West Virginia Research Articles

Abstract 4134912: Geographic, Gender,&Racial Trends in Mortality Due to Coronary Artery Disease in Diabetes among Adults Aged 25 and Older in the United States, 1999-2020: A CDC WONDER Database Analysis

Background: Coronary artery disease (CAD) is a significant contributor to mortality among adults with diabetes mellitus (DM) in the United States. This study examines the patterns of CAD-related mortality in individuals aged 25 and above with DM, with a particular focus on geographic, gender, and racial/ethnic discrepancies from 1999 to 2020. Methods: The study analyzed death certificate information from the CDC WONDER database from 1999 to 2020. Age-adjusted mortality rates (AAMRs), annual percent change (APC), and average annual percentage change (AAPC) were computed per 100,000 individuals, categorized by year, gender, race/ethnicity, and geographic areas. Results: Between 1999 and 2020, CAD in individuals with DM resulted in 1,462,279 deaths among adults aged 25 and above in the United States. The majority of these deaths occurred in medical facilities (44.2%) and at home (29.3%). The overall age-AAMR for CAD in DM-related deaths decreased from 36.3 in 1999 to 31.7 in 2020, with an AAPC of -0.96 (95% CI: -1.29 to -0.77 p < 0.000001). Men had higher AAMRs (41.6) compared to women (22.6), with a more significant decrease in women (AAPC: -2.10, p < 0.000001) than in men (AAPC: -0.34, p = 0.001200). Racial/ethnic disparities showed the highest AAMRs in American Indians/Alaska Natives (43.6), followed by Blacks (37.8), Hispanics (33.8), Whites (29.7), and Asians/Pacific Islanders (22.5). The most significant decrease was in Hispanics (AAPC: -1.64, p < 0.000001). Geographically, AAMRs ranged from 13.7 in Nevada to 51.3 in West Virginia, with the highest mortality observed in the Midwest (AAMR: 34.5). Nonmetropolitan areas exhibited higher AAMRs (35.2) than metropolitan areas (29.7), with a more pronounced decrease in urban areas (AAPC: -1.22, p < 0.000001) compared to nonmetropolitan areas (AAPC: -0.03, p = 0.854629). Conclusion: The decrease in AAMRs for CAD among individuals with DM from 1999 to 2020 indicates improvements in healthcare management. However, the ongoing disparities based on race, gender, and geography call for targeted public health interventions to guarantee fair access to cardiovascular care. Additional endeavors are necessary to comprehend and alleviate the root causes of these inequalities.

Abstract 4134768: Geographic, Gender,&Racial Trends in Mortality Due to Heart Failure in Coronary Artery Disease Among Adults Aged 65 and Older in the United States, 1999-2020: A CDC WONDER Database Analysis

Backgrounds: Heart failure (HF) associated with coronary artery disease (CAD) is a significant contributor to mortality in the elderly population of the United States. This study examines trends in HF in CAD-related mortality among adults aged 65 and older, focusing on geographic, gender, and racial/ethnic disparities from 1999 to 2020. Methods: A retrospective analysis was performed using the CDC WONDER database death certificates from 1999 to 2020. Age-adjusted mortality rates (AAMRs), annual percent change (APC), and average annual percentage change (AAPC) were calculated per 100,000 persons, stratified by year, sex, race/ethnicity, and geographical region. Results: Between 1999 and 2020, there were 6,571,263 deaths attributed to coronary artery disease (CAD) and 6,135,540 deaths related to Heart Failure (HF) in the US. Among adults aged 65 and older, HF in CAD caused 1,597,451 deaths, with 37.1% occurring in medical facilities and 30.3% in nursing homes. The AAMRs for HF in CAD decreased from 241.7 in 1999 to 156.2 in 2020 (AAPC: -2.23, p < 0.000001). This reduction was significant from 1999 to 2014, followed by a slight increase from 2014 to 2020. Men consistently had higher AAMRs than women (227.4 vs. 137.1), with women experiencing a more significant decline in rates (AAPC: -3.23, p < 0.000001). Racial disparities revealed the highest AAMRs among Whites (183.0), followed by American Indians/Alaska Natives (153.7), Blacks (134.6), Hispanics (123.7), and Asians/Pacific Islanders (81.6). The most significant reductions were observed in Hispanics (AAPC: -2.68, p < 0.000001). Geographically, AAMRs varied, ranging from 92.1 in Hawaii to 257.3 in West Virginia, with the Midwest showing the highest mortality (191.0). Nonmetropolitan areas exhibited higher AAMRs than metropolitan areas (202.6 vs. 166.1), although both showed moderate declines over time, more pronounced in urban areas (AAPC: -2.41, p < 0.000001). Conclusion: The study uncovers notable variances in HF in CAD-related mortality among elderly individuals in the United States based on race, gender, and geographic location. While the decrease in AAMRs from 1999 to 2014 indicates progress in cardiovascular care, the subsequent rise from 2014 to 2020 and enduring disparities call for specific public health measures to tackle these inequalities.

