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This paper presents a method that uses observed data from an age-period table to set bounds on the age, period, and cohort effects in an age-period-cohort multiple classification (APCMC) model. The rationale is that with enough periods over a long time span the age distributions within periods on the dependent variable will be affected by different sets of cohorts for each of the periods. This is likely to result in different trends in these separate period age distributions such that the trends in the age distributions will encompass the trend in the age effects that generated the dependent variable values. This approach can help to identify bounds that likely encompass the age, period, cohort parameters that generated the data. The data used in this papers are estimated homicide arrests by single years for those aged 15–64 for the periods 1964 to 2019 in the United States. I utilize the observed trends in the age-distributions for each of the 56 periods as different constraints on the trends for the age effects in the APCMC fixed effects model. These estimates are used to form bounds on the age effects, period effects, and cohort effects. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to assess the economic impact of uniform COVID-controlling policies that were implemented by the US government in 2020 and compare it with hypothetical targeted policies that consider the heterogenous effect of COVID-19 on different age groups. Design/methodology/approach: The author began by showing that the adjusted SEQIHR model is a good fit to the US COVID-induced daily death data in that it can capture the nonlinearities of the data very well. Then, he used this model with extra parameters to evaluate the economic effects of COVID-19 through its impact on the job market. Findings: The results show that targeted COVID-controlling policies could reduce the US death rate and GDP loss to 0.03% and 2%, respectively. By comparing these results with uniform COVID-controlling policies, which led to a 0.1% death rate and 3.5% GDP loss, we could conclude that the death rate reduction is 0.07%. Approximately 378,000 Americans died because of COVID-19 during 2020, therefore, reducing the death rate to 0.03% means saving a significant proportion of the COVID-19 casualties, around 280,000 lives. Originality/value: To the best of the author's knowledge, this paper is the first study to assess the economic impacts of COVID-controlling policies by using the multirisk SEQIHR model. [ABSTRACT FROM AUTHOR]

BACKGROUND: The US life expectancy has been stagnating in recent decades, and along with this, the time trends of life span variation have shown stagnation and even increases with respect to historical levels. OBJECTIVE: We aim to disentangle contributions from subnational levels (US regions) to national changes in life expectancy and life span variation in 2010-2019 and 2019-2020. METHODS: A decomposition of the change in the national life expectancy and life disparity into the contribution of changing mortality and population structure among subnational regions is presented. The US Census regions are the Midwest, Northeast, South, and West. RESULTS: From 2010 to 2019, the South substantially contributed to the life span variation increase due to increasing mortality contributions. The old-age survival improvements across all regions further contributed to increasing life span variation at the national level. Different population growth patterns across regions, especially at older ages, are a further source of change in national life span variation and life expectancy. From 2019 to 2020, during the COVID-19 pandemic, an increase in life span variation and a decrease in life expectancy across all regions were observed. CONTRIBUTION: We present continuous-time decompositions for changes in life expectancy and life span variation. When decomposing subnational contributions to national changes, we also demonstrate the role of the composition effect through subnational-national growth differences. This paper quantifies and highlights the specific contributions of regions and age groups to the national mortality increase in the United States between 2010 and 2019, as well as between 2019 and 2020. [ABSTRACT FROM AUTHOR]

Objective: To demonstrate how visualization can aid in understanding crime rate data and provide new insights and hypotheses for some central criminological questions about homicide offending over time. Methods: The research uses arrest data that is based on a mixture of single year age data and other age groupings to produce single years of age estimates of homicide offending for those 15–64 from 1964 to 2019. This data is then presented in surface plots, contour plots, and with graphs based on simple statistics to address four areas of research: the increase in homicide rates from the mid-1960s to the mid-1970s, the drop in homicide offending from the early 1990s to 2000, the epidemic of youth homicide, and the invariance of the homicide age-curve. Results: The epidemic of youth homicide (ages 15–24) lasts well into the period when homicide rates dropped in the 1990s. For most of the population (excluding those 15–24) the homicide drop is initiated around 1980 rather than the early 1990s. However, the homicide increase of mid-1960s to mid-1970s included increases in the homicide rate for both those 15–24 and those not in the 15–24 age group. Conclusions: Researchers can learn much about important areas in criminology by examining the relationship between age and homicide offending using simple visualizations based on raw data and pursue what they learn using line graphs based on elementary statistics and simple statistical methods. Of course, complicated statistical methods are called for in many situations. [ABSTRACT FROM AUTHOR]

Background: No comprehensive assessment of disorders of gut‐brain interaction (DGBI) in the United States (US) national population has been published in the past three decades. We aimed to provide an updated picture of DGBI in the United States and associated factors, using data from two national Internet surveys. Methods: Data were analyzed from 1949 people surveyed in 2015, and 2023 people surveyed in 2017 as a part of the Rome Foundation Global Epidemiology Study (RFGES). The surveys had nearly identical methodology and included the Rome IV Diagnostic Questionnaire and questions on demographics, quality of life (QoL), emotional symptoms, and healthcare utilization. Key Results: The prevalence of having any DGBI was 36.0% and 39.9% in the two surveys. Prevalence estimates for the 22 DGBI assessed were broadly comparable between the surveys, as their 95% confidence intervals overlapped for every disorder. Females had DGBI more commonly than males in both surveys (odds ratios 1.66 and 1.52), and people of age 65 and older had lower DGBI prevalence than younger age groups. Having DGBI was associated in both surveys with significant QoL impairment, elevated anxiety, depression and somatization symptoms, and increased doctor visits. Conclusions and Inferences: Approximately 4 out of every 10 US adults have a DGBI; more commonly women and people under the age of 65. DGBI adversely affect QoL and emotional well‐being and increase healthcare needs. The similarity of findings between the two surveys supports the reliability of DGBI prevalence estimates obtained with the Internet survey method used globally in the RFGES. [ABSTRACT FROM AUTHOR]

Background: Analysis of Lexis diagrams (population-based cancer incidence and mortality rates indexed by age group and calendar period) requires specialized statistical methods. However, existing methods have limitations that can now be overcome using new approaches. Methods: We assembled a "toolbox" of novel methods to identify trends and patterns by age group, calendar period, and birth cohort. We evaluated operating characteristics across 152 cancer incidence Lexis diagrams compiled from United States (US) Surveillance, Epidemiology and End Results Program data for 21 leading cancers in men and women in four race and ethnicity groups (the "cancer incidence panel"). Results: Nonparametric singular values adaptive kernel filtration (SIFT) decreased the estimated root mean squared error by 90% across the cancer incidence panel. A novel method for semi-parametric age-period-cohort analysis (SAGE) provided optimally smoothed estimates of age-period-cohort (APC) estimable functions and stabilized estimates of lack-of-fit (LOF). SAGE identified statistically significant birth cohort effects across the entire cancer panel; LOF had little impact. As illustrated for colon cancer, newly developed methods for comparative age-period-cohort analysis can elucidate cancer heterogeneity that would otherwise be difficult or impossible to discern using standard methods. Conclusions: Cancer surveillance researchers can now identify fine-scale temporal signals with unprecedented accuracy and elucidate cancer heterogeneity with unprecedented specificity. Birth cohort effects are ubiquitous modulators of cancer incidence in the US. The novel methods described here can advance cancer surveillance research. [ABSTRACT FROM AUTHOR]

