"When You Look at This Chart, That Is Not My Whole Life": Caregiver Perspectives to Inform Improved Primary Care Practice and Outcomes.

Objective: Worsening rates of infant and maternal mortality in the United States serve as an urgent call for multi-modal intervention. Infant Well Child Visits (WCVs) provide an opportunity for prevention, however not all infants receive the recommended schedule of visits, with infants of low-income and Black families missing a higher portion of WCVs. Due to diverse experiences and needs of under-resourced communities throughout the United States, caregiver voice is essential when designing improvement efforts.

Community-Led Interventions to Address Food Inequity.

Approximately 1 in 6 children in the United States, and 1 in 5 children in our local county (Hamilton County, Ohio), are food insecure. Here, we describe a novel community-academic partnership to address food inequity through distributed leadership and shared power with local neighborhood leaders. Using neighborhood-level data and community voice, 3 Cincinnati neighborhoods with high rates of poverty and food insecurity were selected as the primary intervention targets.

"We know what's going on in our community": A qualitative analysis identifying community assets that deter gun violence.

Communities of color are disproportionately impacted by gun violence. Unlocking potential community-led solutions could be the key to quelling the gun violence epidemic and its impact on these communities. In this qualitative study, we explored community perspectives on local assets that may prevent and mitigate gun violence.

Partnering with Families and Communities to Improve Child Health and Health Equity.

Pediatricians and other pediatric health providers collaborate with families and communities, including schools, health departments, and other partners to advance pediatric health challenges and health equity. This article will discuss best practices and guiding principles to support engagement and effective partnership with families and communities. Models for engaging families and communities while promoting health equity will also be discussed.

Association of Population Well-Being With Cardiovascular Outcomes.

Importance: Mortality from cardiovascular disease (CVD) varies across communities and is associated with known structural and population health factors. Still, a population's well-being, including sense of purpose, social relationships, financial security, and relationship to community, may be an important target to improve cardiovascular health.

Objective: To examine the association of population level measures of well-being with rates of CVD mortality in the US.

Use Of Area-Based Socioeconomic Deprivation Indices: A Scoping Review And Qualitative Analysis.

There is considerable interest among researchers, clinicians, and policy makers in understanding the impact of place on health. In this scoping review and qualitative analysis, we sought to assess area-level socioeconomic deprivation indices used in public health and health outcomes research in the US. We conducted a systematic scoping review to identify area-level socioeconomic deprivation indices commonly used in the US since 2015.

Trends in Racial and Ethnic Disparities in Barriers to Timely Medical Care Among Adults in the US, 1999 to 2018.

Importance: Racial and ethnic disparities in delayed medical care for reasons that are not directly associated with the cost of care remain understudied.

Objective: To describe trends in racial and ethnic disparities in barriers to timely medical care among adults during a recent 20-year period.

Design, Setting, And Participants: This was a serial cross-sectional study of 590 603 noninstitutionalized adults in the US using data from the National Health Interview Survey from 1999 to 2018.

Children from disadvantaged neighborhoods experience disproportionate injury from interpersonal violence.

Background: Disparities in pediatric injury have been widely documented and are driven, in part, by differential exposures to social determinants of health (SDH). Here, we hypothesized that neighborhood socioeconomic deprivation and specific sociodemographic characteristics would be associated with interpersonal violence-related injury admission.

Methods: We conducted a retrospective cohort study of all patients ≤16 years, residing in Hamilton County, admitted to our level 1 pediatric trauma center.

Testing the added value of self-reported health and well-being in understanding healthcare utilization and costs.

Purpose: We investigated the relationship between measures of self-reported health and well-being and concurrent and prospective healthcare utilization and costs to assess the added value of these self-reported measures in understanding utilization and cost.

Methods: Kaiser Permanente members (N = 6752) completed a 9-item survey measuring life evaluation, financial situation, social support, meaning and purpose, physical health, and mental health. Responses were linked to medical record information during the period 12 months before and after the survey.

Relationships between socioeconomic deprivation and pediatric firearm-related injury at the neighborhood level.

Background: Disparities in pediatric injury are widely documented and partly driven by differential exposures to social determinants of health (SDH). Here, we examine associations between neighborhood-level SDH and pediatric firearm-related injury admissions as a step to defining specific targets for interventions to prevent injury.

Methods: We conducted a retrospective review of patients 16 years or younger admitted to our Level I pediatric trauma center (2010-2019) after a firearm-related injury.

Evaluation of Temporal Trends in Racial and Ethnic Disparities in Sleep Duration Among US Adults, 2004-2018.

Importance: Historically marginalized racial and ethnic groups are generally more likely to experience sleep deficiencies. It is unclear how these sleep duration disparities have changed during recent years.

Objective: To evaluate 15-year trends in racial and ethnic differences in self-reported sleep duration among adults in the US.

Trends and Variation in the Gap Between Current and Anticipated Life Satisfaction in the United States, 2008-2020.