Abstract 4138715: Disparities in Aortic Dissection and Aortic Aneurysm-Related Mortality in The United States From 1999-2020

Background: Aortic dissection (AD) and aneurysm (AA) have a low incidence but are severe health risks associated with high mortality rates, and based on location, can have a mortality rate of over 80%. We aim to highlight disparities in mortality based on gender, race, age and demographic background. Methods: This retrospective study analyzed death certificate data for AD and AA (ICD-10 code I71) from 1999 to 2020 using the CDC WONDER database. Age-adjusted mortality rates (AAMR) per 100,000 were assessed for adults aged 25 and older by gender, race, year, state, and place of death, while crude mortality rates (CMR) per 100,000 were used for age groups. Joinpoint regression calculated the annual percent change (APC) and average annual percent change (AAPC) with 95% confidence intervals. Results: From 1999 to 2020, AD and AA resulted in 400,748 deaths in the US. During this period, AAMR for men (12.19) was approximately double that for women (5.77). Overall, the AAMR decreased from 12.40 to 6.71 (AAPC: -2.93; 95% CI: -3.06 to -2.79; p-value<0.000001). NH whites had the highest AAMR at 8.93, while Hispanic and Latino populations had the lowest at 4.20. Approximately 52.3% of the deaths occurred in inpatient medical facilities, whereas 18.4% occurred at home. Vermont, West Virginia, and Wyoming had the highest AAMRs, at 11.60, 11.47, and 11.30, respectively. Among racial groups, both males and females experienced a decrease in AAMR except for NH black men. For this group, there was an increase in AAMR from 9.42 in 2012 to 10.43 in 2020 (APC:1.03; 95% CI: 0.15 to 2.22; p-value:0.028). The CMR for young adults rose significantly from 0.62 in 2014 to 0.73 in 2020 (APC:2.55; 95% CI 1.11 to 6.74; p-value:0.02), and for middle-aged adults from 3.09 in 2010 to 3.61 in 2020 (APC: 1.57; 95% CI 1.04 to 2.25; p-value<0.000001). Conversely, a steep decline in CMR was observed for older adults from 27.93 in 2014 to 25.4 in 2020 (APC:-1.34; 95% CI -1.9 to -0.69; p-value:0.0004). Conclusion: Although AD and AA mortality rates have declined over time, significant disparities persist for NH Black men and young/middle-aged adults. This highlights the need for early screening programs and equitable healthcare provision for all populations.

Domestic groundwater wells in Appalachia show evidence of low-dose, complex mixtures of legacy pollutants.