Climate change is a divisive issue in the United States, and most research has focused on partisan differences, thereby leaving the impact of social identities on climate change attitudes underexplored. However, research has shown that the strength of varying and overlapping identities is key to understanding political attitudes. In this paper, we introduce Millennial Generation/Generation Z ("MillZ") as a meaningful social identity that influences political attitudes. Moreover, we contend that Latino*MillZ is an identity that has explanatory value for understanding climate change beliefs. While Latino and Millennial/Generation Z identities are not perfectly aligned, members of the Millennial Generation and Generation Z include a relatively high proportion of Latinos. Furthermore, since Latinos are disproportionately affected by climate change (i.e. the "climate gap") the MillZ identity should generate increased concern for the environment. We utilize an original national survey to explore the interplay of Latino and MillZ identities on attitudes about climate change. Results show that Latino and MillZ identities are both associated with heightened climate change concern and that strong attachment to one identity is sufficient to induce concern when the other is weak. These findings point to the importance of exploring multiple identities and offer evidence that social identities are activated in different ways to influence climate change attitudes. [ABSTRACT FROM AUTHOR]

Building on recent research examining athlete burnout trajectories, this study implemented the developmental model of sport participation to compare emotional and physical exhaustion, reduced sense of accomplishment, and sport devaluation between age groups (specializing [aged 13–15 years] vs. investment [aged 16–18 years]) and gender (boys vs. girls) among U.S. high school athletes. Participants were 367 high school athletes (M = 15.53; 212 males; 186 specializing) across various individual and team sports who completed a survey assessing their demographic information, sport backgrounds, and burnout perceptions. A 2 × 2 multivariate analysis of covariance, controlling for training hours, showed greater emotional and physical exhaustion and sport devaluation in the investment than the specializing group, but no developmental differences in reduced sense of accomplishment. Contrary to our hypothesis, no gender or interaction effects were found. Findings inform interventions and future research that address the role of developmental stages and gender in athlete burnout. [ABSTRACT FROM AUTHOR]

Background: Vasectomy remains a safe, simple, and effective contraceptive option. Conflicting data on the trend of vasectomy use among men have been described previously at various snapshots in time over the last two decades. Objectives: This paper seeks to describe the trend of vasectomy utilization in the last 15 years using a nationally representative US survey. Materials and methods: We analyzed data from male respondents aged 18 to 45 years of the Cycle 6 (2002), 2006–2010, 2011–2013, 2013–2015, and 2015–2017 National Survey of Family Growth (NSFG) surveys. Population estimates are calculated based on the official NSFG instructions, accounting for the complex survey design. Multivariate logistic regression models are used to study demographic and socioeconomic factors associated with vasectomy use in men. Results: Baseline characteristics for men undergoing vasectomy do not differ significantly across survey years. Increased age, White race, marital status, higher education level, birthplace within the United States, higher household income, non‐Catholic affiliation, and higher number of biological kids have significant positive associations with vasectomy use. After accounting for factors associated with vasectomy utilization, there was a significant temporal decline in vasectomy utilization rates in all age groups across survey years which remained in subgroup analyses of all men greater than 25, 30, and 35 years of age. Discussion: This is the first population‐based analysis of US data to observe a decline in vasectomy utilization over the past two decades. The decline was statistically significant after accounting for all demographic and socioeconomic factors. Conclusion: There is a steady decline in the prevalence of vasectomy use in men from 2002 to 2017. Given the limited contraceptive options for men and the importance of contraception and family planning in the United States, further research is needed to understand the temporal decline. [ABSTRACT FROM AUTHOR]

Background: Fruit and vegetable (FV) consumption in children in the United States (US) is very low. Adequate FV consumption is required for proper development during childhood, and dietary habits are established during preschool-age and tend to persist into adulthood. As most U.S. preschool-aged children attend childcare or preschool, this may be an opportune time and setting to conduct interventions to improve FV intake. These interventions should be based in theory and use behavior change techniques (BCTs) to explain mechanisms for expected change. To date, no published reviews have examined the effectiveness of childcare- or preschool-based FV interventions in preschoolers and their use of theoretical frameworks and BCTs. Methods: This systematic review was completed adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria were randomized controlled trials (RCTs) published between 2012 and 2022 of interventions to improve diet or FV intake in preschoolers (aged 2–5 years) in childcare or preschool-settings. A search of four databases was conducted between in September 2022 using search terms pertaining to the study's primary aim (FV consumption), age group (preschool-aged), settings (US childcare or preschool settings), and study design (RCT). Additional criteria were objective measures of FV consumption or skin carotenoids, as a proxy for FV intake. Included studies were narratively synthesized based on intervention type, measured effect, and use of theory and BCTs. Results: The search resulted in six studies that reported on nine interventions. Overall, six interventions increased FV intake, of which five used nutrition education and one manipulated the feeding environment. Among the three interventions with no measured effect, two manipulated the feeding environment and one used peer modeling. Effective studies used at least three BCTs, though no pattern was observed between use of theory or BCTs and intervention effect. Conclusions: While several studies have shown promising results, the limited number of studies identified in this review highlights key gaps in this field: there is a need for studies to test FV interventions in US childcare settings that use objective measures of FV intake, directly compare intervention components and BCTs, are theory-based, and assess long-term behavior change. [ABSTRACT FROM AUTHOR]

This paper describes normative data for newly collected exemplar responses to 70 semantic categories described in previous norming studies (Battig & Montague, Journal of Experimental Psychology, 80(3, pt.2): 1–46, 1969; Van Overschelde, Rawson, & Dunlosky, Journal of Memory and Language, 50(3): 289–335, 2004; Yoon et al., Psychology and Aging, 19(3), 379–393, 2004). These categories were presented to 246 young (18–39 years), middle (40–59 years), and older (60 years and older) English-speaking adults living in the United States who were asked to generate as many category exemplars as possible for each of the 70 categories. In order to understand differences in normative responses, we analyzed these responses a) between age groups within the current sample and b) in comparison to three previously published sets of norms. Experimental studies using such norms typically assume invariance of normative likelihoods across age and historical time. We replicate previous findings such that exemplar frequency correlations suggest moderate stability in generated category members between age groups and cohorts for many, but not all, categories. Further, analyses of rank-order correlations highlight that the traditional measure of typicality may not capture all aspects of typicality, namely that for some categories there is high consistency in the frequency of exemplars across age groups and/or norms, but the ordering of those exemplars differs significantly. We include a cluster analysis to aid in grouping categories based on relative stability across time, cohort, and age groups. These results emphasize the importance of maintaining and updating age-differentiated category norms. [ABSTRACT FROM AUTHOR]

A recent study shows that among the three age groups of youth, adult and older adult, youth‐older adult has the highest age segregation while youth‐adult has the lowest. Similar to many previous age segregation studies, racial‐ethnic differences, an important population axis in segregation studies, were not considered. Prior studies are also limited to using two‐group measures, failing to compare multiple groups together. We explore the complexity in measuring intersectional segregation focusing on the two axes of age and race‐ethnicity and propose a conditional approach to measure age segregation by racial‐ethnic groups, and racial‐ethnic segregation by age groups. Using this approach, we empirically study the 2010 age‐race‐ethnic segregation at the county and state levels in the United States, using census tracts as the basic units. Both the two and multigroup dissimilarity indices were used. Results show that the racial‐ethnic axis had been a stronger force in segregation than the age axis. Results also show disparities of racial‐ethnic segregation across age groups with the highest levels present among older adults and in urban counties. For all three age groups, segregation levels involving Natives and Asians tend to be higher than those without them. In contrast, age segregation was the highest between youths and older adults, and the levels varied across racial‐ethnic groups with Natives at the highest levels. Although age segregation was significantly different between urban and rural counties, higher segregation in urban areas were mostly involving Whites as opposed to higher segregation in rural counties involving minority racial groups. Studying age segregation should not be colour blinded, as nonwhite older adults in rural counties were more likely to experience higher levels of age segregation than other groups. [ABSTRACT FROM AUTHOR]

