Obesity Prevalence and Dietary Factors Among Preschool-Aged Head Start Children in Remote Alaska Native Communities: Baseline Data from the ‘‘Got Neqpiaq?’’ Study

Background: American Indian and Alaska Native preschool-aged children experience a high prevalence of obesity, yet are underrepresented in obesity prevention research. This study examined obesity prevalence and dietary risk factors among Alaska Native preschool-aged children in southwest Alaska. Methods: The study used baseline data from ‘‘Got Neqpiaq?’’ a culturally centered multilevel intervention focused on Yup’ik Alaska Native children, aged 3–5 years, enrolled in Head Start in 12 communities in southwest Alaska (n = 155). The primary outcomes were BMI percentile, overweight, and obesity. Dietary factors of interest were measured using biomarkers: traditional food intake (nitrogen stable isotope ratio biomarker), ultraprocessed food intake (carbon stable isotope ratio biomarker), and vegetable and fruit intake (skin carotenoid status biomarker measured by the Veggie Meter). Cardiometabolic markers (glycated hemoglobin [HbA1c] and blood cholesterol) were also measured. Results: Among the Yup’ik preschool-aged children in the study, the median BMI percentile was 91, and the prevalence of overweight or obesity was 70%. The traditional food intake biomarker was negatively associated with BMI, whereas the ultraprocessed foods and vegetable and fruit biomarkers were not associated with BMI. HbA1c and blood cholesterol were within healthy levels. Conclusions: The burden of overweight and obesity is high among Yup’ik preschool-aged children. Traditional food intake is inversely associated with BMI, which underscores the need for culturally grounded interventions that emphasize traditional values and knowledge to support the traditional food systems in Alaska Native communities in southwest Alaska. Registered with ClinicalTrials.gov #NCT03601299.Ye

Epidemiology of asphyxiation suicides in the United States, 2005–2014

Abstract Background From 2005 to 2014, the asphyxiation suicide rate in the United States (U.S.) increased by 45.7% from 2.45 to 3.57 per 100,000 population. The primary purpose of this cross-sectional study was to describe decedent and incident characteristics of asphyxiation suicides in the U.S. from 2005 to 2014. The secondary purpose of this study was to explore whether any demographic characteristics of asphyxia suicide decedents were associated with type of suicide incident. Methods Data from the National Violent Death Reporting System (NVDRS) were used to describe asphyxiation suicide mechanisms and means in 16 states. Anchor points of hanging suicides were also described. Mechanisms, means, and anchor points were determined through a text search of cause of death, coroner/medical examiner narrative, and law enforcement narrative. Multivariable logistic regression was conducted separately for females and males to estimate beta coefficients to obtain adjusted odds ratios (AORs) and 95% confidence intervals (CIs) to compare hanging-related asphyxiation and other types of asphyxiation. Results From 2005 to 2014, there were 25,270 asphyxiation suicides. Most decedents were male (79.9%) and white, non-Hispanic (76.8%). Most asphyxiation suicides involved hanging (90.7%, N = 22,931); 1717 (6.8%) involved smothering; 968 (3.8%) involved chemicals or gasses; and 145 (0.6%) involved strangulation. For hanging suicides, the three most commonly used means were power or extension cords (N = 1834), bedding (N = 873), and animal ropes (N = 578). The three most common anchor points for hanging suicides were trees (N = 2215), beams (N = 2014), and closets (N = 2009). Among females and males, odds of asphyxiation suicide were highest among those of Other, non-Hispanic race and black, non-Hispanic race, respectively [AOR (95% CI) = 3.73 (1.59, 8.79) and 2.72 (1.34, 5.50), respectively]. Conclusions Commonly available objects are used in asphyxiation suicides. Modification of anchor points represents a potential solution for reducing hanging suicides. Changes in design and availability of grocery bags could help reduce smothering suicides. Strategies to reduce asphyxiation suicides need to be identified. Improving access to and utilization of mental health services can also reduce asphyxiation suicides. Future research should be conducted to better describe characteristics of asphyxiation suicide so that prevention efforts targeted by demographic subgroups can be implemented

Recreational marijuana legalization and use among California adolescents: findings from a statewide survey.

