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Incarceration is associated with adverse physical and mental health that are often brought to light during reentry into the community, particularly in the immediate period following release. Social support, specifically from family members, has been identified as a key protective factor that may promote health and reintegration success among formerly incarcerated individuals. However, less is known about how specific types of family support—emotional and instrumental—relate to health outcomes following release from incarceration. The current study uses data from 517 individuals incarcerated in a large Texas prison, surveyed before and approximately one month after release, to examine the relationship between family support and self-rated physical and mental health. Logistic regression models revealed that strong emotional family support was significantly associated with better self-rated physical health and mental health one month post-release. Additionally, strong instrumental family support predicted better mental health but not physical health among respondents. These findings highlight the crucial role of emotional and instrumental familial support systems in fostering and reducing health disparities and promoting equity among justice-impacted populations.

To assess access to healthy food retailers among formerly incarcerated individuals. Using linked data from the National Longitudinal Study of Adolescent to Adult Health and the Modified Retail Food Environment Index, the present study applies multivariate logistic regression to assess the association between incarceration and (i) living in a food desert and (ii) having low access to healthy food retailers. To account for unobserved heterogeneity, additional analyses are performed comparing formerly incarcerated individuals with persons arrested or convicted for a crime but not previously incarcerated. Sample of respondents living in urban census tracts in the USA. Adults (n 10390) aged 24-34 years. In adjusted logistic regression models, prior incarceration was not significantly associated with living in a food desert (OR=1·097; 95% CI 0·896, 1·343). Prior incarceration significantly increased the likelihood of living in a census tract with low access to healthy food retailers (OR=1·265; 95% CI 1·069, 1·498). This significant association remained when comparing formerly incarcerated individuals with those who had been arrested or convicted of a crime, but not previously incarcerated (OR=1·246; 95% CI 1·032, 1·503). Formerly incarcerated individuals are more likely to live in areas with low access to healthy food retailers compared with their non-incarcerated counterparts. Because lower access healthy food retailers may be associated with worse health and dietary behaviour, disparities in local food retail environments may exacerbate health inequalities among formerly incarcerated individuals.

Adverse childhood experiences (ACEs) have been linked to negative health outcomes and behaviors in adulthood. Despite widespread research on ACEs, their relationship with COVID-19 vaccination uptake, particularly heterogeneity across demographic groups, remains underexplored. This study examined the association between ACEs and COVID-19 vaccination status, with a focus on how this relationship varies by sex and urban-rural residence. Data were obtained from the 2022 Behavioral Risk Factor Surveillance System (BRFSS), including respondents who participated in the ACEs and COVID-19 vaccination optional state modules (N = 12,085 adults). COVID-19 vaccination status (yes/no) served as the dependent variable, while ACEs were categorized into four levels: 0, 1, 2-3, and 4 + ACEs. Multivariable logistic regression analyses, stratified by sex and urban-rural residence, were conducted to assess the association between ACEs and vaccination status. Among the sample, 76.2% reported receiving at least one dose of the COVID-19 vaccine. Multivariable analysis revealed no statistically significant association between ACEs and vaccination status for the full sample. Stratified analyses indicated that male respondents living in rural counties with 4 + ACEs had significantly lower odds of vaccination (adjusted odds ratio [aOR] = 0.57, 95% CI = 0.34-0.96). No significant associations were observed for other demographic groups (e.g., females in urban or rural areas; males in urban areas). The findings suggest that males in rural areas with high ACE exposure may be vulnerable to low COVID-19 vaccination uptake. Targeted trauma-informed public health interventions warrant consideration to address vaccination uptake among this population.

Background Despite the ubiquity of adolescent screen use, there are limited longitudinal studies that examine the prospective relationships between screen time and child behavioral problems in a large, diverse nationwide sample of adolescents in the United States, which was the objective of the current study. Methods We analyzed cohort data of 9,538 adolescents (9–10 years at baseline in 2016–2018) with two years of follow-up from the Adolescent Brain Cognitive Development (ABCD) Study. We used mixed-effects models to analyze associations between baseline self-reported screen time and parent-reported mental health symptoms using the Child Behavior Checklist, with random effects adjusted for age, sex, race/ethnicity, household income, parent education, and study site. We tested for effect modification by sex and race/ethnicity. Results The sample was 48.8% female and racially/ethnically diverse (47.6% racial/ethnic minority). Higher total screen time was associated with all mental health symptoms in adjusted models, and the association was strongest for depressive (B = 0.10, 95% CI 0.06, 0.13, p  < 0.001), conduct (B = 0.07, 95% CI 0.03, 0.10, p  < 0.001), somatic (B = 0.06, 95% CI 0.01, 0.11, p  = 0.026), and attention-deficit/hyperactivity symptoms (B = 0.06, 95% CI 0.01, 0.10, p  = 0.013). The specific screen types with the greatest associations with depressive symptoms included video chat, texting, videos, and video games. The association between screen time and depressive, attention-deficit/hyperactivity, and oppositional defiant symptoms was stronger among White compared to Black adolescents. The association between screen time and depressive symptoms was stronger among White compared to Asian adolescents. Conclusions Screen time is prospectively associated with a range of mental health symptoms, especially depressive symptoms, though effect sizes are small. Video chat, texting, videos, and video games were the screen types with the greatest associations with depressive symptoms. Future research should examine potential mechanisms linking screen use with child behavior problems.

