Former professional American-style football (ASF) players may be at increased risk of sleep apnea (SA) compared with the general population. However, SA may be underdiagnosed or undertreated in former ASF players and be associated with cardiovascular, cognitive, and psychological health. The aim of this study was to characterize former professional ASF players self-reporting SA diagnoses, as well as undiagnosed players who screened positively on a validated SA instrument. A cross-sectional survey was administered as part of the Football Players Health Study at Harvard University between 2017 and 2020. Former ASF players who signed a professional contract after 1960 were eligible to enroll. Data included demographics and football-related exposures (e.g., position and career duration), self-reported SA diagnosis, and STOP-BANG screening scores. Head injury exposure was measured using the number of concussion symptoms accrued during football practice or play. Outcomes included self-reported cognitive functioning, depression, anxiety, and pain. Multivariable logistic and linear regression was used to identify associations between sleep outcomes and (1) demographic and football characteristics and (2) recent mood, cognitive, and pain symptoms, respectively. Among 1,951 participants, 31.8% self-reported SA diagnoses (n = 621), which were associated with older age, Black race, lineman status, and higher numbers of football-accrued concussion symptoms. Only 39.8% (n = 247) of the SA group reported using their positive airway pressure therapy 4+ times per week. Of those without a current diagnosis of SA (n = 1,330), 74.6% (n = 992) scored in the intermediate or high range on the STOP-BANG. In multivariable models adjusted for demographic and football-related exposures, SA diagnosis and intermediate/high STOP-BANG scores were associated with more pain, anxiety, depression, and cognitive symptoms. Data showed that participants with diagnosed but untreated SA reported the highest symptom burden (all p < 0.001). This study identified that many former professional ASF players may be at risk of not being appropriately screened or treated for SA. These results estimate that the actual proportion of former professional ASF players with SA may be as high as 69%. Mood, pain, and cognitive symptoms may be exacerbated in those with treated, undertreated, or suspected SA.

Associations of depressive symptoms and antidepressant medication use with physical function among middle-aged adults: Results from the CARDIA Function study.

The incidence and associated factors of pulmonary embolism after cardiac surgery: A retrospective nationwide inpatient sample database study

Tennessee ranks sixth in stroke mortality in the United States. Yet the patterns of stroke mortality vary significantly across counties and over time. This study aims to examine spatiotemporal disparities of stroke mortality at the county level in Tennessee from 1969 to 2020. A population-based study using the national vital statistics system of stroke mortality data through the Surveillance, Epidemiology, and End Results and National Center for Health Statistics (SEER-NCHS) database. Patients older than 35 years who died from stroke in Tennessee from 1969 to 2020. Data from the SEER-NCHS were aggregated into 4 periods (1969-1980, 1981-1992, 1993-2004, and 2005-2020), and age-adjusted stroke mortality rates were calculated by county and by race and sex for each time period. The stroke mortality rates in Tennessee declined by 35.6%, 28.3%, 7.1%, and 24.4% in 1969-1980, 1981-1992, 1993-2004, 2005-2020, respectively. The degree of decline varied by race and sex groups. In the first 2 periods, the largest decline in stroke mortality was observed among Black women (43.2% and 31.5%). During 1993-2004, the largest decline was observed among Black men (22.4%), while the largest decline was observed among white women during 2005-2020 at 25.5%. There were urban-rural disparities in stroke mortality across counties and over the 4 periods. In general, urban and rural mortality rates were similar from 1969 to 1992; however, a substantial decline (24.1%) was observed in urban counties during 1993-2004, while a larger decline (34.6%) occurred later in rural counties during 2005-2020. County-level variations in stroke mortality were also evident across the 4 periods. Substantial disparities in stroke mortality by counties and race-sex subgroups persisted over the past 5 decades. The disease burden was clustered in a few counties and disproportionately higher among vulnerable populations.

The objective of this study was to analyze the circumstances of encounters involving gun violence at a Children's Hospital (CH) between January 1, 2012, and December 31, 2023. This was a retrospective study of patients 0 to 17 years old, presenting with firearm-related trauma to a CH facility. There were 325 cases. There was a rising frequency trend from 2012 to 2023. The year 2020 saw the highest annual frequency. A significant majority of these cases were the result of assaults experienced by black, male, teenagers living within an urban zip code. There were 16 deaths (4.9%). The extremities were the most common injury location (61%). A total of 188 (57.9%) cases involved hospitalization, 133 (40.9%) cases required surgery, and 67 (20.6%) cases required intensive care unit (ICU) admission. Our study demonstrates the overwhelming burden of gun violence borne by black urban communities, confirming other similar studies.

