Public Attitudes, Inequities, and Polarization in the Launch of the 988 Lifeline.

CONTEXT: To address the considerable burden of mental health need in the United States, Congress passed the National Suicide Hotline Designation Act in 2020. The Act rebranded the national suicide prevention lifeline as 988 - a 3-digit number akin to 911 for individuals to call in the case of a mental health emergency. Surprisingly little is known about American attitudes towards this new lifeline. METHODS: We rely on a demographically representative sample of 5,482 US adults conducted from June 24-28, 2022. We examine the influence of mental health status, partisan identification, and demographic characteristics on public awareness, public support, and intended use of the new 988 lifeline. FINDINGS: We find that while only a quarter of Americans are aware of the lifeline, support for the 988 lifeline is widespread, with over 75% of Americans indicating they would be likely to use the new number if needed. We identify key disparities in awareness, support, and intended use, with Republicans, individuals with low socio-economic status, and Blacks less supportive and in some cases less likely to use the 988 lifeline. CONCLUSIONS: Our results point to the need for additional interventions that increase public awareness of 988 and reduce disparities in program knowledge, support, and intended use.

Rural healthy people 2030: New decade, new challenges.

Rural Healthy People is a companion piece to the federal Healthy People initiative released once a decade to identify the most important Healthy People priorities for rural America, as identified by rural stakeholders, for the current decade. This study reports on the findings of Rural Healthy People 2030. The study relied on a survey of rural health stakeholders collected from July 12, 2021, to February 14, 2022, and: 1) identified the 20 Healthy People priorities most frequently selected as priorities for rural America, 2) studied the priorities that were most frequently selected as a "top 3" priority within each Healthy People 2030 category, and 3) investigated Healthy People 2030 priorities in terms of ranked importance for rural Americans. The analysis finds that for the first time across 3 decades of Rural Healthy People, a greater proportion of respondents selected "Mental Health and Mental Disorders" and "Addiction" as Healthy People priorities for rural America, than did "Health Care Access and Quality". Even still, respondents ranked "Health Care Access and Quality" as the single-most important rural priority. "Economic Stability," a new priority within the Social Determinant of Health category, debuted within the 10 most frequently selected priorities for rural America for the coming decade. As public health practitioners, researchers, and policymakers work toward closing the urban-rural divide, the most important rural priorities to address in the coming decade are mental health and substance use disorders, access to high quality health care services, and social determinants of health, such as economic stability.

Fluctuating Hyperthyroidism and Hypothyroidism in Graves' Disease: The Swinging Between Two Clinical Entities.

Autoimmune thyroid disorders are frequently encountered in clinical practice and consist of a spectrum ranging from Graves' hyperthyroidism to Hashimoto's hypothyroidism. Generally, patients with autoimmune thyroid disorders will lean towards one end of the spectrum or the other, with fluctuations between hyper- and hypothyroidism rarely seen. This is especially the case when persistent hyperthyroidism occurs after a prolonged period of hypothyroidism. Here, we present a case of a young female patient initially presenting with Graves' disease with a previous history of hypothyroidism.