Trends In California Research Articles

Young adult retail purchases of cannabis, product category preferences and sales trends in California 2018-21: Differences compared with older adults.

The aim of this study is to identify cannabis products according to their appeal among young adults and measure product sales trends. This was a retrospective comparative study using point-of-sale data from licensed recreational cannabis retailers that include buyer age with birth year entered by retailers, set in California, USA. Cannabis purchases by young adults (aged 21-24, GenZ) were compared with older adults (age 25+) over 4years (2018-21). Sales for six cannabis product categories were analyzed using a commercial data set with imputations and a raw data set. Age-appeal metrics were dollar and unit sales to young adults, and dollar and unit share ratios (young adults/older adults), where a share ratio of 100 denotes age-appeal comparability. A product category was considered more young-adult appealing than others if its mean on a metric was at least one standard deviation above the grand mean across all product categories. Flower (cannabis plant material) and vapor pen appealed to young adults based on absolute dollar sales, dominating young-adult spending compared with other cannabis products (37.24 and 31.83%, respectively). Vapor pen and concentrate appealed to young adults based on dollar share ratios of 152, meaning these products comprised a 52% greater share of young-adult cannabis spending relative to older-adult spending (31.83/20.97% and 10.47/6.88%, respectively). Less appealing to young adults were pre-roll, edible/beverage and absorbable products (tincture/sublingual, capsule and topical). Flower showed the largest dollar sales growth (B = +$3.50million/month), next to vapor pen (B = +$1.55million/month). Vapor pen tied for highest growth in the percent of product dollars from the largest package size (B = +0.85%/month) and showed the steepest price decline (B = -0.53 price per gram/month). In California, USA, from 2018 to 2021, relative to older adults, young adults spent a greater share of their cannabis dollars on vapor pen and concentrate (products with high potency of delta-9-tetrahydrocannabinol).

Recent and near‐term future changes in impacts‐relevant seasonal hydroclimate in the world's Mediterranean climate regions

AbstractChange over recent decades in the world's five Mediterranean Climate Regions (MCRs) of quantities of relevance to water resources, ecosystems and fire are examined for all seasons and placed in the context of changes in large‐scale circulation. Near‐term future projections are also presented. It is concluded that, based upon agreement between observational data sets and modelling frameworks, there is strong evidence of radiatively‐driven drying of the Chilean MCR in all seasons and southwest Australia in winter. Observed drying trends in California in fall, southwest southern Africa in fall, the Pacific Northwest in summer and the Mediterranean in summer agree with radiatively‐forced models but are not reproduced in a model that also includes historical sea surface temperature (SST) forcing, raising doubt about the human‐origin of these trends. Observed drying in the Mediterranean in winter is stronger than can be accounted for by radiative forcing alone and is also outside the range of the SST‐forced ensemble. It is shown that near surface vapour pressure deficit (VPD) is increasing almost everywhere but that, surprisingly, this is contributed to in the Southern Hemisphere subtropics to mid‐latitudes by a decline in low‐level specific humidity. The Southern Hemisphere drying, in terms of precipitation and specific humidity, is related to a poleward shift and strengthening of the westerlies with eddy‐driven subsidence on the equatorward side. Model projections indicate continued drying of Southern Hemisphere MCRs in winter and spring, despite ozone recovery and year‐round drying in the Mediterranean. Projections for the North American MCR are uncertain, with a large contribution from internal variability, with the exception of drying in the Pacific Northwest in summer. Overall the results indicate continued aridification of MCRs other than in North America with important implications for water resources, agriculture and ecosystems.

Are immigrants migrating away from transit? Immigrant transit use trends in California

While patronage on most public transit systems around the world remains modestly to significantly depressed post-pandemic, transit ridership had mostly been declining across the US since 2014. Advocates, practitioners, and scholars have offered a range of explanations for pre-pandemic patronage decline. This analysis examines the demand-side of this phenomenon by focusing on high-propensity transit riders, and, in particular, immigrants in the most populous US state: California. Drawing on the California add-on to the 2009 and 2017 National Household Travel Surveys, we evaluate changes in transit use among Hispanic and Asian immigrants. We find that during the study period, transit trip frequency of Hispanic immigrants declined, converging toward the ridership patterns of US-born Hispanics. While this trend was largely the result of rising incomes, increased vehicle ownership, and lower residential densities among non-US-born Hispanics, all else equal, Hispanic immigrants continued to use transit more than their US-born counterparts. By contrast, transit trip making by Asian immigrants diverged from that of US-born Asians. Notably, this divergence was not the result of declining per-person trip making by Asian immigrants, which was relatively stable during the study period. Instead, the growing gap was due to increases in transit trip frequency by US-born Asians.