To describe national- and county-level trends and variation in a novel measure of hope. Using data from the Gallup National Health and Well-Being Index (n = 2 766 728), we summarized the difference between anticipated life satisfaction (ALS) and current life satisfaction (CLS), measured by the Cantril Self-Anchoring Scale, for each year from 2008 to 2020 and by county over two 5-year periods in the United States. Across all years, there was a significant positive trend in the difference between ALS and CLS for the nation ( = .

Can a collective-impact initiative improve well-being in three US communities? Findings from a prospective repeated cross-sectional study.

Introduction: Communities are seeking to learn if and how they can improve the well-being of their residents. We therefore examined the impact of a community-led, collective-impact initiative, deployed through Blue Zones Project by Sharecare, aimed at improving health and well-being in one set of US communities.

Methods: We used data from cross-sectional surveys of the Well-Being Index (2010-2017) to assess how the Life Evaluation Index (LEI) in Hermosa Beach, Manhattan Beach and Redondo Beach in California (Beach Cities) changed over time and how this change compares with change for similar cities (Beach Cities-like) and for the USA as a whole.

Pediatricians Contributing to Poverty Reduction Through Clinical-Community Partnership and Collective Action: A Narrative Review.

Poverty affects child health and well-being in short- and long-term ways, directly and indirectly influencing a range of health outcomes through linked social and environmental challenges. Given these links, pediatricians have long advocated for poverty reduction in both clinical settings and society. Pediatricians and others who work in pediatric settings are well-suited to address poverty given frequent touchpoints with children and families and the trust that develops over repeated encounters.

Socioeconomic and Racial Disparities in Diabetic Ketoacidosis Admissions in Youth With Type 1 Diabetes.

Objective: We sought to determine whether census tract poverty, race, and insurance status were associated with the likelihood and severity of diabetic ketoacidosis (DKA) hospitalization among youth with type 1 diabetes (T1D).

Methods: We conducted a retrospective population-based cohort study using Cincinnati Children's Hospital electronic medical record (EMR) data from January 1, 2011, to December 31, 2017, for T1D patients ≤18 years old. The primary outcome was admission for DKA.

Trends in Differences in Health Status and Health Care Access and Affordability by Race and Ethnicity in the United States, 1999-2018.

Importance: The elimination of racial and ethnic differences in health status and health care access is a US goal, but it is unclear whether the country has made progress over the last 2 decades.

Objective: To determine 20-year trends in the racial and ethnic differences in self-reported measures of health status and health care access and affordability among adults in the US.

Design, Setting, And Participants: Serial cross-sectional study of National Health Interview Survey data, 1999-2018, that included 596 355 adults.

Seven practices for pursuing equity through learning health systems: Notes from the field.

Introduction: Despite learning health systems' focus on improvement in health outcomes, inequities in outcomes remain deep and persistent. To achieve and sustain health equity, it is critical that learning health systems (LHS) adapt and function in ways that directly prioritize equity.

Methods: We present guidance, including seven core practices, borne from theory, evidence, and experience, for actors within LHS pursuing equity.

Trends and geographical variation in population thriving, struggling and suffering across the USA, 2008-2017: a retrospective repeated cross-sectional study.

Objectives: Well-being is a holistic, positively framed conception of health, integrating physical, emotional, social, financial, community and spiritual aspects of life. High well-being is an intrinsically worthy goal for individuals, communities and nations. Multiple measures of well-being exist, yet we lack information to identify benchmarks, geographical disparities and targets for intervention to improve population life evaluation in the USA.

Exposure to Family Member Incarceration and Adult Well-being in the United States.

Importance: More than half of the adult population in the United States has ever had a family member incarcerated, an experience more common among Black individuals. The impacts of family incarceration on well-being are not fully understood.

Objective: To assess the associations of incarceration of a family member with perceived well-being and differences in projected life expectancy.

The association of neighborhood walkability with health outcomes in older adults after acute myocardial infarction: The SILVER-AMI study.

Physical activity and social support are associated with better outcomes after surviving acute myocardial infarction (AMI), and greater walkability has been associated with activity and support. We used data from the SILVER-AMI study (November 2014-June 2017), a longitudinal cohort of community-living adults ≥ 75 years hospitalized for AMI to assess associations of neighborhood walkability with health outcomes, and to assess whether physical activity and social support mediate this relationship, if it exists. We included data from 1345 participants who were not bedbound, were discharged home, and for whom we successfully linked walkability scores (from Walk Score®) for their home census block.

Cultivating social relationships and disrupting social isolation in low-income, high-disparity neighbourhoods in Ohio, USA.

Social isolation undermines health. Inequities in social networks exist due to historical and contemporary practices of socioeconomic and racial segregation. Thus, lower income and minority families are less likely to have the number, strength, and variety of social connections as higher income and white families.

Racial and Ethnic Disparities in Access to Health Care Among Adults in the United States: A 20-Year National Health Interview Survey Analysis, 1999-2018.

Importance: Racial and ethnic disparities plague the US health care system despite efforts to eliminate them. To understand what has been achieved amid these efforts, a comprehensive study from the population perspective is needed.

Objectives: To determine trends in rates and racial/ethnic disparities of key access to care measures among adults in the US in the last two decades.