State Residents Research Articles

Gender imbalance in colon cancer screening rates in Texas: A population-based cohort study.

92 Background: Males have a higher risk of acquiring Colorectal Cancer (CRC) than females. In Texas, males are diagnosed with CRC more than females, regardless of race or ethnicity. Texas CRC screening compliance rates are lower than the national average of 72.2%. It is important to understand the gender trends in screening to apply more specific strategies. Methods: We used the Texas Outpatient Public Use Data File (TOPUDF), a deidentified and publicly available statewide dataset, to conduct a population-based cohort study of outpatient colon cancer screenings of residents age 45 -74 years old at hospitals and ambulatory surgery centers during 2021. Colon cancer screenings were identified using Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes. We queried the National Cancer Institute Surveillance, Epidemiology and End Results Program (SEER) for age grouped populations in 2021 stratified by gender, race, age group, and county of residence. We calculated age-adjusted outpatient colon cancer screening rates per 100,000 population (AASRs) using the direct standardization method based on the age group weights from the 2000 standard US population. Confidence intervals for AASR were derived by estimating the standard error as the AASR divided by square root of number of colon cancer screenings. The statistical significance of the difference between female and male AASR were tested by comparing the intersection of 95% confidence intervals (95% CI) for the individual rates. Subgroup analyses included age group, rural vs urban residence, and race/ethnicity. Results: A total 514,601 outpatient colon cancer screenings were included in the study of which 275, 189 (53.5%) were for female residents. During 2021, 51.1% of state residents age 45-74 years old were female. The overall statewide AASR in 2021 was 6071.5 (95% CI 6054.6 – 6088.4)) with the female AASR (6282.1 [95% CI 6258.1 – 6306.0]) significantly higher than the male AASR (5847.7 [95% CI 5823.9 – 5871.5]). For residents aged ≥ 45 years the statewide AASR was 5580.8 (95% CI 5565.5 – 5596) with the female AASR (5735.2 [95% CI 5715.9 – 5754.4]) significantly higher than the male AASR (5429.8 [95% CI 5410.1 – 5449.6]). Female residents had higher AASR amongst White, Black, and Hispanic race/ethnicity groups with the largest difference observed for Blacks; female AASR 5843.9 (5777.7 - 5910.1) vs male AASR 4733.5 (4668.5 - 4798.5). The difference between male and female outpatient screening rates was significant among both rural and urban residents. Conclusions: Despite a clear relationship between male gender and CRC, females have a higher rate of colon cancer screening. The Black population has the largest gender difference among race/ethnicity groups.

Tobacco product flavour policies in the USA

ObjectivesCharacterise US residents’ exposure to restrictions on sales of flavoured electronic nicotine delivery system (ENDS), cigars and menthol cigarettes across states and time, and assess correlations between these policies.MethodsFrom 2022...

Urban In/Formalities: How Arrival Infrastructures Shape Newcomers’ Access To Resources

<p>In recent years, scholars in migration, urban studies and urban planning have increasingly focused on the diversity of arrival processes experienced by international newcomers and the variety of spatial settings they involve. Current research on arrival infrastructures focuses on both place-based opportunity structures and newcomers’ agency in shaping arrival processes, illustrating the interconnectedness of formal and informal infrastructures. Arrival infrastructuring can be understood as a mediating process that connects individuals and their social, economic, and cultural capital to places and societal resources. The concept of ‘in/formality,’ which addresses the formal-informal nexus as a continuum rather than in binary terms, offers a valuable yet underexplored perspective to analyse arrival processes and actors involved, including the state, market, and old and new residents. Through the lens of in/formality, this thematic issue aims to explore the practices, negotiations, and interconnections among different (migrant and non-migrant) actors involved in arrival infrastructuring. The contributions highlight four recurring ways in which the interplay between informal and formal practices manifests: unusual alliances, brokering, boundary spanning, and structured workarounds.</p>

Perception of Anambra State Residents Toward Media Campaigns Against the Consumption of Uncertified Herbal Medicine

