 Years After Policy Implementation.
Huse O, Kalbus A
Public Health Rep · 2026 Jan · PMID 41617245 · Full text
We examined compliance with England's calorie labeling regulations, which require large out-of-home food businesses to display the calories of prepared food and drink at the point of choice, such as menus. By using websi...
We examined compliance with England's calorie labeling regulations, which require large out-of-home food businesses to display the calories of prepared food and drink at the point of choice, such as menus. By using website data from large out-of-home food businesses, we found that all businesses (n = 77) provided calorie labeling somewhere on their websites. However, fewer than half (48%; n = 37) did not provide calorie labels on the default menu (ie, the first menu that a consumer is likely to see). Compliance with the policy's implementation guidance was greatest for the label's position (81%; n = 62) and lowest for prominent formatting (40%; n = 31), while 71% (n = 55) of businesses provided the statement of daily calorie needs. We observed differences among types of out-of-home food businesses, but we did not test them because of the small sample size. Our results suggest imperfect adherence to England's calorie labeling regulations, thus undermining the policy's impact. As the policy's review approaches, policy makers should consider strategies for ensuring compliance.
Geographic and Temporal Trends in Adult Diabetes Prevalence, United States, 2011-2021.
Khalid S, Hitch AT
Public Health Rep · 2026 · PMID 41617226 · Full text
OBJECTIVE: Diabetes is a leading cause of various adverse health outcomes, and its prevalence has risen substantially in the United States in recent decades. While the prevalence of diabetes has stabilized in recent year...
OBJECTIVE: Diabetes is a leading cause of various adverse health outcomes, and its prevalence has risen substantially in the United States in recent decades. While the prevalence of diabetes has stabilized in recent years, geographic disparities remain, particularly in the South. We analyzed the spatial and temporal trends of diabetes prevalence in the United States and identified geographic disparities. METHODS: We conducted a geographic-temporal analysis of Centers for Disease Control and Prevention chronic disease indicator data using a bayesian hierarchical model to assess changes in diabetes prevalence across US divisions and over time from 2011 through 2021. RESULTS: We estimated that diabetes prevalence rates per 1000 population declined in the United States from 56.5 in 2011 to 53.2 in 2021. The East South Central division had a high prevalence rate of diabetes (8.4), followed by New England (5.4) and West South Central (3.4). The diabetes prevalence rate was higher among men (2.64 per 1000 population) than among women. CONCLUSION: Our findings highlight the need for continued public health efforts, such as reducing rates of obesity and improving health care access, to mitigate the prevalence of diabetes in the South and to maintain the continued decrease in prevalence rates in the coming years.
Prevalence, Awareness, and Control of Hypertension Among Adults by Disability Status, United States, August 2021-August 2023.
Shah NN, Kit BK, Fryar CD … +2 more , Weeks JD, Akinbami LJ
Public Health Rep · 2026 · PMID 41605846 · Full text
OBJECTIVES: Nearly half of US adults have hypertension. The prevalence of hypertension is higher among adults with disabilities than among those without disabilities; however, national estimates use old data and definiti...
OBJECTIVES: Nearly half of US adults have hypertension. The prevalence of hypertension is higher among adults with disabilities than among those without disabilities; however, national estimates use old data and definitions, and hypertension awareness and control are understudied. This study compared hypertension prevalence, awareness, and control among adults with and without disabilities. METHODS: We analyzed data from the National Health and Nutrition Examination Survey (August 2021-August 2023) for adults aged ≥18 years (N = 5999). To determine disability status, we used the Washington Group on Disability Statistics questionnaire, which covers the domains of seeing, hearing, walking, communication, cognition, self-care, upper-body function, and affect. Hypertension was defined as blood pressure ≥130/80 mm Hg or use of antihypertensive medication. Among adults with hypertension, awareness was defined as self-report of physician diagnosis and control as blood pressure <130/80 mm Hg. We estimated adjusted prevalence ratios (APRs) using logistic regression, adjusting for demographic and health characteristics and accounting for the complex survey design. RESULTS: Hypertension prevalence was significantly higher among adults with disabilities than among those without disabilities (57.2% vs 45.1%; < .001). Among those with hypertension, the prevalence of awareness (71.3% vs 55.0%; < .001) and control (27.3% vs 18.4%; < .001) was significantly higher among adults with disabilities than among those without disabilities. Adjusted analyses showed a higher prevalence of hypertension (APR = 1.12; 95% CI, 1.04-1.21), awareness (APR = 1.22; 95% CI, 1.14-1.30), and control (APR = 1.31; 95% CI, 1.12-1.54) among adults with disabilities than among those without disabilities. CONCLUSIONS: Primary prevention may be particularly important for adults with disabilities. Improving awareness and control remains a key public health challenge regardless of disability status.
