BACKGROUND: Children in households experiencing poverty are disproportionately exposed to maltreatment. Income support policies have been associated with reductions in child abuse and neglect. The advance child tax credit (CTC) payments may reduce child maltreatment by improving the economic security of some families. No national studies have examined the association between advance CTC payments and child abuse and neglect. This study examines the association between the advance CTC payments and child abuse and neglect-related contacts to the Childhelp National Child Abuse Hotline. METHODS: A time series study of contacts to the Childhelp National Child Abuse Hotline between January 2019 and December 2022 was used to examine the association between the payments and hotline contacts. An interrupted time series (ITS) exploiting the variation in the advance CTC payments was estimated using fixed effects. RESULTS: The CTC advance payments were associated with an immediate 13.8% (95% CI -17.5% to -10.0%) decrease in contacts to the hotline in the ITS model. Following the expiration of the advance CTC payments, there was a significant and gradual 0.1% (95% CI +0.0% to +0.2%) daily increase in contacts. Sensitivity analyses found significant reductions in contacts following each payment, however, the reductions were associated with the last three of the six total payments. CONCLUSION: These findings suggest the advance CTC payments may reduce child abuse and neglect-related hotline contacts and continue to build the evidence base for associations between income-support policies and reductions in child abuse and neglect.

This article is the third in a series of four articles on respirator history. This article continues to follow the history of respirator approval, use, and improvements in the US as discussed in our article entitled, History of U.S. Respirator Approval, published in the ISRP Journal, Vol. 35, No. 1, 2018 (Spelce. et. al.2018). In addition, a 1957 respirator decision logic diagram illustrates the U.S. Bureau of Mines (USBM) rules to follow for respirator selection (USBM 1957).

This is the final article in a series of four articles on respirator history. This article continues to follow the history of respirator approval, use, and improvements in the U.S. as discussed in our article entitled, History of U.S. Respirator Approval, published in the ISRP Journal, Vol. 35, No. 1, 2018 (Spelce et al., 2018). This article is entirely about the history of respirators for protection against particulate hazards since the most extensive records available for the United States Bureau of Mines (USBM) approval schedules are for dust/fume/mist respirators.

This article is the second in a series of four articles on respirator history. The discussions presented in this article follow the history of respirator requirements, use, improvements, and certification in America. Included is a discussion of respirator evolution prior to American certification standards and discussion of the need, primarily from the mining industry, for government respirator certification. The reasons for government intervention and the origination of the American respirator certification program are discussed.

OBJECTIVE: The aim of this study was to assess associations of various content areas of Twitter posts with help-seeking from the US National Suicide Prevention Lifeline (Lifeline) and with suicides. METHODS: We retrieved 7,150,610 suicide-related tweets geolocated to the United States and posted between 1 January 2016 and 31 December 2018. Using a specially devised machine-learning approach, we categorized posts into content about prevention, suicide awareness, personal suicidal ideation without coping, personal coping and recovery, suicide cases and other. We then applied seasonal autoregressive integrated moving average analyses to assess associations of tweet categories with daily calls to the US National Suicide Prevention Lifeline (Lifeline) and suicides on the same day. We hypothesized that coping-related and prevention-related tweets are associated with greater help-seeking and potentially fewer suicides. RESULTS: The percentage of posts per category was 15.4% (standard deviation: 7.6%) for awareness, 13.8% (standard deviation: 9.4%) for prevention, 12.3% (standard deviation: 9.1%) for suicide cases, 2.4% (standard deviation: 2.1%) for suicidal ideation without coping and 0.8% (standard deviation: 1.7%) for coping posts. Tweets about prevention were positively associated with Lifeline calls (B=1.94, SE=0.73, p=0.008) and negatively associated with suicides (B=-0.11, standard error=0.05, p=0.038). Total number of tweets were negatively associated with calls (B=-0.01, standard error =0.0003, p=0.007) and positively associated with suicide, (B=6.410(-5), standard error =2.610(-5), p=0.015). CONCLUSION: This is the first large-scale study to suggest that daily volume of specific suicide-prevention-related social media content on Twitter corresponds to higher daily levels of help-seeking behaviour and lower daily number of suicide deaths. PREREGISTRATION: As Predicted, #66922, 26 May 2021.