Background: Emerging adults (aged 18–29) report high levels of musculoskeletal pain; however, it is unknown if body location and intensity patterns are related to different biopsychosocial characteristics. This study identified patterns of self-reported musculoskeletal pain among emerging adults and assessed if there were differences in their lifestyle and psychological characteristics. Methods: Data from survey responses from a large public university and a large medical university in the United States were used (n = 1,318). Self-reported pain location and intensity at five body regions were assessed, and latent class analysis identified classes separately for men and women. Mental health, physical activity, and sleep outcomes were compared between the classes. Results: Four classes were identified for men and women. Three of the classes were consistent between genders – "no pain," (women = 28% of their sample; men = 40% of their sample) "mild multisite pain," (women = 50%; men = 39%) and "moderate-severe multisite pain" (women = 9%; men = 7%). The fourth class for women was "moderate spine pain," (13%) and for men was "mild extremity pain" (13%). For both men and women, the "moderate-severe multisite" pain classes reported the highest levels of depression, anxiety, and stress, poorer sleep, and higher work physical activity than the "no pain" class. The "mild multisite" and "moderate spine" (women only) pain classes fell between the "no pain" and "moderate-severe" pain classes. The characteristics of the "mild upper extremity pain" class for men was similar to the "no pain" class. Conclusions: The identified classes provide unique information on pain location and intensity in emerging adults. The high prevalence of "mild multisite pain" (n = 593; 45% of the total sample) demonstrates an intervention opportunity during this age range to prevent further increases in musculoskeletal pain later in life. Future work should assess the longitudinal outcomes of these pain classes, the impact of interventions for this age group, and the balance between leisure and occupational physical activity when addressing musculoskeletal health. [ABSTRACT FROM AUTHOR]

In 2019, the United States (US) Advisory Committee on Immunization Practices (ACIP) recommended that healthcare providers engage in shared clinical decision making for adults aged 27–45 who may benefit from HPV vaccination. However, it is difficult to assess these benefits as there is a lack of data on HPV burden on young and mid-adult women. This analysis estimates the incidence of conization and the burden associated with treating pre-cancerous states related to HPV with a loop electrosurgical excision procedure (LEEP) or a cold knife conization (CKC) among commercially insured women aged 18–45. This retrospective cohort study used the IBM MarketScan commercial claims encounter database for women aged 18–45 treated with conization. We assessed the annual incidence of conization (2016–2019) and adjusted the two-year health care costs post-conization using a multivariable Generalized Linear Model (GLM)—accounting for follow-up time and other characteristics—stratified by the age groups, namely 18–26 and 27–45. The inclusion criteria were met by 6735 women, with a mean age of 33.9 years (SD = 6.2). Conization incidence was lowest for women aged 18–26 (41/100,000 to 62/100,000 women-years) and highest for women aged 31–35 (243/100,000 to 269/100,000). The GLM-adjusted, all-cause healthcare costs per patient per year were USD 7279 and USD 9249 in the 18–26 and 27–45 age groups, respectively. The adjusted costs for disease-specific care were USD 3609 and USD 4557 for women ages 18–26 and 27–45, respectively. The burden of conization and the associated costs were significant, indicating a potential healthcare benefit of HPV vaccination among young and middle-aged women. [ABSTRACT FROM AUTHOR]

Introduction: It is assumed that age-related increases in loss (e.g., health decline) motivate behavioral changes (e.g., prevention of health decline) across adulthood. This assumption has rarely been directly tested in empirical research, and the current study seeks to fill this gap. Methods: By performing random intercept cross-lagged panel model and multilevel modeling analyses on a three-wave longitudinal dataset from the Midlife in the United States survey (N = 7,108; 51.6% female; between 20 and 75 years at T1), we examined the between-person and the within-person associations between subjective health and engagement in physical activity. Chronic conditions, difficulty in performing daily activities, and demographic variables were controlled for. Results: At the between-person level, subjective (i.e., self-rated) health was positively associated with physical activity in the whole sample and the older subgroup (T1 age >55 years), but not in the younger subgroup (T1 age <35 years). At the within-person level, the association between subjective health and subsequent physical activity was negative in the whole sample and the older subgroup, but nonsignificant (between T1 and T2) or positive (between T2 and T3) in the younger subgroup. Discussion: This study revealed various associations between subjective health and engagement in physical activity across levels (the within- vs. between-person level) and across age groups (younger vs. older group). The finding contributes to a better understanding of people's health behavior in reaction to health decline at different ages. It also supports the proposition that age-related intraindividual increases in losses (e.g., health decline) motivate behaviors that counteract such losses (e.g., physical activity that protects health). [ABSTRACT FROM AUTHOR]

The study of service encounters in bilingual communities offers opportunities to gain insight into the factors that influence language choice and accommodation in these interactions and the ways that language may be used to build community. Previous work on bilingual service encounters has found that age, gender, speech turn, and customer ethnicity may all contribute to service providers' choice of one language over another. This study reexamines language choice and accommodation in Spanish-English service encounters by observing the language use of 96 service providers in 35 Latino-owned restaurants of the Washington metropolitan area. Using data from service encounters between bilingual service providers and Latino and white customers, we explore the extent to which the factors identified in previous studies are relevant in this region. Additionally, we explore whether the increasingly polarized political climate in the United States has impacted language use. We argue that while customer ethnicity is the main deciding factor to start an interaction, service providers always accommodate to customer language subsequently. This demonstrates the importance of both language as a community builder – even in the face of social pressures that sanction the use of Spanish in public spaces – and the power differential that exists between workers and customers in determining language use. [ABSTRACT FROM AUTHOR]

Background: With the ongoing global COVID-19 pandemic and the recent political divide in the United States (US), there is an urgent need to address the soaring mental well-being problems and promote positive well-being. The Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) measures the positive aspects of mental health. Previous studies confirmed its construct validity, reliability, and unidimensionality with confirmatory factor analysis. Six studies have performed a Rasch analysis on the WEMWBS, and only one evaluated young adults in the US. The goal of our study is to use Rasch analysis to validate the WEMBS in a wider age group of community-dwelling adults in the US. Methods: We used the Rasch unidimensional measurement model 2030 software to evaluate item and person fit, targeting, person separation reliability (PSR), and differential item functioning (DIF) for sample sizes of at least 200 persons in each subgroup. Results: After deleting two items, the WEMBS analyzed in our 553 community-dwelling adults (average age 51.22 ± 17.18 years; 358 women) showed an excellent PSR = 0.91 as well as person and item fit, but the items are too easy for this population (person mean location = 2.17 ± 2.00). There was no DIF for sex, mental health, or practicing breathing exercises. Conclusions: The WEMWBS had good item and person fit but the targeting is off when used in community-dwelling adults in the US. Adding more difficult items might improve the targeting and capture a broader range of positive mental well-being. [ABSTRACT FROM AUTHOR]

Colorectal cancer (CRC) incidence rates have decreased among adults aged 50 years or older while increasing in adults under age 50 years. Understanding these trends is challenging because of the multiple related time scales of age, diagnosis period, and birth cohort. We analyzed incidence rates of rectal, distal colon, and proximal colon cancer for individuals aged 20 years or more from the Surveillance, Epidemiology, and End Results Program for diagnosis years 1978–2017. We used a 2-stage generalized linear model to determine age, period, and cohort effects for CRC incidence. We first estimated birth cohort effects among people under age 45 years. We used these results to specify prior distributions for cohort effects in a Bayesian model to estimate period effects among people aged 45 years or more. There was no evidence of period effects for people under age 45 years. Risks of rectal and distal colon cancer increased for later birth cohorts. Compared with the 1943–1952 birth cohort, the 1983–1992 birth cohort had 2.2 times the risk of rectal cancer, 1.9 times the risk of distal colon cancer, and 1.3 times the risk of proximal colon cancer. For people aged ≥45 years, period effects showed declines in CRC risk that were attributable to screening. [ABSTRACT FROM AUTHOR]