Community Preventive Services Task Force Recommends Interventions to Address Leading Causes of Death in Rural Settings.
Harmon S, Langley G, Stein R … +3 more , Clymer JM, Stoddard S, Peng Y
Public Health Rep · 2026 Jan · PMID 41605836 · Full text
Abstract loading — click title to view on PubMed.
Characteristics of Cases of Prescription Fentanyl Exposure Among US Children Aged <6 Years Reported to Poison Centers, 2012-2024.
Abe K, Fullerton L, Swift S … +2 more , Tollestrup K, Bonney C
Public Health Rep · 2026 · PMID 41605257 · Full text
OBJECTIVES: Illicit fentanyl exposure among US children has increased in the past 10 years. However, whether rates of prescription fentanyl exposure have changed in this population is unknown. We described prescription f...
OBJECTIVES: Illicit fentanyl exposure among US children has increased in the past 10 years. However, whether rates of prescription fentanyl exposure have changed in this population is unknown. We described prescription fentanyl exposure among young children. METHODS: We studied cases of prescription fentanyl exposure among children aged <6 years that were reported to the National Poison Data System (NPDS) from 2012 through 2024. We described the characteristics of prescription fentanyl exposure and US geographic patterns. We used binomial tests, the Pearson χ test, and joinpoint trend analysis with a type I error rate of .05 as the threshold for significance. RESULTS: From 2012 through 2024, a total of 376 cases of prescription fentanyl exposure among children aged <6 years were reported to NPDS. Boys (n = 179; 47.6%) and girls (n = 196; 52.1%) were equally represented ( = .48). Significantly more children aged <2 years than aged 2 to 6 years in our study group had prescription fentanyl exposure (61.5%; < .001), and the most common formulation was transdermal patch (n = 202; 53.7%). Joinpoint trend analysis showed a slight but not significant increase in prescription fentanyl exposure among children aged <6 years from 2012 through 2015. However, from 2015 through 2024, prescription fentanyl exposure significantly decreased (annual percentage change = -7.9; < .05). The state with the highest annual exposure rate from prescription fentanyl was Vermont (4.3 per 1 million population). CONCLUSIONS: From 2015 through 2024, during a time of increasing exposure to illicit fentanyl, prescription fentanyl exposure among children aged <6 years decreased. Safe disposal of transdermal patches is important, and caregiver education is needed to prevent serious medical outcomes.
Completing the Continuum of Public Health Education.
Riegelman RK
Public Health Rep · 2026 · PMID 41605256 · Full text
Abstract loading — click title to view on PubMed.
Trends in Daily Fruit and Vegetable Intake Among Young Children in the United States, 2021-2023.
Awan S, Grap ME, Goding Sauer AM … +4 more , Marks KJ, Self JL, Dooyema CA, Hamner HC
Public Health Rep · 2026 · PMID 41605247 · Full text
At the national and state levels, data on changes over time in fruit and vegetable intake among young children are limited. Using nationally representative data from the National Survey of Children's Health during 2021-2...
At the national and state levels, data on changes over time in fruit and vegetable intake among young children are limited. Using nationally representative data from the National Survey of Children's Health during 2021-2023, we examined trends in daily fruit and vegetable intake among children aged 1 to 5 years. We conducted trend analyses nationally, by age, and by state. We found no significant linear trends in daily fruit or vegetable intake at the national level or by age. At the state level, fruit intake increased significantly from 2021 to 2023 in Connecticut (from 65.8% to 77.2%; = .049), Illinois (from 68.5% to 77.8%; = .03), and Montana (from 66.1% to 81.0%; = .01) and decreased significantly in Massachusetts (from 82.2% to 65.0%; = .001); no state had significant changes in daily vegetable intake. Lack of improvement in daily fruit and vegetable intake among young children emphasizes the continued need for monitoring and evidence-based interventions.
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