Lack of water quality data for private drinking water sources prevents robust evaluation of exposure risk for communities co-located with historically contaminated sites and ongoing industrial activity. Areas of the Appalachian region of the United States (i.e., Pennsylvania, Ohio and West Virginia) contain extensive hydraulic fracturing activity, as well as other extractive and industrial technologies, in close proximity to communities reliant on private drinking water sources, creating concern over potential groundwater contamination. In this study, we characterized volatile organic compound (VOC) occurrence at 307 private groundwater well sites within Pennsylvania, Ohio, and West Virginia. The majority (97%) of water samples contained at least one VOC, while the average number of VOCs detected at a given site was 5 ± 3. The majority of individual VOC concentrations fell below applicable U.S. Environmental Protection Agency (EPA) Maximum Contamination Levels (MCLs), except for chloroform (MCL of 80 μg L-1; n = 1 at 98 μg L-1), 1,2-dibromoethane (MCL of 0.05 μg L-1; n = 3 ranging from 0.05 to 0.35 μg L-1), and 1,2-dibromo-3-chloropropane (MCL of 0.2 μg L-1; n = 7 ranging from 0.20 to 0.58 μg L-1). To evaluate well susceptibility to VOCs from industrial activity, distance to hydraulic fracturing site was used to assess correlations with contaminant occurrences. Proximity to closest hydraulic fracturing well-site revealed no statistically significant linear relationships with either individual VOC concentrations, or frequency of VOC detections. Evaluation of other known industrial contamination sites (e.g., US EPA Superfund sites) revealed elevated levels of three VOCs (chloroform, toluene, benzene) in groundwaters within 10 km of those Superfund sites in West Virginia and Ohio, illuminating possible point source influence. Lack of correlation between VOC concentrations and proximity to specific point sources indicates complex geochemical processes governing trace VOC contamination of private drinking water sources. While individual concentrations of VOCs fell well below recommended human health levels, the low dose exposure to multiple VOCs occurring in drinking supplies for Appalachian communities was noted, highlighting the importance of groundwater well monitoring.

Trends in coronary artery disease mortality among adults with diabetes: Insights from CDC WONDER (1999–2020)

BackgroundCoronary artery disease (CAD) in diabetes mellitus (DM) is a significant cause of mortality among US adults. This study investigates trends in CAD-related mortality in adults aged 25 and older with DM, focusing on geographic, gender, and racial/ethnic disparities from 1999 to 2020. MethodsA retrospective analysis was conducted using death certificate data from the CDC WONDER database from 1999 to 2020. Age-adjusted mortality rates (AAMRs), annual percent change (APC), and average annual percentage change (AAPC) were calculated per 100,000 persons, stratified by year, sex, race/ethnicity, and geographical region. ResultsCAD in DM accounted for 1,462,279 deaths among US adults aged 25+. Most deaths occurred in medical facilities (44.2 %) and at home (29.3 %). The overall AAMR for CAD in DM-related deaths decreased from 36.3 in 1999 to 31.7 in 2020, with an AAPC of −0.96 (95 % CI: −1.29 to −0.77, p < 0.000001). Men had higher AAMRs (41.6) compared to women (22.6), with a more significant decrease in women (AAPC: −2.10, p < 0.000001) than in men (AAPC: −0.34, p = 0.001200). Racial/ethnic disparities showed the highest AAMRs in American Indians/Alaska Natives (43.6), followed by Blacks (37.8), Hispanics (33.8), Whites (29.7), and Asians/Pacific Islanders (22.5). The most significant decrease was in Hispanics (AAPC: −1.64, p < 0.000001). Geographically, AAMRs ranged from 13.7 in Nevada to 51.3 in West Virginia, with the highest mortality observed in the Midwest (AAMR: 34.5). Nonmetropolitan areas exhibited higher AAMRs (35.2) than metropolitan areas (29.7), with a more pronounced decrease in metropolitan areas (AAPC: −1.22, p < 0.000001) compared to nonmetropolitan areas (AAPC: −0.03, p = 0.854629). ConclusionThe notable increase in mortality rates associated with CAD among patients with DM from 2018 to 2020 presents a substantial concern that necessitates targeted public health interventions to ensure equitable access to cardiovascular care.

Herman G. Canady: A reintroduction.

For nearly four decades, Herman G. Canady actively promoted psychological science in the public interest. A skillful leader and administrator, Canady helped to establish one of the first national organizations of Black psychologists and was purportedly one of the founding members of the West Virginia State Psychological Association. He also collaborated with a diverse range of professional colleagues on relevant social issues of the time. Despite the depth and breadth of Canady's contributions to psychology, very little is known about his impact on the field. The goal of this article is to reintroduce the discipline to Canady. Drawing upon a range of archival materials, personal correspondence, and interviews, I highlight how Canady used the platform of psychological science in ways that not only redefined "racial psychology," but also brought attention to educational inequities, stressed the importance of institution-building, and demonstrated the utility of cross-cultural alliances for addressing important social causes. Canady's influence-and that of others of his generation-merits further study and deeper analysis. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The case for geography in nursing practice.