Declines in cervical intraepithelial neoplasia grades 2 to 3 and adenocarcinoma in situ (CIN2+) observed among young women suggest impact from human papillomavirus (HPV) vaccination. To further evaluate vaccine impact including cross‐protection and type replacement, we described high‐risk (HR)‐HPV type‐specific cervical precancer incidence rates among women aged 20 to 39 years, 2008 to 2016. We analyzed cross‐sectional population‐based data on 18 344 cases of CIN2+ from a 5‐site surveillance system. Diagnostic specimens were tested for individual HPV types, including 14 HR‐HPV types (HPV16/18/31/33/35/39/45/51/52/56/58/59/66/68). We estimated age‐specific annual HR‐HPV type‐specific CIN2+ incidence per 100 000 screened women for individual types, vaccine HR‐HPV types (HPV16/18) and nonvaccine HR‐HPV types (non‐HPV16/18). We evaluated trends using average annual percent changes (AAPC) and 95% confidence intervals (CI), and estimated total declines by comparing 2015‐2016 to 2008‐2009 using incidence rate ratios. Among 20‐24‐year‐olds, HPV16/18‐CIN2+ declined from 2008 through 2016 (AAPC: −21.3%, 95% CI: −28.1%, −13.8%), whereas no trend was observed for non‐HPV16/18‐CIN2+ (AAPC: −1.8%, 95% CI: −8.1%, 4.9%). After 2010, CIN2+ among 20‐24‐year‐olds was more often caused by nonvaccine vs vaccine HR‐HPV types. No significant declining trends were observed in older age groups. In 2015‐2016 compared with 2008‐2009, HPV16‐CIN2+ declined 78%, HPV18‐CIN2+ 72% and HPV31‐CIN2+ 51% among 20‐24‐year‐olds; no increases were observed in type‐specific CIN2+ incidence. Among 25‐29‐year‐olds, HPV16‐CIN2+ declined 18%; CIN2+ attributed to seven nonvaccine types increased significantly. No significant declines were observed in older groups. Significant declines in HPV16/18‐CIN2+ in 20‐24‐year‐olds and HPV16‐CIN2+ in 25‐29‐year‐olds corroborate impact of HPV vaccination. A declining trend in HPV31‐CIN2+ is consistent with cross‐protection from vaccination. [ABSTRACT FROM AUTHOR]

With social media in the 21st century, Americans can argue that the United States has become an interconnected society that exposes all people to different cultures and lifestyles. Although a powerful medium, social media has presented adverse effects that decreases the trust that Millennials, especially Black Millennials, have in American society. In this paper, Millennials ask, what is the value of the Millennial population to American society? Millennials, a creative class of individuals, are working within a system that was created without them in mind and without developing a values-based system that is comprised of empathy and an understanding of the societal challenges, Americans will continue to perpetuate a divided America amongst age groups without the proper solutions for correction. This conversation is rooted in the essence of empathy, equity, and understanding where policy and decision-making in the public and governmental organizations must incorporate to increase Millennial visibility and build a culturally competent and mentally healthier America that will benefit all. [ABSTRACT FROM AUTHOR]

Address based sampling (ABS) has become current state-of-the-art methodology for conducting household surveys by mail, telephone or web in the United States. One potential advantage of ABS frames is that additional information about the sampled households can be appended and leveraged for data collection and analytic purposes. The appended data come from many sources and are of variable quality and completeness. The goals of this research were to evaluate data quality of demographic and socioeconomic variables provided for recent ABS samples from one vendor, and to examine their potential usefulness for sample design, including oversampling. We report on the completeness of the appended data as well as their concordance with data reported by respondents to two recent large ABS household surveys, one that invited households to complete the survey online and another that was mail only. Based on the quality assessment, we also examine the utility of the appended variables for oversampling. Our general conclusions are that the quality of select appended variables has improved such that the Hispanic origin, Hispanic surname, and presence of age group 65+ variables may be used to efficiently oversample these subgroups. However, this is not the case for oversampling other subgroups through appended variables for home tenure; those with head of household whose educational attainment is high school or less; low income households; households with children; presence of age groups 18–24, 25–34, and 35–64; or households based on the number of adults in the household. [ABSTRACT FROM AUTHOR]

Purpose: Although circumcision is the most commonly performed surgery in males, less is known about the incidence and indications of adult circumcision. In this study, we aim to present the incidence of adult circumcision across the United States. Methods: Using IBM MarketScan® Commercial Database from 2015 to 2018, we obtained claims for circumcision in men between 18 and 64 years of age. We calculated the incidence of adult circumcision over the study period and across the United States. We also collected data on indications for surgery using International Classification of Diseases codes. Results: We identified a total of 12,298 claims for adult circumcisions. The mean age was 39 (±12.9) years. The average incidence rates remained relatively constant from 98.1 per 100,000 person-years in 2015 to 98.2 per 100,000 person-years in 2018 (Δ+0.1%). The age-standardized incidence rates varied significantly across the United States (from 0 to 194.8 per 100,000 person-years) with South Dakota having the highest rate. The most common indications for adult circumcision were phimosis (52.5%), routine/ritual circumcision (28.7%), phimosis + balanitis/balanoposthitis (6.8%), balanitis (3.8%) and balanoposthitis (2.6%), and significantly varied by age groups. Conclusion: This study suggested a wide geographic variation in rates of adult circumcision between states with highest incidences in the Northeast United States. Future studies can identify the underlying causes for the observed variations. [ABSTRACT FROM AUTHOR]

Background: While the high prevalence of preterm births and its impact on infant mortality in the US have been widely acknowledged, recent data suggest that even full-term births in the US face substantially higher mortality risks compared to European countries with low infant mortality rates. In this paper, we use the most recent birth records in the US to more closely analyze the primary causes underlying mortality rates among full-term births.Methods and Findings: Linked birth and death records for the period 2010-2012 were used to identify the state- and cause-specific burden of infant mortality among full-term infants (born at 37-42 weeks of gestation). Multivariable logistic models were used to assess the extent to which state-level differences in full-term infant mortality (FTIM) were attributable to observed differences in maternal and birth characteristics. Random effects models were used to assess the relative contribution of state-level variation to FTIM. Hypothetical mortality outcomes were computed under the assumption that all states could achieve the survival rates of the best-performing states. A total of 10,175,481 infants born full-term in the US between January 1, 2010, and December 31, 2012, were analyzed. FTIM rate (FTIMR) was 2.2 per 1,000 live births overall, and ranged between 1.29 (Connecticut, 95% CI 1.08, 1.53) and 3.77 (Mississippi, 95% CI 3.39, 4.19) at the state level. Zero states reached the rates reported in the 6 low-mortality European countries analyzed (FTIMR < 1.25), and 13 states had FTIMR > 2.75. Sudden unexpected death in infancy (SUDI) accounted for 43% of FTIM; congenital malformations and perinatal conditions accounted for 31% and 11.3% of FTIM, respectively. The largest mortality differentials between states with good and states with poor FTIMR were found for SUDI, with particularly large risk differentials for deaths due to sudden infant death syndrome (SIDS) (odds ratio [OR] 2.52, 95% CI 1.86, 3.42) and suffocation (OR 4.40, 95% CI 3.71, 5.21). Even though these mortality differences were partially explained by state-level differences in maternal education, race, and maternal health, substantial state-level variation in infant mortality remained in fully adjusted models (SIDS OR 1.45, suffocation OR 2.92). The extent to which these state differentials are due to differential antenatal care standards as well as differential access to health services could not be determined due to data limitations. Overall, our estimates suggest that infant mortality could be reduced by 4,003 deaths (95% CI 2,284, 5,587) annually if all states were to achieve the mortality levels of the best-performing state in each cause-of-death category. Key limitations of the analysis are that information on termination rates at the state level was not available, and that causes of deaths may have been coded differentially across states.Conclusions: More than 7,000 full-term infants die in the US each year. The results presented in this paper suggest that a substantial share of these deaths may be preventable. Potential improvements seem particularly large for SUDI, where very low rates have been achieved in a few states while average mortality rates remain high in most other areas. Given the high mortality burden due to SIDS and suffocation, policy efforts to promote compliance with recommended sleeping arrangements could be an effective first step in this direction. [ABSTRACT FROM AUTHOR]