The study examined the perception of Anambra state residents toward media campaigns against the consumption of uncertified herbal medicine. The essence of the study was to determine the extent of exposure of the residents to media campaigns against the consumption of uncertified herbal medicine. Study adopted two theoretical frameworks, and a survey research method was used. The study found, among others, that a majority of the respondents were moderately exposed to media campaigns against the consumption of uncertified herbal medicine; radio was the medium through which most of the respondents accessed media campaigns against the consumption of uncertified herbal medicine. Further findings revealed that the media campaigns against consumption of uncertified herbal medicine among the residents have not been so effective. The study concluded that the media campaigns against the consumption of uncertified herbal medicine convey uncertainty, a grey area by Anambra state residents. Thus, the study recommended that media should actively shed light on the dangers of consuming uncertified herbal medicine, committing themselves to features, editorials, radio presentations, news programmes, call-in-programs, and documentaries, among others.

New York State Climate Impacts Assessment Chapter 10: Water Resources.

Clean, abundant water is essential to the health of New York State's residents, ecosystems, and economy. This critical natural resource faces numerous challenges associated with climate change, including potential impacts on the quality and quantity of source waters-both surface waters and groundwater. Climate change can also affect the infrastructure that treats and delivers safe drinking water to New Yorkers, manages wastewater to protect water quality, and protects against flooding. The Water Resources chapter examines these impacts and highlights opportunities for New Yorkers to adapt and build resilience as the state's climate changes.

New York State Climate Impacts Assessment Chapter 09: Transportation.

The transportation sector's functionality depends on climate conditions. Many New York State residents, communities, businesses, and institutions have already experienced transportation-related climate change impacts, and many more will experience impacts in the future. This chapter examines climate change impacts on the various modes of transportation in New York State. It also highlights climate-driven vulnerabilities among the state's communities, workers, regions, and businesses, with particular attention paid to issues of equity and environmental justice.

Anxious Awakening of the Dormant...

This article looks at how once-promising infrastructures that became dormant mediate collective and individual anxiety for historically-marginalized border community in Indonesia. Dormant infrastructures are sleeping, waiting for the right technical and non-technical interventions to awake them. Here, anxiety revolves around the temporary and permanent awakening of these dormant infrastructures, leading to a reconfiguration of the relationship between the state and border residents.

A timespace of zero‐COVID in Southwest China: Building community, governing time

AbstractIn this article, I take the organization of universal COVID testing as a point of departure for understanding the lived experiences of China's zero‐COVID policy and look at “the Community” (shequ) as a dynamic interface between the state and urban residents during the liminal time of a global pandemic. Drawing on Bryant and Knight's notion of “vernacular timespace” (2019), I analyze the timespace of zero‐COVID as a state‐regulated future orientation interwoven with collective anticipation of crisis, bureaucratic temporal governance, and contestations over time as a form of agency in everyday life. Instead of assuming a unitary form of present‐future relationship that was homogeneous and unchallenged, I argue that the collective anticipation of a public health crisis was constantly shaped, managed, and contested throughout the processes of pandemic community building. This research hopes to enrich reflections on the interplays of time, power, and legitimacy in post‐pandemic urban governance.

How North Carolina's New Center on the Workforce for Health Can Contribute to Oral Health Improvements.

The recently created North Carolina Center on the Workforce for Health can help to ensure an adequate oral health workforce to appropriately meet the dental care needs of all our state's residents.