ObjectivesFunctional limitations may be associated with firearm ownership among veterans by amplifying perceptions of vulnerability and the need for security, yet their role remains underexplored despite emerging research on health-related factors influencing firearm acquisition in this group. This study examines the relationship between the number of functional limitations and recent firearm purchasing among a sample of low-income US military veterans.MethodsData are from the National Veteran Homeless and Other Poverty Experiences (NV-HOPE) study, which surveyed US veterans in households under 300% of the US federal poverty level. The survey was conducted in December 2022 and January 2023 (n = 1,008). Functional limitations were assessed based on self-reported assistance needed in daily tasks. Multiple logistic regression was used to analyze the association between functional limitations and firearm purchases in the past year, adjusting for demographic and socioeconomic factors. Analyses were conducted in Stata v. 18, and statistical significance was determined at the p < 0.05 threshold.Results5.5% of respondents reported purchasing a firearm in the past year. Increased functional limitations were positively associated with recent firearm purchases (Adjusted Odds Ratio [aOR] = 1.14, 95% Confidence Interval [CI] = 1.03, 1.26). Sensitivity using Firth Logit for rare events confirmed the robustness of this finding.DiscussionVeterans experiencing a greater number of functional limitations are more likely to report recently purchasing a firearm. These findings underscore the importance of addressing health needs among firearm-owning veterans through VA programs that support disabled veterans and their caregivers.

BackgroundThe disproportionately high rate of incarceration and COVID-19 cases during the summer of 2020 in the United States contributed to a set of circumstances that has produced considerable public health concerns as correctional facilities have emerged as significant COVID-19 hot spots. During the COVID-19 pandemic, having a family member incarcerated can be an especially stressful experience. This study assesses how concern about an incarcerated family member contracting COVID-19 impacts diverse coping strategies.ResultsData are from a survey of individuals who have a family member incarcerated in Texas (N = 365). Ordinary least squares regression is used to examine the association between concern about an incarcerated family member contracting COVID-19 and coping strategies. Findings demonstrate that higher levels of concern for an incarcerated person’s wellbeing during the COVID-19 pandemic is associated with dysfunctional coping mechanisms, but not adaptive or functional coping strategies.ConclusionsResults suggest appropriate systemic responses by correctional administrations and public health practices can help mitigate dysfunctional coping mechanisms by family members during infectious disease outbreaks in correctional facilities.

Since 1990, the world's homicide rate has declined by nearly 20%. While prior research has documented parallel homicide declines across many individual countries, the causes of a shared international homicide decline remain unknown. Drawing on a worldwide process of population ageing, and on research linking age to criminal activity, this study investigates the contribution of global demographic shifts to the international homicide decline. We draw from (1) a High Coverage Sample of 126 countries since 1990, and (2) a Long Series Sample of 26 countries since 1960 and utilize fixed-effect regressions to evaluate the impact of age structure on homicide trends. In addition, we use a quantile regression to explore variations in the relationship between age structure and homicide conditional on homicide levels. Results using the High Coverage Sample suggest no relationship between age structure and homicide. However, results from the Long Series Sample suggest that changes in the relative size of countries' youth population is a major predictor of homicide trends since 1960. In exploring this divergence, we find that the influence of age structure on homicide becomes less evident as other risk factors for violence gain prominence. Thus, while high homicide countries had the most to gain from falling homicide rates, the safety benefits of an ageing population have been concentrated among the least violent countries. While the homicide declines of individual countries have often been attributed to domestic policies, the universality of international homicide trends suggests the influence of broader global phenomenon. We find that countries' homicide trends are strongly associated with changes in the size of their youth populations, particularly where there are few competing criminogenic forces. Based on these results, we propose an explanation for the international homicide decline, while highlighting the importance of demographic patterns in explaining homicide trends.

