30-Second Takeaway
- Multicomponent and navigation-based interventions meaningfully increase lung cancer screening uptake in high-risk adults.
- Adverse childhood experiences, race, disability, and socioeconomic status shape cancer screening, oral health, and maternal outcomes.
- Short-term ozone, extreme heat, and rising heat vulnerability contribute measurably to mortality risk worldwide.
- Continuous Medicaid eligibility reduces coverage gaps and emergency department use, especially for children with special health care needs.
- Behavioral and policy interventions can mitigate climate- and system-driven risks, but current evidence quality is uneven.
Week ending December 27, 2025
Prevention at the Frontlines: Screening Uptake, Climate Risks, and Structural Determinants of Health
Multicomponent strategies modestly increase lung cancer screening uptake
Across 11 randomized trials of high-risk adults eligible for low-dose CT, interventions increased lung cancer screening uptake (RR 1.34, 95% CI 1.02–1.76). Multicomponent interventions had the largest effect (RR 2.11, 95% CI 1.21–3.68), combining elements such as outreach, decision support, and navigation. Patient navigation showed a similarly large point estimate (RR 2.18) but with wide confidence intervals, reflecting limited data. Implementation was shaped by innovation features and organizational context, underscoring the need for workflow fit and institutional support.
Adverse childhood experiences reduce breast and prostate cancer screening adherence
Using 2020 BRFSS data from 134,174 adults in 28 states, this study linked adverse childhood experiences with cancer screening adherence. Women with two ACEs or ≥4 ACEs had modestly lower adherence to breast cancer screening (aPR 0.95 for both groups). Men with one, two, or three ACEs had lower adherence to prostate cancer screening (aPR 0.88–0.87). Insurance coverage and having a personal doctor were the strongest predictors of screening adherence, offering modifiable targets for trauma-informed preventive care.
Short-term ozone exposure increases total, cardiovascular, and respiratory mortality
This meta-analysis pooled 178 time-series and case-crossover studies worldwide, standardizing exposure to daily maximum 8-hour ozone averages. Each 10 μg/m³ short-term ozone increase was associated with higher total mortality (RR 1.0033, 95% CI 1.0031–1.0036). Cardiovascular (RR 1.0046) and respiratory mortality (RR 1.0047) showed similar small but consistent excess risks per 10 μg/m³ increment. Nonlinear exposure–response with thresholds around 42–100 μg/m³ supports tightening ozone standards, particularly in low- and middle-income countries.
Structural and clinical drivers of U.S. maternal mortality remain entrenched
This review synthesizes trends, causes, and inequities in U.S. maternal mortality despite advances in obstetric care. Maternal deaths are concentrated among racially marginalized, socioeconomically disadvantaged, and certain geographic communities, reflecting structural and social determinants. Variation in access to high-quality maternal care, insurance coverage, and reproductive health services contributes substantially to risk. Major gaps in maternal mortality surveillance limit timely, actionable prevention strategies and evaluation of policy interventions.
References
Numbered in order of appearance. Click any reference to view details.
Additional Reads
Optional additional studies from this edition.