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Until the 19th century, 'risk' was a specialized term: it was the commodity exchanged in a marine insurance contract. 'Freaks of Fortune' tells how the modern concept of risk emerged in the United States.

Inequities in Coronavirus Disease 2019 (COVID-19) vaccine and booster coverage may contribute to future disparities in morbidity and mortality within and between Massachusetts (MA) communities. We conducted a population-based cross-sectional study of primary series vaccination and booster coverage 18 months into the general population vaccine rollout. We obtained public-use data on residents vaccinated and boosted by ZIP code (and by age group: 5 to 19, 20 to 39, 40 to 64, 65+) from MA Department of Public Health, as of October 10, 2022. We constructed population denominators for postal ZIP codes by aggregating census tract population estimates from the 2015-2019 American Community Survey. We excluded nonresidential ZIP codes and the smallest ZIP codes containing 1% of the state's population. We mapped variation in ZIP code-level primary series vaccine and booster coverage and used regression models to evaluate the association of these measures with ZIP code-level socioeconomic and demographic characteristics. Because age is strongly associated with COVID-19 severity and vaccine access/uptake, we assessed whether observed socioeconomic and racial/ethnic inequities persisted after adjusting for age composition and plotted age-specific vaccine and booster coverage by deciles of ZIP code characteristics. We analyzed data on 418 ZIP codes. We observed wide geographic variation in primary series vaccination and booster rates, with marked inequities by ZIP code-level education, median household income, essential worker share, and racial/ethnic composition. In age-stratified analyses, primary series vaccine coverage was very high among the elderly. However, we found large inequities in vaccination rates among younger adults and children, and very large inequities in booster rates for all age groups. In multivariable regression models, each 10 percentage point increase in \"percent college educated\" was associated with a 5.1 (95% confidence interval (CI) 3.9 to 6.3, p < 0.001) percentage point increase in primary series vaccine coverage and a 5.4 (95% CI 4.5 to 6.4, p < 0.001) percentage point increase in booster coverage. Although ZIP codes with higher \"percent Black/Latino/Indigenous\" and higher \"percent essential workers\" had lower vaccine coverage (-0.8, 95% CI -1.3 to -0.3, p < 0.01; -5.5, 95% CI -7.3 to -3.8, p < 0.001), these associations became strongly positive after adjusting for age and education (1.9, 95% CI 1.0 to 2.8, p < 0.001; 4.8, 95% CI 2.6 to 7.1, p < 0.001), consistent with high demand for vaccines among Black/Latino/Indigenous and essential worker populations within age and education groups. Strong positive associations between \"median household income\" and vaccination were attenuated after adjusting for age. Limitations of the study include imprecision of the estimated population denominators, lack of individual-level sociodemographic data, and potential for residential ZIP code misreporting in vaccination data. Eighteen months into MA's general population vaccine rollout, there remained large inequities in COVID-19 primary series vaccine and booster coverage across MA ZIP codes, particularly among younger age groups. Disparities in vaccination coverage by racial/ethnic composition were statistically explained by differences in age and education levels, which may mediate the effects of structural racism on vaccine uptake. Efforts to increase booster coverage are needed to limit future socioeconomic and racial/ethnic disparities in COVID-19 morbidity and mortality.

Empathy is a core human social ability shaped by biological dispositions and caregiving experiences; yet the mechanisms sustaining maturation of the neural basis of empathy are unknown. Here, we followed eighty-four children, including 42 exposed to chronic war-related adversity, across the first decade of life, and assessed parenting, child temperament, and anxiety disorders as contributors to the neural development of empathy. At preadolescence, participants underwent magenetoencephalography while observing others’ distress. Preadolescents show a widely-distributed response in structures implicating the overlap of affective (automatic) and cognitive (higher-order) empathy, which is predicted by mother-child synchrony across childhood. Only temperamentally reactive young children growing in chronic adversity, particularly those who later develop anxiety disorders, display additional engagement of neural nodes possibly reflecting hyper-mentalizing and ruminations over the distressing stimuli. These findings demonstrate how caregiving patterns fostering interpersonal resonance, reactive temperament, and chronic adversity combine across early development to shape the human empathic brain. People’s early experiences and dispositions influence their ability to show and feel empathy. Here, using a sample of children exposed to war-related trauma, the authors examine how parenting, temperament, anxiety, and adversity affect the maturation of neural responses associated with empathy.

