Gender and ethnic disparities in students' perceptions of how different groups of persons suspected of possessing and/or selling illegal drugs are treated in the criminal justice system.

Ethnic minorities and individuals of low socioeconomics status are disproportionately more likely to be detained, arrested, and convicted and receive longer sentences for drug offenses. This article explores gender and ethnic differentials among college students' perceptions on the criminal justice treatment of different gender, ethnic, and income groups applied to alleged drug offenders. It uses survey data provided by students at a large public university in South Florida. A two-way classification model examines the nature of disparities in perceptions. Students perceive widespread ethnic inequalities and female and Black students perceive greater disparities in the criminal justice system for all disadvantaged groups.

Predictor of HPV Vaccination Uptake among Foreign-Born College Students in the U.S.: An Exploration of the Role of Acculturation and the Health Belief Model.

OBJECTIVE: to measure the HPV vaccination rate and knowledge about HPV and its vaccine among foreign-born college students; additionally, to measure the effect of acculturation and HBM constructs on the HPV vaccination behavior among foreign-born college students. METHODS: a cross-sectional design with a non-probability sample of foreign-born college students was collected via a web-based self-administered survey that measured the HPV vaccination rate, assessed knowledge about HPV and its vaccine, and evaluated the effect of acculturation and HBM constructs on HPV vaccination behavior among foreign-born college students. RESULTS: Foreign-born college students had moderate knowledge about HPV and the HPV vaccine, and about 63% were HPV-vaccinated. Perceived susceptibility, perceived barriers, and cues to action were significantly associated with the HPV vaccination behavior, while knowledge levels about HPV and the HPV vaccine and acculturation levels were not significantly associated with the HPV vaccination behavior of foreign-born college students. CONCLUSIONS: The current study shows a moderate vaccination rate and moderate knowledge about HPV and its vaccine among foreign-born college students. Additionally, vaccination campaigns need to increase awareness about the susceptibility to acquiring HPV and minimize the barriers to receiving the vaccine to increase the HPV vaccination rate among foreign-born college students.

Acknowledging and addressing the gender disparity in pre-exposure prophylaxis use for HIV prevention.

Objective: One in four persons living with HIV in the USA is a woman. While the annual HIV diagnoses for 2019 decreased by approximately 9% when compared with 2015, this decrease was seen in men, while the rates remained stable for women. Pre-exposure prophylaxis (PrEP) is one major biomedical tool that could benefit women at risk of HIV. However, women only account for approximately 5% of PrEP users annually. The objective of this study is to identify and address the gender disparity in PrEP use. Methods: This study used epidemiological data from the AIDSVu database to confirm the presence of a gender disparity in PrEP use across the USA. Cross-sectional data from 2019 showed that PrEP use was significantly higher in men, which suggested the existence of a disparity. The PrEP-to-Need ratio was then used to examine the trends in PrEP use relative to the rate of HIV infections, from 2012 to 2019, and to confirm the existence of the gender disparity in PrEP use. Key findings: There is a marked gender disparity in PrEP use. This disparity is widening and therefore demands more attention to women at risk of HIV. Some recommendations for addressing the disparity include the following: raising awareness, capacity building for providers, scaling up efforts to better reach women at risk of HIV and additional research to understand the drivers of the disparity. Conclusions: Policy makers could therefore prioritize the health outcomes of women by promoting research and education aimed at extending PrEP offerings to effectively reach women.

Nature and Composition of Earnings Reported by Health Economists and Related Professionals: Gender, Education, and job Characteristics Matter.

Background: Despite the fast growth of the workforce comprising health economics (HE), outcomes research (OR), and market access (MA) professionals, little is known about their earnings determination. Only three studies have examined their earnings and none has considered the number of hours worked, traditionally a critical component of income determination models. Objectives: (i) Estimate an indicator of annual earnings of HE/OR/MA professionals, comparing male versus female and U.S. versus non-U.S. earnings levels, and (ii) assess the magnitude of the effect of selected human-capital and job-related covariates on their annual earnings determination. Methods: The study used 2019 self-reported survey data from a sample of 304 HE/OR/MA professionals registered in the HealthEconomics.com global subscriber list. A two-way classification model with multiple replications was used to identify and test earnings variations of HE/OR/MA professionals across genders and locations. An earnings determination function using ordinary least squares was used to identify disparities in response to covariates including average workweek, human-capital stock, and job-related variables by gender and location. Results: Substantial earning disparities were observed between HE/OR/MA professionals living in the U.S. and those living in other countries. Non-U.S. respondents exhibited earnings gaps of 44.7% in wages/salaries and 46.8% in total earnings relative to their U.S. counterparts with greater gaps for women than men. The female earnings gap outside the U.S. was considerably greater than in the U.S. Holding a graduate degree; working in a pharmaceutical or biotechnology firm; age, a proxy for experience; and working remotely impacted earnings differentials across different subgroups. Conclusions: The findings of this paper shed light into the nature and composition of earnings of HE/OR/MA professionals across genders and locations. Exploring the dynamics of earning disparities by gender and location has increased in relevance given the rapidly-changing and uncertain job market environment driven by the COVID-19 pandemic.