Young Adult Retail Purchases of Cannabis, Product Category Preferences, and Sales Trends in California 2018-2021: Differences Compared with Older Adults

Young Adult Retail Purchases of Cannabis, Product Category Preferences, and Sales Trends in California 2018-2021: Differences Compared with Older Adults

Impact of a Statewide Livestock Antibiotic Use Policy on Resistance in Human Urine Escherichia coli Isolates: A Synthetic Control Analysis.

On 1 January 2018, California implemented Senate Bill 27 (SB27), banning, for the first time in the United States, routine preventive use of antibiotics in food-animal production and any antibiotic use without a veterinarian's prescription. Our objective was to assess whether SB27 was associated with decreased antimicrobial resistance among E. coli isolated from human urine. We used U.S. nationwide monthly state-level data from BD Insights Research Database (Becton, Dickinson, and Co.) spanning 1 January 2013 to 30 June 2021 on antibiotic-resistance patterns of 30-d nonduplicate E. coli isolated from urine. Tested antibiotic classes included aminoglycosides, extended-spectrum cephalosporins (ESC), fluoroquinolones, and tetracyclines. Counts of tested and not-susceptible (resistant and intermediate, hereafter resistant) urine isolates were available by sex, age group (, year), month, and state. We applied a synthetic control approach to estimate the causal effect of SB27 on resistance patterns. Our approach created a synthetic California based on a composite of other states without the policy change and contrasted its counterfactual postpolicy trends with the observed postpolicy trends in California. We included E. coli urine isolates, 90% among women, across 33 states. From 2013 to 2017, the median (interquartile range) resistance percentages in California were 11.9% (7.4, 17.6), 13.8% (5.8, 20.0), 24.6% (9.6, 36.4), 7.9% (2.1, 13.1), for aminoglycosides, ESC, fluoroquinolones, and tetracyclines, respectively. SB27 was associated with a 7.1% reduction in ESC resistance (p-value for joint null: ), but no change in resistance to aminoglycosides, fluoroquinolones, or tetracyclines. Further research is needed to determine the role of SB27 in the observed reduction in ESC resistance E. coli in human populations, particularly as additional states implement similar legislation. https://doi.org/10.1289/EHP11221.

Wildfire activity is driving summertime air quality degradation across the western US: a model-based attribution to smoke source regions

Over recent decades, wildfire activity across western North America has increased in concert with summertime air quality degradation in western US urban centers. Using a Lagrangian atmospheric modeling framework to simulate smoke transport for almost 20 years, we quantitatively link decadal scale air quality trends with regional wildfire activity. Modeled smoke concentrations correlate well with observed fine-mode aerosol (PM2.5) concentrations (R > 0.8) at the urban centers most impacted by smoke, supporting attribution of observed trends to wildfire sources. Many western US urban centers (23 of 33 total) exhibit statistically significant trends toward enhanced, wildfire-driven, extreme (98th quantile) air quality episodes during the months of August and September for the years 2003–2020. In the most extreme cases, trends in 98th quantile PM2.5 exceed 2 μg m−3 yr−1, with such large trends clustering in the Pacific Northwest and Northern/Central California. We find that the Pacific Northwest is uniquely impacted by smoke from wildfires in the mountainous Pacific Northwest, California, and British Columbia, leading to especially robust degradation of air quality. Summertime PM2.5 trends in California and the Intermountain West are largely explained by wildfires in mountainous California and the American Rockies, respectively. These results may inform regional scale forest management efforts, and they present significant implications for understanding the wildfire—air quality connection in the context of climate driven trends toward enhanced wildfire activity and subsequent human exposure to degraded air quality.