The discipline of geography is an increasingly necessary lens required to understand population-level diseases. Syndemics, or co-occurring diseases or epidemics within a specific population, are contextualized by place-preexisting social, economic, and political structures. Nurse practitioners are well-positioned to critically assess the impact of geography on patient health and well-being. This perspective provides a brief summary of syndemic crises, with a case example in the West Virginia coalfields. The position of this paper is one that supports geography, in addition to social determinants of health, as a framework for syndemics. A geographic perspective provides a more comprehensive picture of marginalized populations and regions facing the phenomenon. Given the significance of holistic nursing, attention to the role of geography in syndemics provides an increased dimension of care and treatment.

Icelandic Prevention Model in Rural Appalachian Communities: Gauging Stakeholder Experience with the Core Processes Three Years into County-Level Implementation

Background: This study assessed stakeholder experience with the core processes of The Integrated Community Engagement (ICE) Collaborative, a primary prevention approach addressing adolescent substance use in rural West Virginia, after three years of county-level implementation. Objectives: Guided by the Icelandic Prevention Model (IPM), the ICE Collaborative aims to enhance cooperation between researchers, policy makers, local practitioners, and community members and facilitate a paradigm shift in youth and community substance use prevention. This shift involves moving away from strategies focused on the repeated allocation of short-term grants that fund time-limited programs to a long-term, holistic, and sustainable approach overseen by local practitioners and coalitions. Results: We conducted qualitative interviews and focus groups with 33 stakeholders during the fall of 2022. Data analyses generated six major themes: 1) It Takes a Village to Prevent Adolescent Substance Use, 2) Improving Understanding and Commitment to Prevention Through Outreach, 3) Enhancing Student Engagement and Program Accessibility, 4) Addressing the Chronic Underfunding of Prevention and Youth Development Programs, 5) Acknowledging Family Contexts and Family Member Substance Use as Risk Factors, and 6) ICE/IPM Inspiring Solution-based Conversations, Goal Setting, and Strategy Selection. Conclusions: Stakeholders reported multiple positive characteristics of ICE for their communities and applauded the long-term focus and access to local data. Several suggestions for improved strategies were also reported. Results are discussed in line with the theoretical underpinnings of the IPM and current discourse around community health promotion in rural areas.

Regional Workforce Dynamics in West Virginia: Insights from Shift-Share and Location Quotient Analysis

West Virginia, home to approximately 1.77 million residents, has been grappling with significant economic challenges characterized by persistent poverty and sluggish growth. Despite ongoing development efforts, the state’s Gross State Product (GSP) has seen only a modest increase of 0.1% over the past five years, reaching USD 71.7 billion, while the unemployment rate remains at 4.0%. The annualized employment growth rate of 0.7% lags behind the national average, and only about 54% of West Virginia’s adult population is either employed or actively seeking employment, resulting in one of the lowest labor force participation rates in the nation. In contrast, certain industrial sectors, such as healthcare, social assistance, retail trade, and accommodation and food services, have shown intermittent growth at the county and regional levels. To explore the unique characteristics and significance of these regions in relation to employment growth, this study examines regional employment patterns in West Virginia from 2001 to 2020, focusing on the main regions of the state: Metro Valley, Mid-Ohio Valley, New River/Greenbrier Valley, Mountain Lakes, and Potomac Highlands. Utilizing shift-share and location quotient (LQ) analyses, this research identifies the sectors driving regional employment and assesses their performance. Key findings reveal strong sectoral performance in mining, manufacturing, and finance in the Mid-Ohio Valley; wholesale trade, transportation, and utilities in the Metro Valley; agriculture and administrative services in the New River/Greenbrier Valley; agriculture and manufacturing in the Potomac Highlands; and scientific services, healthcare, and utilities in the Mountain Lakes region. Based on these insights, this study recommends targeted policy interventions to address regional disparities, enhance sectors with significant short- and long-term benefits, and foster balanced economic development across the state.