BACKGROUND: Many of the factors that increase risk of child marriage are common among refugees and internally displaced persons (IDPs). We sought to address the gaps in knowledge surrounding child marriage in displaced and host populations in the Kurdistan Region of Iraq (KRI). METHODS: A multistage cluster sample design was employed collecting data of KRI host communities, Iraqi IDPs, and Syrian refugees. Interviews were conducted in eligible households, requiring at least one adult female and one female adolescent present, addressing views of marriage, demographics and socioeconomic factors. Household rosters were completed to assess WHO indicators, related to child marriage including completed child marriage in females 10-19 and completed risk of previously conducted child marriages in females 20-24. RESULTS: Interviews were completed in 617 hosts, 664 IDPs, and 580 refugee households, obtaining information on 10,281 household members and 1,970 adolescent females. Overall, 10.4% of girls age 10-19 were married. IDPs had the highest percentage of married 10-19-year-old females (12.9%), compared to the host community (9.8%) and refugees (8.1%). Heads of households with lower overall education had higher percentages of child marriage in their homes; this difference in prevalence was most notable in IDPs and refugees. When the head of the household was unemployed, 14.5% of households had child marriage present compared to 8.0% in those with employed heads of household. Refugees and IDPs had larger percentages of child marriage when heads of households were unemployed (refugees 13.1%, IDPs 16.9%) compared to hosts (11.9%). When asked about factors influencing marriage decisions, respondents predominately cited family tradition (52.5%), family honor (15.7%), money/resources (9.6%), or religion (8.0%). Over a third of those interviewed (38.9%) reported a change in influencing factors on marriage after displacement (or after the arrival of refugees in the area for hosts). CONCLUSIONS: Being an IDP in Iraq, unemployment and lower education were associated with an increase in risk for child marriage. Refugees had similar percentages of child marriage as hosts, though the risk of child marriage among refugees was higher in situations of low education and unemployment. Ultimately, child marriage remains a persistent practice worldwide, requiring continued efforts to understand and address sociocultural norms in low socioeconomic and humanitarian settings.

Purpose: Despite evidence showing the importance of structural determinants for child well-being and the existence of policies that can promote child well-being, many communities are not adopting these policies. Limited awareness of structural determinants may explain this gap. This study establishes the public's recognition of structural determinants and their associations with support for policies that promote child well-being. Methods: Secondary analyses of survey data collected in 2019 from a random sample of 2496 adults in the United States. This survey asked why some children “struggle” (e.g., do poorly in school, use drugs, or get involved in crime). Respondents could select individual (e.g., lack of effort) and structural (e.g., low wages) explanations. Respondents were also asked about their support for policies that are supportive of children and families. Results: Stronger beliefs of structural explanations were associated with greater support for policies that strengthen family economics, family-friendly work, and afford access to high-quality early childcare and education. Beliefs in individual explanations were inversely associated with support for these policies. Conclusions: These findings suggest increasing recognition of the structural determinants that hinder child development may help increase support for policies that are effective in improving children's outcomes. © 2021 Society for the Psychological Study of Social Issues. This article has been contributed to by US Government employees and their work is in the public domain in the USA.

The care and protection of children and youths is widely understood to be the responsibility of adults, communities, and society. The importance of safe, stable, nurturing relationships and environments to support children as they grow into healthy adults enjoying meaningful lives has been well documented.1 Yet, this is not the world that exists for all children, especially those at increased risk of experiencing violence.2 Why is this? If children deserve better, why do inequities in risk for violence persist? What accounts for the limited progress on their behalf?3 | | Story telling is a strategy used in public health to communicate about the lives of people and communities. The term “narrative” is often used interchangeably with “storytelling,” but although these terms are related, “narrative” refers more precisely to connected stories that are articulated and refined over time to advance a central idea or belief. Public narratives are meta-stories that provide an understanding or interpretation of people and situations; dominant public narratives are those that eclipse others and have the most power to shape public consciousness, including society’s collective senses of both responsibility and possibility.4 Words matter, but narrative is about more than words. Narrative is about the ideas that get communicated through language, images, culture, and media. Understanding how narratives operate is critical to violence prevention efforts.5

INTRODUCTION: Adverse childhood experiences, such as violence victimization, substance misuse in the household, or witnessing intimate partner violence, have been linked to leading causes of adult morbidity and mortality. Therefore, reducing adverse childhood experiences is critical to avoiding multiple negative health and socioeconomic outcomes in adulthood. METHODS: Behavioral Risk Factor Surveillance System data were collected from 25 states that included state-added adverse childhood experience items during 2015-2017. Outcomes were self-reported status for coronary heart disease, stroke, asthma, chronic obstructive pulmonary disease, cancer (excluding skin cancer), kidney disease, diabetes, depression, overweight or obesity, current smoking, heavy drinking, less than high school completion, unemployment, and lack of health insurance. Logistic regression modeling adjusting for age group, race/ethnicity, and sex was used to calculate population attributable fractions representing the potential reduction in outcomes associated with preventing adverse childhood experiences. RESULTS: Nearly one in six adults in the study population (15.6%) reported four or more types of adverse childhood experiences. Adverse childhood experiences were significantly associated with poorer health outcomes, health risk behaviors, and socioeconomic challenges. Potential percentage reductions in the number of observed cases as indicated by population attributable fractions ranged from 1.7% for overweight or obesity to 23.9% for heavy drinking, 27.0% for chronic obstructive pulmonary disease, and 44.1% for depression. CONCLUSIONS AND IMPLICATIONS FOR PUBLIC HEALTH PRACTICE: Efforts that prevent adverse childhood experiences could also potentially prevent adult chronic conditions, depression, health risk behaviors, and negative socioeconomic outcomes. States can use comprehensive public health approaches derived from the best available evidence to prevent childhood adversity before it begins. By creating the conditions for healthy communities and focusing on primary prevention, it is possible to reduce risk for adverse childhood experiences while also mitigating consequences for those already affected by these experiences.