Lassa fever in Nigeria: epidemiology and risk perception

Annual outbreaks of Lassa fever have resulted in a public health threat in Nigeria and other endemic countries in Sub-Saharan Africa. While the Lassa Virus (LASV) is endemic in rodent populations, zoonotic spillover to humans causes annual outbreaks. This study reviewed the burden of Lassa fever (LF) in Nigeria between 2020 and 2023 and conducted a cross-sectional survey of Nigerians to evaluate their risk perceptions of LF. During the period under review, 28,780 suspected and 4,036 confirmed cases of LF were reported from 34 of the 37 states of Nigeria. These cases resulted in 762 deaths (a CFR of 18.9%). The overall case positivity rate was 14% (4,036/28,780), with more positive cases in 2020 (17.5%, n = 1,189/6,791). A total of 2,150 study participants were enrolled in the prospective cross-sectional study, with most of them (87.5%, n = 1,881/2,150) having previously heard of Lassa fever (LF). The numerical scoring system revealed that 35.43% (n = 762/1,881) of those aware of LF have poor knowledge of its preventive measures, route of transmission, and control measures. Approximately 6.84% (n = 147/2,150) of them were at a high risk of contracting LF, with 27.6% (n = 584/2,150) of study participants feeling concerned about contracting LF because of the presence of rodents in their immediate vicinity, occupational exposure to healthcare workers, and the probability of contamination of food by infected rodents without necessary food safety measures. Multivariable logistic regression analysis revealed that tertiary education was associated with an increased likelihood of better LF knowledge (OR: 17.32; 95% CI: 10.62, 28.26; p < 0.01) and a lower risk of contracting LF when compared to respondents with no formal education. In addition, study participants who reside in low-burden states have lower LF perception than those residents in high-LF-burden states (OR: 0.59; 95% CI: 0.38–0.91; p = 0.049). On the other hand, study participants with poor risk perception (knowledge) of LF had a higher likelihood (RR: 0.33; 95% CI: 0.20, 0.53; p < 0.01) of contracting LF when compared to those with good knowledge of LF. Similarly, those residents in low LF burden states were less likely (OR: 0.09; 95% CI: 0.05,0.17; p < 0.01) to contract LF when compared to those residents in high burden states. There is a need to improve LF diagnostics capacity, infection prevention and control measures, and implementation of the One Health approach to controlling LASV from animal reservoirs. In addition, public enlightenment campaigns to address fundamental knowledge gaps are crucial to mitigating the ongoing and future impact of LF in Nigeria.

Assessment of perspectives, knowledge and attitude about antibiotic use and resistance in Sudanese population.

The spread of multidrug-resistant pathogens is a major global health concern. A survey was conducted to evaluate the knowledge and attitudes towards antimicrobial use and resistance in Sudan. A cross-sectional survey with a 39-item questionnaire was distributed via social media platforms to Sudanese residents in Khartoum state. Responses were collected anonymously from April to October 2022 and subjected to statistical analysis to assess associations between variables. A total of 1,037 participants agreed to participate, with a 94.3% response rate. Two-thirds of participants reported using oral antibiotics in the past 12 months. Only a quarter obtained antibiotics with a prescription. Less than half (45.3%) of the participants underwent diagnostic tests before using antibiotics, and 30.2% adjusted or discontinued the antibiotic dosage. Forty-two percent correctly identified that antibiotics are ineffective against viral infections, but confusion regarding their use persisted. The mean knowledge score was 3.3 ± 1.7, indicating average knowledge levels. Significant variations in knowledge and attitudes were observed based on age, gender, marital status, and education. The mean score of the participants' attitude was 25.5 ± 3.97. Female, younger, and single participants exhibited more positive attitudes towards antibiotics use and resistance. The participants exhibited average knowledge levels and mixed attitudes towards antibiotic use and resistance. Misconceptions and inadequate indications for antibiotic use were identified. Gender, age, marital status, and education influenced participants` knowledge and attitudes. These findings can inform strategies to promote appropriate practices and combat the spread of antibiotic resistance across health and non-health sectors.

Archetypes and change in wildfire risk perceptions, behaviours and intentions among adults in Tasmania, Australia