Spatial and demographic heterogeneity in excess mortality in the United States, 2020-2023: a multi-model approach.

In this study, we assessed the overall impact of the Covid-19 pandemic in the United States between 2020 and 2023 through estimates of excess all-cause mortality. Monthly mortality rates over a 19-year period, stratified by age, sex and state of residence were used to forecast expected mortality for the pandemic years. A combination of models - two timeseries, a spatial random effects and a generalized additive -- was used to better capture uncertainty. Results indicate that US national excess mortality decreased in 2023 to 157 thousand (95% prediction interval: 35K-282K) from 502K (436K-567K), 574K(484K-666K) and 377K (264K-484K) during the years 2020-2022, respectively. Unlike in previous years, deaths with Covid-19 as the underlying-cause-of-death possibly accounted for all excess deaths during 2023. While for the older age groups (75+ years) the year 2020, before vaccines were available, had the highest excess mortality rate, the two younger age groups had the highest excess mortality in 2021. In each age group, women were estimated to have consistently lower excess mortality than men. West Virginia had the highest age-standardized excess mortality among all states in 2021 and 2022. Our findings demonstrate the value of a multi-model approach in capturing heterogeneity in excess mortality.

Cardiovascular events in estimated glomerular filtration rate-mutation non-small-cell lung cancer patients on osimertinib

ObjectivesThere have been cases of cardiotoxicity induced by osimertinib in patients with non-small-cell lung cancer (NSCLC). However, limited data exist for a comprehensive cardiotoxicity profile analysis for osimertinib use in...

Development and Implementation of the “Exercise is Medicine” Elective at an Osteopathic Medical School

Abstract Introduction Lifestyle changes are a powerful way to combat many chronic illnesses. However, education on appropriate instruction of physical activity appears to be insufficient among medical students. This manuscript highlights development, incorporation, and feedback of the Exercise is Medicine elective at the West Virginia School of Osteopathic Medicine. Materials and Methods Twenty-four medical students attended ten weekly sessions, each of which lasted 2 h and covered a different topic. Participants were selected based on previous experience with exercise-based medicine and their personal beliefs on incorporating it into clinical encounters. Outcomes were gathered using surveys consisting of the Likert Scale, rating, yes/no/maybe, and free text questions. Results Confidence in prescribing lifestyle changes increased (p &lt; 0.0001) from pre- to post-elective. Feelings of incorporating course material into practice increased (p &lt; 0.05) after the elective. Feelings that physicians could impact their patients’ physical activity did not change. Conclusion Implementation of the Exercise is Medicine elective was well received among students and increased student knowledge and confidence in prescribing lifestyle changes to a variety of patient populations.

Police Officers’ Perspectives of Harm Reduction Programs in West Virginia

Background As the United States’ drug epidemic continues and resources dwindle, some police agencies are searching for alternatives to combat drug use in their communities. Some police agencies are interacting with harm reduction programs (HRPs) more frequently. Few studies have documented polices’ perspectives of these programs in rural areas. The purpose of this study was to garner police officers’ perspectives of HRPs and how these programs may influence their work in a rural state. Methods Semistructured interviews were conducted with police officers from January to February 2023. Participants had to be ≥18 years of age and be currently employed as an officer within the state of West Virginia. Participants were recruited across the state using non-probability sampling techniques. The interviews were conducted using a standardized script, audio recorded, and transcribed. Two researchers partook in a thematic analysis with inductive coding to determine themes using NVIVO v11 software. Results Participants ( N = 11) were mainly ≥45 years of age (55%) with ≥25 years of enforcement experience (55%). Five themes transpired: (1) nature of police work, (2) perceived benefits of HRPs, (3) perceived detriments of HRPs, (4) need for education, and (5) programmatic effectiveness and accessibility. Many officers felt HRPs could serve as an alternative to arrest for people who use drugs (PWUD) and decrease their drug use, crime, and infectious disease (i.e., improve safety) overtime. Conversely, officers felt HRPs could be detrimental if they were ineffectual as they could draw more PWUD into a community which could increase crime. Officers also discussed how harm reduction principles often conflict with their training. Conclusions From law enforcements’ perspective, HRPs can positively and negatively impact their work. Officers want more education and data on HRP effectiveness and accessibility. These findings may inform future HRP implementation in rural states such as West Virginia.