Gender and Pharmacists' Career Satisfaction in the United States.

Job satisfaction reflects pharmacists' evaluation of their current work experiences, while career satisfaction is an evaluation of how satisfied pharmacists are with their profession across various jobs. The objectives of this article were to measure career satisfaction and specific facets of current-job satisfaction of U.S. pharmacists, compare satisfaction across genders, and examine the determinants of career satisfaction. This study was based on self-reported survey data collected from a random sample of licensed pharmacists practicing throughout the United States. The sample consisted of 422 men and 315 women. Within each gender, pharmacists' career satisfaction was modeled using ordinary least squares as a function of three sets of variables: personal characteristics, earnings and workweek, and other job-related variables. Female pharmacists exhibited higher levels of contentment with their careers than their male counterparts. Their career-satisfaction levels were not affected by age, marital status, annual earnings, or average workweek, covariates that systematically influenced male pharmacists' career satisfaction. Job satisfaction substantially affected pharmacists' long-term career satisfaction. Male and female pharmacists responded differently to stimuli, so a uniform set of work-related incentives may not be effective for both genders. Initiatives perceived by male practitioners as increasing satisfaction may be adversely perceived by female practitioners, and vice-versa.

Disparities in the Wage-and-Salary Earnings, Determinants, and Distribution of Health Economics, Outcomes Research, and Market Access Professionals: An Exploratory Study.

OBJECTIVE: The aim was to estimate the wage-and-salary earnings of a sample of health economics, outcomes research, and market access (HE/OR/MA) professionals; compare male versus female and US versus non-US earnings; assess the magnitude of the effect of several human-capital and job-related covariates on the determination of earnings; and examine inequality in the distribution of earnings. METHODS: The study used self-reported survey data collected in 2017 from a subset of HE/OR/MA professionals in the HealthEconomics.com global subscriber list. HE/OR/MA professionals in this subset completed a questionnaire. The sample consisted of 372 participants who reported their wage-and-salary earnings and other indicators. The sample was not necessarily representative of the global HE/OR/MA community. The study methods included a two-way classification model with multiple replications, an ordinary least-squares model, and three inequality indicators. PRINCIPAL FINDINGS: The results suggested substantial disparities between the wage-and-salary earnings of respondents living in the USA and those living in other countries; mild gender disparities in earnings; greater inequality outside the USA than within the USA; and, within each location, more unequal distribution of men's earnings than that of women's earnings. CONCLUSIONS: Although the findings may not be extrapolated to the worldwide population of HE/OR/MA professionals, they provide a point of comparison with earlier studies and offer insights into the mechanics of one of the most innovative and fastest growing health-sector workforce segments in developed as well as emerging countries.

The rate of return to a pharmacy education investment in the U.S.

BACKGROUND: Potential pharmacy students need a financial frame of reference to compare alternative fields of study or even determine if studying is financially worthwhile. OBJECTIVE: Estimate the rate of return to a pharmacy education investment in the U.S. METHODS: A model is used to estimate the rate of return to a pharmacy education. It is formulated using exclusively present values (i.e., dollars at 2019 prices). Several assumptions are made regarding the individual getting the education, the costs incurred, the amount borrowed, and the benefits derived. The robustness of the model is tested using sensitivity analysis and the rate of return is recalculated each time. RESULTS: The estimated real rate of return to a pharmacy education investment in the U.S., devoid of inflation and under the assumptions initially postulated in the model, is 4.89%. The nominal rate of return is 6.44%. Post-estimation sensitivity analysis shows that the real rate of return is relatively inelastic with respect to changes in eight inputs considered, thus indicating robustness in the results of the model. CONCLUSIONS: The real rate of return estimated here establishes pharmacy as a financially viable occupation for young individuals possessing the aptitude and commitment to pursue a patient-centered career in medication management.

A Theoretical Framework for Estimating the Rate of Return to a Pharmacy Education Anywhere.