This study integrates life-course theory and mobility research to explore livability factors that attract migrants in different age groups between rural and urban counties in the United States. Place livability is measured by economy, housing market, natural amenity, neighborhood, civic and social engagement, and health. Migrants are grouped into young, middle-aged, and older adults. Results of Structural Equation Modeling show that, as people age, the attractiveness of place shifts from a focus on the economy and housing market to the neighborhood and engagement. Rural communities, which rank the highest on engagement, attract working aged and older migrants. Natural amenities and lower housing costs also attract migrants moving to rural counties. This study suggests that the natural environment and social environment could make up for the lack of accessible physical design in rural communities. Affordable housing and an inclusive community are key to retaining and increasing the population in rural communities. [ABSTRACT FROM AUTHOR]

When feminists in the antebellum United States organized to end slavery and demand their rights, they immediately faced critics who ridiculed them as ugly old maids, wrinkled old ladies, and superannuated old ex-slaves. "Old" in this sense was not the same as old age but rather an aesthetic judgment wielded by antifeminist and anti-Black journalists, caricaturists, and politicians to suggest that women speaking in public looked unattractive, ridiculous, or pitiful and should therefore be dismissed without engaging their ideas or political strategies. To gain a public hearing, feminists needed to shift how Americans saw mature women, but the very plasticity of the term "old" did more to divide women from each other than to create a unified age group. Images of female oldness remained keyed to middle-class marriage, racial difference, and chronological age in ways that divided old maids from married matrons, white women from Black women, and middle-aged women from those over sixty. Moving beyond a simplistic analysis of ageism, defined as prejudice by one age group toward another, this article develops an intersectional approach to analyzing the gendered and racialized aesthetics of oldness. By examining Anglo-American visual culture from the 1830s to the 1890s through the analytic of age, I demonstrate how antifeminist and anti-Black representations of female oldness created distortions in public recognition and led some women to internalize negative stereotypes with which abolitionists and feminists had to contend in order to enter politics. [ABSTRACT FROM AUTHOR]

To understand and predict the consumer patterns of generational groups within a highly technological world, it is critical to study their experiences, social views, and attitudes about music. Today, limited information is available to the research community about "Gen Z," a population group that recently entered college life and the next largest consumer group after the Millennials. This study aims at closing this gap by exploring and comparing distinctive patterns and consumer behavior in the music market between Gen Z and Millennials. Using a group of 1624 college students from two universities in the United States, we found that Gen Z is less prone to music piracy than Millennials, and those who pirate music tend to share similar social norms, a limited understanding of copyright infringements, and poor views about the music industry. New technologies are also transforming the way future generations are drawn into music piracy. We conclude that music infringement will continue to be an ethical dilemma and the industry should continue in its effort to design consumer policies to assist young generations. [ABSTRACT FROM AUTHOR]

The article presents information on various research papers published in the 2005 issue of the periodical "Journal of Adolescent Research." It also highlights the author's wish to evaluate the progress toward making the vitality criterion the standard for publication in the periodical, for the benefit of its readers. One of the papers demonstrates persuasively the value of making the voices of adolescents and emerging adults a standard and even essential part of research papers on the age groups. The author stated that he has used the vitality criterion as the guide as he has reviewed and reached decisions about manuscripts. Another paper presented the voices of adolescents and emerging adults. According to the author, the voices of the adolescents and emerging adults in the papers are vivid and memorable, whether they are speaking about sibling relationships, life after high school or the meaning of democracy. The author stated that the papers that had the most vivid cultural context were mostly from outside the United States.

Objective: To estimate the prevalence of amyotrophic lateral sclerosis (ALS) in the United States for 2016 using data from the National ALS Registry (Registry). Established in 2009, the Registry collects data on ALS patients in the U.S. to better describe the epidemiology of ALS, examine risk factors such as environmental and occupational exposures, and characterize the demographics of those living with the disease. Methods: To identify adult prevalent cases of ALS, the Registry compiles data from three national administrative databases (maintained by the Centers for Medicare and Medicaid Services, the Veterans Health Administration, and the Veterans Benefits Administration). To ascertain cases not necessarily included in these databases and to better understand risk-factors associated with ALS and disease progression, the Registry also includes data collected from patients who voluntarily enroll via a web portal to complete online surveys. Results: In 2016, the Registry conservatively identified 16,424 adult persons who met the Registry definition of ALS for an age-adjusted prevalence rate of 5.2 per 100,000 U.S. population. The pattern of patient characteristics (e.g., age, sex, and race/ethnicity) has not changed from previous Registry reports. Overall, ALS was more common among whites, males, and persons aged 60–69 years. The age groups with the lowest number of ALS cases were persons aged 18–39 years. Males had a higher prevalence rate of ALS than females overall and across all data sources. Conclusions: Data collected by the National ALS Registry are being used to better describe the epidemiology and demographics of ALS in the U.S. [ABSTRACT FROM AUTHOR]

This paper assesses the effectiveness of child safety seat laws in the United States. Over the past 35 years, these laws have steadily increased mandatory child safety seat restraint ages. We exploit state-year level variation in the age until which children are required to ride in child safety seats to estimate triple difference models using Fatality Analysis Reporting System (FARS) data from 1975 to 2011. Our findings show that increasing the age thresholds is effective in increasing the actual age of children in safety seats. Across the child-age distribution, restraint rates increase by between 10 and 30 percentage points or by between 50 and 170 percent, in the long run. We also estimate the impact of the child safety seat laws on the likelihood that a child dies in a fatal accident. We find that the laws saved up to 39 children per year. Finally, we find that the laws primarily induce compliant parents to switch from traditional seatbelt use to child safety seat use, with only small effects among parents who do not restrain their children. [ABSTRACT FROM AUTHOR]

The question of what to feed becomes a new challenge as an infant reaches the transition to complementary foods. Limited information is available that provides a texture progression map for complementary food introduction. Thus, the objective of this study was to determine the relationship between age and food texture experiences (FTE) in young children aged 4–36 months in the United States. A parent‐reported survey was fielded with 328 children categorized into five age groups (AGs): 4–8 months (AG1), 9–12 months (AG2), 13–18 months (AG3), 19–24 months (AG4), and 25–36 months (AG5). The present study analyzed four questions focused on FTE, with statistical analyses including probit and logit models, and analysis of variance. Results showed that all 16 food textures were tried at least once (>50%) by AG3. The question answered by participants, "How well does your child manage a specific texture," showed that significant differences existed among AGs for the management of 10 food textures (including chewy, hard, soft), whereas teething alone had no effect. The most refused textures by the children were AG1—crispy (27%), AG2—leafy (23%), AG3—leafy (40%), AG4—tough meat (52%), and AG5—leafy (51%). With increasing AG, the refusal probability of nine food textures, including chewy, leafy, and rubbery, also increased (p <.05). The refusal probability of cold food temperatures decreased with increasing age (p <.05). This study observed FTE in children across AGs and provides useful information to parents and practitioners as they introduce food textures into children's diets. [ABSTRACT FROM AUTHOR]

