About The Study: In this analysis of a national data set representing an estimated 4.7 million pediatric hospitalizations between 2009 and 2019, the number and proportion of pediatric acute care hospitalizations due to mental health diagnoses increased significantly. The majority of mental health hospitalizations in 2019 included a diagnosis of attempted suicide, suicidal ideation, or self-injury, underscoring the increasing importance of this concern.
Authors: Mary Arakelyan, M.P.H., of the Dartmouth Hitchcock Medical Center in Lebanon, New Hampshire, is the corresponding author.
(doi:10.1001/jama.2023.1992)
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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or emailmedia relations.
About JAMA Health Forum: JAMA Health Forum is an international, peer-reviewed, online, open access journal that addresses health policy and strategies affecting medicine, health and health care. The journal publishes original research, evidence-based reports and opinion about national and global health policy; innovative approaches to health care delivery; and health care economics, access, quality, safety, equity and reform. Its distribution will be solely digital and all content will be freely available for anyone to read.
About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: In this study using data from 3,037 community-dwelling Medicare beneficiaries, food insecurity was prevalent and associated with a decline in executive function. Interventions and policies aiming to increase healthy food access or reduce food insecurity should be assessed for their impact on older adults’ cognitive outcome.
Authors: Boeun Kim, Ph.D., M.P.H., R.N., of Johns Hopkins University in Baltimore, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.4674)
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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or emailmedia relations.
About JAMA Health Forum: JAMA Health Forum is an international, peer-reviewed, online, open access journal that addresses health policy and strategies affecting medicine, health and health care. The journal publishes original research, evidence-based reports and opinion about national and global health policy; innovative approaches to health care delivery; and health care economics, access, quality, safety, equity and reform. Its distribution will be solely digital and all content will be freely available for anyone to read.
About The Study: Marriage and children were associated with a greater earnings penalty for female physicians, primarily due to fewer hours worked relative to men, in this study of 95,000 U.S. physicians. Addressing the barriers that lead to women working fewer hours could contribute to a reduction in the male-female earnings gap while helping to expand the effective physician workforce.
Authors: Lucy Skinner, M.P.H., of the Geisel School of Medicine at Dartmouth in Hanover, New Hampshire, is the corresponding author.
(doi:10.1001/jamahealthforum.2023.0136)
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About The Study: This cohort study found that in people with SARS-CoV-2 infection who had at least one risk factor for progression to severe disease, treatment with nirmatrelvir within five days of a positive SARS-CoV-2 test result was associated with reduced risk of post−COVID-19 condition (also known as long COVID) across the risk spectrum in this cohort and regardless of vaccination status and history of prior infection. The totality of the findings suggests that treatment with nirmatrelvir during the acute phase of COVID-19 may reduce the risk of post–acute adverse health outcomes.
Authors: Ziyad Al-Aly, M.D., of the VA St. Louis Health Care System in St. Louis, is the corresponding author.
(doi:10.1001/jamainternmed.2023.0743)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: This case control study found that for female individuals, the loss of abortion rights was associated with a 10% increase in prevalence of mental distress relative to the mean over the three months after the Supreme Court of the U.S. decision. Restricting legal abortion access may be associated with disproportionate outcomes among individuals of lower socioeconomic status and in medically underserved areas, who may experience greater economic and mental health burdens of having unwanted pregnancies due to increased travel costs of obtaining abortions.
Authors: Muzhe Yang, Ph.D., of Lehigh University in Bethlehem, Pennsylvania, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.4509)
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About The Study: This systematic review and meta-analysis of 41 studies including 860,000 patients found that certain demographic characteristics (e.g., age and sex), comorbidities, and severe COVID-19 were associated with an increased risk of post−COVID-19 condition (PCC; also known as long COVID), whereas vaccination had a protective role against developing PCC sequelae. These findings may enable a better understanding of who may develop PCC and provide additional evidence for the benefits of vaccination.
Authors: Vassilios S. Vassiliou, M.B.B.S., Ph.D., of Norfolk and Norwich University Hospital in Norwich, United Kingdom, is the corresponding author.
(doi:10.1001/jamainternmed.2023.0750)
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About TheStudy: Statin use for primary prevention of atherosclerotic cardiovascular disease (ASCVD) was low among all race and ethnicity groups regardless of ASCVD risk, with the lowest use occurring among Black and Hispanic adults in this study of survey data representing 39.4 million adults. Improvements in access to care may promote equitable use of primary prevention statins in Black and Hispanic adults.
