BackgroundInternational research suggests there are benefits to paternity leave, including positive impacts on the health and wellness of mothers and children, and mental health among fathers. However, U.S.-based studies remain limited, often relying on localized data. Prior quantitative study which assessed multi-state data was not able to take employer support or lack of support for leave-taking into account.ObjectiveTo assess associations between access to employer-supported paternity leave and mental health among U.S. workers; to examine the distribution of access by industry.MethodsParticipants were a cross-sectional, nationally representative 2024 panel of U.S. adults who responded to a question about paternity leave (n = 2608). A single item assessed paternity leave availability and perceived employer support. Mental health was self-rated (good/very good/excellent versus fair/poor). We estimated associations between paternity leave access and mental health among all participants and among men using survey-weighted quasibinomial logistic regression. Weighted descriptive analyses were conducted by sociodemographic characteristics and industry.ResultsLack of access to paternity leave was associated with fair/poor mental health in the full sample (no access: adjusted odds ratio (aOR): 1.73, 95% confidence interval (CI): 1.18, 2.54; availability without employer support: aOR: 2.24, 95% CI: 1.16, 4.31) and among men (no access: aOR: 1.92, 95% CI: 1.14, 3.22; availability without employer support: aOR: 2.44, 95% CI: 1.06, 5.63).ConclusionsAccess to employer-supported paternity leave may be protective for U.S. workers' mental health. Industry-specific access disparities highlight opportunities for workplace interventions.

OBJECTIVE:Few studies have examined the mental health burden faced by working parents. We assessed the prevalence of fair or poor self-reported mental health and identified desired workplace improvements among US working parents. METHODS:We conducted a descriptive analysis of the 2024 SummerStyles survey, a nationally representative web-based panel survey of US adults aged ≥18 years. Working parents were defined as adults employed full- or part-time with ≥1 child aged <18 years. We calculated weighted percentages and 95% CIs to characterize mental health status and workplace priorities across demographic and occupational groups. RESULTS:Among 1201 working parents, 15.3% (weighted n = 126) reported fair or poor mental health. The prevalence of self-reported fair or poor mental health was higher among women than among men (20.0% vs 11.4%), among those with lower annual household income (<$25 000: 31.6%) versus higher annual household income ($25 000-$49 999: 20.1%; $50 000-$99 999: 19.6%; >$100 000: 10.0%), among those with less versus more educational attainment (high school graduate or less: 20.2%; some college: 20.0%; ≥bachelor's degree: 10.9%), and among those with retail/stores/shopping jobs (26.8%) versus jobs in other industries (health care: 20.4%; education and tutoring: 8.0%; professional, scientific, technical, and business services: 11.4%; finance, banking, and health insurance: 10.2%). Desired workplace improvements included increased paid leave (20%), ability to work remotely/telework (20%), and flexible work schedules (19%), with differences by demographic and occupational characteristics. CONCLUSIONS:Tailored workplace policies, such as flexible scheduling and expanded leave benefits, may support the mental health of US working parents. Additional research should explore industry-specific nuances of preferred workplace flexibilities among US working parents to guide work-based interventions.

OBJECTIVE:The aim of the study was to describe characteristics of women with a recent live birth who are, and are not, asked about their work by healthcare providers before pregnancy. METHODS:We analyzed 2016-2021 data from 48 jurisdictions participating in the Pregnancy Risk Assessment Monitoring System. Questionnaires asked mothers about provider-led conversations about their work. We descriptively compared weighted percentages with 95% confidence intervals across demographic and occupational characteristics. RESULTS:Of 157,724 participants, 36% reported not being asked about their work by a provider in the year before pregnancy. Higher proportions of younger and lower-income mothers, certain Asian and Native groups, and mothers in some occupations and industries posing a risk of occupational hazards reported no provider-led conversations about their work. CONCLUSIONS:Healthcare providers can more routinely ask patients about work to assess for possible occupational hazards to pregnancy.

We used National Birth Defects Prevention Study data to investigate associations between working patterns shortly before and during pregnancy and gestational diabetes and pregnancy-related hypertension. We analyzed working patterns (multiple-job holders, job changers, single-job holders) during the three months before and during pregnancy for 8140 participants who delivered a live-born child without a birth defect. “Multiple-job holders” worked more than one job simultaneously, “job changers” worked more than one job with no overlap, and “single-job holders” (referent) worked one job. We used multivariable logistic regression to estimate associations between working pattern and each outcome, adjusting for maternal age and educational attainment at delivery. We explored effect measure modification by household income, peak weekly working hours, and maternal race/ethnicity. Multiple-job holders had higher odds of gestational diabetes (adjusted odds ratio [aOR]: 1.5; 95% confidence interval [CI]: 1.1–2.1) and pregnancy-related hypertension (aOR: 1.5; 95% CI: 1.0–2.2) compared with single-job holders. Multiple-job holders with a household income of more than 30,000 USD per year, 32–44 peak weekly working hours, and from racial/ethnic minority groups had higher odds of gestational diabetes compared with single-job holders in respective categories. Detailed occupational information is important for studies of occupation and maternal health.