Background Anthropogenic climate change globally increases wildfire risk. Understanding how wildfire threats impact community-wide risk perceptions and response options will critically inform resilience education strategies. Aim To gain an increased understanding of wildfire risk perceptions and self-evacuation intentions among residents in the wildfire-prone state of Tasmania, Australia. Methods We co-designed survey questions with stakeholders from emergency management, health and community recovery, using a computer-aided telephone interview to survey residents over 18 years of age. Numerical classification analysis, linear regression and descriptive statistics were used to analyse survey data. Results We identified four archetypes – the ‘immediate leaver’, ‘prepared stayer’, ‘unprepared leaver’ and ‘informed leaver’, each with distinct sociodemographic characteristics. Key variables were gender, age, location and income, with women most likely to leave and lower-income householders from rural areas most likely to stay. Previous wildfire experience and owning a home were significantly associated with increased preparedness actions. Compared to 2016, we found a significant increase in the proportion of residents intending to leave their property, with rural men least likely and urban women most likely to leave. Implications Recent education campaigns have likely driven increases in wildfire threat-related self-evacuation, yet the existence of distinct archetypes argues for more tailored messaging and education programs.

National Borders among Families: Removal and ‘Bare Life’ in India

This paper is about the state-driven process of ‘migrant ‘illegality’ (Genova 2002) and its impact on the life of Bengali speaking residents in the Assam state of India. While the movement of people across borders between India and present-day Bangladesh has been historical and complex, this ethnographic work explores how the state-driven process of migrant illegality and the production of ‘bare life’ have disrupted intimate relations and family life among the migrant population in Assam. While the recent NRC (National Register of Citizens) update in Assam identified 1.9 million people as illegal migrants, there has been bureaucratic enactment of ‘migrant illegality’ by Assam Border Police for the last several years. The institutional procedures, court documents and narratives of the select cases of ‘detected’ as well as ‘detained’ residents from ethnographic fieldwork reveal how the absence of formal papers and errors in the family records, kinship relations and property inheritance among the poor migrant families transforms actual citizens to ‘illegal migrants’ in the bureaucratic manoeuvring and reduces them to their ‘bare life’. The paper also shows how prejudice, arbitrariness, and contradictions feed into the bureaucratic process and lead to intense crises among family units, as several migrant families have both Indians and alleged ‘Bangladeshis’ in their homes today. The paper argues that the major consequence of this state-driven ‘migrant illegality’ in the last two decades has been the creation of national borders among families, unsettling intimate relations and shared spaces.

Prevalence and pattern of self-medication with antibiotics among residents of Abia State, Southeastern Nigeria: a call for action

Background: Antibiotic self-medication occurs worldwide, and it is a major driver of antibiotic misuse and antimicrobial resistance. In developing countries like Nigeria, antibiotics are frequently sold as over-the-counter medications. There is a need to explore this pattern, aiding stakeholders in informed decision-making. We assessed the prevalence and pattern of antibiotic self-medication among the residents of Abia State. Methods: A cross-sectional study was conducted among eligible adults in the State with respondents selected using the multistage sampling technique. An interviewer-administered questionnaire was used to obtain information from the respondents. Data analysis was done using SPSS version 26 and the level of significance was set at 5%. Results: A total of 1,491 respondents were surveyed. The mean age was 34.7±13.1 years and females constituted 55.7%. The overall prevalence of antibiotic self-medication was 46.5% (95%CI: 43.9-49.1). The majority of the respondents took self-medication for cough (48.6%) and ampicillin/cloxacillin was the major antibiotic used (30.1%). The reason for antibiotic self-medication mostly reported was the perception of minor illness (62.7%). Most (52.4%) of the respondents got the antibiotics from pharmacies without prescriptions. The predictors of antibiotic self-medication included residence (aOR=2.44, 95% CI: 1.12-5.30), retention of previous prescriptions (aOR=10.98, 95% CI: 4.40-27.47), storage of leftover antibiotics (aOR=4.13, 95% CI: 1.79-9.54) and perceived susceptibility of antibiotic self-medication (aOR=4.96, 95% CI: 1.71-14.39). Conclusions: Close to half of the residents practiced antibiotic self-medication with its pattern identified. We recommend tailored strategies including appropriate health education and enforcement of regulatory policies to promote community antibiotic stewardship.