Authors: Joshua A. Jacobs, Pharm.D., of the Spencer Fox Eccles University of Utah School of Medicine in Salt Lake City, and Ambarish Pandey, M.D., of the University of Texas Southwestern Medical Center in Dallas, are the corresponding authors.
(doi:10.1001/jamacardio.2023.0228)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: In this analysis involving 19,000 female participants, mailing human papillomavirus (HPV) self-sampling kits to women overdue for cervical cancer screening was cost-effective for increased screening uptake relative to usual care. These results support mailing HPV kits as an efficient outreach strategy for increasing screening rates among eligible women in U.S. health care systems.
Authors: Richard T. Meenan, Ph.D., M.P.H., M.B.A., of Kaiser Permanente Northwest in Portland, Oregon, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.4052)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: The findings of this study suggest that adolescents’ positive perceptions of their relationships with their mothers and fathers are associated with a wide range of favorable outcomes in young adulthood. Investments in improving parent-adolescent relationships may have substantial benefits for young adult population health.
Authors: Carol A. Ford, M.D., of Children’s Hospital of Philadelphia, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.3944)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: In this study of 31 million births in the United States from 2011 to 2018, neonatal Down syndrome diagnoses increased more in states that enacted 20-week abortion bans compared with states that did not enact bans. Because these abortion bans were enacted throughout the study period and are known to inhibit choice in patient decision-making, it is possible that the difference in the rates of diagnosis is associated with these policies.
Authors: Sarina R. Chaiken, B.A., and Aaron B. Caughey, M.D., Ph.D., of the Oregon Health & Science University in Portland, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.3684)
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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or emailmedia relations.
About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: This study including 608,000 obstetric discharges found that Black and Hispanic patients experienced higher adjusted odds of postpartum emergency department visits across all hospital types, particularly at safety net hospitals and those disproportionately serving racial and ethnic minority populations. These findings support the urgent need to mitigate structural racism underlying maternal health disparities.
Authors: Michelle P. Lin, M.D., M.P.H., M.S., of Stanford University in Palo Alto, California, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.3927)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: The results of this study of National Institutes of Health (NIH)-funded surgeons suggest that women surgeons remained underrepresented among surgeon-scientists over a 25-year period despite early career success in receiving NIH funding. These findings suggest that substantial additional support for women surgeon-scientists is necessary to achieve a gender-diverse surgical research workforce.
Authors: Mytien Nguyen, M.S., of the Yale School of Medicine in New Haven, Connecticut, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.3630)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: The findings of this study suggest a consistent, widespread, and significant decline in activity following the onset of COVID-19 in the United States. Vulnerable populations, including individuals at a lower socioeconomic status and those reporting worse mental health in the early COVID-19 period, were at the highest risk of reduced activity. The researchers found a significant decline in daily step counts that persisted even after most COVID-19–related restrictions were relaxed, suggesting COVID-19 affected long-term behavioral choices. It is currently unknown whether this reduction is steps is clinically meaningful over time.
Authors: Evan L. Brittain, M.D., M.Sc., of Vanderbilt University Medical Center in Nashville, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.3526)
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About JAMA Health Forum: JAMA Health Forum is an international, peer-reviewed, online, open access journal that addresses health policy and strategies affecting medicine, health and health care. The journal publishes original research, evidence-based reports and opinion about national and global health policy; innovative approaches to health care delivery; and health care economics, access, quality, safety, equity and reform. Its distribution will be solely digital and all content will be freely available for anyone to read.
About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: Long-term heat and cold exposure from the second trimester until four weeks after birth was associated with newborn lung volumes, especially among female newborns, in this study of 343 mother-child pairs. The findings suggest an association between ambient temperature and newborns’ respiratory systems and underlines the vulnerability of pregnant women and their future children to climate change.
Authors: Ariane Guilbert, M.Sc., and Johanna Lepeule, Ph.D., of Universite Grenoble Alpes in La Tronche, France, are the corresponding authors.
(doi:10.1001/jamanetworkopen.2023.3376)
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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or emailmedia relations.