Adverse childhood experiences (ACEs) are associated with negative health outcomes, including poorer oral health. While research has shown that ACEs are associated with lower dental care utilization, most studies focus on childhood and adolescence, with limited attention to their long-term impact in adulthood or differences across racial and ethnic groups.. This study examines the relationship between ACE exposure and past-year dental care use in adulthood and assesses racial/ethnic differences in this association. Using data from the 2020 Behavioral Risk Factor Surveillance System (BRFSS), we analyzed a sample of 88,728 adults from 21 states and the District of Columbia. The primary outcome was any past-year dental care use. ACEs were summed into a composite score. Multivariable logistic regression models assessed the relationship between ACEs and past-year dental care use, with multiplicative interaction terms used to examine racial/ethnic differences in the observed association. Overall, 63.2% of adults reported any past-year dental care use. Higher ACE exposure was associated with lower odds of dental care use (adjusted odds ratio [aOR] = 0.95, 95% CI: 0.93–0.97, p  < .001). The negative association between ACEs and dental care use was strongest for non-Hispanic White respondents, whereas the relationship between ACEs and dental care was attenuated for non-Hispanic Black and Hispanic respondents. These findings expand knowledge on the association of ACEs with dental care use in adulthood and how this relationship may vary across the population.

Background Problematic screen use, defined as an inability to control use despite private, social, and professional life consequences, is increasingly common among adolescents and can have significant mental and physical health consequences. Adverse Childhood Experiences (ACEs) are important risk factors in the development of addictive behaviors and may play an important role in the development of problematic screen use. Methods Prospective data from the Adolescent Brain Cognitive Development Study (Baseline and Year 2; 2018–2020; N = 9,673, participants who did not use screens were excluded) were analyzed in 2023. Generalized logistic mixed effects models were used to determine associations with ACEs and the presence of problematic use among adolescents who used screens based on cutoff scores. Secondary analyses used generalized linear mixed effects models to determine associations between ACEs and adolescent-reported problematic use scores of video games (Video Game Addiction Questionnaire), social media (Social Media Addiction Questionnaire), and mobile phones (Mobile Phone Involvement Questionnaire). Analyses were adjusted for potential confounders including age, sex, race/ethnicity, highest parent education, household income, adolescent anxiety, depression, and attention-deficit symptoms, study site, and participants who were twins. Results The 9,673 screen-using adolescents ages 11–12 years old (mean age 12.0) were racially and ethnically diverse (52.9% White, 17.4% Latino/Hispanic, 19.4% Black, 5.8% Asian, 3.7% Native American, 0.9% Other). Problematic screen use rates among adolescents were identified to be 7.0% (video game), 3.5% (social media), and 21.8% (mobile phone). ACEs were associated with higher problematic video game and mobile phone use in both unadjusted and adjusted models, though problematic social media use was associated with mobile screen use in the unadjusted model only. Adolescents exposed to 4 or more ACEs experienced 3.1 times higher odds of reported problematic video game use and 1.6 times higher odds of problematic mobile phone use compared to peers with no ACEs. Conclusions Given the significant associations between adolescent ACE exposure and rates of problematic video and mobile phone screen use among adolescents who use screens, public health programming for trauma-exposed youth should explore video game, social media, and mobile phone use among this population and implement interventions focused on supporting healthy digital habits.

Racial inequities are deeply embedded in the fabric of the United States. Two areas where racial disparities are highly prevalent are in the criminal justice system and in reproductive health outcomes. The United States has the largest incarceration rate in the world and incarcerates Black persons at a rate of nearly five times that of White persons.1 Millions of persons in the United States also experience contact with law enforcement each year, and Black individuals experience the bulk of unjust and aggressive police encounters. The National Academies of Science, Engineering, and Medicine recently concluded, \"There are likely to be large racial disparities in the volume and nature of police-citizen encounters when police target high-risk people or high-risk places, as is common in many proactive policing programs.\"2(p301)Unfortunately, the racial disparities that disadvantage Black persons in the United States are also present in reproductive health, which is perhaps most clearly seen in the Black-White gap in preterm births.3 Scholars note that these disparities are \"likely largely due to social and physical exposures that vary by race due to enduring inequity in [the] USA.\"4(p934) The role of racially patterned social stressors (e.g., proactive policing) as a contributor to the racial preterm birth gap has gone overlooked, necessitating research to better understand how criminal justice systems contribute to reproductive health disparities.The study byJahn et al. (p. S21) in this issue of AJPH forwards research at the intersection of criminal justice and public health in a rigorous analysis that illuminates the unambiguous racial disparities in reproductive health and proactive policing; their study also details how the two intersect. Using data from the New Orleans Police Department and state vital statistics, the authors geocoded records from every birth occurring in New Orleans, Louisiana, from 2018 to 2019 (n = 9102) and linked these records with census tract data on proactive police stops. The findings show that Black birthing persons experience preterm birth at a rate that is nearly twice as high as that of White birthing persons (15.8% vs 8.0%).