Objective: The legalization of recreational marijuana use and retail sales raises concerns about possible effects on marijuana use among adolescents. We evaluated the effects of recreational marijuana legalization (RML) in California in November 2016 on use among adolescents and investigated subgroup differences in these effects. Method: We analyzed data from successive cross-sectional samples of 7th, 9th, and 11th grade students (N = 3,330,912) who participated in the California Healthy Kids Survey from 2010–2011 to 2018–2019. Participants reported grade, sex, ethnicity, race, and lifetime and past-30-day marijuana use. Results: Multilevel analyses showed that RML was associated with increases in the likelihood of lifetime (odds ratio = 1.18, 95% CI [1.15, 1.21], p < .01) and past-30-day marijuana use (odds ratio = 1.23, 95% CI [1.20, 1.26], p < .01) relative to previous downward trends. RML was more strongly associated with increases in prevalence of marijuana use among 7th versus 9th and 11th graders, females versus males, non-Hispanic versus Hispanic youth, and White versus African American, American Indian/Native Alaskan, and multiracial youth. Overall, RML was not significantly associated with frequency of past-30-day use among users, although stronger positive associations between RML and frequency of use were found for 11th graders, Asian Americans, and African Americans. The association was weaker for females. Conclusions: RML in California was associated with an increase in adolescent marijuana use in 2017–2018 and 2018–2019. Demographic subgroup differences in these associations were observed. Evidence-based prevention programs and greater local control on retail marijuana sales may help to reduce marijuana availability and use among adolescents

Moderate Alcohol Use and Depression in Young Adults: Findings From a National Longitudinal Study

Objectives. We examined the association between moderate alcohol use and depressive mood among young adults before and after adjustment for demographic, health, and socioeconomic factors that may act as confounders. Methods. We analyzed 2 waves of interview data collected from 13892 young adults who participated in the National Longitudinal Study of Adolescent Health to compare frequency of depressive symptoms in moderate drinkers with frequency of symptoms in young adults in other alcohol use categories. Results. With adjustment for health and socioeconomic factors, frequency of depressive symptoms were similar among moderate drinkers, lifetime and long-term abstainers, and heavy/heavier moderate drinkers but remained significantly higher among heavy drinkers. Conclusions. Moderate alcohol use may have no effect on depression in young adults relative to abstinence from alcohol use

Effects of a Community-Level Intervention on Alcohol-Related Motor Vehicle Crashes in California Cities: A Randomized Trial

IntroductionThis trial assesses the effects of a community-level alcohol prevention intervention in California on alcohol-related motor vehicle crashes.Study designThe study is a group RCT with cities as the unit of assignment to condition and as the unit of analysis.Setting/participantsA total of 24 California cities with populations between 50,000 and 450,000 were chosen at random and roughly matched into pairs before randomly assigning 12 each to the intervention and control conditions.InterventionThe intervention, aimed at reducing excessive drinking among adolescents and young adults, included driving under the influence sobriety checkpoints, saturation patrols, and undercover operations to reduce service of alcohol to intoxicated patrons in bars, all including high visibility so the public would be aware of them. A measure of overall intervention intensity or dosage was created.Main outcome measuresThe outcome was a monthly percentage of all motor vehicle crashes that were single vehicle nighttime crashes for drivers aged 15-30 years.ResultsMultilevel analyses were conducted to examine intervention effects on alcohol-related crashes among drivers aged 15-30 years. Crash data were obtained in 2018 with data preparation and analysis conducted in 2019. Intent-to-treat analyses indicated a 17% reduction in the percentage of alcohol-involved crashes among drivers aged 15-30 years relative to controls, which translates to about 310 fewer crashes. Dosage was found to have a statistically significant effect on crashes among this age group, although not in the expected direction.ConclusionsEnhanced alcohol enforcement operations involving both community health and law enforcement agencies can help to reduce alcohol-impaired driving and related consequences among young people. Including measures of intervention dosage raises interesting questions about the understanding of the impact of the community intervention. Future studies should continue to further develop implementation strategies that may more effectively and efficiently reduce community alcohol-related harm

Intoxication by drinking location: a web-based diary study in a New Zealand university community

Drinking to intoxication is a modifiable risk factor for various health, social, and legal problems. The objective was to estimate the relative risk of intoxication by type of drinking location. Participants were 1614 university students (mean age 19.0 years) in residential halls who completed a web survey (67% response). Respondents reported their drinking for each day of the preceding week, in residential halls, pubs/bars/nightclubs, student flats/houses, and ‘other’ locations. An estimated blood alcohol concentration (EBAC) was computed and intoxication was defined as EBAC > 0.08%. Pubs/bars/nightclubs accounted for 51% of all alcohol consumed, followed by residential halls (34%), student flats/houses (9%), and other locations (6%). Episodes resulting in intoxication comprised 61% of all drinking episodes in pubs/bars/nightclubs, 55% in student flats/houses, 53% in residential halls, and 37% in other locations. Multi-level analyses revealed positive associations between the first three location types (relative to ‘other’) and intoxication among women. Drinking in pubs/bars/nightclubs was associated with intoxication among men. Other significant predictors included hazardous drinking in the respondent's residential hall, pre-university drinking, and first-year status. Student intoxication is commonplace in licensed premises and residential halls. These environments are amenable to interventions to reduce the incidence of intoxication