Despite growing acceptance of cannabis, considerable knowledge gaps persist regarding its effects on overall health status and quality of life. This study examines the impact of cannabis use on individuals' overall, physical, and mental health status. To address potential endogeneity in cannabis use, we employ an instrumental variable (IV) approach using individual-level data. Three sets of IVs-state-level cannabis laws, cannabis prices, and average cannabis use within matched gender-age groups-are used to estimate two-stage least-squares models. While the results vary across health measures and IVs, the findings based on the strongest IV-group average cannabis use-suggest that more days of cannabis use are associated with fewer days in good mental health among users aged 21 to 64, particularly males. For adults aged 65 and older, the effects are mixed.

Objectives. To assess relationships between changes in population levels, health care access, health care grievances, and mortality in California prisons. Methods. We examined 30 California prisons using June 2013 to May 2023 data from California Correctional Health Care Services and the California Department of Justice. Associations between prison occupancy rates and care access, health care grievances, and mortality were estimated in linear or generalized linear models controlling for staff vacancies and the characteristics of incarcerated people. Because of the prevalence of COVID-19-specific dynamics in prisons in 2020-2021, baseline models included data up to December 2019; data from January 2022 through May 2023 were added as a robustness check. Results. Reductions in prison occupancy rates were associated with increased access to care. Associations were more pronounced when postpandemic data were added. However, decreasing occupancy rates were not associated with declines in health care grievances or mortality. Conclusions. Lowering prison occupancy rates could help ensure better access to care, but it is not a panacea for alleviating varied health-related problems and dangers inside carceral facilities. (AmJ Public Health. 2025;115(6):936-944. https://doi.org/10.2105/AJPH.2025.308011)

Background:The purpose of the study was to investigate the relationship between community-level variables and emergency department (ED) visit rates before and during COVID-19. The focus was on opioid-related ED visits. Despite large declines in overall ED visits during COVID-19, opioid-related visits increased. While visits for avoidable conditions decreased, the opposite was true for opioid-related visits. Methods:We combined data from Florida EDs with community-level variables from the 2020 American Community Survey. The outcome measures of the study were quarterly ZIP code tabulation-area-level ED visit rates for opioid-related ED visits as well as visit rates for all other causes. Associations with opioid-related visit rates were estimated before and during COVID-19. Results:The associations between community-level variables and opioid-related visit rates did not match those found when analyzing overall ED visit rates. The increase in opioid-related visits during COVID-19 was not unique to or more prevalent in areas with a larger percentage of racial/ethnic minority populations. However, socioeconomic status was important, as areas with higher unemployment, lower income, lower home ownership, and higher uninsured had higher overall ED visit rates and opioid visit rates during the pandemic. In addition, the negative association with income increased during the pandemic. Conclusion:These results suggest socioeconomic status should be the focus of prevention and treatment efforts to reduce opioid-related visits in future pandemics. Healthcare organizations can use these results to target their prevention and treatment efforts during future pandemics.

In 2019, there were approximately ten million admissions to more than 3,000 US jails-facilities that had become increasingly deadly in the prior decades. Between 2000 and 2019, jail mortality rose by approximately 11 percent. Although incarceration is widely viewed as a health hazard, relationships between jail conditions and jail deaths are understudied. Using data from the Bureau of Justice Statistics and Reuters journalists, we assessed mortality rates and conditions in approximately 450 US jails in the period 2008-19. During those years, certain facility characteristics were related to mortality. For example, high turnover rates and high populations were associated with higher death rates. Greater proportions of non-Hispanic Black people in jail populations were associated with more deaths due to illness, and the presence of larger shares of non-US citizens was associated with lower overall mortality rates. Our findings suggest that heavy reliance on incarceration and the prevalence of broad health disparities escalate jail mortality.