Hidden nicotine: Cotinine levels among young adult Black men who smoke cannabis blunts.

Comparing service providers and youth advice on coordinated service delivery in Ontario's child welfare system.

This article traces the history of the Phoenixonian Institute, one of the earliest sites of Black education in the state of California, which operated from 1862 to 1875. Although it entered the Union as a free state, California’s public schools initially barred Black students (along with Indigenous and Chinese students) from admission. In response, Black Californians worked to build an educational infrastructure of their own. This article argues that Black communities pursued schooling actively throughout the state’s early history, relying on the transcontinental activism of Black educators, who carried traditions of abolitionist politics, community activism, and legislative appeal with them as they migrated to the West. In doing so, this study adds a needed dimension to the history of Black education in the United States, expanding a literature which has traditionally centered the South, and deepens our understanding of community formation and political activism in the Black West.

Abstract Ideological diversity has long characterized the Black community, yet this diversity has historically manifested as political homogeneity in electoral participation. While Black men vote for Democratic candidates at lower rates than Black women, they continue to support Democrats at higher rates than Latino, Asian, and white men and women. Despite their comparatively high turnout, Black men are frequently scapegoated for Democratic losses, even while the party has acknowledged Black women’s loyalty. We argue that Black men’s political leanings reflect a complex interplay of gendered, racial, and ideological forces, particularly their attitudes toward Black women, white men, and broader policy concerns. We also argue that, compared with Black women, Black men disproportionately use Black-led podcasts as counterpublics, spaces outside mainstream consciousness to discuss issues internal to the Black community. Using content analysis of Black male–hosted podcasts from 2014–2025 and data from the 2020 Collaborative Multiracial Post-Election Survey (CMPS), we show that Black men’s Democratic party support, although not as strong as Black women’s, remains robust. We introduce the Black Patriarchy Index, which captures dimensions of hostile sexism, bootstrap racial uplift ideology, and rejection of intersectional solidarity. Our findings demonstrate that the modest but significant rise in conservatism among Black men relative to Black women can be partially explained by higher scores on this index, illustrating how Black men’s conservative attitudes shape political ideology and party loyalty within the Black electorate.

Cardiovascular disease is a risk factor for severe COVID-19 (ie, hospitalization or death). Whether better cardiovascular health (CVH) is associated with lower risk of severe COVID-19 among adults without cardiovascular disease is unknown. We aimed to test if the American Heart Association's Life's Essential 8 (LE8) metric and its components were associated with severe COVID-19 in the C4R (Collaborative Cohort of Cohorts for COVID-19 Research) consortium. Participants with cardiovascular disease were excluded. Two waves of questionnaires, events surveillance, and a serosurvey identified COVID-19 infections. Associations of incident severe COVID-19 with continuous LE8, categorical LE8 (low [<50], moderate [50 to <80], and high [≥80] CVH), and individual LE8 components, were tested in adjusted cause-specific hazards models. Among 29 740 participants in 9 cohorts (mean age, 66±14 years; 61% women; 35% White race; 22% Black race; 34% Hispanic ethnicity), there were 681 severe COVID-19 cases between March 1, 2020, and February 28, 2023. There was a 20% lower hazard of severe COVID-19 per each 1-SD higher LE8 (adjusted hazard ratio [aHR], 0.80 [95% CI, 0.73-0.88]). Relative to low CVH, high CVH was associated with lower risk of severe COVID-19 (aHR, 0.54 [95% CI, 0.37-0.78]); this was not seen for moderate CVH (aHR, 0.81 [95% CI, 0.64-1.04]). Of LE8 components, better physical activity, body mass index, blood pressure, and sleep were associated with a lower hazard of severe COVID-19. Better CVH was associated with lower severe COVID-19 risk among cardiovascular disease-free adults. Whether CVH optimization could mitigate adverse risk from COVID-19 and other harmful viruses warrants further investigation.