Self-reported health effects from wildfire smoke: A cross-sectional study in New York State

Abstract Background Wildfires and exposure to wildfire smoke (WFS) are forecasted to increase, in part driven by climate change. As witnessed in 2023, regions in Europe and North America are facing more sustained periods of poor air quality due to WFS. Growing evidence suggests average daily WFS correlates with morbidity and mortality, but the impact of prolonged WFS exposure remains understudied, especially in areas where WFS is a newer occurrence. We examine associations between consecutive days of WFS experienced and self-reported health symptoms in the northeastern United States. Methods This retrospective cross-sectional study explored New York State (NYS) residents’ experience with WFS in summer 2023 via an online survey. Participants reported the longest period of consecutive WFS days and symptoms experienced. Log-binomial regression models estimated prevalence ratios (PR) and 95% confidence intervals (CI). Results 553 NYS residents were included, representing a healthy, primarily female and White population, ranging from 18 to 86 years. 549 (99.3%) reported experiencing WFS, with the longest period of consecutive WFS days varying (≤3 days: n = 152; 4 to 6 days: n = 255; ≥7 days: n = 146). 490 (88.6%) reported ≥1 health symptom, with itchy/watery eyes, sore throat, and headache as the most frequent. Compared to ≤ 3 consecutive WFS days, symptom prevalence was 9.1% higher for those reporting 4 to 6 days (PR [95% CI]:1.09 [1.00, 1.19]) and 16.7% higher for ≥7 days (1.17 [1.07, 1.27]). The trend of increased symptom prevalence with longer WFS periods persisted and was pronounced for specific symptoms. Control for potential confounders did not appreciably change estimates. Conclusions Our findings suggest longer sustained WFS exposure associates with higher symptom prevalence, which may be precursors to more serious health conditions. As global populations face more WFS with climate change, public health professionals should prioritize strategies to mitigate prolonged exposure. Key messages • In a convenience sample of 553 primarily healthy New York State residents, 99.3% reported experiencing wildfire smoke and 88.6% reported at least 1 symptom of poor health during summer 2023. • Associations between consecutive days of wildfire smoke experienced and prevalence of any and specific symptoms tended to vary in a dose-response manner.

Cultivating Choice: Determinants of Home Cannabis Growing Among Legal Users in the United States

As cannabis legalization evolves in the United States, policies regarding home cultivation vary significantly across states. This study examines factors influencing the decision to grow cannabis at home by cannabis‐consuming residents in legal states. Using data from a large online survey (n = 4,823) of recent cannabis users in cannabis‐legal states, we explore four potential explanations for home cultivation: legal access, needs‐based motivations, resource‐based factors, and identity‐based reasons. Our analysis reveals that home growers differ significantly from non‐growers across multiple dimensions. The stance of state policies on home cultivation plays a role in determining who will grow their own. Notably, a strong sense of cannabis identity is the most powerful predictor for home cultivation. While some aspects of needs‐based and resource‐based motivations play a role, multivariate analyses demonstrate that the most compelling explanation includes a mix of variables, demonstrating the complexity of cannabis consumption and choices to cultivate.

Shifts in Racial Inequalities and White Backlash in the 21st Century U.S.

Progress toward racial equality over the course of U.S. history has not been linear, and reductions in racial inequalities have historically been met with racist backlash. In the current research, we examine whether shifts in racial inequalities in key structural areas in recent decades can be used to predict implicit and explicit racial attitudes among White U.S. residents (N = 222,203). Consistent with the hypothesis that increasing racial equality is threatening, the majority of the statistically significant effects we observed indicated increased pro-White attitudes among White residents of states where racial inequalities decreased over time. State-level reductions in racial inequalities related to government assistance and employment-which have both been highly politicized-were predictive of greater pro-White attitudes among White U.S. residents. Overall, the current findings provide suggestive evidence that reductions in state-level racial inequalities may threaten the status quo, heightening pro-White attitudes among White U.S. residents.