Ta doped titanium dioxide (TiO2:Ta) films were deposited by a metalorganic chemical vapor deposition (MOCVD) system. X-ray diffraction (XRD) measurement revealed the TiO2:Ta films with low Ta contents (<= 4.0 at.%) to be epitaxial films of anatase phase. X-ray photoelectron spectroscopy (XPS) measurement showed that Ta element only existed as Ta5+ in TiO2 lattice without other valence states. The electrical characteristics of the films could be modified through Ta doping. The minimum resistivity was obtained at Ta content of 2.0%. As Ta content increased, the carrier concentration increased from 4.9 x 10(17) to 1.3 x 10(19)cm(-3) while the Hall mobility decreased from 20.4 to 3.07 cm(2)V(-1)s(-1). The deposited TiO2:Ta films all presented high visible transparency over 93.0%. A thin-film transistor based on 1.0% Ta-doped TiO2 film was fabricated, which exhibited high performances with a ION/IOFF ratio of 7.5 x 10(7), a subthreshold swing of 0.55 V/decade, and a saturation mobility of 3.4 cm(2)V(-1)s(-1).

The legal landscape for marijuana in the United States has changed dramatically over the last three decades. While several studies have examined the relationship between marijuana legalization and traffic fatalities, some of the research is becoming outdated and existing evidence remains mixed. Our research revisits the topic with two updates. First, our study includes states that legalized marijuana more recently and provides updated evidence on the effects of marijuana legalization. Second, considering recent discussions about the limitations of difference-in-differences designs, we employ alternative estimators that are robust to heterogeneous and dynamic treatment effects. Overall, our alternative estimators suggest either a smaller reduction (i.e., 3.9% drop in the overall fatality rate) or no change in traffic fatalities associated with legalizing marijuana for medical use, compared to the two-way fixed-effect estimator. We find no significant impact on traffic fatalities associated with legalizing marijuana for recreational use.

Emergency department (ED) visits for drug overdoses increased nationally during COVID-19 despite declines in all-cause ED visits. The study purpose was to compare characteristics of ED visits for opioid and stimulant overdoses before and during COVID-19 in Florida. This study tested for disparities in ED visits for opioid and stimulant overdoses by race/ethnicity, age, and insurance status. The study identified ED visits for opioid and stimulant overdose in Florida during quarters two and three of 2019 and compared them with quarters two and three of 2020. Overall, there was an increase in the number of opioid and stimulant overdoses during COVID-19. Combined with the decline in the number of all-cause ED visits, drug overdoses represented a larger share of ED visits during COVID-19 compared with before COVID-19. The study did not find evidence of disparities by race/ethnicity, as each group experienced similar increases in the likelihood of ED visits involving drug overdoses during COVID-19. Differences emerged according to age and insurance status. ED visits involving those under age 18 were more likely to involve opioid or stimulant overdose, and ED visits among those over age 65 were less likely to involve opioid overdose during COVID-19. ED visits among those with vulnerable insurance status were more likely to involve opioid overdose during COVID-19. Patterns of behavior change during periods of restricted activity due to a pandemic. These changes in behavior change the mix of risks that people face, suggesting the need for a reallocation of population health management resources during pandemics.

Scheelite ABO4-type solid electrolytes have attracted much attention for potential applications as oxygen ionic conductors of solid oxide fuel cells. Herein, a systematic study was carried out on the electrical transport properties of CdMoO4 under high pressure by impedance spectroscopy measurements and theoretical calculations. The sequence of structural phase transitions at pressures was determined as I41/a → C2/c → P21/c by the Crystal structure AnaLYsis by Particle Swarm Optimization (CALYPSO) method. A pressure-induced conduction transition from mixed ionic–electronic to pure electronic conduction was observed. Below 25.6 GPa, O2− ions play a major role in the electrical transport process. The microscopic transport mechanism was analyzed with grain boundary energies and migration energy barriers. Above 26.9 GPa, the grain boundary response was weakened significantly after a pressure cycle, and the grain boundary conductivity increased by about three times due to pressure. These results provide guidelines for the optimization and application of scheelite ABO4-based oxygen ionic conductors in solid oxide fuel cells.