Undertaking a pharmacy education is an investment in human capital. Candidates trade off present versus future costs and benefits. They make this investment with the expectation of earning enough income throughout their worklives to make their undertaking financially worthwhile. Whether or not this occurs is determined by the rate of return. The aim of the current study was to construct a theoretical model to estimate the rate of return to a pharmacy education investment. Specifications for model assumptions, inputs, and outputs are discussed. The outputs are the rates of return, the inputs are the costs and benefits of a pharmacy education, and the assumptions illustrate the circumstances of the individual or group for whom the model is built. The rate of return is the annual percentage that equates the streams of benefits and costs over the investment span. The higher the value of the rate of return to a pharmacy education is, the more profitable is the investment. This theoretical model may be used to estimate the financial viability of pharmacy and compare it to the viability of other professions or to the viability of pharmacy among various locations.

Public insurance expansions and mental health care availability.

OBJECTIVE: To provide new evidence on the effects of large-scale public health insurance expansions, associated with the Affordable Care Act (ACA), on the availability of specialty mental health care treatment in the United States. We measure availability with the probability that a provider accepts Medicaid. DATA SOURCE/STUDY SETTING: The National Mental Health Services Survey (N-MHSS) 2010-2018. STUDY DESIGN: A quasi-experimental differences-in-differences design using observational data. DATA COLLECTION: The N-MHSS provides administrative data on the universe of specialty mental health care providers in the United States. Response rates are above 90 percent in all years. Data cover 85 019 provider/year observations. PRINCIPAL FINDINGS: ACA-Medicaid expansion increases the probability that a provider accepts Medicaid by 1.69 percentage points, 95 percent confidence interval: [0.0017,0.0321], which corresponds to an increase from 87.27 percent pre-expansion to 90.27 percent postexpansion in expansion states or a 1.94 percent increase. We observe spillovers to Medicare, although this finding is sensitive to specification. CONCLUSIONS: This study provides evidence on the impact of ACA-Medicaid expansion on accepted forms of payment for specialty mental health care treatment. Findings suggest that expansion increases availability of providers who deliver valuable care for enrollees with severe mental illness. These findings may help policy makers reflecting on the future directions of the US health care delivery system.

A Probe into the Wages and Salaries of Health Economics, Outcomes Research, and Market Access Professionals.

OBJECTIVE: To estimate the central tendency and spread of health economics, outcomes research, and market access (HE/OR/MA) professionals' wage-and-salary earnings; compare male versus female and US versus non-US earnings levels; and examine inequality in their distribution. METHODS: Self-reported survey data were collected in 2015 from HE/OR/MA professionals in the HealthEconomics.com global subscriber list. The study design consisted of a two-way classification model with multiple replications and three inequality indicators. HE/OR/MA professionals from the HealthEconomics.com global subscriber list completed a questionnaire. The sample consisted of 403 participants. RESULTS: Within each location, men earned higher wages and salaries than women, and within each gender, HE/OR/MA professionals living in the USA earned higher wages and salaries than those living outside the USA. Evidence of a gap was suggested by the presence of gender and location disparities in earnings determinants. Results also suggested the presence of moderate inequality that was similar for both genders and greater for non-US than US residents. CONCLUSIONS: This study shed light into the labor market structure of HE/OR/MA professionals and may be conducive to more rational and efficient workforce management policies.

Gender and Age Variations in Pharmacists' Job Satisfaction in the United States.

While several studies have attested the presence of systematic gender and age variations in pharmacists' satisfaction with their jobs, only a few of them have considered both classifications simultaneously. None have done so while systematically examining multiple facets of practitioners' work. This article estimated U.S. pharmacists' satisfaction levels with various facets of their work, compared them simultaneously between genders and among age groups, and tested for the presence of gender-age interaction effects. The study was based on self-reported survey data collected from 701 pharmacists (31.0% response rate). Mean and standard deviation values for 18 indices related to pharmacists' work were calculated. When age groups were controlled, female pharmacists expressed overall higher levels of satisfaction with their job than male pharmacists; they also expressed greater satisfaction with multiple specific facets and with the profession, as well as greater workload and stress than male pharmacists. The findings revealed few significant differences among age groups and a limited gender-age interaction effect for pharmacists' satisfaction with key facets of their work. These findings should contribute to the development and refinement of rational criteria for increasing sources of satisfaction in pharmacy settings.

A journey on plate tectonics sheds light on European crayfish phylogeography.

