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Background: Air pollutants may contribute to the development of Parkinson's disease (PD), but empirical evidence is limited and inconsistent. Objectives: This study aimed to prospectively investigate the associations of PD with ambient exposures to fine particulate matter with aerodynamic diameter [less than or equal to]2.5 [micro]m (P[M.sub.2.5]) and nitrogen dioxide (N[O.sub.2]). Methods: We analyzed data from 47,108 US women from the Sister Study, enrolled from 2003-2009 (35-80 years of age) and followed through 2018. Exposures of interest included address-level ambient P[M.sub.2.5] and N[O.sub.2] in 2009 and their cumulative averages from 2009 to PD diagnosis with varying lag-years. The primary outcome was PD diagnosis between 2009 and 2018 (n = 163). We used multivariable Cox proportional hazards and time-varying Cox models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). Results: N[O.sub.2] exposure in 2009 was associated with PD risk in a dose- response manner. The HR and 95% CI were 1.22 (95% CI: 1.03, 1.46) for one interquartile [4.8 parts per billion (ppb)] increment in N[O.sub.2], adjusting for age, race and ethnicity, education, smoking status, alcohol drinking, caffeine intake, body mass index, physical activity, census region, residential area type, area deprivation index (ADI), and self-reported health status. The association was confirmed in secondary analyses with time-varying averaged cumulative exposures. For example, the multivariable adjusted HR for PD per 4.8 ppb increment in N[O.sub.2] was 1.25 (95% CI: 1.05, 1.50) in the 2-year lag analysis using cumulative average exposure. Post hoc subgroup analyses overall confirmed the association. However, statistical interaction analyses found that the positive association of N[O.sub.2] with PD risk was limited to women in urban, rural, and small town areas and women with [greater than or equal to]50th percentile ADI but not among women from suburban areas or areas with Discussion: In this nationwide cohort of US women, higher level exposure to ambient N[O.sub.2] is associated with a greater risk of PD. This finding needs to be independently confirmed and the underlying mechanisms warrant further investigation. https://doi.org/10.1289/EHP13009, Introduction Idiopathic Parkinson's disease (PD) is the second-most prevalent neurodegenerative disease in the US, primarily affecting adults 65 years of age or older. (1) Despite an increasing disease burden due [...]

Background: Nearly half of all pregnancies in the United States are considered unintended (mistimed or unwanted), and this rate is even higher among younger and lower income women. The Affordable Care Act (ACA) dependent coverage provision may have influenced the frequency of unintended pregnancies by increasing accessibility to and affordability of family planning services among young adults. Furthermore, the impact of this provision may differ by young adult income level as those with lower income are less likely to be insured and thus more likely to benefit from this provision. Our objective was to estimate the association between the ACA dependent coverage provision and unintended pregnancy, overall, and by young adult income level. Methods: We applied a difference-in-differences approach to data from multiple cycles of the National Survey of Family Growth (n = 10,104) and compared trends in unintended pregnancy between those who were eligible to benefit (ages 18–25 years) and those who were ineligible to benefit (ages 26–33 years) from the provision, overall, and among income subgroups. Results: We found evidence that the dependent coverage provision was associated with a −7.4 percentage point reduction (95% CI: −13.5, −1.3) in the prevalence of unintended pregnancy among young adults with lower income (<100% of the federal poverty level). There was limited evidence, however, that the provision was associated with unintended pregnancy among young adults with higher income levels. Conclusions: These findings suggest the ACA dependent coverage provision may have reduced unintended pregnancy among a particularly high-risk group (i.e., young adults with lower income). [ABSTRACT FROM AUTHOR]

Objective Growing evidence suggests that maternal socioeconomic mobility (SM) is associated with pregnancy outcomes. Our study investigated the association between maternal SM from childhood to adulthood and the risk of preterm delivery (PTD), and examined heterogeneity of associations by race/ethnicity. Methods In this study, 3019 pregnant women enrolled from 5 Michigan communities at 16-27 weeks' gestation (1998-2004) provided their parents' socioeconomic position (SEP) indicators (education, occupation, receipt of public assistance) and their own and child's father's SEP indicators (education, occupation, Medicaid status, and household income) at the time of enrollment. Latent class analysis was used to identify latent classes of childhood SEP indicators, adulthood SEP indicators, and SM from childhood to adulthood, respectively. A model-based approach to latent class analysis with distal outcome assessed relations between latent class and PTD, overall and within race/ethnicity groups. Results Three latent classes (low, middle, high) were identified for childhood SEP indicators and adulthood SEP indicators, respectively; while four latent classes (static low, upward, downward, and static high) best described SM. Women with upward SM had decreased odds of PTD (Odds ratio = 0.60, 95% confidence interval: 0.42, 0.87), compared to those with static low SEP. This SM advantage was true for all women and most pronounced in white/others women. Conclusions Maternal experiences of upward SM may be important considerations when assessing PTD risk. Our results support the argument that policies and programs aimed at improving women's SEP could lower PTD rates., Author(s): Yan Tian [sup.1] , Claudia Holzman [sup.1] , Jaime Slaughter-Acey [sup.2] , Claire Margerison-Zilko [sup.1] , Zhehui Luo [sup.1] , David Todem [sup.1] Author Affiliations: (Aff1) 0000 0001 2150 [...]