Introduction There is a need to reflect on the COVID-19 vaccine distribution plans across Canada and the extent to which they considered equity-deserving populations, as lessons from the rollout can inform future emergency responses and foster trust in public health. This paper examined and compared strategies implemented by six Canadian provinces to increase access and promote the uptake of COVID-19 vaccines among selected priority populations. We also explored the factors that impacted the implementation of these strategies. Methods In six provinces (Alberta, British Columbia, Manitoba, Nova Scotia, Ontario, and Quebec), we conducted an environmental scan of provincial rollout documents and media sources reporting vaccine distribution among selected priority populations: First Nations, Inuit, and Métis; Black communities; essential workers; people experiencing homelessness; and people with disabilities. We subsequently interviewed 39 key informants to validate the environmental scan results, identify additional strategies to increase COVID-19 vaccine uptake, and uncover perceptions of the facilitators and challenges that influenced the strategies implementation. Results We identified that provincial health authorities employed several strategies to overcome structural, geographical, and attitudinal barriers to COVID-19 vaccines experienced by the priority populations. Most provinces implemented walk-in, mobile, and pop-up vaccination clinics, mobilized their public and private health workforce, and designed multilingual communication materials. Facilitators in implementing COVID-19 vaccination strategies included harmonizing communication efforts, leveraging existing relationships and networks, and ensuring representation and leadership of community partners. Challenges to implementing COVID-19 vaccination strategies included uncoordinated communication efforts, inadequate distribution of vaccines to areas with the greatest need, mistrust in the government and healthcare system, vaccine hesitancy, and lack of cultural competence by vaccine providers. Conclusions This study highlights the divide between well-intentioned strategies and interventions and the reality of on-the-ground implementation. The findings offer valuable insights and can inform the implementation of strategies to distribute vaccines equitably in future large-scale vaccination efforts in Canada and globally.

To elucidate the role of housing status in observed racial disparities in opioid overdose mortality, we conducted a cross-sectional study using vital statistics, medical, and housing records in San Francisco, California from 2021 to 2023. We reported standardized mortality ratio (SMR); indirectly age- and sex-standardized mortality rate; and observed, expected, and excess deaths for each race or ethnicity group among people experiencing homelessness, using adult Californians as the standard population. Forty-seven percent (812/1727) of overdose decedents were recently homeless, and people experiencing homelessness had 33 times the rate of opioid overdose mortality (SMR 33.2, CI 29.1-37.3) compared to the general population, standardized by age, race, and sex. There were a minimum of 244 excess deaths per year in San Francisco due to the increased risk of overdose among people experiencing homelessness, which disproportionally affected Black people. Reducing opioid overdose mortality and related disparities requires addressing the housing crisis.

This forum features practitioner perspectives on designing technologies for and with communities. We highlight compelling projects and provocative points of view that speak to both community technology practice and the interaction design field as a whole. — Sheena Erete, Editor

Black adolescent females are disproportionately affected by obesity and its associated adverse health outcomes. Though racial disparities in obesity and related health outcomes are often attributed to differences in socioeconomic status, growing evidence suggests that structural racism is a contributing factor. To prevent the numerous comorbidities associated with obesity in black females, interventionists must confront the tripartite impact of structural racism, racial discrimination, and intersectionality on physical activity and dietary behaviors. The purpose of this paper was to describe Public Health Critical Race Praxis (PHCRP) as a race-conscious approach to intervention development, refinement, and evaluation. PHCRP can be applied to behavioral intervention research to provide a lens to develop, refine, deliver, and/or evaluate culturally tailored interventions. We present a description of the 4 PHCRP foci for interventionists with examples of the 10 affiliated principles.PHCRP Application:The intervention team led with the overarching principle, race consciousness, to guide their refinement efforts, including acknowledgment of personal biases, identification of the mechanisms in which bias perpetuates racism, and development of counteractivities to combat these biases. The intervention team operationalized PHCRP by critically evaluating decisions through a race-conscious lens, ensuring that the 4 foci remained foundational throughout the refinement process. Interventionists have unintentionally reinforced racism with complicit silence by not directly addressing the profound influence of racism on health behaviors. We urge interventionists to regard the inclusion of a race-conscious framework, such as PHCRP, as a necessary requirement for designing interventions with marginalized populations.