A decade ago, AJPH published a special supplement on environmental justice (https://ajph.aphapublications. org/toc/ajph/101/S1), with dozens of articles addressing themes such as residential proximity to hazardous facilities, expanded risk assessment frameworks that acknowledged cumulative exposures and differential vulnerability, and perspectives on community engagement, empowerment, and capacity building.Much has changed over the past decade. The escalating burden of climate change, growing recognition of the insidiousness of racism, and political extremism have had profound influences on public health and environmental justice. Given this, we put out a call for papers on \"New Frontiers of Environmental Justice,\" soliciting articles that address novel topics, utilize innovative methods, and reflect on approaches for addressing environmental justice in the future. In the current and subsequent issues of AJPH, we present articles that grapple with some of these complex questions.This special section features complementary framing and research articles that beckon more inclusive understandings of oppression and action-oriented processes to pursue justice. For instance, Goldsmith and Bell (p. 79) explore how environmental exposures disproportionately affect the LGBTQ + (lesbian, gay, bisexual, transgender, queer or questioning, and others) population while Collins et al. (p. 54) and Gaard (p. 57) discuss the implications of an intersectional approach within environmental justice research and policy. Relatedly, McDonald etal. (p. 50) expose toxic disparities in beauty products marketed toward people of color, including LGBTQ+ members, and call for regulatory changes within the cosmetics industry.

BackgroundClimate mitigation policies that focus on the transportation sector yield near-term health co-benefits that could motivate policy action.ObjectiveWe quantified CO2 emission reductions as well as the air pollution and health benefits of urban transportation policies promoting electric vehicles (EV) and walking and bicycling in Seattle, Washington.MethodsWe compared a business-as-usual scenario projected to 2035 with intervention scenarios in which 35% of gasoline vehicles were switched to EV, and 50% of car trips less than 8 kilometers were replaced by walking or bicycling. We modeled changes in primary traffic-generated oxides of nitrogen (NOx) and fine particulate matter (PM2.5) as well as walking and bicycling activity, CO2 emissions from traffic, and fatal traffic injuries due to the transportation policy scenarios. We estimated the impacts of these changes on annual cases of asthma and premature mortality in the Seattle population.ResultsIncreasing the use of EV, walking, and bicycling is estimated to reduce CO2 emissions by 744 tons/year (30%) and lower annual average concentrations of primary traffic-generated NOx and PM2.5 by 0.32 ppb (13%) and 0.08 μg/m3 (19%), respectively. In Seattle, the lower air pollutant concentrations, greater active transportation, and lower fatal traffic injuries would prevent 13 (95% CI: −1, 28), 49 (95% CI: 19, 71), and 5 (95% CI: 0, 14) premature deaths per year, respectively and 20 (95% CI: 8, 27) cases of asthma per year.SignificanceMoving towards cleaner vehicles and active transportation can reduce CO2 emissions, improve air quality, and population health. The resulting public health benefits provide important motivation for urban climate action plans.Impact statementUsing key components of the health impact assessment framework, we quantify the environmental and health benefits of urban transportation policy scenarios that promote electric vehicle use and replace short car trips with walking and bicycling as compared with a business as usual scenario in 2035. Our findings demonstrate that transportation scenarios promoting cleaner vehicles and active transportation can reduce CO2 emissions, improve air quality, and increase physical activity levels, resulting in significant public health benefits.

Most genetic variants that contribute to disease 1 are challenging to correct efficiently and without excess byproducts 2 , 3 , 4 – 5 . Here we describe prime editing, a versatile and precise genome editing method that directly writes new genetic information into a specified DNA site using a catalytically impaired Cas9 endonuclease fused to an engineered reverse transcriptase, programmed with a prime editing guide RNA (pegRNA) that both specifies the target site and encodes the desired edit. We performed more than 175 edits in human cells, including targeted insertions, deletions, and all 12 types of point mutation, without requiring double-strand breaks or donor DNA templates. We used prime editing in human cells to correct, efficiently and with few byproducts, the primary genetic causes of sickle cell disease (requiring a transversion in HBB ) and Tay–Sachs disease (requiring a deletion in HEXA ); to install a protective transversion in PRNP ; and to insert various tags and epitopes precisely into target loci. Four human cell lines and primary post-mitotic mouse cortical neurons support prime editing with varying efficiencies. Prime editing shows higher or similar efficiency and fewer byproducts than homology-directed repair, has complementary strengths and weaknesses compared to base editing, and induces much lower off-target editing than Cas9 nuclease at known Cas9 off-target sites. Prime editing substantially expands the scope and capabilities of genome editing, and in principle could correct up to 89% of known genetic variants associated with human diseases. A new DNA-editing technique called prime editing offers improved versatility and efficiency with reduced byproducts compared with existing techniques, and shows potential for correcting disease-associated mutations.