INTRODUCTION:Little is known about how the drivers of COVID-19 vaccination vary across the U.S. To inform vaccination outreach efforts, this study explores geographic variation in correlates of COVID-19 nonvaccination among adults.METHODS:Participants were a nationally representative sample of U.S. adults identified through random-digit dialing for the National Immunization Survey-Adult COVID Module. Analyses examined the geographic and temporal landscape of constructs in the Behavioral and Social Drivers of Vaccination Framework among unvaccinated respondents from May 2021 to December 2021 (n=531,798) and sociodemographic and geographic disparities and Behavioral and Social Drivers of Vaccination predictors of COVID-19 nonvaccination from October 2021 to December 2021 (n=187,756).RESULTS:National coverage with at least 1 dose of COVID-19 vaccine was 79.3% by December 2021, with substantial geographic heterogeneity. Regions with the largest proportion of unvaccinated persons who would probably get a COVID-19 vaccine or were unsure resided in the Southeast and Midwest (Health and Human Services Regions 4 and 5). Both regions had similar temporal trends regarding concerns about COVID-19 and confidence in vaccine importance, although the Southeast had especially low confidence in vaccine safety in December 2021, lowest in Florida (5.5%) and highest in North Carolina (18.0%). The strongest Behavioral and Social Drivers of Vaccination correlate of not receiving a COVID-19 vaccination was lower confidence in COVID-19 vaccine importance (adjusted prevalence ratio=5.19, 95% CI=4.93, 5.47; strongest in the Northeast, Southwest, and Mountain West and weakest in the Southeast and Midwest). Other Behavioral and Social Drivers of Vaccination correlates also varied by region.CONCLUSIONS:Contributors to nonvaccination showed substantial geographic heterogeneity. Strategies to improve COVID-19 vaccination uptake may need to be tailored regionally.

BACKGROUND:Few studies have evaluated birth defects among children of firefighters. We investigated associations between birth defects and paternal work as a firefighter compared to work in non-firefighting and police officer occupations. METHODS:We analyzed 1997-2011 data from the multi-site case-control National Birth Defects Prevention Study. Cases included fetuses or infants with major structural birth defects and controls included a random sample of live-born infants without major birth defects. Mothers of infants self-reported information about parents' occupations held during pregnancy. We investigated associations between paternal firefighting and birth defect groups using logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Referent groups included families reporting fathers working non-firefighting and police officer jobs. RESULTS:Occupational groups included 227 firefighters, 36,285 non-firefighters, and 433 police officers. Twenty-nine birth defects were analyzed. In adjusted analyses, fathers of children with total anomalous pulmonary venous return (TAPVR; OR = 3.1; 95% CI = 1.1-8.7), cleft palate (OR = 1.8; 95% CI = 1.0-3.3), cleft lip (OR = 2.2; 95% CI = 1.2-4.2), and transverse limb deficiency (OR = 2.2; 95% CI = 1.1-4.7) were more likely than fathers of controls to be firefighters, versus non-firefighters. In police-referent analyses, fathers of children with cleft palate were 2.4 times more likely to be firefighters than fathers of controls (95% CI = 1.1-5.4). CONCLUSIONS:Paternal firefighting may be associated with an elevated risk of birth defects in offspring. Additional studies are warranted to replicate these findings. Further research may contribute to a greater understanding of the reproductive health of firefighters and their families for guiding workplace practices.

INTRODUCTION:Focusing on subpopulations that express the intention to receive a COVID-19 vaccination but are unvaccinated may improve the yield of COVID-19 vaccination efforts. METHODS:A nationally representative sample of 789,658 U.S. adults aged ≥18 years participated in the National Immunization Survey Adult COVID Module from May 2021 to April 2022. The survey assessed respondents' COVID-19 vaccination status and intent by demographic characteristics (age, urbanicity, educational attainment, region, insurance, income, and race/ethnicity). This study compared composition and within-group estimates of those who responded that they definitely or probably will get vaccinated or are unsure (moveable middle) from the first and last month of data collection. RESULTS:Because vaccination uptake increased over the study period, the moveable middle declined among persons aged ≥18 years. Adults aged 18-39 years and suburban residents comprised most of the moveable middle in April 2022. Groups with the largest moveable middles in April 2022 included persons with no insurance (10%), those aged 18-29 years (8%), and those with incomes below poverty (8%), followed by non-Hispanic Native Hawaiian or other Pacific Islander (7%), non-Hispanic multiple or other race (6%), non-Hispanic American Indian or Alaska Native persons (6%), non-Hispanic Black or African American persons (6%), those with below high school education (6%), those with high school education (5%), and those aged 30-39 years (5%). CONCLUSIONS:A sizable percentage of adults open to receiving COVID-19 vaccination remain in several demographic groups. Emphasizing engagement of persons who are unvaccinated in some racial/ethnic groups, aged 18-39 years, without health insurance, or with lower income may reach more persons open to vaccination.