Crayfish can be used as model organisms in phylogeographic and divergence time studies if reliable calibrations are available. This study presents a comprehensive investigation into the phylogeography of the European stone crayfish (Austropotamobius torrentium) and includes samples from previously unstudied sites. Two mitochondrial markers were used to reveal evolutionary relationships among haplogroups throughout the species' distributional range and to estimate the divergence time by employing both substitution rates and geological calibration methods. Our haplotype network reconstruction and phylogenetic analyses revealed the existence of a previously unknown haplogroup distributed in Romania's Apuseni Mountains. This haplogroup is closely related to others that are endemic in the Dinarides, despite their vast geographical separation (~600 km). The separation is best explained by the well-dated tectonic displacement of the Tisza-Dacia microplate, which started in the Miocene (~16 Ma) and possibly carried part of the A. torrentium population to the current location of the Apuseni Mountains. This population may thus have been isolated from the Dinarides for a period of ca. 11 m.y. by marine and lacustrine phases of the Pannonian Basin. The inclusion of this geological event as a calibration point in divergence time analyses challenges currently accepted crayfish evolutionary time frames for the region, constraining the evolution of this area's crayfish to a much earlier date. We discuss why molecular clock calibrations previously employed to date European crayfish species divergences should therefore be reconsidered.

Pockets of Inequality in the Distribution of U.S. Pharmacists' Wages and Salaries: A Gender Comparison.

BACKGROUND: The literature contains conflicting arguments regarding inequalities in the distribution of U.S. pharmacists' wages and salaries and the existence of a gender earnings gap. Some authors argue that the dispersion is small compared to other professions and there is no gap; others report that after controlling for number of hours worked, human-capital stock, and job-related preferences, male pharmacists earn higher wages and salaries than female pharmacists. OBJECTIVES: Estimate the central tendency and spread of wages and salaries of pharmacists practicing in the U.S., compare earning levels of male and female pharmacists, and examine the pockets of inequality within each gender. METHODS: The study used self-reported survey data collected from a random sample of licensed pharmacists practicing throughout the United States. The sample consisted of 375 men and 279 women. Means and standard deviations of wage-and-salary earnings for male and female pharmacists were estimated by age, number of hours worked, years of professional experience, marital status, type of pharmacy degree, main role as pharmacist, and type of practice site. The spread of wages and salaries within gender was analyzed using the Gini coefficient. RESULTS: A total of 654 pharmacists provided answers to all relevant questions in the questionnaire (28.9% response rate). Wages and salaries of male pharmacists exceeded those of female pharmacists, but the gap was restricted to practitioners with selected characteristics-older, married, with more experience, whose primary role was dispensing medications, and practicing in a hospital setting. The greatest wage-and-salary inequalities were observed among older pharmacists, with more years of professional experience, and whose primary role was dispensing medications. Different gender-specific pockets of inequality were identified in all variables studied and all categories within these variables. CONCLUSION: The seemingly smooth gender-specific distribution of earnings in the pharmacy profession might be the result of opposing trends by different groups of practitioners that cancel each other when analyzed aggregately. By estimating the wages and salaries for selected categories of pharmacists and examining the pockets of inequality within each gender, this study shed light into recent labor market developments and will hopefully stimulate further research into the dynamics of the pharmacist workforce.

Gender, age, and pharmacists' job satisfaction

A comprehensive literature review was conducted on the concept of job satisfaction in the pharmacist workforce field and the facets it comprises, as well as its measurement, aiming to (I) review the nature, mechanisms, and importance of job satisfaction in the context of the pharmacist workforce, (II) survey some of the most salient facets that configure job satisfaction, and (III) discuss validity and measurement issues pertaining to it. Although female pharmacists generally hold less appealing jobs, earn lower wages and salaries, and are promoted less frequently than their male counterparts, they report higher levels of job satisfaction. Age has a U-shape effect on job satisfaction, with middle-age pharmacists less satisfied than both younger and older practitioners. Workload, stress, advancement opportunities, job security, autonomy, fairness in the workplace, supervisors, coworkers, flexibility, and job atmosphere are facets contributing to pharmacists' job satisfaction. Finally, discrepancy exists among researchers in measuring job satisfaction as a single global indicator or as a composite measure derived from indices of satisfaction with key aspects of a job. Understanding the mechanisms that affect pharmacists' job satisfaction is important to employers in their pursuit to respond to practitioners' needs, decrease turnover, and increase productivity. As pharmacists' response to work-related conditions and experiences depends on gender and age, a unique set of rewards and incentives may not be universally effective. Additional research into the dynamics of the forces shaping pharmacists' perceptions, opinions, and attitudes is needed in order to design and implement policies that allocate human resources more efficiently within the various pharmacy settings

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Impact of Antidepressant Use on Healthcare Utilization among Individuals with Type 2 Diabetes and Depression Symptoms in the United States: Sociodemographic, Clinical, and Behavioral Factors Matter.