Paddlefish movement and dam passage in the Ohio and Kanawha Rivers, West Virginia

The Paddlefish (Polyodon spathula), a large-bodied and highly migratory species of large river systems, has experienced population declines or extirpation in parts of its native range. As an effort to reestablish a Paddlefish population in the Ohio River of West Virginia, the West Virginia Division of Natural Resources has stocked fingerling Paddlefish in the previous two decades. Post-stocking studies could assess the status of the reintroduced population, which includes collecting information on their seasonal movements and dam passage frequency through navigation dams of the Ohio and Kanawha Rivers. Using acoustic telemetry techniques, we monitored seasonal movements and assessed dam passage of five Paddlefish in the Robert C. Byrd Pool of the Ohio and Kanawha rivers. Paddlefish were highly mobile with two individuals using the entire R.C. Byrd Pool during the 11-month study period. Most movements occurred during the expected spawning period of April and May, where all individuals frequented the upper section of the pool in the Kanawha River. Downstream passage was documented for one individual at the R.C. Byrd lock during July 2023, but no evidence of upstream passage was documented for the locks at Racine (Ohio River) or Winfield (Kanawha River). Tagging of additional Paddlefish would be beneficial to increase sample size for future assessments and continue efforts toward the long-term conservation and management of Ohio River Paddlefish.

Nitrogen induced soil carbon gains are resistant to loss after the cessation of excess nitrogen inputs

Nitrogen (N) deposition has increased soil carbon (C) storage across eastern US temperate forests by reducing microbial decomposition. However, the fate of these N-induced soil C gains are uncertain given strong declines in N-deposition rates and rising soil temperatures. As N deposition has reduced soil pH and plant C investments into the rhizosphere, we compared the extent to which removing limitations to microbial decomposition by increasing soil pH, adding artificial root exudates, or elevating soil temperature would increase microbial decomposition in soils that have and have not received excess N inputs. We hypothesized that alleviating these microbial decomposition limitations would prime soil C losses from soils that have received excess N inputs. To test this hypothesis, we conducted a soil microcosm experiment where we compared microbial respiration, microbial biomass, and soil enzyme activity in soils from an unfertilized watershed and a previously N-fertilized watershed 4 years after the end of a 30-year N deposition experiment at the Fernow Experimental Forest in West Virginia. In both watersheds, we found that removing pH, plant carbon, or temperature limitations to decomposition stimulated microbial respiration. However, microbial decomposition and soil C losses were consistently lower in the previously N-fertilized watershed across all treatments. This response, coupled with a lack of differences in microbial biomass between watersheds and treatments, suggests that long-term N fertilization has fundamentally altered soil microbial communities and has led to a sustained impairment of the ability of the microbial community to decompose soil organic matter. Collectively, our results indicate that the legacy effect of N deposition on microbial communities may influence the persistence of soil C stocks in the face of global change.

Impact of the Opioid Crisis on Parent–Child Interaction Therapy Outcomes: A Mixed-Methods, Community-Based Comparison in West Virginia

Impact of the Opioid Crisis on Parent–Child Interaction Therapy Outcomes: A Mixed-Methods, Community-Based Comparison in West Virginia

Demographic Risk Factors Vary in the Invasion Front of Chronic Wasting Disease in West Virginia, USA.

After detecting chronic wasting disease (CWD) in white-tailed deer (Odocoileus virginianus) in Hampshire County, West Virginia, USA, in 2005, we investigated the change of CWD apparent prevalence and potential factors influencing infection risk during the invasion front. Over eight sampling years (2006-2012 and 2017) during a 12-yr period within a 101-km2-area monitoring zone, we sampled and tested a total of 853 deer for CWD by ELISA and immunohistochemistry. Bayesian logistic regression of risk factors included collection year, age class, sex, and adjusted body weight (weight after accounting for sex, age, kidney fat index, and number of fetuses). In the whole-herd model (n=634), collection year, age, and adjusted body weight were associated with increased odds of CWD, whereas an age-weight interaction had a negative relationship. We found that males drove the positive associations with age and adjusted body weight, whereas females were responsible for the negative interaction effect. These findings suggest potential behavioral and physiological mechanisms related to sex that may influence CWD exposure. Older males exhibited higher CWD prevalence, aligning with previous studies. Notably, the novel finding of adjusted body weight as a risk factor in males warrants further investigation, and this study highlights the need for future research on social behavior and its role in CWD transmission within white-tailed deer populations.