COVID-19 has disrupted society and health care systems, creating a fertile environment for deaths beyond the virus. The year 2020 will prove to be the most deadly year on record in the United States. Direct deaths due to COVID-19 have been well documented and reported. Older people (those over 65) have been hardest hit, with over 80% of the COVID-19 deaths in this age group. What has been less clear is the impact on those under 65 years old, particularly those under 44 years old. This study considers both COVID-19 deaths and non-COVID-19 deaths during a 39 weeks period beginning 1 March in both 2020 and averaged over the five years from 2015 to 2019. Across 22 age and gender cohorts, death risks are compared using odds ratios. The results indicate that younger people (those under 15 years old) have experienced the same or a reduction in death risk between 2020 and the average from 2015 to 2019, suggesting that societal changes were protective for some of them. With all COVID-19 deaths removed from the 2020 death counts, 15-64 year olds experienced increased death risk between 2020 and the 2015 to 2019 average. For example, 15-44 year old males experienced a significant increase in their death risk, even though the absolute number of COVID-19 deaths for this cohort is small. The key take away from this study is that COVID-19 resulted in a large number of additional deaths in 2020 compared to the average from 2015 to 2019, both directly from the virus and indirectly due to societal responses to the virus. [ABSTRACT FROM AUTHOR]

An accurate representation of occupancy schedules is needed to assess potential energy savings from occupancy-based controls in residential buildings. In this study the variation in US residential occupancy profiles is developed by household income level, age group, household size, and day of the week using 14 years of American Time Use Survey and Current Population Survey data. Based on cluster analysis results, the most common occupancy profiles were Day absence and Stay home where, the time of absence varies from less than 5 to 15 h per day. Low-income individuals and households spent significantly more time at home compared to higher income groups. Finally, a preliminary survey conducted to analyse the impacts of the COVID-19 pandemic suggests that it has substantially impacted occupancy patterns and is likely to do so post-pandemic as well. The results of this research help improve the representation of occupancy schedules in building energy simulation methods. [ABSTRACT FROM AUTHOR]

Within the last two decades, social science research on work as a calling has rapidly grown. To date, knowledge regarding prevalence and demographic differences of calling in the United States derives from data collected mainly from regionally limited and/or occupationally homogenous samples. The present study used data from the Portraits of American Life Study, a nationally stratified panel study of religion in the United States (U.S.), to estimate calling's prevalence in the U.S. Our findings represent the first known population estimates of seeking, perceiving, and living a calling in the U.S. Results revealed that calling is a relevant concept for many U.S. adults, with 43% endorsing "mostly true" or "totally true" to the statement "I have a calling to a particular kind of work." Small differences for presence of and search for a calling emerged across age groups, employment statuses, and levels of importance of God or spirituality. For living a calling, significant differences were identified only for importance of God or spirituality, contrasting with previous findings that suggested that living a calling varies as a function of income and social status. Implications for research and practice are explored. [ABSTRACT FROM AUTHOR]

Studies have shown that Chilean and US infants differ in their levels of self-regulation. One of the mechanisms of early socializing is the use of language, particularly mental state language. The current study seeks to deepen our knowledge of the ways in which mental state language is related to socialization processes in early childhood, including the ways both culture and children’s gender influence a mothers’ use of mental state talk. We used a quantitative and descriptive approach with 109 mothers and their children (64 Chilean and 45 US dyads), measured twice, at 12 and 30 months old. Mental state references related to regulation were coded during a story-sharing task, including positive (calm and patient) and negative (messy and impatient) references to regulating behavior. Chilean mothers generally showed more regulatory references than US mothers, especially if the children were at a younger age (12 month). Frequencies of regulatory references increased in US mothers at 30 months but were still less than in Chilean mothers. At the 12-month measuring point, Chilean mothers showed more negative regulatory attributes than positive regulatory attributes. Finally, US mothers mainly used references to secondary emotions (e.g., pride) and positive regulatory attributes (being obedient, mature and patient) at both ages. [ABSTRACT FROM AUTHOR]

Inaccurate age determinations can have serious effects on age-structured stock assessments that are used to manage fish populations. A recent push toward using an age-based model for the northern stock of black sea bass (Centropristis striata) led to an increase in direct aging effort in the northeastern United States. Yet, no large-scale otolith age validation study for this stock exists. We examined the annual periodicity of otolith growth in this species through marginal increment analysis with otoliths of fish from 3 age groups (fish of ages 1-2, ages 3-4, and ages 5+) and from 2 regions, north and south of the Hudson Canyon. Additionally, we validated the assignment of the first annulus through modal length-frequency analysis of young-of-the-year fish. The marginal increment ratio differed between age groups throughout the year, supporting the separation of these samples for age validation purposes. Higher ratios were observed in black sea bass from the region south of the Hudson Canyon throughout most of the year; however, fish from north of the canyon appear to accrete more otolith material during winter. Annual growth increments were deposited once per year, in spring or early summer, for all fish. In addition, absolute age was validated for the first time for this stock. [ABSTRACT FROM AUTHOR]

For decades, planners have been drawing circles of a quarter-mile radius to determine easily walkable distances for neighborhood and activity center planning. However, the radius of such "planners' circles," or walksheds, is often informed more by convention than by data. Here we examine walk-trip distances based on two national household travel surveys for the United States and Germany. We describe how walk distances vary by personal and trip characteristics, with a particular focus on trip purpose and pedestrian age. We conducted both univariate and multivariate analyses to compare patterns between the United States and Germany. The multivariate analysis examines quantile regressions for 50th, 75th, and 90th percentiles to understand both typical and longer walk distances. The observed distances that people walk vary significantly across age groups, trip purposes, and national contexts. Leisure trips tend to be longest, whereas shopping and errand trips tend to be shortest. There are substantial differences between the United States and Germany in the average lengths of walks (mean/median walk distance: Germany, 1,490/980 m, 0.93/0.61 miles; United States, 970/530 m, 0.60/0.33 miles) and in the effects of independent variables. A significant portion of the variation in walk-trip distances between the United States and Germany is likely due to Germany's higher quality walk environments. Rather than always resort to a quarter-mile or 400-m radius, planners can use the data here to customize the size of the planners' circle, or walkshed, they draw to take into account the primary trip purposes and demographic segments under consideration. Moreover, planners can draw circles with a shorter radius corresponding to the 50th percentile to plan for the most common walk-trip lengths while also considering larger circles corresponding to the 75th and 90th percentiles to provide more supportive and safer pedestrian environments for longer trips. [ABSTRACT FROM AUTHOR]