Meteorological driving forces of reference evapotranspiration and their trends in California

Reference evapotranspiration (ETo) is a variable that helps determine atmospheric pressure on living (reference) grass to release water into the atmosphere. For this purpose, four main driving forces: air temperature, air humidity, solar radiation, and wind speed need to be measured over the well-watered reference grass. The relative influence of these driving forces is region and climate-specific, with daily and seasonal variations. A clear understanding of the dynamic interactions of ETo's driving factors can illuminate the water and energy cycles of the earth and assist modelers with more accurate predictions of ETo. In this study, Pearson correlation, mutual information, and random forest feature importance analyses have been used to evaluate the relative importance of meteorological driving forces of ETo in California. To better understand the interrelations of these variables, 1,365,823 daily data samples from 237 standardized weather stations for 36 years have been clustered into homogeneous climatic zones and analyzed. To compensate for the effects of seasonality, feature importance analysis is also conducted on seasonal and monthly clustered data. Moreover, seasonal and annual trends of ETo and its driving factors are investigated for California and homogeneous zones using the Mann-Kendall test. Our findings reveal that for annually clustered data, solar radiation is the most influential driving factor of ETo in California. However, analysis of seasonal and monthly clustered data shows that vapor pressure deficit is the most informative factor during the summer and spring, while solar radiation is more important during the colder seasons. Results of trend analysis don't suggest a consistent monotonic trend for ETo and other variables for different seasons and zones. However, it is shown that agricultural regions with heavy irrigation dependence like the Central Valley are getting warmer and drier, especially during the irrigation season. This can adversely affect the water resources, agriculture industry, and food production of California, and modeling efforts like this can be very informative for future water resources management.

Analysis of Recent Mean Temperature Trends and Relationships with Teleconnection Patterns in California (U.S.)

The global mean surface temperature has risen since the late 19th century. However, temperatures do not increase uniformly in space or time and few studies have focused on that peculiarity in the State of California. The aim of this research is to deepen our knowledge of the evolution of mean temperatures in the State of California on monthly, seasonal and annual time scales. The period under study comprises 40 years (from 1980 to 2019) and data from 170 meteorological stations were analysed. Statistical techniques, including Sen’s slope and Mann-Kendall, were applied to each of the stations to establish the sign and slopes of trends and their statistical significance. The spatial distribution of monthly, seasonal and annual trends was analysed using the Empirical Bayesian Kriging (EBK) geostatistical technique. The trend analysis was also carried out for the State as a whole. This research also studies the relationships between mean temperatures and nine teleconnection patterns with influence on the Californian climate. To find out these links, a correlation analysis was performed using the partial non-parametric Spearman Test at a 95% confidence level. The study reveals a positive trend of +0.01 °C year−1 for the whole state and that Southern California is getting warmer than Northern California for the study period. On a seasonal scale, the local temperature increased significantly both in autumn and summer (+0.06 °C and +0.035 °C year−1 respectively) from 1980 to 2019. On a monthly scale, the largest increases are found in November at +0.04 °C year−1. Temperatures in February, March, April and May are highly correlated with most of the teleconnection patterns studied in the State of California. West Pacific Oscillation (WPO) teleconnection pattern has shown the highest negative correlation. However, The Pacific Decadal Oscillation (PDO) has a positive correlation with mean temperatures in coastal areas such as Los Angeles, San Francisco and Monterey. Moreover, Antarctic Oscillation (AAO) and Arctic Oscillation patterns (AO) are unlikely to show great influence on average temperature trends in California.

Opioid Distribution Trends in California Following Recreational Cannabis Legalization

Introduction The US opioid overdose epidemic has risen to an all-time high. Prescription opioids often serve as a gateway to illicit opioids, which have appreciable overdose potential. Recent investigations have highlighted the efficacy and safety of cannabis-based products for pain management. Providing alternative pain treatment options may help mitigate the opioid epidemic. Methods The distribution of codeine, fentanyl, hydrocodone, morphine, and oxycodone per 100 000 people and by 3-digit zip codes from 2014 to 2018 in California and Texas were compared. Overdose rates were also evaluated. California legalized recreational marijuana in 2016, but in Texas marijuana is functionally prohibited. Drug weights were obtained from the Automation of Reports and Consolidated Orders System and converted to oral morphine milligram equivalents. Overdose data was retrieved from the Centers for Disease Control’s WONDER database. Results California and Texas showed significant reductions in cumulative opioid distribution from 2014 to 2018 (− 43.7% and − 27.3%, respectively). Opioid distribution per 100 000 people decreased − 38.9% in California relative to − 26.4% in Texas. Opioid and heroin overdoses increased between 1999 and 2019 by + 11.6% in California but + 272.7% in Texas. Discussion This evidence supports marijuana legalization as a mitigating factor to the opioid epidemic and opioid misuse.

