Lead (Pb) is extremely toxic and a major cause of chronic diseases worldwide. Pb is associated with health disparities, particularly within low-income populations. In biological systems, Pb mimics calcium and, among other effects, interrupts cell signaling. Furthermore, Pb exposure results in epigenetic changes that affect multigenerational gene expression. Exposure to Pb has decreased through primary prevention, including removal of Pb solder from canned food, regulating lead-based paint, and especially eliminating Pb additives in gasoline. While researchers observe a continuous decline in children's blood lead (BPb), reservoirs of exposure persist in topsoil, which stores the legacy dust from leaded gasoline and other sources. Our surveys of metropolitan New Orleans reveal that median topsoil Pb in communities ( = 274) decreased 44% from 99 mg/kg to 54 mg/kg ( value of 2.09 × 10), with a median depletion rate of ∼2.4 mg⋅kg⋅y over 15 y. From 2000 through 2005 to 2011 through 2016, children's BPb declined from 3.6 μg/dL to 1.2 μg/dL or 64% ( value of 2.02 × 10), a decrease of ∼0.2 μg⋅dL⋅y during a median of 12 y. Here, we explore the decline of children's BPb by examining a metabolism of cities framework of inputs, transformations, storages, and outputs. Our findings indicate that decreasing Pb in topsoil is an important factor in the continuous decline of children's BPb. Similar reductions are expected in other major US cities. The most contaminated urban communities, usually inhabited by vulnerable populations, require further reductions of topsoil Pb to fulfill primary prevention for the nation's children.
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http://dx.doi.org/10.1073/pnas.1906092116 | DOI Listing |
Implement Sci Commun
January 2025
Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, IL, Chicago, USA.
Background: Studies have demonstrated that standardizing labor induction (IOL), often with the use of protocols, may reduce racial inequities in obstetrics. IOL protocols are complex, multi-component interventions. To target identified implementation barriers, audit and feedback (A&F) was selected as an implementation strategy.
View Article and Find Full Text PDFHealth Qual Life Outcomes
January 2025
Department of Human Sciences, LUMSA University, Rome, 00193, Italy.
Background: The number of people living with congenital heart disease (CHD) in 2017 was estimated to be 12 million, which was 19% higher than that in 1990. However, their death rate declined by 35%, emphasizing the importance of monitoring their quality of life due to its impact on several patient outcomes. The main objective of this study is to analyze how parents' psychosocial factors contribute to children's and adolescents' perceptions of their QoL, focusing on their medical condition.
View Article and Find Full Text PDFBMC Public Health
January 2025
Department of Women's and Children's Health, Karolinska Institutet, Tomtebodavägen 18A, Stockholm, Solna, 171 77, Sweden.
Background: Globally, the quality of maternal and newborn care remains inadequate, as seen through indicators like perineal injuries and low Apgar scores. While midwifery practices have the potential to improve care quality and health outcomes, there is a lack of evidence on how midwife-led initiatives, particularly those aimed at improving the use of dynamic birth positions, intrapartum support, and perineal protection, affect these outcomes.
Objective: To explore how the use of dynamic birth positions, intrapartum support, and perineal protection impact the incidence of perineal injuries and the 5-min Apgar score within the context of a midwife-led quality improvement intervention.
BMJ Open
January 2025
Population Council, New Delhi, India.
Objective: This study examined economic inequality in coverage of selected maternal and child healthcare (MCH) indicators in India and its states over the last 15 years.
Design: The study analysed last three rounds of the National Family Health Survey data, conducted during 2005-2006, 2015-2016 and 2019-2021. Bivariate analyses, ratio of richest to poorest, slope index of inequality (SII) and multivariate binary logistic regression analyses were used to examine the coverage as well as inequalities in the outcome indicators for India and its states and at district level.
JAMA Health Forum
January 2025
Department of Health Policy and Management, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania.
Importance: 2021 Advance child tax credit (ACTC) monthly payments were associated with reduced US child poverty rates; however, policymakers have expressed concerns that permanent adoption would increase parental substance use.
Objective: To assess whether 2021 ACTC monthly payments were temporally associated with changes in substance use among parents compared with adults without children.
Design, Setting, And Participants: The primary sample included adults aged 18 to 64 years who responded to the National Survey on Drug Use and Health in 2021.
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