Introduction: As the FDA works to determine whether a nicotine reduction policy would benefit public health, one key question is whether to mandate an immediate or gradual reduction in nicotine levels in cigarettes. The aim of this study was to determine whether the effects of gradual versus immediate nicotine reduction on cigarettes per day (CPD), total nicotine equivalents, and subjective responses differed in younger adults versus older adults.Methods: Using data from a recent randomized trial conducted in the United States (N = 1250) that switched smokers over a 20-week period to very low nicotine content (VLNC) cigarettes either immediately, gradually (via monthly reductions in nicotine content), or not at all (control condition, normal nicotine content research cigarette), we analyzed the moderating effect of age (age 18-24 or 25+).Results: For both age groups, CPD in the immediate condition was significantly lower relative to gradual condition (estimated mean difference of 6.3 CPD in young adults, 5.2 CPD in older adults; p's < .05). Younger and older adults in the immediate and gradual reduction conditions had lower total nicotine equivalents at Week 20 (all p's < .05) than those in the control condition; age group did not moderate this effect. Positive subjective responses to cigarettes were lower among young adults relative to older adults in the immediate condition.Conclusions: These results indicate that an immediate reduction in nicotine would result in beneficial effects in both young and older adults. Young adults show less positive subjective effects of smoking following switching to VLNC cigarettes relative to older adults.Implications: As researchers work to understand how a potential reduced-nicotine product standard for cigarettes may affect public health, one question is whether nicotine should be reduced immediately or gradually. This study demonstrates that both young and older adults who were switched immediately to the lowest content of nicotine smoked fewer CPD and had lower nicotine intake than those in the gradual condition. Furthermore, young adults appear to show lower positive subjective effects following switching to VLNC cigarettes relative to older adults. This is consistent with previous work demonstrating that young people appear to show lower abuse liability for VLNC cigarettes. [ABSTRACT FROM AUTHOR]

Introduction: Little is known about the relationship between smoke-free laws and persistent disparities in secondhand smoke (SHS) exposure among nonsmoking adults in the United States.Aims and Methods: We constructed time-varying smoke-free law measures representing whether or not at least 50% of each US county's population was covered by smoke-free laws in workplaces and hospitality venues (restaurants/bars). We merged these data with restricted data on cotinine-derived SHS exposure among nonsmokers from the National Health and Nutrition Examination Survey, 1999-2014 (N = 25 444). Using logistic regression, we estimated associations between smoke-free law coverage and SHS exposure among all nonsmokers, and within age strata (25-39, 40-59, 60+). We explored differential associations by gender, race/ethnicity, education, and poverty-income ratio (PIR) by testing the significance of interactions terms for the full sample and within age strata.Results: In adjusted models, hospitality coverage was associated with lower odds of SHS exposure in the full sample (odds ratio [OR] = 0.62; 95% confidence interval [CI] = 0.51-0.76), and within each age group, with ORs ranging from 0.58 (ages 25-39) to 0.67 (ages 60+). Workplace coverage was associated with lower SHS exposure only among younger adults (OR = 0.81; 95% CI = 0.65-0.99). Within the full sample and among adults ages 40-59, hospitality laws were associated with narrowing SHS exposure differentials between males and females. Among adults ages 40-59, workplace laws were associated with narrowing exposure differentials between males and females, but worsening exposure disparities by PIR.Conclusions: Smoke-free laws may reduce SHS exposure among adult nonsmokers, but may be insufficient to improve disparities in SHS exposure.Implications: In a repeated cross-sectional sample of adult nonsmokers, smoke-free laws in hospitality venues were consistently associated with lower odds of SHS exposure and appeared to narrow exposure differentials between males and females. Associations between workplace smoke-free laws and SHS exposure were variable by age. Among adults ages 40-59, workplace laws were associated with narrowing exposure differentials between males and females while exacerbating exposure differentials by PIR. Differential patterns of association highlight the need to examine the impacts of tobacco control policies on downstream health equity. [ABSTRACT FROM AUTHOR]

This study aims to assess recent trends and characteristics for infanticide and the sub-groups: neonaticide and post-neonaticide during the time period 2003–2017. Multiple Cause-of-Death Mortality Data were used to identify infanticides in the United States based on ICD-10 codes. Joinpoint regression analysis was used to calculate trends in the rates of infanticide, neonaticide, and post-neonaticide during the study period. Logistic regression was used to examine the association between the socio-demographic characteristics and each of the outcomes. During the study period, 4545 (1.2%) infants were identified as being victims of infanticide. The rates of neonaticide declined by 4.2% over the study period, whereas those of infanticide and post-neonaticide remained statistically unchanged. Males and non-Hispanic (NH) Blacks were more likely to be victims of infanticide and post-neonaticide, compared to females and NH Whites respectively, but had similar likelihood of neonaticide. While foreign-born residents exhibited nearly a fourfold increased likelihood of neonaticide, they had about 70% lesser likelihood of post-neonaticide than US-born residents. Conclusion: Reasons for the disparities found in this study are multifactorial. We believe that access to healthcare needs to be improved and community resources need to be made more available to address the proposed mechanisms that lead to infanticide. What is Known: • Among injury-related causes of death in infants, homicide has consistently been ranked as the second leading cause of injury-related death in this age group. What is New: • Males and non-Hispanic (NH) Blacks were more likely to be victims of infanticide and post-neonaticide, compared to females and NH Whites, respectively, whereas foreign-born residents exhibited nearly a fourfold increased likelihood of neonaticide as compared to Untied States residents. [ABSTRACT FROM AUTHOR]

Introduction: While colorectal cancer (CRC) incidence and mortality have decreased for older adults, the rates are increasing in adults younger than 50 years of age in the United States as well as globally. In response to strong epidemiologic evidence as well as sophisticated models, the American Cancer Society (ACS) has recommended screening adults for CRC starting at age 45. Understanding the factors associated with the rise of incidence in adults younger than age 50 may help to identify those adults who may be at greatest risk. Areas covered: In this review, we provide an overview of the recent literature and discuss possible explanations for the increase in CRC in young adults including obesity and other recognized CRC risk factors, delay in diagnosis of symptomatic patients (<50 years of age), and review perspectives on the current and future status of the field. Expert opinion: Currently there are little data regarding risk factors for CRC in average risk young adults who are asymptomatic. With potential endorsement of screening at 45 years of age by US Preventive Services Task Force, more data regarding clinical and molecular risk factors associated with CRC in young adults will be available. [ABSTRACT FROM AUTHOR]

Summary: Childhood obesity is a major public health challenge across Latin America and the United States. Addressing childhood obesity depends on valid, reliable, and culturally sensitive measurements. Such progress within and between countries of the Americas could be enhanced through better measurement across different age groups, different countries, and in sending and receiving communities. Additionally, better and more comparable measurements could accelerate cross‐border collaboration and learning. Here, we present (1) frameworks that influenced our perspectives on childhood obesity and measurement needs across the Americas; (2) a summary of resources and guidance available concerning measurement and adaptation of measures for childhood obesity research; and (3) three major areas that present challenges and opportunities for measurement advances related to childhood obesity, including parental behavior, acculturation, and the potential to incorporate ethnographic methods to identify critical factors related to economics and globalization. Progress to reduce childhood obesity across the Americas could be accelerated by further transnational collaboration aimed at improving measurement for better surveillance, intervention development and evaluation, implementation research, and evaluation of natural experiments. Additionally, there is a need to improve training related to measurement and for improving access to valid and reliable measures in Spanish and other languages common in the Americas. [ABSTRACT FROM AUTHOR]

Background: Many DNA methylation-based indicators have been developed as summary measures of epigenetic aging. We examine the associations between 13 epigenetic clocks, including 4 second generation clocks, as well as the links of the clocks to social, demographic, and behavioral factors known to be related to health outcomes: sex, race/ethnicity, socioeconomic status, obesity, and lifetime smoking pack-years.Methods: The Health and Retirement Study is the data source which is a nationally representative sample of Americans over age 50. Assessment of DNA methylation was based on the EPIC chip and epigenetic clocks were developed based on existing literature.Results: The clocks vary in the strength of their relationships with age, with each other and with independent variables. Second generation clocks trained on health-related characteristics tend to relate more strongly to the sociodemographic and health behaviors known to be associated with health outcomes in this age group.Conclusions: Users of this publicly available data set should be aware that epigenetic clocks vary in their relationships to age and to variables known to be related to the process of health change with age. [ABSTRACT FROM AUTHOR]