About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: In this study of Oregon residents in households of at least two members, the findings suggest that household prescription availability is associated with increased odds of opioid overdose for others in the household, even if they do not have their own opioid prescription. These findings underscore the importance of educating patients about proper opioid disposal and the risks of household opioids.
Authors: Michelle A. Hendricks, Ph.D., of Comagine Health in Portland, Oregon, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.3385)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: In this study of 722,000 hospitalization episodes, patients with Alzheimer disease and related dementias (ADRD) had higher readmission rates and overall readmission and episode costs than their counterparts without ADRD. Hospitals may need to be better equipped to care for patients with ADRD, especially in the post-discharge period. Considering that any type of hospitalization may put patients with ADRD at a high risk of 30-day readmission, judicious preoperative assessment, postoperative discharge, and care planning are strongly advised for this vulnerable patient population.
Authors: Neil Kamdar, M.A., of the University of Michigan Medical School in Ann Arbor, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.2109)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: This survey study found that people with disabilities were more likely to report household employment loss and financial hardship during the initial COVID-19 pandemic, which are especially pronounced among racial and ethnic minority respondents. These findings suggest people with disabilities may be disproportionately affected by the initial pandemic and may require additional resources and policy strategies (e.g., training programs, workplace accommodations) as several labor markets adapt to the pandemic (e.g., shifting to remote working).
Authors: Kea Turner, Ph.D., M.P.H., M.A., of the H. Lee Moffitt Cancer Center and Research Institute in Tampa, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.3364)
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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or emailmedia relations.
About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: Results of this secondary analysis of a randomized trial involving 100 healthy children ages 8 to 12 indicated that even 39 minutes less of sleep per night for one week significantly reduced several facets of health-related quality of life in children. This finding shows that ensuring children receive sufficient good-quality sleep is an important child health issue.
Authors: Rachael W. Taylor, Ph.D., of the University of Otago in Dunedin, New Zealand, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.3005)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: In this case-control study of COVID-19 vaccines and illness, vaccine effectiveness associated with protection against medically attended COVID-19 illness was lower with increasing time since last dose; estimated vaccine effectiveness was higher after receipt of one or two booster doses compared with a primary series alone.
Authors: Ruth Link-Gelles, Ph.D., M.P.H., of the Centers for Disease Control and Prevention COVID-19 Response Team in Atlanta, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.2598)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: The results of this study showed that intimate partner violence experiences at the start of the pandemic were associated with worse mental health symptoms and modifiable health factors for female participants younger than age 60. Screening and interventions for intimate partner violence and related health factors are needed to prevent severe, long-term health consequences.
Authors: Arielle A. J. Scoglio, Ph.D., of the Harvard T.H. Chan School of Public Health in Boston, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.2977)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: In this study of 318 mothers in Australia, the U.K., and the U.S., antenatal COVID-19–related stress was significantly associated with poor postpartum maternal mental health outcomes and increased negative affectivity among infants. Pregnant individuals should be classified as a vulnerable group during pandemics and should be considered a public health priority, not only in terms of physical health but also mental health.
Authors: Susanne Schweizer, Ph.D., of the University of Cambridge in Cambridge, United Kingdom, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.2969)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: In this study of 398,000 adult outpatients with COVID-19, the absolute risk of venous thromboembolism (VTE) was low. Several patient-level factors were associated with higher VTE risk; these findings may help identify subsets of patients with COVID-19 who may benefit from more intensive surveillance or VTE preventive strategies.
Authors: Margaret C. Fang, M.D., M.P.H., of the University of California, San Francisco, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.2338)
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About The Study: Implementation in California of its Insurance Gender Nondiscrimination Act was associated with a significant increase in utilization of gender-affirming surgery in California compared with the control states Washington and Arizona. These data might inform state legislative efforts to craft policies preventing discrimination in health coverage for state residents, including transgender and gender-diverse patients.
Authors: Anna Schoenbrunner, M.D., of Ohio State University in Columbus, is the corresponding author.
(doi:10.1001/jama.2023.0878)
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About JAMA Health Forum: JAMA Health Forum is an international, peer-reviewed, online, open access journal that addresses health policy and strategies affecting medicine, health and health care. The journal publishes original research, evidence-based reports and opinion about national and global health policy; innovative approaches to health care delivery; and health care economics, access, quality, safety, equity and reform. Its distribution will be solely digital and all content will be freely available for anyone to read.