Current Burden of and Geographic Disparities in Liver Mortality and Access to Liver Transplant

Liver disease is a leading cause of mortality in the US. Liver transplant can be a lifesaving procedure for patients with severe liver disease. To assess temporal trends and geographic variance in liver-related mortality (LRM) and liver transplant in the US. In this cohort study, the frequencies and geographic variance of LRM in 2018 and 2021 were obtained in a cross-sectional analysis of the Underlying Cause of Death data available on the Centers for Disease Control and Prevention's Epidemiologic Research database. The number of livers donated and transplanted according to the state of residence of each donor and recipient were obtained from the United Network for Organ Sharing. Liver-related mortality in 2018 and 2021, overall and by state, as well as the liver transplant rate according to state of residence of recipient and donor. Overall LRM in the US was 93 418 in 2021, with a crude rate of 28.1 per 100 000 individuals, an increase of 19.1% compared with rates seen immediately prior to the COVID-19 pandemic in 2018 (77 282 [23.6 per 100 000 individuals]). Liver-related mortality in 2021 varied several-fold between states, from 18.4 per 100 000 individuals per year in Utah to 65.9 per 100 000 individuals per year in New Mexico. The mean number of liver-related deaths per transplant from all donor sources (in state and out of state) was 7.2 in the lowest LRM quintile compared with 21.5 in the highest (95% CI, 12.1-16.6; SE, 1.1; P < .001). Ten states had no liver transplant center. Paradoxically, residents of states with the highest LRM had a much lower rate of liver transplant (at any location) from organs procured from in-state residents than states with the lowest LRM quintile (13.0% vs 35.2% in-state donors; 95% CI, 14.1%-30.3%; SE, 3.9%; P < .001). This study suggests that rates of LRM have increased dramatically since the COVID-19 pandemic and vary several-fold between states. Rates of liver transplant are paradoxically lowest among residents living in states with the highest LRM. These findings highlight apparent geographic disparities in access to liver transplant that allocation policy cannot address.

Association between state-level medical marijuana legalization and marijuana use during pregnancy: A population-based study.

Despite marijuana's association with adverse pregnancy and birth outcomes, its use during pregnancy increased over the last two decades. During this period, medical marijuana has been legalized in 38 states and the District of Columbia. States with legalized medical marijuana have observed increased marketing of marijuana and related products. This study aims to examine the association between state-level medical marijuana legalization and marijuana use during pregnancy in the United States. Using the 2015-2021 National Survey on Drug Use and Health, we evaluated the association between marijuana use in the past month among currently pregnant mothers (N = 4338) and legalized medical marijuana in their state of residence. Survey-weighted descriptive, bivariate, and multivariable logistic regression analyzes were performed. About 5.7% of pregnant women reported using marijuana in the past month, and 59.0% lived in a state where medical marijuana was legalized across 2015-2021. Compared to those living in states without marijuana legalization, more pregnant women living in states with marijuana legalization reported using marijuana (4.6% vs. 6.5%). In the multivariable model, pregnant women residing in states with medical marijuana legalization were more likely to use marijuana than residents of states without legalization (adjusted Odds Ratio: 1.56; 95% Confidence Interval: 1.11-2.18). This is the first known study to find that pregnant women living in states where medical marijuana is legalized are more likely to use marijuana during pregnancy. Pregnant women should be informed of adverse pregnancy and birth outcomes linked to marijuana use during pregnancy.

The 2023 State of Nebraska Families: State Priorities and Key Areas of Promise

Nebraska is often referred to as “the good life” by state residents. In 2022, Nebraska was comprised of over 800,000 family households and had a population nearing two million. Nebraska is the only state in the U.S. with a unicameral legislature and is comprised of both rural and urban contexts over a diverse geography. Like other states, in the past decade, there have been changes in the demographic makeup of the population, due in part to immigration, an aging population, and out migration. Given this context, we focus our review of Nebraska families on state priorities identified in a Nebraska Cooperative Extension needs assessment that include attracting and retaining a skilled workforce, and enhancing economic vitality, health, and wellbeing. We describe the state geography, demographics, and government contexts. We then describe where current policy programming, and resources stand in addressing relevant family-focused needs and issues of the key working age population. We end with recommendations focused on the strengths of Nebraska, given its relatively small population and community-oriented nature that can be leveraged to support innovations in policies and programs to create a healthy environment for families, that ultimately enhance the economic vitality of the state.