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Effects of Policing and Detainment on Psychosocial Vulnerability and Drug and Sex Risk among Minority Men who have Sex with Men

Working lives and health in later life

BACKGROUND: Substance use is prevalent and is associated with academic performance among adolescents. Few studies have examined the association between abstinence from all substances and academic achievement. METHODS: Data from a nationally representative sample of 9578 12th graders from the 2015 Monitoring the Future survey were analyzed to examine relationships between abstinence from substance use and 4 academic variables: skipping school, grades, academic self-efficacy, and emotional academic engagement. Participants were categorized as lifetime non-users, former users, and past-year users based on the use of 14 substances. RESULTS: Approximately one-fourth of participants had never used cigarettes, alcohol, or other drugs during their lifetime, and 8% wt  used at least one substance during their lifetime but not during the past year. Adjusting for demographic variables, past-year substance users had 2.71 greater odds of skipping school during the past month than lifetime non-users and 1.74 greater odds of having low grades. Lifetime non-users reported greater academic self-efficacy and emotional academic engagement than past-year users. CONCLUSIONS: Many 12th graders have abstained from all substance use during their lifetime, and these adolescents experience better academic outcomes than their substance-using peers. Substance use prevention programs should be evaluated as a way to promote academic achievement.

Purpose:  Sexual minorities experience signi fi cant health disparities across a variety of mental, behav ioral, and physical health indicators. Yet, an understanding of the etiology and progression of sexual minority health disparities across the lifespan is limited. Methods:  We used the U.S. National Epidemiologic Survey of Alcohol and Related Conditions III to  evaluate the association between sexual minority status and seven past-year health outcomes (alcohol  use disorder, tobacco use disorder, drug use disorder, major depressive episode, generalized anxiety  disorder, sexually transmitted infection, and cardiovascular conditions). To do this, we used unadjusted  and adjusted logistic regression among our study sample (n ¼ 30,999; aged 18 e 65 years) and time- varying effect models to evaluate how sexual orientation differences in these outcomes vary across  adulthood. Results:  Relative to heterosexuals, sexual minorities had elevated odds of past-year alcohol use disorder  and drug use disorder across all ages (18 e 65 years) although the magnitude of the disparity varies by  age. Sexual minorities were also more likely to experience major depressive episode, generalized anxiety  disorder, tobacco use disorder, sexually transmitted infection, and cardiovascular disease, but only at  speci fi c ages. Conclusions:  Sexual minority health disparities vary appreciably across the adult lifespan, thus eluci dating critical periods for focused prevention efforts.

  BACKGROUND: Stroke is a leading cause of morbidity and mortality in the United States. Associations between short-term exposures to particulate matter (PM) air pollution and stroke are inconsistent. Many prior studies have used administrative and hospitalization databases where misclassification of the type and timing of the stroke event may be problematic. METHODS: In this case-crossover study, we used a nationwide kriging model to examine short-term ambient exposure to PM10 and PM2.5 and risk of ischemic and hemorrhagic stroke among men enrolled in the Health Professionals Follow-up Study. Conditional logistic regression models were used to obtain estimates of odds ratios (OR) and 95% confidence intervals (CI) associated with an interquartile range (IQR) increase in PM2.5 or PM10. Lag periods up to 3 days prior to the stroke event were considered in addition to a 4-day average. Stratified models were used to examine effect modification by patient characteristics. RESULTS: Of the 727 strokes that occurred between 1999 and 2010, 539 were ischemic and 122 were hemorrhagic. We observed positive statistically significant associations between PM10 and ischemic stroke (ORlag0-3 = 1.26; 95% CI: 1.03-1.55 per IQR increase [14.46 μg/m3]), and associations were elevated for nonsmokers, aspirin nonusers, and those without a history of high cholesterol. However, we observed no evidence of a positive association between short-term exposure to PM and hemorrhagic stroke or between PM2.5 and ischemic stroke in this cohort. CONCLUSIONS: Our study provides evidence that ambient PM10 may be associated with higher risk of ischemic stroke and highlights that ischemic and hemorrhagic strokes are heterogeneous outcomes that should be treated as such in analyses related to air pollution.