Transit Blues in the Golden State: Regional transit ridership trends in California

Public investment in transit increased following the Great Recession, yet transit use nationally mostly fell, even prior to the 2020 pandemic. We investigate this troubling disjuncture by comparing transit ridership trends during the 2010s in two of America’s largest regions: Greater Los Angeles and the San Francisco Bay Area. While both California regions lost transit riders, we see substantial differences in the scale, timing, geography, and modes of these declines. In the LA area, ridership fell longer and further, spread more across routes, times, and sub-regions and concentrated on the region’s dominant operator. In both regions, increasing auto access appears to have played a central role, albeit in different ways. Greater LA saw increased automobile ownership, particularly among high-propensity transit riders. In the Bay Area, as jobs and housing have dispersed, ridehail services like Lyft and Uber may have eroded non-commute transit use.

Where Are Students With Autism and Intellectual Disability Learning? Placement Trends in California

Abstract The variability in placement of students with autism and intellectual disability and lack of access to general education for these students suggests the need to identify factors associated with placement and then address the role of current policy. This article presents the results of a 5-year trend analysis of placement of students with autism and intellectual disability in California and the relationship between these trends in placement and district factors. Results suggest trends in increased access to general education environments for both groups of students and relationships between the probability of placement in general education settings and the percentage of students in the district who receive free or reduced-price meals. Implications for district and state leaders are discussed.

Tobacco price and use following California Proposition 56 tobacco tax increase.

BackgroundCalifornia Proposition 56 increased cigarette excise tax by $2 per pack with equivalent increases on non-cigarette tobacco products. We estimated the changes in cigarette price, cigarette use, and non-cigarette use following the implementation of Proposition 56 in California in 2017.MethodsSeven waves of Tobacco Use Supplements to the Current Population Survey (TUS-CPS) 2011–2019 data were used to obtain state-level aggregate self-reported outcomes, including cigarette price per pack, current and daily cigarette use, cigarette consumption per day, and current and daily use of non-cigarette tobacco products (hookah, pipe, cigar, and smokeless tobacco). A modified version of a synthetic control method was used to create a “synthetic” California that best resembled pre-policy sociodemographic characteristics and outcome trends in California while correcting time-invariant pre-policy differences. Various sensitivity analyses were also conducted.ResultsThe implementation of Proposition 56 was associated with an increase in self-reported cigarette price per pack in California ($1.844, 95%CI: $0.153, $3.534; p = 0.032). No evidence suggested that Proposition 56 was associated with the changes in the prevalence of current or daily cigarette use, cigarette consumption per day, or the prevalence of current or daily use of non-cigarette tobacco products.ConclusionMost of the cigarette tax increase following Proposition 56 in California was passed on to consumers. There is a lack of evidence that the implementation of Proposition 56 was associated with the changes in the use of cigarettes and other tobacco products such as hookah, pipe, cigar, and smokeless tobacco.

Smoking behavior in 18–20 year-olds after tobacco 21 policy implementation in California: A difference-in-differences analysis with other states

