Ana Daniela Gonzalez-Alvarez

Background: Substance use during pregnancy threatens maternal and fetal health, and the COVID-19 pandemic may have altered patterns of use and disparities. Methods: We analyzed 2019-2021 Nationwide Emergency Department Sample data to examine emergency department visits among pregnant individuals with documented substance use (opioids, cannabis, alcohol, or nicotine). A difference-in-differences approach assessed pandemic-related changes and disparities by race/ethnicity and insurance status. Results: During the pandemic, odds of emergency department visits involving alcohol use increased by 16% (adjusted odds ratio [aOR] = 1.16, 95% confidence interval [CI] = 1.05-1.27) and cannabis use by 10% (aOR = 1.10, 95% CI = 1.01-1.20). Prepandemic, Native American individuals had markedly higher odds of opioid use, while African American individuals had higher odds of cannabis and nicotine use. Disparities in cannabis use narrowed for Hispanic and Native American individuals compared to White individuals. Uninsured and Medicaid-insured patients showed consistently elevated odds for opioid, cannabis, and nicotine use. Conclusions: The pandemic was associated with increased alcohol and cannabis use in pregnancy and shifting disparities across racial and insurance groups. Targeted public health strategies are needed to address substance use among pregnant individuals, especially during societal disruptions.

Background: Current food systems contribute significantly to poor public health and environmental degradation. With increasing rates of chronic disease and undernutrition globally and in the United States of America (U.S.), transforming food systems toward sustainability is a critical public health priority. Objectives: This narrative review aimed to summarize U.S. policies from the past decade relevant to sustainable food systems, focusing on four domains—availability, accessibility, affordability, and desirability—proposed by the 22nd Annual Harvard Nutrition Obesity Symposium. Methods: Systematic searches were conducted using MEDLINE (PubMed), Scopus, U.S. Congress websites, and Google searches. Studies and policies published between 2013 and 2023 that addressed at least one of the four domains were included. Policies were reviewed according to their alignment with the policy lifecycle framework, encompassing formulation through implementation. Results: A review of the final 632 articles explained that, despite growing interest in sustainable food systems, there is a lack of comprehensive U.S. policies that address the four domains in an integrated manner. Most initiatives were limited in scope, often school-based, and not explicitly sustainability-focused. Food availability and accessibility policies exist but remain fragmented, while affordability and desirability domains are severely underrepresented. Few laws or bills have been enacted or evaluated for population-level or environmental outcomes. Conclusions: Transforming U.S. food systems requires more robust evidence-based policy development and evaluation. There is an urgent need for integrated multisectoral policy frameworks to ensure health, equity, and sustainability across all food system domains.

Objectives This study aimed to evaluate the change in the Dietary Diversity (DD) Index of Maya women of reproductive age living in rural areas of the Western Highlands of Guatemala after nutrition, health, and agroecology interventions. Methods This is a secondary analysis study on DD from two matched groups from three villages in the Lake Atitlan area in the department of Sololá. The first cohort was recruited in 2017 (sample of n = 77). The second cohort was recruited in 2020 (sample of n = 61). Both were followed until 2021. The program provided various resources for assistance for food production and home improvements (sessions from 2018 to 2022). Agroecology sessions were conducted in the test farm. Due to the COVID-19, adjustments were made to continue the education and training sessions. Results Both cohort samples had a statistically significant increase in participants who consumed at least 15 g from five groups of foods (2017: p = .00002; 2020: p = .045). There was a statistically significant increase in mean food groups consumed daily (2017: p < .00001; 2020: p = .005). Conclusions for Practice Implementing interventions that include nutrition, health, and agroecology practices in the long term has demonstrated a statistically significant increase in the Dietary Diversity Index of Maya women in their reproductive years living in rural villages in the Western Highlands.

