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We describe how longitudinal legal data have been used in limited, but important, ways for cross-national analysis and propose incorporating global policy surveillance into core global public health practice.Objectives. To quantify changes in US health care spending required to reach parity with high-resource nations by 2030 or 2040 and identify historical precedents for these changes.Methods. We analyzed multiple sources of historical and projected spending from 1970 through 2040. Parity was defined as the Organisation for Economic Co-operation and Development (OECD) median or 90th percentile for per capita health care spending.Results. Sustained annual declines of 7.0% and 3.3% would be required to reach the median of other high-resource nations by 2030 and 2040, respectively (3.2% and 1.3% to reach the 90th percentile). Such declines do not have historical precedent among US states or OECD nations.Conclusions. Traditional approaches to reducing health care spending will not enable the United States to achieve parity with high-resource nations; strategies to eliminate waste and reduce the demand for health care are essential.Public Health Implications. Excess spending reduces the ability of the United States to meet critical public health needs and affects the country's economic competitiveness. Rising health care spending has been identified as a threat to the nation's health. Sirtinol supplier Public health can add voices, leadership, and expertise for reversing this course.Some people with disabilities may have greater risk of contracting COVID-19 or experiencing worse outcomes if infected. Although COVID-19 is a genuine threat for people with disabilities, they also fear decisions that might limit lifesaving treatment should they contract the virus.During a pandemic, health systems must manage excess demand for treatment, and governments must enact heavy restrictions on their citizens to prevent transmission. Both actions can have a negative impact on people with disabilities.Ironically, the sociotechnical advances prompted by this pandemic could also revolutionize quality of life and participation for people with disabilities. Preparation for future disasters requires careful consideration.Objectives. To demonstrate how inferences about rural-urban disparities in age-adjusted mortality are affected by the reclassification of rural and urban counties in the United States from 1970 to 2018.Methods. We compared estimates of rural-urban mortality disparities over time, produced through a time-varying classification of rural and urban counties, with counterfactual estimates of rural-urban disparities, assuming no changes in rural-urban classification since 1970. We evaluated mortality rates by decade of reclassification to assess selectivity in reclassification.Results. We found that reclassification amplified rural-urban mortality disparities and accounted for more than 25% of the rural disadvantage observed from 1970 to 2018. Mortality rates were lower in counties that reclassified from rural to urban than in counties that remained rural.Conclusions. Estimates of changing rural-urban mortality differentials are significantly influenced by rural-urban reclassification. On average, counties that have remained classified as rural over time have elevated mortality. Longitudinal research on rural-urban health disparities must consider the methodological and substantive implications of reclassification.Public Health Implications. Attention to rural-urban reclassification is necessary when evaluating or justifying policy interventions focusing on geographic health disparities.Objectives. To examine associations between caregiving mental or behavioral health outcomes among emerging US adults, defined as persons aged 18 to 25 years.Methods. The study sample included emerging adult respondents to the 2015-2017 Behavioral Risk Factor Surveillance System's caregiving module. Exposures were caregiver (n = 3087), expectant caregiver (n = 2303), and noncaregiver (n = 12 216) status. Expectant caregivers were defined as persons not currently providing care but anticipating doing so within the next 2 years. Outcomes included frequent mental distress (FMD), drinking (binge or heavy), and current smoking (cigarette or e-cigarette use). We used robust Poisson regression to calculate adjusted prevalence ratios (APRs) and corresponding 95% confidence intervals (CIs). We adjusted all models for income.Results. Caregivers had a similar prevalence of FMD when compared with both expectant caregivers (APR = 1.67; 95% CI = 1.28, 2.17) and noncaregivers (APR = 1.50; 95% CI = 1.23, 1.82). Caregivers had a higher prevalence of current cigarette smoking compared with noncaregivers (APR = 1.44; 95% CI = 1.21, 1.71).Conclusions. Among emerging adults, providing care is associated with poorer mental health. Point estimates looking at FMD were higher when we compared caregivers with expectant caregivers, suggesting a difference in exchangeability between comparison groups.Public Health Implications. This study highlights the importance of including emerging adults in caregiving research.Objectives. To examine public support for health insurance, income support, and unemployment policies during the initial phase of disease transmission and economic distress following the coronavirus disease 2019 (COVID-19) outbreak and to assess varying public support based on beliefs about the role of government.Methods. We fielded a nationally representative survey of US adults (n = 1468) from April 7, 2020, to April 13, 2020.Results. Of US adults, 77% supported paid sick leave, and a majority also supported universal health insurance, an increased minimum wage, and various unemployment support policies. Public support for an active government role in society to improve citizens' lives increased by 10 percentage points during this initial pandemic response relative to September 2019. Belief in a strong governmental role in society was associated with greater support for social safety-net policies.Conclusions. During the initial phase of the COVID-19 pandemic in early April 2020, most US adults favored a range of safety-net policies to ameliorate its negative health and economic consequences.
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