Deferred Action for Childhood Arrivals (DACA) recipients face an uncertain fate as their future in the United States is being debated. Yet even before the program was introduced in June 2012 and became endangered in September 2017, they encountered challenges in navigating a fragmented health care landscape throughout the United States. This paper focuses on  DACA  recipients' experiences in accessing health care throughout their lives, both before and after receiving DACA. We conducted semi-structured interviews and questionnaires with 30 DACA recipients living in Maryland between April–December 2016. Participants represented 13 countries of origin and ranged in age between 18 and 28. Results demonstrate that DACA recipients have had punctuated coverage throughout their lives and continue to face constrained access despite temporary gains in status. Health care access is further stratified within their mixed-status families. Participants have also experienced shifts in their health care coverage due to moving between jurisdictions with variable eligibility and changing life circumstances related to family, school, and employment. This article underscores the importance of examining young adult immigrants' access to care over time as they weather changes in the broader policy context and in highly variable contexts of reception nationwide, shaped by state, but also county and city policies and programs. The challenges and gaps in coverage DACA recipients face also underscore the need for both health care and immigration reform.

Jie Chen and colleagues will publish a study examining the behavioral health treatment among individuals with co-occurring opioid use disorder and mental illness

BACKGROUND: Using a population-based sample of youth, we examined rates of cigarette use and trends in cigarette use disparities between heterosexual youth and 3 subgroups of sexual minority youth (SMY) (ie, lesbian or gay, bisexual, and unsure) from 2005 to 2015. METHODS: Data are from 6 cohorts of the Youth Risk Behavior Survey, a national, biennial, school-based survey of ninth- to 12th-grade students in the United States (n = 404 583). Sex-stratified analyses conducted in 2017 examined trends in 2 cigarette-related behaviors: lifetime cigarette use and heavy cigarette use (20+ days in the past 30). RESULTS: Disparities in lifetime cigarette use between lesbian and heterosexual girls were statistically smaller in 2015 relative to 2005 (adjusted odds ratio [aOR] 0.29; 95% confidence interval [CI] 0.12–0.75; P = .011). Sexual orientation disparities in heavy use were narrower for bisexual boys in 2015 compared with 2005 (aOR 0.39; 95% CI 0.17–0.90; P = .028). Girls and boys unsure of their sexual identity had wider disparities in heavy use in 2015 (aOR 3.85; 95% CI 1.39–11.10; P = .009) relative to 2005 (aOR 2.44; 95% CI 1.22–5.00; P = .012). CONCLUSIONS: SMY remain at greater risk for cigarette-related behaviors despite greater acceptance of lesbian, gay, and bisexual people in the United States. Focused policies and programs aimed at reducing rates of SMY cigarette use are warranted, particularly for youth questioning their sexual identity.

There is a growing recognition of social media data as being useful for understanding local area patterns. In this study, we sought to utilize geotagged tweets—specifically, the frequency and type of food mentions—to understand the neighborhood food environment and the social modeling of food behavior. Additionally, we examined associations between aggregated food-related tweet characteristics and prevalent chronic health outcomes at the census tract level. We used a Twitter streaming application programming interface (API) to continuously collect ~1% random sample of public tweets in the United States. A total of 4,785,104 geotagged food tweets from 71,844 census tracts were collected from April 2015 to May 2018. We obtained census tract chronic disease outcomes from the CDC 500 Cities Project. We investigated associations between Twitter-derived food variables and chronic outcomes (obesity, diabetes and high blood pressure) using the median regression. Census tracts with higher average calories per tweet, less frequent healthy food mentions, and a higher percentage of food tweets about fast food had higher obesity and hypertension prevalence. Twitter-derived food variables were not predictive of diabetes prevalence. Food-related tweets can be leveraged to help characterize the neighborhood social and food environment, which in turn are linked with community levels of obesity and hypertension.

Hazards of childbirth persist in rich and poor nations