In June 2016, California implemented a Tobacco 21 (T21) policy that increased the minimum sale age of tobacco products from 18 to 21. This study examined the association between California's T21 policy and smoking behavior (ever, current, daily, and nondaily) in 18–20 year-olds using data from the 2012–2019 Behavioral Risk Factor Surveillance System (n = 15,863). The annual change in odds of smoking among 18–20 year-olds post-policy (July 2016–December 2019) was compared with the pre-policy period (January 2012 – June 2016) 1) within California and 2) compared with states without a T21 policy. As a sensitivity analysis, 21–23 year-olds in California were used as the referent. Difference-in-difference estimates (D-I-D) were calculated using adjusted logistic regression and compared the post to pre-policy change in trends in California to the referent groups.Before California's T21 policy, there was an 11% annual decrease in the odds of ever smoking among 18–20 year-olds in California and a 6% decrease in the referent states. After the policy, these trends did not change significantly. Results for current smoking were similar. For daily smoking, there was an 8% annual decrease before the policy and a 26% annual decrease after the policy among 18–20 year-olds in California; D-I-D estimates were 0.80 (95% CI: 0.57, 1.14) using referent states as the comparison and 0.62 (95% CI: 0.41, 0.95) using 21–23 year-olds in California as the comparison. There was an association between California's T21 policy and a decrease in daily smoking among 18–20 year-olds, compared with 21–23 year-olds, more than three years post-implementation.

Who lives in transit-friendly neighborhoods? An analysis of California neighborhoods over time

In this paper we examine social and economic trends in California’s transit-friendly neighborhoods since 2000. In particular, we explore the relationship between high-propensity transit users – who we define here as members of households classified as poor, immigrant, African-American, and without private vehicles – and high-transit-propensity places – which are neighborhoods that regularly host high levels of transit service or use. As housing costs have increased dramatically in California and neighborhoods change, many planners and transit advocates reasonably worry that in transit-friendly neighborhooods, lower-propensey transit users may replace residents who tend to ride transit frequently. Such changes in residential patterns could help to explain sharp transit ridership declines in California in the 2010s ahead of much sharper pandemic-related ridership losses in 2020. Indeed, we find that California’s most transit-friendly neighborhoods have changedin ways that do not bode well for transit use. The state's shares of poor, immigrant, African American, and zero-vehicle households have all declined modestly to substantially since 2000. Collectively, these trends point to changes in California’s most transit-friendly neighborhoods that are not very, well, transit-friendly.

Highlighting and overcoming data barriers: creating open data for retrospective analysis of US electric power systems by consolidating publicly available sources

Studies of power system operation commonly draw from two key databases produced by the US Environmental Protection Agency: the Acid Rain Program’s Continuous Emission Monitoring System (CEMS) data, and the Emissions and Generation Resource Integrated Database (eGRID). Separate reporting requirements and heterogeneity in data aggregation between these two databases creates a barrier to systematic spatial and temporal retrospective power system analysis. This work describes the inherent challenges to this undertaking and documents a method for reconciling the two seemingly disparate data sources. While fundamental differences in data reporting and aggregation prevent us from achieving full coverage, this work represents an important initial step to aligning these two repositories of US power system data. We demonstrate the value of this linkage by computing relative unit-level, hourly utilization metrics for most thermal power plants in the US. Analysis of these metrics across time illustrates thermal generator cycling trends in California between 2011 and 2017. These unit-level results indicate that combined cycle units within California increased their part-load generation by 15% and resultant CO2 emissions by 17% and decreased their start/stop frequency over time by 8.5% and resultant emissions by 47%. Open cycle gas turbines overall increased their generation- number of start/stop cycles by 97% and resultant emissions by 85%, part-load generation by 120% and resultant emissions by 100%, and full load generation by 40% and resultant emissions 18%. We also observe a temporal shift in thermal generation from morning hours to evening in California.

Abstract C085: Racial/ethnic disparities in pancreatic cancer incidence rates and temporal trends in California (1988-2015)

