JAMA

Estimation of multiple chronic condition (MCC) prevalence throughout adulthood provides a critical reflection of MCC burden. We analyzed electronic health record codes for 58 conditions to estimate MCC prevalence for All of Us (AoU) Research Program adult participants (N=242,828). Approximately 76% of AoU participants were diagnosed with MCCs, with over 40% having 6 or more conditions and prevalence increasing with age; the most frequently occurring MCC combinations varied by age category (i.e.,...

ImportanceAmid efforts in the United States to promote health equity, there is a need to assess progress in reducing excess deaths and years of potential life lost (YPLL) among Black people compared with White people. ObjectiveTo evaluate trends in excess mortality and YPLL among Black people compared with White people. DesignSerial cross-sectional. SettingNational data from the Centers for Disease Control and Prevention, 1999-2020 ParticipantsNon-Hispanic White and non-Hispanic Black people...

IntroductionExperiences of discrimination and bias in health care contribute to health disparities for LGBTQ+ and other minority populations. To avoid discrimination, many LGBTQ+ people go to great lengths to find healthcare providers who they trust and are knowledgeable about their health needs. This study examines whether access to an LGBTQ+ affirming provider may improve health outcomes for LGBTQ+ populations across a range of preventive health and chronic disease management outcomes. Method...

BackgroundThe COVID-19 pandemic has focused attention on race and income disparities in SARS-CoV-2 mortality and morbidity. Much less attention has been paid to other socioeconomic factors including income. ObjectiveThe goal of this study was to compare disparities in medical care utilization and related expenditures associated with income to those associated with race and ethnicity in the US for those aged 0 to 64 for four categories of medical services: hospital, emergency room, ambulatory ca...

BackgroundTo advance precision medicine and improve population health, the All of Us Research Program aims to collect data, including a survey of social determinants of health (SDOH), from over 1 million participants. This report (1) outlines the process used to construct the All of Us SDOH survey and (2) presents the psychometric characteristics and scoring recommendations for SDOH survey measures. MethodsA consensus process was used to select a definition of SDOH and conceptual frameworks to ...

ObjectiveThe goal of this study was to investigate the association of perceived discrimination with health outcomes and disparities. Materials and MethodsThe study cohort consists of 60,180 participants from the four largest SIRE groups in the All of Us Research Program participant body: Asian (1,291), Black (4,726), Hispanic (5,336), and White (48,827). A perceived discrimination index (PDI) was derived from participant responses to the "Social Determinants of Health" survey, and the All of Us...

BackgroundExcess death for Black people compared with White people is a measure of health equity. We sought to determine the excess deaths under the age of 65 (<65) for Black people in the United States (US) over the most recent 20-year period. We also compared the excess deaths for Black people with a cause of death that is traditionally reported. MethodsWe used the Center of Disease Control (CDC) WONDERs Multiple Cause of Death 1999-2019 dataset to report age-adjusted mortality rates among no...

BackgroundLife expectancy is a critical measure of population health. In the U.S., Black Americans have historically experienced lower life expectancy than White Americans due to factors such as health insurance inequities, socioeconomic disparities, and systemic barriers. Though the Black-White life expectancy gap narrowed after 1990, it has fluctuated in recent years, influenced by socioeconomic changes and the COVID-19 pandemic. ObjectiveThis study examines how national-level differences in ...

BACKGROUNDPrior studies reported large decreases in US life expectancy during 2020 as a result of the COVID-19 pandemic, disproportionately affecting Hispanic and Black populations and vastly exceeding the average change in life expectancy in other high-income countries. Life expectancy estimates for 2021 have not been reported. This study estimated changes in life expectancy during 2019-2021 in the US population, in US racial/ethnic groups, and in 21 peer countries. The study compared outcomes ...

Background/PurposeChimeric Antigen Receptor-T Cell Therapy (CAR-T) has revolutionized the treatment of B-cell precursor acute lymphoblastic leukemia (B-ALL), but its global availability is limited. This study assessed current access and barriers to CAR-T CD19 cell therapy for children across Europe. MethodsA country questionnaire developed by the EBMT PDWP, St. Jude Childrens Research Hospital, and IBFM assessed current access to advanced therapies for B-ALL in Europe using Qualtrics software. ...

