closer look
Opinion: Add exposure to gun violence to a common screening tool for health care
Saul Loeb / AFP via Getty Images
The adverse childhood experience questionnaire is a crucial tool in medicine, but it could use an update, public health graduate student Sydney Durrah writes in a STAT First Opinion. Gun violence has become so pervasive that the screening tool doctors now use to evaluate their patients' physical and mental well-being falls short: It fails to ask whether someone experienced, witnessed, or was affected by gun violence as a child. Survivors of gun violence face an elevated risk of developing substance use disorders. There has been a surge in antidepressant use among youth and an increase in suicide risk in communities that have experienced school shootings
"Gun violence represents a distinct form of violence with unique implications for individuals' health and well-being," Durrah writes. "Understanding an individual's exposure to gun violence allows for a precise assessment of community risk factors and resilience." Read more, including what spurred the questionnaire's development in the mid-1990s.
addiction
Drug overdose deaths stayed steady in 2022
After quadrupling over the past two decades, overdose deaths leveled off in 2022, a new CDC report says. The 107,941 deaths were only slightly higher than the 106,699 recorded the year before, a sliver-thin margin that is raising hopes that overdose rates have stopped rising. Most of the deaths involved fentanyl, a potent synthetic opioid that entered the illicit drug supply about 10 years ago. Heroin, methadone, and prescription painkillers have been causing fewer deaths. Other changes:
- More deaths now involve such stimulants as cocaine and methamphetamine.
- Disparities are widening: Overdose rates among white Americans decreased slightly from 2021 to 2022, but overdoses among Black people jumped. American Indian and Alaska Native populations saw the largest increase in overdose death rates, accelerating a preexisting trend in tribal communities across the country.
STAT's Lev Facher has more.
global health
Falling fertility rates will change populations on a global scale, paper predicts
Taking the very long view, a new analysis of fertility rates around the world predicts a dramatic decline in birth rates and a transformative shift in population patterns by 2100. The Lancet paper estimates that, by 2050, more than three-quarters of countries will see their populations shrink, rising to 97% by century's end. The report also says births will nearly double in low-income regions from 2021 to 2100, when 1 out of every 2 children on the planet will be born in sub-Saharan Africa.
What does this mean? Not too many generations ago, overpopulation was the concern, but now it's a "demographically divided world" that is feared. That's because middle- and high-income countries with a diminishing workforce could strain health and social systems of an aging population. Countries with younger, faster-growing populations might have fewer resources to cope with economic instability, heat stress from climate change, and limited health systems, as well as less access to contraception and education for women. "The global health community must plan to address these divided sets of demographic challenges worldwide," the authors write.
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