About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: The findings of this study of nearly 24,000 individuals suggest that insurance is a modifiable risk factor that plays an important role in the racial and ethnic inequities observed in the diagnosis of advanced-stage cervical cancer. Expanding access to care and improving the quality of services rendered for uninsured patients and those covered by Medicaid may mitigate the known inequities in cervical cancer diagnosis and related outcomes.
Authors: Hunter K. Holt, M.D., M.A.S., of the University of Illinois at Chicago, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.2985)
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About JAMA Health Forum: JAMA Health Forum is an international, peer-reviewed, online, open access journal that addresses health policy and strategies affecting medicine, health and health care. The journal publishes original research, evidence-based reports and opinion about national and global health policy; innovative approaches to health care delivery; and health care economics, access, quality, safety, equity and reform. Its distribution will be solely digital and all content will be freely available for anyone to read.
About The Study: In this study of 4.3 million patients, those who were younger, publicly insured, Hispanic, or non-Hispanic Black had shorter primary care physician visits. Shorter visits were associated with a higher likelihood of inappropriate antibiotic prescribing for patients with upper respiratory tract infections and co-prescribing of opioids and benzodiazepines for patients with painful conditions. These findings suggest opportunities for additional research and operational improvements to visit scheduling and quality of prescribing decisions in primary care.
Authors: Hannah T. Neprash, Ph.D., of the University of Minnesota in Minneapolis, is the corresponding author.
(doi:10.1001/jamahealthforum.2023.0052)
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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or emailmedia relations.
About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: The findings of this study of 1,440 children in Canada with SARS-CoV-2 infection suggest that although the characteristics of presenting symptoms have changed as the SARS-CoV-2 virus has evolved, the proportions of infected children experiencing undesirable outcomes has remained stable.
Authors: Stephen B. Freedman, M.D.C.M., M.Sc., of the University of Calgary in Calgary, Canada, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.2328)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: The results of this survey study suggest that the prevalence of metabolically healthy obesity (people with obesity who do not have obesity-related cardiometabolic abnormalities) increased among U.S. adults during the past 2 decades, but differences in trends existed across sociodemographic subgroups. Effective strategies are needed to improve metabolic health status and prevent obesity-related complications in adults with obesity.
Authors: An Pan, Ph.D., of the Huazhong University of Science and Technology in Wuhan, China, and Kun Yang, M.D., of the Hubei University of Medicine in Shiyan, China, are the corresponding authors.
(doi:10.1001/jamanetworkopen.2023.2145)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: Researchers found in this examination of newborn drug testing at a Midwestern academic medical center before and after statewide legalization of recreational cannabis that clinicians ordered newborn drug tests more frequently for Black newborns when no drug testing was done during pregnancy. These findings call for further exploration of how structural and institutional racism contribute to disproportionate testing and subsequent Child Protective Services investigation, surveillance, and criminalization of Black parents.
Authors: Lauren Oshman, M.D., M.P.H., of the University of Michigan in Ann Arbor, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.2058)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: Child firearm assaults increased substantially during the COVID-19 pandemic in four major U.S. cities, according to the results of this study. Racial and ethnic disparities increased, as Hispanic, Asian, and especially Black children experienced disproportionate shares of the increased violence.
Authors: Jonathan Jay, Dr.P.H., J.D., of the Boston University School of Public Health in Boston, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.3125)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: This study of 24,000 participants age 45 or older found an independent association between perceived stress and both prevalent and incident cognitive impairment. The findings suggest the need for regular screening and targeted interventions for stress among older adults.
Authors: Ambar Kulshreshtha, M.D., Ph.D., of the Emory University School of Medicine in Atlanta, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.1860)
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
About The Study: The findings of this study suggest that despite initial telemedicine gains at rural Veterans Affairs (VA) health care sites, the pandemic was associated with an increase in the rural-urban telemedicine divide across the VA health care system. To ensure equitable access to care, the VA health care system’s coordinated telemedicine response may benefit from addressing rural disparities in structural capacity (e.g., internet bandwidth) and from tailoring technology to encourage adoption among rural users.
Authors: Lucinda B. Leung, M.D., Ph.D., M.P.H., of the Veterans Affairs Greater Los Angeles Healthcare System in Los Angeles, is the corresponding author.
(doi:10.1001/jamanetworkopen.2023.1864)
Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.
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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or emailmedia relations.