Abstract Background: Pancreatic cancer is a leading cause of cancer death in the United States. Racial/ethnic disparities in pancreatic cancer incidence exist, with African Americans experiencing the highest incidence. Little is known about incidence and temporal trends in other minorities, especially in Asian Americans, heterogeneous populations that are the fastest-growing minority in US. To better understand pancreatic cancer burden, we examined pancreatic cancer incidence patterns and temporal trends among detailed racial/ethnic populations, including Asian-American subgroups. Methods: We identified a total of 97,665 invasive pancreatic cancer cases (ICD-O-3: C25.0-C25.9) using the California Cancer Registry diagnoses between 1988 and 2015. Cases were grouped into mutually exclusive major racial/ethnic groups of non-Hispanic (NH) white, NH black, Hispanic, NH Asian/Pacific Islander (API), and NH American Indian/Alaska Native (AIAN). Asians were further identified by ethnicity of Chinese, Filipino, Japanese, Korean, Vietnamese, other Southeast Asian, and South Asian. Age-adjusted incidence rates (AAIRs per 100,000) by race/ethnicity and time period were calculated. The average annual percent changes (AAPC) in incidence rates between 1988 and 2015 were estimated using Joinpoint Regression. Results: The AAIRs of pancreatic cancer varied significantly across the aggregated racial/ethnic groups. The AAIRs ranged from the highest of 16.0 (95% CI: 15.6 to 16.4) in NH blacks to 11.5 (95% CI: 11.5 to 11.6) in NH whites, 10.7 (95% CI: 10.5 to 10.8) in Hispanics, 9.2 (95% CI: 9.0 to 9.4) in NH APIs, and to the lowest of 8.0 (95% CI: 7.2 to 8.9) in NH AIAN. Despite the relatively low rate in the NH APIs, the rates across Asian subgroups varied significantly, with rates as high as NH whites observed in Japanese (AAIR: 11.5; 95% CI: 10.9 to 12.1) and Korean (AAIR: 11.0; 95% CI: 10.3 to 11.7) to the low rate in South Asians (AAIR: 6.6; 95% CI: 5.9 to 7.4). A small but significant decline in pancreatic cancer incidence rates was observed among NH blacks (AAPC: -0.5; 95% CI: -0.8 to -0.2). NH AIANs experienced the most sizable and significant surge in pancreatic cancer incidence (AAPC: 4.5; 95% CI: 2.4 to 6.6), followed by South Asians (AAPC: 2.4; 95% CI: 0.3 to 4.5), Koreans (AAPC: 1.6; 95% CI: 0.5 to 2.7), and NH whites (AAPC: 0.4; 95% CI: 0.2 to 0.6). Conclusions: Our findings provide the most updated trends in pancreatic cancer incidence across multiple and disaggregated racial/ethnic groups in California. We showed significant heterogeneity of pancreatic cancer incidence in Asian Americans, with high-risk Japanese and Korean populations. These results fill a gap regarding pancreatic cancer burden in Asian Americans and underscore the importance of disaggregating ethnic populations in cancer research. Citation Format: Lihua Liu, Juanjuan Zhang, Dennis Deapen, Mariana Stern, Andrea Sipin, Veronica Wendy Setiawan. Racial/ethnic disparities in pancreatic cancer incidence rates and temporal trends in California (1988-2015) [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr C085.

Disparities in Hepatocellular Carcinoma Incidence in California: An Update.

Given changes in hepatocellular carcinoma (HCC) incidence and the ethnodemographic landscape, we analyzed recent HCC incidence patterns and trends in California. Using 47,992 primary, invasive HCC cases diagnosed from 1988 to 2014 from the California Cancer Registry, we calculated age-adjusted incidence rates (IR), annual percent change (APC), and 95% confidence intervals (CI) by sex, race/ethnicity, and nativity among Hispanics and Asian ethnic groups. Compared with non-Hispanic Whites (NHW), all other racial/ethnic groups had higher HCC incidence. Vietnamese had the highest IRs (males: 47.4, 95% CI, 45.3-49.5; females: 14.1, 95% CI, 13.0-15.3). Foreign-born Chinese, Japanese, Korean, and Vietnamese had higher incidence than U.S.-born. The reverse was observed for Hispanic males, whereas no differences by nativity were seen for Hispanic females. IRs increased most for NHWs. Among Asians, male and female Filipinos and Japanese males experienced rate increases, whereas male and female Koreans and Chinese males experienced rate decreases. U.S.-born male and female Hispanics and Japanese had higher APCs than foreign-born, as did Filipino males, whereas Chinese males had a reverse pattern. Annual increases in HCC incidence slowed down in recent years for U.S.-born Hispanic males and females and stabilized among male NHWs and non-Hispanic Blacks. For some Asian groups, early time periods exhibited increasing/stable APCs, whereas later time periods showed decreasing APCs. We found significant racial/ethnic and nativity differences in HCC IRs and trends. With changing trends, closer surveillance of HCC incidence by disaggregated race/ethnicity and nativity is warranted among Hispanics and Asians.