OBJECTIVES:To examine the impact of COVID-19 surges on hospital outcomes, particularly among non-COVID-19 patients.STUDY DESIGN:An interrupted time series design.METHODS:Using data from a large insurance claims clearinghouse, the study estimates the impact of the onset of the pandemic and the share of hospital COVID-19 patients on the likelihood of (1) in-hospital death, (2) in-hospital death or discharge to hospice, (3) discharge to other hospitals, (4) discharge to skilled nursing facilities (SNFs), and (5) discharge to home care.RESULTS:The odds of in-hospital death were about 1.7 times that before the onset of the pandemic among all patients and 1.2 times that among non-COVID-19 patients. Increased share of COVID-19 patients was associated with higher odds of in-hospital death among all patients and non-COVID-19 patients. The effects were more pronounced among patients 45 years and older and those with septicemia or pneumonia, and they were also stronger during the months in which COVID-19 cases surged. Although no sizable changes were found in the odds of discharge to other hospitals or SNFs, transfers to home care grew during the pandemic.CONCLUSIONS:The negative impact of the pandemic on mortality among non-COVID-19 patients confirms existing concerns about patient care. No evidence suggests large-scale changes in practices regarding discharge/transfer to other facilities. The findings shed light on future efforts to monitor and improve inpatient care as the pandemic evolves.

Objectives. To examine rates of emergency department (ED) visits and hospitalizations among incarcerated people in Florida during a period when health care management in the state's prisons underwent transitions. Methods. We used Florida ED visit and hospital discharge data (2011-2018) to depict the trend in ED visit and hospital discharge rates among incarcerated people. We proxied incarcerated people using individuals admitted from and discharged or transferred to a court or law enforcement agency. We fitted a regression with year indicators to examine the significance of yearly changes. Results. Among incarcerated people in Florida, ED visit rates quadrupled, and hospitalization rates doubled, between 2015 and 2018, a period when no similar trends were evident in the nonincarcerated population. Public Health Implications. Increasing the amount and flexibility of payments to contractors overseeing prison health services may foster higher rates of hospital utilization among incarcerated people and higher costs, without addressing major quality of care problems. Hospitals and government agencies should transparently report on health care utilization and outcomes among incarcerated people to ensure better oversight of services for a highly vulnerable population.

This study aims to evaluate the cost-benefit of vaccination services, mostly partial series administration, provided by a mobile clinic program (MCP) in Houston for children of transient and low-income families. The study included 469 patients who visited the mobile clinics on regular service days in 2 study periods in 2014 and 836 patients who attended vaccination events in the summer of 2014. The benefit of partial series vaccination was estimated based on vaccine efficacy/effectiveness data. Our conservative cost-benefit estimates show that, compared with office-based settings, every dollar spent on vaccination by the MCP would result in $0.9 societal cost averted as an incremental benefit in regular service days and $3.7 during vaccination-only events. To further improve the cost-benefit of vaccination services in the MCP, decision-makers and stakeholders may consider improving work efficiency during regular service days or hosting more vaccination events.

High-deductible health plans (HDHPs) have become increasingly prevalent among employer-sponsored health plans and plans offered through the Health Insurance Marketplace in the United States. This study examined the impact of deductible levels on health care experiences in terms of care access, affordability, routine checkup, out-of-pocket cost, and satisfaction using data from the Health Reform Monitoring Survey. The study also tested whether the experiences of Marketplace enrollees differed from off-Marketplace individuals, controlling for deductible levels. Results from multivariable and propensity score weighted regression models showed that many of the outcomes were adversely affected by deductible levels and Marketplace enrollment. These results highlight the importance of efforts to help individuals choose the plan that fits both their medical needs and their budgets. The study also calls for more attention to improving provider acceptance of HDHPs and Marketplace plans as these plans become increasingly common over time.

This study assesses the dollar benefit of a neighborhood approach intervention on disaster risk reduction in small-sized, densely populated, and hazard-prone informal settlements across Latin American and Caribbean countries. We use a life satisfaction approach that assigns a dollar value to gains in wellbeing associated with the neighborhood approach intervention. Our primary data was a survey to a sample of 349 beneficiaries from small towns in Haiti, Guatemala, and Jamaica, and in major cities’ surrounded areas of Peru, Colombia, and Honduras. Out of 14 interventions, we found that community empowerment, physical works in public spaces and urban gardens/food approaches produced a gain of USD1,038 to USD1,241 to individual beneficiaries. Our study suggests a large benefit associated with the neighborhood approach intervention. It also shows that the life satisfaction approach is a promising method for the valuation of non-market and public goods, especially for countries where data on hazards and risks is not available to help monetize risk reductions.