Social media has become more popular in the last few years. It has been used in public health development and healthcare settings to promote healthier lifestyles. Given its important role in today’s culture, it is necessary to understand its current trends and future directions in public health. This review aims to describe and summarize how public health professionals have been using social media to improve population outcomes. This review highlights the substantial influence of social media in advancing public health objectives. The key themes explored encompass the utilization of social media to advance health initiatives, monitor diseases, track behaviors, and interact with communities. Additionally, it discusses potential future directions on how social media can be used to improve population health. The findings show how social media has been used as a tool for research, implementing health campaigns, and health promotion. Social media integration with artificial intelligence (AI) and Generative Pre-Trained Transformers (GPTs) can impact and offer an innovative approach to tackle the problems and difficulties in health informatics. The research shows how social media will keep growing and evolving and, if used effectively, has the potential to help close public health gaps across different cultures and improve population health.

Formula feeding, as an alternative to breastfeeding, offers benefits such as convenience and consistent nutrition. Among the drawbacks of formula feeding, however, is potential dilution or concentration errors in the of formula during preparation that may lead to infant health issues. The present study aimed to investigate the accuracy of caregiver measurements as they prepared infant formula under multiple conditions, compared with manufacturer specifications. A diverse sample of caregivers (N = 84) participated in this cross-over experimental study. Participants hand-scooped infant formula powder and poured water to prepare 4oz and 7oz feedings, using both a standardized set of infant formula products and participants’ own products. Linear mixed effects models were used to estimate fixed effects of target amount (4oz versus 7oz) and products (participant versus researcher) on mean absolute percent error (MAPE) of measurement. Across all conditions MAPE was significantly greater for measuring powder than for water (9.0% vs. 4.4%; p<0.001) with a combined powder and water MAPE at 13.0%. Greater measurement error was associated with the odd-sized 7oz preparation and participants’ own products. We observed considerable variability and substantial error during infant formula preparation, particularly for hand-scooping of powder, which tended toward higher values than the theoretical gold standard.

Excellent self-rated health has been associated with decreased mortality and positive health outcomes in adults. However, less is known about youth populations. To evaluate lifestyle behaviors and their relationship with excellent self-rated health in an adolescent population in the United States. The FLASHE study, conducted by the National Cancer Institute, is a cross-sectional survey with publicly available self-reported data. The present study included complete data from 1250 adolescents (males N= 626, mean age = 14.5y, SD = 1.61y; and females N=624, mean age=14.4y, SD = 1.57y). Logistic regression models were used to analyze associations between lifestyle behavior exposures and the outcome of excellent self-rated health. Lifestyle exposures included: free-time physical activity; sedentary behavior time; beneficial and detrimental food intake; perception of the importance of family meals; meeting sleep duration guidelines, having trouble sleeping, and having a regular bedtime. In addition, potential confounders included weight status, smoking, sex, age, socioeconomic status, and race/ethnicity in adjusted models. Approximately 47% of males (n=295) and 35% of females (n=217) reported having excellent self-rated health. In the fully adjusted model, the frequency of beneficial food intake (OR=1.06, 95%CI=1.02–1.11 for each additional exposure, p=0.004); perception of the importance of family meals (OR=1.88, 95%CI=1.35–2.63, strongly agree vs. not agree, p<0.001); frequency of physical activity in free-time (OR=2.17, 95%CI=1.20–3.92, very often vs. none, p<0.001; ); and had no trouble sleeping (OR=0.42, 95%CI=0.27–0.64, yes vs. no, p<0.001), were significantly associated with excellent self-rated health. These results support the importance of enhancing future efforts to implement salutogenic interventions that address health behaviors to improve health outcomes in adolescents, focusing on everyday living situations and actively promoting health.

Social media has become more popular in the last few years. It has been used in public health development and healthcare settings to promote healthier lifestyles. Given its important role in today's culture, it is necessary to understand its current trends and future directions in public health. This review aims to describe and summarize how public health professionals have been using social media to improve population outcomes. Additionally, it discusses potential future directions on how social media can be used to improve population health. The findings showed how social media has been used as a tool for research, designing and implementing health campaigns, messaging, and health promotion. In addition, social media integration with Artificial Intelligence (AI) and Generative Pre-Trained transformers (GPT) can have a big impact and offer an innovative approach to tackle the problems and difficulties in health informatics. These innovations might improve patient participation, individualized assistance, and care experiences. The research showed how likely social media will keep growing and evolving and, if used effectively, have the potential to help close public health gaps across different cultures and improve population health.