Exposure to Adverse Childhood Experiences (ACEs) is associated with a host of harmful outcomes, including increased risk for cancer. A scoping review was conducted to gain a better understanding of how ACEs have been studied in association with risk factors for cancer. This review includes 155 quantitative, peer-reviewed articles published between 2005 and 2015 that examined associations between ACEs and modifiable cancer risk factors, including alcohol, environmental carcinogens, chronic inflammation, sex hormones, immunosuppression, infectious agents, obesity, radiation, ultraviolet (UV) radiation, and tobacco, among U.S. adults. This review highlights the growing body of research connecting ACEs to cancer risk factors, particularly alcohol, obesity, and tobacco. Fewer studies investigated the links between ACEs and chronic inflammation or infectious agents. No included publications investigated associations between ACEs and environmental carcinogens, hormones, immunosuppression, radiation, or ultraviolet radiation. Mitigating the impact of ACEs may provide innovative ways to effect comprehensive, upstream cancer prevention. © 2018

The U.S. Bureau of Mines (USBM) was established on July 1, 1910 with a mission to address the previous decade's coal mine fatality incidence rate of greater than 2,000 annually. The need for federal government involvement to assure dependable and safe mine rescue respirators was recognized by the USBM with the first respirator approval being issued in 1919. Prior to this, some occupations exposed individuals to inhalation hazards. Firefighters, in particular, had a critical need of respiratory protection. This article provides a brief summary of pre-World War I (WWI) (1914 to 1918) respiratory protection for firefighters based largely on the work of Bruce J. Held. Also discussed is the then newly established United States Bureau of Mines' (USBM) role with the U.S. War Department during WWI for protection against chemical warfare agents.

Substantial research shows that early adversity, including child abuse and neglect, is associated with diminished health across the life course and across generations. Less well understood is the relationship between early adversity and adult socioeconomic status, including education, employment, and income. Collectively, these outcomes provide an indication of overall life opportunity. We analyzed data from 10 states and the District of Columbia that used the adverse childhood experiences (ACE) module in the 2010 Behavioral Risk Factor Surveillance System to examine the association between ACEs and adult education, employment, and income. Compared to participants with no ACEs, those with higher ACE scores were more likely to report high school non-completion, unemployment, and living in a household below the federal poverty level. This evidence suggests that preventing early adversity may impact health and life opportunities that reverberate across generations. Current efforts to prevent early adversity might be more successful if they broaden public and professional understanding (i.e., the narrative) of the links between early adversity and poverty. We discuss our findings within the context of structural policies and processes that may further contribute to the intergenerational continuity of child abuse and neglect and poverty.

CONTEXT: Adverse childhood experiences (ACEs) can affect health and well-being across the life course. OBJECTIVE: This systematic review summarizes the literature on associations between ACEs and risk of cancer in adulthood. DATA SOURCES: We searched PubMed to identify relevant publications published on or before May 31, 2015. STUDY SELECTION: We included original research quantifying the association between ACEs and adult cancer incidence. Case reports and reviews were excluded. DATA ABSTRACTION: Two reviewers independently abstracted and summarized key information (eg, ACE type, cancer type, risk estimates) from included studies and resolved all discrepancies. RESULTS: Twelve studies were included in the review. In studies in which ACE summary scores were calculated, significant associations were observed between the scores and an increased risk of cancer in adulthood. Of the different types of ACEs examined, physical and psychological abuse victimization were associated with risk of any cancer in 3 and 2 studies, respectively. Two studies also reported significant associations with regard to sexual abuse victimization (1 for cervical cancer and 1 for any cancer). However, 2 other studies reported no significant associations between childhood sexual or physical abuse and incidence of cervical or breast cancer. LIMITATIONS: Because of heterogeneity across studies, we were unable to compute a summary effect estimate. CONCLUSIONS: These findings suggest that childhood adversity in various forms may increase a person's cancer risk. Further research is needed to understand the mechanisms driving this relationship and to identify opportunities to prevent and mitigate the deleterious effects of early adversity on long-term health.