Introduction: Preventing tuberculosis (TB) disease requires treatment of latent TB infection (LTBI) as well as prevention of person-to-person transmission. We estimated the LTBI prevalence for the entire United States and for each state by medical risk factors, age, and race/ethnicity, both in the total population and stratified by nativity. Methods: We created a mathematical model using all incident TB disease cases during 2013–2017 reported to the National Tuberculosis Surveillance System that were classified using genotype-based methods or imputation as not attributed to recent TB transmission. Using the annual average number of TB cases among US-born and non-US-born persons by medical risk factor, age group, and race/ethnicity, we applied population-specific reactivation rates (and corresponding 95% confidence intervals [CI]) to back-calculate the estimated prevalence of untreated LTBI in each population for the United States and for each of the 50 states and the District of Columbia in 2015. Results: We estimated that 2.7% (CI: 2.6%–2.8%) of the U.S. population, or 8.6 (CI: 8.3–8.8) million people, were living with LTBI in 2015. Estimated LTBI prevalence among US-born persons was 1.0% (CI: 1.0%–1.1%) and among non-US-born persons was 13.9% (CI: 13.5%–14.3%). Among US-born persons, the highest LTBI prevalence was in persons aged ≥65 years (2.1%) and in persons of non-Hispanic Black race/ethnicity (3.1%). Among non-US-born persons, the highest LTBI prevalence was estimated in persons aged 45–64 years (16.3%) and persons of Asian and other racial/ethnic groups (19.1%). Conclusions: Our estimations of the prevalence of LTBI by medical risk factors and demographic characteristics for each state could facilitate planning for testing and treatment interventions to eliminate TB in the United States. Our back-calculation method feasibly estimates untreated LTBI prevalence and can be updated using future TB disease case counts at the state or national level. [ABSTRACT FROM AUTHOR]

This study identifies factors (state of residence, personal characteristics, and living situation) associated with access to self-directed funding (SDF) for adults with intellectual disability in the United States. Data from 10,033 participants from 26 states in the 2012-2013 National Core Indicators Adult Consumer Survey were analyzed. We examined state, age group, residence type, disability diagnoses, mental health status, and type of disability support funding used. Availability of SDF for people with ID varied by state and aligned mostly with state-by-state policy data on SDF eligibility and availability. The results of a logistic regression analysis demonstrated that access to SDF was lower in older adults and higher for people who lived in their parents' or relatives' home, an independent home, and with certain personal characteristics. Potential influences from policy and practice, and approaches to increase access to SDF are discussed. [ABSTRACT FROM AUTHOR]

The goal of this paper is to estimate peer influence in video gaming time among adolescents. Using a nationally representative sample of the U.S. school-aged adolescents in 2009–2010, we estimate a structural model that accounts for the potential biases in the estimate of the peer effect. Our peer group is exogenously assigned and includes one year older adolescents in the same school grade as the respondent. The peer measure is based on peers’ own reports of video gaming time. We find that an additional one hour of playing video games per week by older grade-mates results in .47 hours increase in video gaming time by male responders. We do not find significant peer effect among female responders. Effective policies aimed at influencing the time that adolescents spend video gaming should take these findings into account. [ABSTRACT FROM AUTHOR]

A common policy approach to reducing childhood obesity aims to shape the environment in which children spend most of their time: neighborhoods and schools. This paper uses richly detailed data on the body mass index (BMI) of all New York City public school students in grades K-8 to assess the potential for place-based approaches to reduce child obesity. We document variation in the prevalence of obesity across NYC public schools and census tracts, and then estimate the extent to which this variation can be explained by differences in individual-level predictors (such as race and household income). Both unadjusted and adjusted variability across neighborhoods and schools suggest place-based policies have the potential to meaningfully reduce child obesity, but under most realistic scenarios the improvement would be modest. [ABSTRACT FROM AUTHOR]

The “fetal origins” hypothesis suggests that fetal conditions not only affect birth characteristics such as birth weight and gestational age, but also have lifelong health implications. Despite widespread interest in this hypothesis, few methodological advances have been proposed to improve the measurement and modeling of fetal conditions. A Statistics in Medicine paper by Bollen, Noble, and Adair examined favorable fetal growth conditions (FFGC) as a latent variable. Their study of Filipino children from Cebu provided evidence consistent with treating FFGC as a latent variable that largely mediates the effects of mother’s characteristics on birth weight, birth length, and gestational age. This innovative method may have widespread utility, but only if the model applies equally well across diverse settings. Our study assesses whether the FFGC model of Cebu replicates and generalizes to a very different population of children from North Carolina (N = 705) and Pennsylvania (N = 494). Using a series of structural equation models, we find that key features of the Cebu analysis replicate and generalize while we also highlight differences between these studies. Our results support treating fetal conditions as a latent variable when researchers test the fetal origins hypothesis. In addition to contributing to the substantive literature on measuring fetal conditions, we also discuss the meaning and challenges involved in replicating prior research. [ABSTRACT FROM AUTHOR]

This paper presents data from the Program for the International Assessment of Adult Competencies with a focus on the interrelationships among health information seeking behavior (HISB), and health status or use of preventive health measures for U.S. adults both with and without a high school diploma. Key results of ordinal and binary logistic regression analyses indicated that, after controlling for demographic factors, (1) adults with a high school diploma use more text-based health information sources while adults without a high school diploma use more oral sources, (2) using the Internet as a source of health information is more strongly related to reporting excellent/very good health status than having a high school diploma, (3) those without a high school diploma who use the Internet report the largest increase in health status over any other health information source, and (4) for those with learning disability or vision problem, a high facility in reading English is an important predictor of whether the Internet is used as a health information source. The Internet appears to play a key role in both enhancing health status and enabling use of preventive measures for those with and without a high school diploma; although, individuals without a high school diploma who use the Internet for health information derive substantial benefit in health status. [ABSTRACT FROM AUTHOR]

This study examines population-weighted, sex- and age-disaggregated official COVID-19 mortality data (as of July 25, 2020) from the United States to understand gender gaps (men–women) across age. The analysis yields three key findings: (1) all age groups report about 8 percentage points more deaths among men than women; (2) non-elderly adults (<65 years) have a larger gender gap in reported mortality than elderly (≥65 years) adults; and (3) the gender gap in reported mortality varies across states, with thirteen states reporting more deaths among women than men. Women's lack of access to healthcare and a state's healthcare capacity have a significant correlation with the gender gap in reported mortality for both non-elderly and elderly adults. The findings underscore the possible presence of an underreporting bias against women in the officially reported COVID-19 death tolls in the US. HIGHLIGHTS The COVID-19 gender mortality gap in the US is similar to that of other developed nations. While men are more likely than women to die from COVID-19 infections, the reverse is true in thirteen states. The gap is high in states with low hospital capacity and women's low healthcare access. COVID-19 fatalities among women are more likely to be underreported than those among men. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 (COVID-19) pandemic in the United States has revealed major disparities in the access to testing and messaging about the pandemic based on the geographic location of individuals, particularly in communities of color, rural areas, and areas of low income. This geographic disparity, in addition to deeply rooted structural inequities, have posed additional challenges to adequately diagnose and provide care for individuals of all ages living in these settings. We describe the impact that COVID-19 has had on geographically disparate populations in the United States and share our recommendations on what might be done to ameliorate the current situation. [ABSTRACT FROM AUTHOR]