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Introduction Estimating Neonatal Abstinence Syndrome (NAS) and prenatal substance exposure rates in Medicaid can help target program efforts to improve access to services. Methods The data for this study was extracted from the 2016–2020 Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) Research Identifiable Files (RIF) and included infants born between January 1, 2016 and December 31, 2020 with a either a NAS diagnosis or prenatal substance exposure. Results Between 2016 and 2020, the estimated national rate of NAS experienced a 18% decline, while the estimated national rate of prenatal substance exposure experienced a 3.6% increase. At the state level in 2020, the NAS rate ranged from 3.2 per 1000 births (Hawaii) to 68.0 per 1000 births (West Virginia). Between 2016 and 2020, 28 states experienced a decline in NAS births and 20 states had an increase in NAS rates. In 2020, the lowest prenatal substance exposure rate was observed in New Jersey (9.9 per 1000 births) and the highest in West Virginia (88.1 per 1000 births). Between 2016 and 2020, 38 states experienced an increase in the rate of prenatal substance exposure and 10 states experienced a decline. Discussion Estimated rate of NAS has declined nationally, but rate of prenatal substance exposure has increased, with considerable state-level variation. The reported increase in prenatal substance exposure in the majority of US states (38) suggest that substances other than opioids are influencing this trend. Medicaid-led initiatives can be used to identify women with substance use and connect them to services.

INTRODUCTION: In response to the US opioid crisis, interventions are being implemented to lower opioid prescribing to reduce opioid misuse and overdose. As opioid prescribing falls, opioid misuse may shift from prescriptions to other, possibly illicit, sources. We examined how the percentage of patients with an opioid use disorder (OUD) diagnosis in a given year without a current opioid prescription changed over a decade among commercially insured enrollees and Medicaid beneficiaries. We also examined how the percentages differed by enrollee demographic factors. METHODS: We used commercial and Medicaid claims from the IBM MarketScan® databases from 2005 to 2015 to identify enrollees with and without current opioid prescriptions who have been diagnosed with OUD. We measured the percentage of enrollees with OUD without a current opioid prescription by year and demographic factors. RESULTS: We identified 99,396 enrollee-years with OUD covered by commercial insurance and 60,492 enrollee-years with OUD covered by Medicaid. Among enrollees with OUD, the percentage without a current opioid prescription increased from 37% in 2005 to 49% in 2012 before falling back to 39% in 2015 in the commercial population, and increased from 32% in 2005 to 38% in 2015 in the Medicaid population. Differences in percentages were observed by age, sex, race, and region, particularly among young people where 70 to 89% had OUD without a current prescription. CONCLUSIONS: Most enrollees with OUD in the data had current opioid prescriptions, suggesting that continuing efforts to reduce misuse of prescribed opioids among patients with prescriptions may be effective. However, a substantial percentage of enrollees with OUD may be obtaining opioids via other, likely illegitimate, channels, particularly younger people, which suggests an opportunity for targeted efforts to reduce opioid diversion.

Despite concerns surrounding depression in adolescence and the existence of effective treatments, adolescent depression often goes untreated. In 2014, only 41.2% of adolescents experiencing a major depressive episode (MDE) received mental health treatment. Parents play a key role in adolescents’ treatment utilization. We examined whether among mothers with any mental illness, mothers’ utilization of mental health treatment was associated with greater likelihood of their adolescent children who experienced an MDE receiving mental health treatment. Using nationally representative data from the National Survey on Drug Use and Health (2008–2014), we performed logistic regression analysis to model the odds of adolescents (aged 12 to 17 years) with a past year MDE receiving any mental health treatment in the past year as a function of their mothers’ mental health treatment utilization in the past year, adjusting for control variables. The rate of adolescent treatment utilization was 66% when mothers had utilized treatment, as compared to 45% when mothers did not utilize treatment (p

Adolescents living in single-mother households are more likely to have behavioral health conditions, but are less likely to utilize any behavioral health services. Using nationally representative mother-child pair data pooled over 6 years from the National Survey on Drug Use and Health, the study finds that when single mothers were uninsured, their adolescent children were less likely to utilize any behavioral health services, even when the children themselves were covered by insurance. The extension of health coverage under the Affordable Care Act (ACA) to uninsured single mothers could improve the behavioral health of the adolescent population.

Using population samples from Belarus for the years 1996–2008, we estimate the effect of the number of cigarettes smoked per day on body mass index (BMI) and on the probability of being overweight or obese and stratify the estimates by the length of the smoking career. We instrument cigarette smoking with cigarette prices and group-specific smoking rates. We find a significant negative effect of smoking on BMI and the probability of overweight and obesity across various specifications. The negative effect of smoking increases in magnitude at the higher percentiles of the BMI distribution and with the length of smoking career.