In the U.S., respiratory protection is broadly supported by a system of coordinated efforts among governmental organizations, professional associations, researchers, industrial hygienists, manufacturers, and others who produce knowledge, best practice guidance, standards, regulations, technologies, and products to assure workers can be effectively protected. Ultimately, the work of these partners is applied by employers in establishing and implementing an effective ANSI/ASSE Z88.2-2015 conforming respirator program. This article describes key partners and their activities and/or responsibilities to assure an effective respirator program.

This article describes several aspects of oxygen (O(2)) deficiency with an emphasis on respirator programs and respirator selection. The Occupational Safety and Health Administration's (OSHA) 29 CFR 1910.134 and ANSI/ASSE Z88.2-2015 (Z88.2) have much in common. However, their exposure criteria and terminology used for describing levels of O(2)-deficiency and the approaches to assessing O(2)-deficiency differ. These differences can have a significant impact on an employer's respirator program and respirator selections for workplaces at altitudes above sea level. Under certain circumstances, Z88.2 leads to a more conservative respirator selection than OSHA because its O(2)-deficiency criteria and hazard assessment approach relies directly on partial pressure of oxygen (PO(2)) at all altitudes. Z88.2 defines an O(2)-deficient atmosphere as either immediately dangerous to life or health (IDLH), or non-IDLH based on the atmosphere's PO(2) and defines respirator selection for these two O(2)-deficient atmospheres. Unlike Z88.2, OSHA does not directly access the biologically significant aspect of an atmosphere's PO(2) in its hazard assessment. OSHA defines an O(2)-deficient atmosphere based upon a percentage of oxygen. OSHA does not use the term "O(2)-deficient IDLH"; however, OSHA considers any atmosphere with less than 19.5% O(2) as IDLH and defines respirator selection for IDLH atmospheres. Although OSHA does not use the term "PO(2)" in their respirator standard, OSHA's exceptions to O(2)-deficient IDLH respirator selection policy are based on PO(2) altitude-adjusted, O(2) percentage criteria. This article provides descriptions of OSHA and Z88.2 requirements to evaluate workplace oxygen deficiency, their approaches to O(2)-deficiency hazard assessment, and describes their significance on respirator programs and selections. Alternative solutions to wearing respirators for protection against O(2)-deficiency resulting solely from high altitudes are also discussed. Selection and implementation of alternative solutions by the employer and their Physician or other Licensed Health Care Professional (PLHCP) are not covered by either respirator standard. Appendix A provides information about the physiological effect of wearing respirators and the mechanics of respiration, which is an important consideration in lower O(2) atmospheres.

Public health policy approaches have demonstrated measurable improvements in population health. Yet, "one-size-fits-all" approaches do not necessarily impact all populations equally and, in some cases, can widen existing disparities. It has been argued that interventions, including policy interventions, can have the greatest impact when they target the social determinants of health. The intent of this article was to describe how selected current policies and policy areas that have a health equity orientation are being used with the aim of reducing health disparities and to illustrate contemporary approaches that can be applied broadly to a variety of program areas to advance health equity. Applying a health equity lens to a Health in All Policies approach is described as a means to develop policies across sectors with the explicit goal of improving health for all while reducing health inequities. Health equity impact assessment is described as a tool that can be effective in prospectively building health equity into policy planning. The discussion suggests that eliminating health inequities will benefit from a deliberate focus on health equity by public health agencies working with other sectors that impact health outcomes.

To describe income levels and the prevalence of major hardships among women during or just before pregnancy. We separately analyzed 2002-2006 population-based postpartum survey data from California's Maternal and Infant Health Assessment (n = 18,332) and 19 states participating in CDC's Pregnancy Risk Assessment Monitoring System (n = 143,452) to examine income and several hardships (divorce/separation, domestic violence, homelessness, financial difficulties, spouse/partner's or respondent's involuntary job loss or incarceration, and, in California only, food insecurity and no social support) during/just before pregnancy. In both samples, over 30% of women were poor (income ≤100% of federal poverty level [FPL]) and 20% near-poor (101-200% FPL); and around 60% of low-income (poor or near-poor) women experienced at least one hardship. While hardship prevalence decreased significantly as income increased, many non-low-income women also experienced hardships; e.g., in California, 43% of all women and 13% with incomes >400% FPL experienced one or more hardships. These findings paint a disturbing picture of experiences around the time of pregnancy in the United States for many women giving birth and their children, particularly because 60% had previous births. The high prevalence of low income and of serious hardships during pregnancy is of concern, given previous research documenting the adverse health consequences of these experiences and recognition of pregnancy as a critical period for health throughout the life course. Low income and major hardships around the time of pregnancy should be addressed as mainstream U.S. maternal-infant health and social policy issues.