Delineating Urbanicity and Rurality: Impact on Environmental Exposure Assessment.

Environmental exposures and their health impacts can vary substantially between urban and rural areas. However, different methods for classifying these areas could lead to inconsistencies in environmental exposure and health studies, which are often overlooked. We constructed different urban/rural classification systems based on multiple population-based (e.g., total population, population density, and commuting) and built-environment-based (e.g., nighttime light intensity, building density, road density, distance to urban centers, point of interest density, and urban area coverage) indicators and various classification schemes. These classification systems were applied to Virginia and West Virginia, United States. We compared differences in urban/rural spatial patterns, demographic compositions, and exposures of particulate matter (PM2.5), greenspace, and land surface temperature using these urban/rural classification systems to understand their impacts on environmental exposure and health research. Our findings reveal clear differences in spatial patterns and demographic compositions across various systems. We also observed that different systems can lead to changes in the magnitude and direction of urban/rural disparities in environmental exposure assessment. Addressing the complexities in delineating urbanicity and rurality may include careful consideration of classification systems to reflect those aspects of urbanicity and rurality that are relevant to the research question or the use of multiple, complementary systems.

Trends in racial/ethnic and geographic disparities in substance use disorders mortality in the United States, 2000-2019.

Substance use disorders (SUD) are a major public health concern in the United States. This study examined racial/ethnic and state-level disparities in SUD mortality in the United States from 2000 to 2019. Age-standardized mortality rates for SUD were obtained for 5 racial/ethnic groups (White respondents, Black respondents, Latino, Asian-Pacific Islander [API], American Indian/Alaska Native [AIAN]) by state and sex from 2000 to 2019. Joinpoint regression analysis was used to model temporal trends overall and by demographic factors. From 2000 to 2019, the overall mortality rate increased from 8.0 to 28.8 deaths per 100,000 population across all groups. AIANs had the highest mortality in 2019 (57.8 per 100,000), followed by Black respondents, White respondents, Latinos, and APIs. Significant increases occurred across all racial/ethnic groups, with the greatest average annual percentage change (AAPC2000-2019) among White respondents (6.7%; 95% confidence interval [CI]: 6.2%-7.3%), APIs (6.0%, 95% CI: 5.6%-6.2%), and AIANs (5.9%, 95% CI: 5.6%-6.2%). Mortality rates increased more rapidly for females than males among White respondents, AIANs, Black respondents, and Latinos. Substantial state-level variation emerged, with the highest mortality rates in 2019 seen in West Virginia, the District of Columbia, Delaware, Ohio, and Pennsylvania. Racial/ethnic and geographic disparities in SUD mortality have widened significantly from 2000 to 2019, highlighting priority areas for prevention efforts. This study provides detailed insights into long-term trends in racial, ethnic, and geographic disparities in SUD mortality across the United States, informing targeted prevention and intervention strategies.

The Battle of Blair Mountain and the News Media: Professional Ideology and the Coverage of Bloodshed in West Virginia

In 1921, “labor trouble” was the euphemistic phrase used by newspapers to describe the often-bloody conflicts that took place between working miners and their bosses in West Virginia. The Battle of Blair Mountain was one such conflict, a well-known clash between striking miners and mine operators that was made famous because airplanes were used, however unsuccessfully, to drop bombs on the miners during the hostilities. This study examines the coverage of this event by the New York Times and Washington Post to understand the ideological assumptions of professional journalists at the time toward this brutal conflict. Using a historically informed analysis of newspaper content, this study shows how the professional norms of journalism culminated in a highly ideologically informed coverage of labor struggle, revealing upper and middle-class anxiety toward class conflict in early twentieth century America.