We examined the impact of a PrEP navigation implementation strategy on care engagement at nine New York City Federally Qualified Health Centers (FQHCs) in an Ending the HIV Epidemic (EHE) jurisdiction. Between March 2021 and April 2022, FQHCs implemented the strategy, which consisted of five distinct navigation activities conducted by the Navigator (e.g., PrEP refill). We extracted electronic medical record (EMR) data on navigation services attempted/delivered, HIV prevention service delivery (e.g., HIV testing), and demographic characteristics for 303 patients prescribed PrEP and identified as eligible for navigation (27.4% Black, 48.8% Latino). We analyzed differences in HIV prevention service delivery by navigation success. Out of 303 patients, 95 (31.4%) were reached for navigation and 208 (68.6%) were not. Patients who were successfully navigated had significantly greater care engagement during the study period. In addition, patients who were successfully navigated were more likely to have had timely care engagement. There were no differences in navigation success by characteristics examined (e.g., sex in EMR, race/ethnicity, insurance coverage). The navigation service most utilized was medical appointment assistance (77.9%). Navigation appeared effective in enhancing PrEP care engagement. Although additional strategies may be needed to reach patients not successfully navigated through this implementation strategy, our work may inform researchers, policymakers, and practitioners focused on enhancing PrEP care about evaluating implementation strategies.

ABSTRACT Although some literature explores the experiences of Black male teachers (BMST) across subject areas and grade levels, very little research examines the motivations, realities, and recruitment of Black men science teachers in urban public secondary schools. This qualitative study draws on Critical Race Theory and Black Male Intersectionality to analyse the counter-narratives of three Black men science teachers. Participant narratives revealed four themes: (1) relational capital in STEM education, (2) planting seeds: informal experiences as pathways into teaching, (3) reflecting on the motivations for entering teaching, and (4) navigating race and gender in teacher education and science teaching. Across the four themes, the experiences of BMST reveal how their professional journeys are shaped by relational connections, informal recruitment pathways, personal motivations, and racialised and gendered professional contexts.

To describe the demographic and health profiles of Black people in the African Caribbean Track Study (A/C Study) who consented to linkage to administrative databases, examine variations in healthcare use, and compare these patterns to those observed in the general population to inform efforts to reduce health disparities. Using a matched cohort design, participants who consented to administrative data linkage in the A/C Study were matched 1:10 to general population controls based on age (± 5years), sex, and census metropolitan area. We compared sociodemographic characteristics, HIV prevalence, and healthcare use using descriptive statistics and logistic regression. Of the 1380 A/C Study participants, 309 provided consent and 115 (8.3%) were successfully linked to administrative data and matched to 1150 controls (total N = 1265). A/C Study participants were significantly more likely to reside in areas of higher material deprivation and residential instability. HIV prevalence was substantially higher in the A/C cohort compared to the general population (OR = 29.87; 95% CI, 8.10-110.12). A/C participants also had significantly higher odds of ER use (OR = 2.16; 95% CI, 1.38-3.40). No significant differences were observed in primary care visits, hospitalizations, specialist visits, or UPC index. This study highlights disparities in HIV burden and emergency care use among Black communities in Ontario, underscoring persistent inequities in access to timely, preventive care. These findings demonstrate the value of data linkage for equity-focused health system research and emphasize the need for culturally responsive interventions to improve outcomes among Black populations in Canada.

Suicide risk is higher in patients with multiple myeloma (MM) than in the general population. We used LASSO and Cox regression to identify factors associated with suicide in MM and to build a predictive nomogram. Sex, race, marital status, radiotherapy, year of diagnosis, and Rural-Urban Continuum Codes were independent predictors. Female sex, Black race, receipt of radiotherapy, more recent diagnosis (2010-2014, 2015-2020), and living in a metropolitan area were associated with lower suicide risk, whereas being single increased risk. Model performance was evaluated using Kaplan-Meier curves, calibration plots, decision curve analysis, internal validation, and a competing-risk model, all of which showed good discrimination, calibration, and robustness. The resulting nomogram provides an accurate and clinically useful tool to identify MM patients at elevated risk of suicide and may help guide targeted psychological and supportive interventions.

Disparities in Adjuvant Radioactive Iodine Use in High-Risk Follicular Thyroid Carcinoma: Evaluation of NCCN and ATA Guideline Concordance.

Cancer screening discrepancies among Black people in Canada: a scoping review.