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Lesbian, gay, bisexual, transgender/nonbinary, and queer (LGBTQ +) adolescents experience considerable disparities in dating violence and sexual assault victimization relative to heterosexual and cisgender peers. These disparities may be driven in part by the disruptive effects of heterosexism and cissexism on school-based and family relationships. To quantify the potential roles of these processes and identify priorities for prevention efforts, we estimated the extent to which dating violence and sexual assault victimization in LGBTQ + adolescents could be reduced by eliminating sexual orientation and gender modality inequities in school adult support, bullying victimization, and family adversity. We analyzed data from a cross-sectional, population-based survey of high school students in Dane County, Wisconsin (N = 15,467; 13% sexual minority; 4% transgender/nonbinary; 72% White) using interventional effects analysis, adjusting for grade, race/ethnicity, and family financial status. We found that eliminating inequities in bullying victimization and family adversity could significantly reduce dating violence and sexual assault victimization in LGBTQ + adolescents, particularly sexual minority cisgender girls and transgender/nonbinary adolescents. For instance, eliminating gender modality inequities in family adversity could reduce sexual assault victimization in transgender/nonbinary adolescents by 2.4 percentage points, representing 27% of the existing sexual assault victimization disparity between transgender/nonbinary and cisgender adolescents (P < 0.001). Results suggest that dating violence and sexual assault victimization in LGBTQ + adolescents could be meaningfully reduced by policies and practices addressing anti-LGBTQ + bullying as well as heterosexism- and cissexism-related stress in LGBTQ + adolescents' families.

Adverse birth outcomes put children at increased risk of poor future health. They also put families under sudden socioeconomic and psychological strain, which has poorly understood consequences. We tested whether infants experiencing an adverse birth outcome-low birthweight or prematurity, as well as lengthy hospital stays-were more likely to be evicted in early childhood, through age 5 years. We analyzed 5,655 observations contributed by 2,115 participants in the Fragile Families and Child Wellbeing Study-a national, randomly sampled cohort of infants born in large US cities between 1998 and 2000-living in rental housing at baseline. We fitted proportional hazards models using piecewise logistic regression, controlling for an array of confounders and applying inverse probability of selection weights. Having been born low birthweight or preterm was associated with a 1.74-fold increase in children's hazard of eviction (95% confidence interval: 1.02, 2.95), and lengthy neonatal hospital stays were independently associated with a relative hazard of 2.50 (95% confidence interval: 1.15, 5.44) compared with uncomplicated births. Given recent findings that unstable housing during pregnancy is associated with adverse birth outcomes, our results suggest eviction and health may be cyclical and co-constitutive. Children experiencing adverse birth outcomes are vulnerable to eviction and require additional supports.

The coronavirus disease 2019 (COVID-19) epidemic in the United States has disproportionately impacted communities of color across the country. Focusing on COVID-19-attributable mortality, we expand upon a national comparative analysis of years of potential life lost (YPLL) attributable to COVID-19 by race/ethnicity (Bassett et al., 2020), estimating percentages of total YPLL for non-Hispanic Whites, non-Hispanic Blacks, Hispanics, non-Hispanic Asians, and non-Hispanic American Indian or Alaska Natives, contrasting them with their respective percent population shares, as well as age-adjusted YPLL rate ratios-anchoring comparisons to non-Hispanic Whites-in each of 45 states and the District of Columbia using data from the National Center for Health Statistics as of 30 December 2020. Using a novel Monte Carlo simulation procedure to perform estimation, our results reveal substantial racial/ethnic disparities in COVID-19-attributable YPLL across states, with a prevailing pattern of non-Hispanic Blacks and Hispanics experiencing disproportionately high and non-Hispanic Whites experiencing disproportionately low COVID-19-attributable YPLL. Furthermore, estimated disparities are generally more pronounced when measuring mortality in terms of YPLL compared to death counts, reflecting the greater intensity of the disparities at younger ages. We also find substantial state-to-state variability in the magnitudes of the estimated racial/ethnic disparities, suggesting that they are driven in large part by social determinants of health whose degree of association with race/ethnicity varies by state.

Medically underserved populations in the United States continue to experience higher cancer burdens of incidence, mortality, and other cancer-related outcomes. It is imperative to understand how health inequities experienced by diverse population groups may contribute to our increasing unequal cancer burdens and disparate outcomes. The National Cancer Institute convened a diverse group of scientists to discuss research challenges and opportunities for cancer epidemiology in medically underserved and understudied populations. This report summarizes salient issues and discusses five recommendations from the group, including the next steps required to better examine and address cancer burden in the United States among our rapidly increasing diverse and understudied populations. Cancer Epidemiol Biomarkers Prev; 25(4); 573-80. ©2016 AACR SEE ALL ARTICLES IN THIS CEBP FOCUS SECTION, "MULTILEVEL APPROACHES TO ADDRESSING CANCER HEALTH DISPARITIES".

Summary: Irregular sleep and non‐optimal sleep duration separately have been shown to be associated with increased disease and mortality risk. We used data from the prospective cohort Multi‐Ethnic Study of Atherosclerosis sleep study (2010–2013) to investigate: do aging adults whose sleep is objectively high in regularity in timing and duration, and of sufficient duration tend to have increased survival compared with those whose sleep is lower in regularity and duration, in a diverse US sample? At baseline, sleep was measured by 7‐day wrist actigraphy, concurrent with at‐home polysomnography and questionnaires. Objective metrics of sleep regularity and duration from actigraphy were used for statistical clustering using sparse k‐means clustering. Two sleep patterns were identified: "regular‐optimal" (average duration: 7.0 ± 1.0 hr obtained regularly) and "irregular‐insufficient" (duration: 5.8 ± 1.4 hr obtained with twice the irregularity). Using proportional hazard models with multivariate adjustment, we estimated all‐cause mortality hazard ratios. Among 1759 participants followed for a median of 7.0 years (Q1–Q3, 6.4–7.4 years), 176 deaths were recorded. The "regular‐optimal" group had a 39% lower mortality hazard than did the "irregular‐insufficient" sleep group (hazard ratio [95% confidence interval]: 0.61 [0.45, 0.83]) after adjusting for socio‐demographics, lifestyle, medical comorbidities and sleep disorders. In conclusion, a "regular‐optimal" sleep pattern was significantly associated with a lower hazard of all‐cause mortality. The regular‐optimal phenotype maps behaviourally to regular bed and wake times, suggesting sleep benefits of adherence to recommended healthy sleep practices, with further potential benefits for longevity. [ABSTRACT FROM AUTHOR]