Nonfatal Assault Injury Trends in California, 2005 to 2015.

Interpersonal violence is a major global public health problem, and the burden of nonfatal assault injuries is far greater than that of homicides. To understand trends and inform prevention priorities, we sought to describe nonfatal assault injury trends across demographic groups from 2005 to 2015 in California, USA. Comprehensive hospitalization and emergency department discharge records were used to estimate annual rates of nonfatal assault injury overall and by means and age group and age-standardized annual rates by race/ethnicity, gender, and county. The overall rate of assault injury was stable in California from 2005 to 2015 (mean = 364 per 100,000), but there was substantial heterogeneity across demographic groups, including increases among African Americans (900 to 1,194), American Indian/Alaskan Natives (423 to 572), older individuals (age 25-29 = 697 to 727; 30-39 = 495 to 557; 40-49 = 352 to 404; 50-59 = 194 to 313; 60+ = 66 to 106), and women (199 to 252). Assault injury rates increased among several demographic groups, warranting the attention of professionals involved in violence prevention efforts. Epidemiologic examination to better understand causes of increases can inform prevention efforts. Similar analyses should be applied to other settings to determine how broadly these patterns are observed.

Slowdown in the Decline of Tuberculosis Rates in California, 2000-2016.

To determine the impact of the 2007-2009 economic crisis on tuberculosis (TB) trends among California residents. We analyzed available data from 4 different population-representative data sets. We used time charts, trend lines, and change-point detection tests during 2000 to 2016 to describe TB trends in California. We found statistically significant changes in California TB trends with the time of the onset of the economic downturn based on age-adjusted TB case rates and TB mortality rates, crude rate of TB hospitalizations, and self-reported TB. Change on TB incidence was especially apparent among racial/ethnic minority groups. To our knowledge, changes in TB trends in the United States matching in time with the 2007-2009 economic crisis have not been previously reported. This study identified a slowdown in the decline of TB rates by 2007 to 2009 and provides new knowledge on TB trends that can be used to achieve California's goal of eliminating TB by 2040 and in the prevention and control of TB in the United States.

Striking Racial/Ethnic Disparities in Liver Cancer Incidence Rates and Temporal Trends in California, 1988-2012.

Hepatocellular carcinoma (HCC) is characterized by disparate risk patterns by race/ethnicity. We examined HCC incidence patterns and temporal trends among detailed racial/ethnic populations, including disaggregated Asian-American subgroups. Using data from the population-based California Cancer Registry, we identified 41 929 invasive HCC cases diagnosed during 1988-2012. Patients were grouped into mutually exclusive racial/ethnic groups of non-Hispanic (NH) white, NH black, Hispanic, and NH Asian/Pacific Islander (API), as well as Asian subgroups of Chinese, Filipino, Japanese, Korean, Vietnamese, Cambodian, Laotian, and South Asian. Age-adjusted and age-specific incidence rates by sex, race/ethnicity, and time period were calculated. The average annual percent change (AAPC) in incidence rates was estimated using joinpoint regression. All estimates were provided with the 95% confidence intervals (CIs). Aggregated NH API had higher HCC risk than NH whites, NH blacks, and Hispanics. When disaggregated, Southeast Asians (Vietnamese, Cambodians, and Laotians) had overall HCC incidence rates eight to nine times higher than NH whites and more than twice that of other ethnic Asians. Statistically significant rising temporal trends of HCC were found in NH whites, NH blacks, and Hispanics, especially those older than age 50 years. Overall HCC risk declined in Chinese males (AAPC = -1.3%, 95% CI = -2.0 to -0.6), but rose in Filipino (AAPC = +1.2%, 95% CI = 0.3 to 2.1) and Japanese males (AAPC = +3.0%, 95% CI = 0.4 to 5.6) and Vietnamese (AAPC = +4.5%, 95% CI = 0.7 to 8.5) and Laotian (+3.4%, 95% CI = 0.1 to 6.8) females. Our findings provide valuable information for the identification of at-risk ethnic subgroups of Asian Americans while underscoring the importance of disaggregating ethnic populations in cancer research.