ABSTRACTSO_ST_ABSIMPORTANCEC_ST_ABSSignificant racial and ethnic differences exist in Lifes Essential 8 (LE8), but the trends in these disparities over time are not well understood. Additionally, the key components of LE8 to these differences are unclear. OBJECTIVETo evaluate trends in racial and ethnic disparities in LE8 over a 10-year period and to identify the primary contributors among the eight LE8 components to these disparities. DESIGN, SETTING, AND PARTICIPANTSSerial population based c...

BackgroundMultiracial adults represent a growing U.S. population but are often grouped together or reassigned to single-race categories in public health data. Aggregation can obscure important variation across subgroups, limiting opportunities for targeted prevention. MethodsWe analyzed 2014-2023 California Behavioral Risk Factor Surveillance System data (n=100,177) to estimate prevalence of 28 health indicators across racial and ethnic groups, including disaggregated Multiracial subgroups. We ...

We used 2017 Behavioral Risk Factor Surveillance System (BRFSS) data (N=444,649) to estimate the proportion of US adults who report comorbidities that suggest heightened risk of complications from COVID-19. Co-morbidities included cardiovascular disease, chronic obstructive pulmonary disease (COPD), diabetes, asthma, hypertension, and/or cancer other than skin, based on data from China. Overall 45.4% (95% CI 45.1-45.7) of adults reported any of the 6 comorbidities, increasing from 19.8% (19.1-20...

ImportanceDiscrimination in healthcare disrupts trust and can negatively influence patients. However, the impact of experiencing discrimination on long-term patterns of healthcare utilization is unknown. ObjectiveTo assess how perceived discrimination in healthcare settings is associated with longitudinal patterns of doctor visits among middle-aged and older adults in the United States. DesignProspective cohort study of US adults in the Health and Retirement Study (HRS) who were followed every...

High-income countries like Canada have the highest self-reported levels of life satisfaction in the world, although little is known regarding the experiences of racialized people and immigrants to these countries. This study investigates the factors that influence subjective well-being among a large national cohort study of 8,063 adults from the Canadian Alliance of Healthy Hearts and Minds cohort study recruited between 2014 and 2018, including a subset of 2,142 immigrants. Measures of demograp...

ImportanceLarge regional variations in consumer satisfaction with private health insurance plans have been observed, but the factors driving this variation are unknown. ObjectiveTo identify explanatory state-level and insurance family-level predictors of satsifaction with private health insurance. DesignCross-sectional study examining regional and state variations in consumer health insurance plan satisfaction using National Committee for Quality Assurance data from 2015 to 2018, state-level h...

Although there have been many studies on antibody responses to SARS-CoV-2 in breastmilk, very few have looked at the fate of these in the baby. We carried out a study in 22 mother/baby pairs (mothers who breastfed and who were SARS-CoV-2 vaccinated before or after delivery) looking at mother blood, mother milk, baby blood, baby nose, and baby stool. Breastfed infants only acquired systemic anti-SARS-CoV-2 IgG antibodies if their mothers were vaccinated antepartum. None of the infants had SARS-Co...

ObjectiveTo examine racial and ethnic inequities in wealth and health among New York City adults. MethodsWe conducted the 2024 NYC Racial Wealth and Health Gap Survey using a stratified quota sample of 2,866 adults across 11 racial and ethnic groups. Wealth was measured through self-reported assets and debts, and health through self-reported status and psychological distress. We calculated descriptive statistics across groups and used quantile regression to test for significant differences in a...

BackgroundDespite the excellent survival for chronic myeloid leukemia (CML) patients treated with tyrosine kinase inhibitors (TKI), most CML patients report poorer quality of life due to TKI side-effects. In the DESTINY trial (NCT01804985), CML patients halved their TKI dose for 12 months prior to TKI cessation, with 24 months of follow-up off therapy. Enrolled patients (n=174) were in stable deep molecular remission (DMR; BCR::ABL1IS <0.01%) or major molecular response (MMR; BCR::ABL1IS <0.1%),...

BackgroundHematopoietic cell transplant (HCT) outcomes are well characterized in clinical trials and international registries, but data remain scarce for patients who undergo transplantation abroad and return home for follow-up. While transplant centers typically report procedural details and early mortality for this cohort, long-term survival and chronic graft versus host disease (GVHD) outcomes are seldom captured, underscoring the need for comprehensive reporting. MethodsWe conducted a retro...