The EQ-5D is one of the most frequently used, generic, preference-based instruments for measuring the health utilities of patients in economic evaluations. It is recommended for health technology assessment by the National Institute for Health and Clinical Excellence. Because the EQ-5D plays such an important role in economic evaluations, useful information on its responsiveness to detect meaningful change in health status is required. This study systematically reviewed and synthesized evidence on the responsiveness of the EQ-5D to detect meaningful change in health status for clinical research and economic evaluations. We searched the EuroQol website, PubMed, PsychINFO, and EconLit databases to identify studies published in English from the inception of the EQ-5D until August 15, 2014 using keywords that were related to responsiveness. Studies that used only the EQ-VAS were excluded from the final analysis. Narrative synthesis was conducted to summarize evidence on the responsiveness of the EQ-5D by conditions or physiological functions. Of 1401 studies, 145 were included in the narrative synthesis and categorized into 19 categories for 56 conditions. The EQ-5D was found to be responsive in 25 conditions (45 %) with the magnitude of responsiveness varying from small to large depending on the condition. There was mixed evidence of responsiveness in 27 conditions (48 %). Only four conditions (7 %) (i.e., alcohol dependency, schizophrenia, limb reconstruction, and hearing impairment) were identified where the EQ-5D was not responsive. The EQ-5D is an appropriate measure for economic evaluation and health technology assessment in conditions where it has demonstrated evidence of responsiveness. In conditions with mixed evidence of responsiveness, researchers should consider using the EQ-5D with other condition-specific measures to ensure appropriate estimates of effectiveness. These conditions should be a main focus for future research using the new EQ-5D version with five response levels.

In this paper, we explore the influence of alcohol consumption and sports participation on popularity of overweight adolescent males and females of different races and ethnicities. Using data collected in 1994 and 1996 from a large nationally representative survey of adolescent friendship networks, we estimate models accounting for school-level fixed effects, and a wide range of individual-level controls to ascertain the causal effect of these behaviors on change in popularity. We find that sports participation leads to increase in the number of friends among overweight white males. Additionally, overweight white females and males experience a significant gain in popularity by engaging in alcohol consumption. These results underscore the importance of promoting sports and physical activity not only to objectively reverse the childhood obesity trend but also as a way to achieve popularity that is superior to alcohol consumption.

This paper estimates whether marriage can improve health outcomes for African-Americans through changes in risky health behaviors like smoking, drinking, and drug use. Using data from the National Longitudinal Study on Adolescent Health and propensity score matching methodology to account for the potential selection bias, the results show that marriage does lead to a reduction in risky health behaviors, specifically drinking and drug use. This question has important policy implications because if marriage has the same benefits for African-Americans as it does for the general population, social welfare programs can be re-evaluated to incorporate marriage promotion, and further support can be given to programs that decrease adverse health behaviors.

It is well recognized that sea surface temperature (SST) plays a dominant role in the formation and intensification of tropical cyclones. A number of observational/empirical studies were conducted at different basins to investigate the influence of SST on the intensification of tropical cyclones and in turn, modification in SST by the cyclone itself. Although a few modeling studies confirmed the sensitivity of model simulation/forecast to SST, it is not well quantified, particularly for Bay of Bengal cyclones. The present study is designed to quantify the sensitivity of SST on mesoscale simulation of an explosively deepening storm over the Bay of Bengal, i.e., Orissa super cyclone (1999). Three numerical experiments are conducted with climatological SST, NCEP (National Center for Environmental Prediction) skin temperature as SST, and observed SST (satellite derived) toward 5-day simulation of the storm using mesoscale model MM5. At model initial state, NCEP skin temperature and observed SST over the Bay of Bengal are 1-2°C warmer than climatological SST, but cooler by nearly 1°C along the coastline. Observed SST shows a number of warm patches in the Bay of Bengal compared with NCEP skin temperature. The simulation results indicate that the sea surface temperature has a significant impact on model-simulated track and intensity of the cyclonic storm. The track and intensity of the storm is better simulated with the use of satellite-observed SST.

This paper deals with the estimation of the scale matrix of a multivariatet-model with unknown location vector and scale matrix to improve upon the usual estimators based on the sample sum of product matrix. The well-known results of the estimation of the scale matrix of the multivariate normal model under the assumption of entropy loss function have been generalized to that of a multivariatet-model.

The Chernobyl nuclear accident of 1986 had deleterious health consequences for the population of Belarus, especially for those who were children at the time of the disaster. Using the 2003–2008 waves of the Belarusian Household Survey of Income and Expenditure (BHSIE), we estimate the effect of radiation exposure on the health, education, and labor market outcomes among cohorts and areas affected by the accident, utilizing the nuclear accident as a natural experiment. We find that young individuals who came from the most contaminated areas had worse health, were less likely to hold university degrees, were less likely to be employed, and had lower wages compared to those who were older at the time of the accident and who came from less contaminated areas.