OBJECTIVES:To examine the role of individual race/ethnicity and community racial/ethnic mix on the type of opioid-related emergency department (ED) visits in Florida.METHODS:The study identifies opioid-related ED visits that involved heroin, non-heroin poisoning, and opioid use disorder (OUD) from the first quarter of 2010 to the second quarter of 2018 in Florida. The trend is depicted by patients' race/ethnicity and racial/ethnic mix of residential communities. Combined with zip code tabulation area data, the study builds a multilevel model and examines how individual-level and community-level covariates relate to the type of opioid-related ED visits.RESULTS:While opioid-related ED visit rate was highest among white patients, majority-black communities caught up with the majority-white communities in the visit rate. The multilevel model results suggest that the likelihood of an opioid-related ED visit involving heroin, non-heroin poisoning, or OUD differed by patient race/ethnicity as well as community racial/ethnic mix. Opioid-related ED visits among minority patients were more likely to involve non-heroin poisoning than non-Hispanic white patients, whereas patients from minority-dominant communities were more likely to involve heroin poisoning than from majority-white communities. However, community racial/ethnic mix was not significantly or less significantly associated with the likelihood of involving OUD ED visits.CONCLUSIONS:The study highlights the heterogeneity of the opioid overdose problem across racial/ethnic patients and communities with different racial/ethnic mixes. Future policies may consider the effect of living in different racial/ethnic mixed communities in addition to individual race/ethnicity.

BACKGROUND:Despite the high risk and economic burden of influenza-related diseases, about one-third of adults aged 65 and older still forego annual influenza vaccination. Mass media, as a leading source of health information for the public, can influence and promote health behaviors, such as vaccination. However, empirical evidence on the effect of media coverage on influenza vaccination uptake remains limited. OBJECTIVE:We examine the impact of media coverage by month on influenza vaccination among the elderly. METHODS:This study exploits variation in the number of influenza-related news reports by month and across seasons and examines its impact on vaccine uptake in a linear probability model with state fixed effects and seasonable random effects. We combine individual-level influenza vaccination data from the Behavioral Risk Factor Surveillance System(BRFSS), 2010-2017, and media coverage data from the NewsBank database along with several other data sources including weather data from the Global Historical Climatology Network and data on the influenza season from FluView from the Centers for Disease Control and Prevention. RESULTS:Our main results indicate every 100 additional media reports about influenza published in October were associated with an increase in the vaccination uptake rate among those aged 65+ of 0.3 percentage points. This association holds in January, but not in November or December. It was more pronounced in late-peak seasons and in seasons where the vaccine was highly effective. CONCLUSION:This study provides suggestive evidence that variation in the number of media reports is associated with variation in influenza vaccination uptake.

The generalized translog cost (GTLC) methodology is widely used in applied econometric modeling of production. Usually without rationale, the mean expansion point is overwhelmingly the arithmetic. However, the arithmetic mean could yield biased estimates and inferences. Consequently, our core innovation is testing operational inferences from fitting a dual GTLC model to multiple expansion points of data concerning US physical therapy, an increasingly vital industry. Our panel data includes 4,500 bi‐weekly observations across 27 US states. The study clearly demonstrates how the economic contents (e.g., economies of scale and elasticities) of the underlying production technology differ markedly across the three Pythagorean means.

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Prescription drugs are the third largest component of U.S. healthcare spending, and quickly growing. This novel study provides greater information on consumer behavior in the market for prescription drugs, and how that behavior may vary due to fluctuating economic conditions, using an annual panel dataset. Specifically, the research presented applied the income elasticity decomposition methodology to prescription drug expenditures, deriving both its quality and quantity components. Per capita gross domestic product and median home values were used interchangeably to test whether alternative income concepts affect income elasticity estimates. The system generalized method of moments three-stage least squares estimation results revealed that the: (a) 0.647 short-run income elasticity comprises 0.453 and 0.194 in quantity and quality components; (b) long-run income elasticity estimate of 0.167 has 0.027 and 0.140 quantity and quality components. Pharmaceuticals were found to behave as a necessity and normal good with significant tendencies for long-run consumption shifts towards quality. Further illustrated are supply and demand-side impacts, with policy implications for Medicare and Medicaid programs, among others.