Type of household firearm ownership and firearm suicide among adolescents, 1976-2018.

After declining steadily for almost two decades, the rate of firearm suicide among adolescents (aged 15-19 years) has increased nearly every year since 2007. At the same time, overall levels of household firearm ownership have been declining. In this paper, we examined whether and how types of firearms in the homes of adolescents have changed over time, and the extent to which such changes are associated with trends in firearm suicides among adolescents. Our analyses focused on understanding these trends among Black and White male and female adolescents to better understand longstanding race-gender differences in firearm ownership and firearm suicide. With combined data from the General Social Survey (GSS) and the National Center for Health Statistics (NCHS), the findings show that handgun ownership in Black and White households increased over the last four decades, while overall levels of firearm ownership declined. Increases in handgun ownership were predictive of increased firearm suicide rates among White adolescents, especially among males. We found no significant relationship between firearm suicide among Black adolescents and firearm ownership among Black households, regardless of gun type, which is potentially unsurprising given that firearm ownership is substantially lower in Black households compared to White households. Possibly reflecting race and gender differences in household gun ownership, our findings also show that rates of firearm suicide were lower for Black and female adolescents and highest for White male adolescents. Taken together, these findings provide new evidence on the relationship between trends in firearm ownership and adolescent firearm suicide and address important questions about the influence of race and gender for understanding firearm suicide among adolescents.

Gestational exposure to neighborhood police-reported crime and early childhood blood pressure in Durham, NC.

Gestational exposure to police-reported crime is associated with adverse birth outcomes, but no previous research has evaluated the effects of gestational crime exposure on early childhood health or attempted to disentangle the health effects of neighborhood crime from the effects of neighborhood policing. Using data from 672 Newborn Epigenetics Study participants, we evaluate the effects of gestational exposure to violent crime and racialized drug policing on early childhood blood pressure. We demonstrate that violence and drug policing are consistently associated with increased blood pressure among children born to Black participants but not White or Latinx participants.

Increased Oxygen Desaturation Time During Sleep Is a Risk Factor for NASH in Patients With Obstructive Sleep Apnea: A Prospective Cohort Study.

Introduction: Given that obstructive sleep apnea (OSA) is commonly associated with metabolic disorders, in this prospective study, we sought to determine the prevalence and risk factors for hepatosteatosis, non-alcoholic steatohepatitis (NASH), and advanced liver fibrosis in patients with clinical and polygraphic criteria of OSA (n = 153) and in subjects with normal lung function parameters (NLP, n = 43). Methods: Hepatosteatosis, NASH, and advanced liver fibrosis were determined by blood-based non-invasive tools, such as the fatty liver index and the hepatic steatosis index, a serum lipidomic (OWLiver™) test, and three distinct fibrosis algorithms, respectively. Logistic regression models adjusted by potential confounders were performed to evaluate risk factors. Results: Insulin resistance and dyslipidemia were more frequent in patients with OSA than in subjects with NLP. The prevalence of hepatosteatosis was significantly higher in patients with OSA than in subjects with NLP. NASH was also found more frequently in patients with OSA than in subjects with NLP. In contrast, advanced liver fibrosis was rarely detected in the entire study population, and no significant differences were observed between patients with OSA and subjects with NLP. Besides male gender, increased body mass index (BMI), and presence of type 2 diabetes, percentage of sleep time with oxygen saturation <90% (Tc90%) was the only polygraphic variable significantly associated with NASH in patients with OSA. Conclusions: This study shows that hepatosteatosis and NASH are highly prevalent in patients with OSA and indicates that those with a Tc90% higher than 10% are at increased risk for NASH.

Estimating exposure to neighborhood crime by race and ethnicity for public health research.

BACKGROUND: Police-reported crime data (hereafter "crime") is routinely used as a psychosocial stressor in public health research, yet few studies have jointly examined (a) differences in crime exposure based on participant race and ethnicity, (b) differences in measures of crime exposure, and (c) considerations for how exposure to police is captured in police-recorded crime data. We estimate neighborhood exposure to crime and discuss the implications of structural differences in exposure to crime and police based on race and ethnicity. METHODS: Using GPS coordinates from 1188 participants in the Newborn Epigenetics Study, we estimated gestational exposure to crime provided by the Durham, North Carolina, Police Department within (a) 800 m and (b) the Census block group of residence. We controlled for non-overlapping spatial boundaries in crime, Census, residential, and police data to report crime spatial (crime per km2) and population (crime per 1000 people per km2) density. RESULTS: We demonstrate dramatic disparities in exposure to crime based on participant race and ethnicity and highlight variability in these disparities based on the type of crime and crime measurement method chosen. CONCLUSIONS: Public health researchers should give thoughtful consideration when using police-reported crime data to measure and model exposure to crime in the United States, as police-reported data encompasses joint exposure to police and crime in the neighborhood setting.

Employment and Health Among Recently Incarcerated Men Before and After the Affordable Care Act (2009-2017).

Objectives. To explore whether and how the Affordable Care Act (ACA) affects the relationship between employment and health insurance coverage, health care utilization, and health outcomes among recently incarcerated men aged 18 to 64 years in the United States.Methods. With data from the National Survey on Drug Use and Health (NSDUH), we used a difference-in-differences approach to compare changes in outcomes by employment status among recently incarcerated men.Results. Uninsurance declined significantly among recently incarcerated men after ACA implementation. As the uninsured rate of unemployed men fell below that of their employed counterparts, the ACA helped to fully eliminate the effect of employment on insurance coverage among recently incarcerated men. The employment gap in diabetes widened after ACA implementation as unemployed men saw significant increases in diagnosed diabetes. Employment disparities in hospital visits, diagnosed hypertension, and reported mental illness also declined in the period following ACA implementation, but these changes were not statistically significant.Conclusions. These findings highlight how the ACA, by providing a new route to health care, reduces the confounding forces associated with employment that are linked to both incarceration and health.

The Institutional Determinants of Health Insurance: Moving Away from Labor Market, Marriage, and Family Attachments under the ACA.

For more than a century, the American welfare state required working-age adults to obtain social welfare benefits through their linkages to employers, spouses, or children. Recent changes to U.S. healthcare policy prompted by the Patient Protection and Affordable Care Act (ACA), however, provide adults with new pathways for accessing a key form of social welfare-health insurance-decoupled from employers, spouses, and children. Taking advantage of this fundamental shift in the country's system of social welfare provision, I use data from the National Survey on Drug Use and Health (NSDUH) to explore patterns of health insurance coverage from before and after the ACA became active in 2014. The results show that the salience of labor market, marriage, and family attachments as pathways to coverage significantly declined in the first three years following passage of the ACA. By providing adults with a new route to coverage decoupled from their institutional attachments, the ACA helped narrow health insurance inequalities across gender, race and ethnicity, and education. Given the strong association between health insurance and health outcomes, the results from this study raise important questions about the centrality of institutional attachments for our knowledge of health inequalities.

Silence Speaks: The Relationship between Immigration and the Underreporting of Crime.

Scarce in criminological literature is an exploration of whether crime reporting varies geographically. Yet, there are substantive reasons to believe not only that the percentage of crimes reported to the police varies across jurisdictions, but also that crime reporting can be explained by ecological characteristics. Drawing upon data from both the National Crime Victimization Survey and the census, this study examines the relationship between immigration and the likelihood that crimes are reported to the police. Results indicate that crime reporting is inversely related to increases in the rates of noncitizens and foreign-born residents within a metropolitan area, and that the negative effect is greater for violence than for property crime. Implications for policing and public safety are discussed.