Individuals with diabetes are twice as likely to struggle from depressive symptoms than individuals without diabetes. However, this joint condition is undertreated in nearly two-thirds of patients. Failure to monitor the comorbidity may lead to suboptimal therapy. This study evaluated the association of antidepressant use with healthcare utilization in a national sample of patients with type 2 diabetes and depression symptoms in the United States. It further assessed the differences in sociodemographic, clinical, and behavioral factors between those who use antidepressants and those who do not. This study was a secondary data analysis using the National Health and Nutrition Examination Survey (NHANES) for the period 2005⁻2014. To assess if there were significant differences in sociodemographic, clinical, and behavioral factors between those who were taking antidepressants or not, Chi Square and independent t-tests were used. To assess if there was a significant association between antidepressant use and healthcare utilization, univariate and multivariate regression analyses were conducted. Of the 955 participants, only 33% were on antidepressants. There were significant differences in sociodemographic, clinical, and behavioral factors among those who used antidepressants and those who did not. Regardless of antidepressant use, the study population had access to health care. Those on antidepressants had fewer diabetes specialists' visits and more mental health care. There might be underlying health care disparities related to the use of, and access to, antidepressants. Further studies are needed to comprehensively explore the management of these comorbidities.

Gender differences in the measurement of pharmacists' job satisfaction.

BACKGROUND: Men and women choose different levels of commitment in their careers and at home. Compared to men, women value the significance of tasks performed and social relations more and earnings less. The objective of this study was to explore whether male and female pharmacists show the same levels of satisfaction overall and with key facets of their job, whether overall satisfaction is associated with satisfaction with 12 key facets of pharmacists' jobs, and whether this association is similar for men and women. METHODS: The study used self-reported survey data collected from a random sample of licensed pharmacists practicing throughout the United States. The sample consisted of 436 males and 300 females. Pearson correlation coefficients were calculated to assess the association between overall job satisfaction and its key components. The 13 job satisfaction indices and the Pearson correlation coefficient values were compared by gender. RESULTS: Women were consistently more satisfied than men. Variations in overall job satisfaction were at best accompanied by moderate variations in the 12 job satisfaction facets, raising concerns about the validity of configuring a composite index from multiple indices of satisfaction. CONCLUSION: The results of this study can be used by healthcare managers and policymakers to facilitate communication, enhance teamwork, and promote a better allocation of scarce resources. Since men and women responded differently to various facets of their jobs, a constant set of rewards and stimulants may not be equally effective for both genders as employers transform the workplace to more adequately meet practitioners' needs and increase their productivity.

The effect of state laws designed to prevent nonmedical prescription opioid use on overdose deaths and treatment.

Nonmedical use of prescription opioids has reached epidemic levels in the United States and globally. In response, federal, state, and local governments are taking actions to address substantial increases in prescription opioid addiction and its associated harms. This study examines the effect of two state laws specifically designed to curtail access to prescription opioids to nonmedical users: pain management clinic and doctor shopping laws. We use administrative data on overdose deaths and admissions to specialty substance use disorder treatment coupled with a differences-in-differences design. Our findings suggest that both pain management clinic and doctor shopping laws have the potential to reduce prescription opioid overdose deaths. Moreover, doctor shopping laws appear to reduce prescription opioid treatment admissions. As many states have adopted these laws in recent years, the full effects of the laws may not yet be realized. Future research using more postlaw passage data should reevaluate the effectiveness of these laws.

Gender, age, and pharmacists' job satisfaction.

A comprehensive literature review was conducted on the concept of job satisfaction in the pharmacist workforce field and the facets it comprises, as well as its measurement, aiming to (i) review the nature, mechanisms, and importance of job satisfaction in the context of the pharmacist workforce, (ii) survey some of the most salient facets that configure job satisfaction, and (iii) discuss validity and measurement issues pertaining to it. Although female pharmacists generally hold less appealing jobs, earn lower wages and salaries, and are promoted less frequently than their male counterparts, they report higher levels of job satisfaction. Age has a U-shape effect on job satisfaction, with middle-age pharmacists less satisfied than both younger and older practitioners. Workload, stress, advancement opportunities, job security, autonomy, fairness in the workplace, supervisors, coworkers, flexibility, and job atmosphere are facets contributing to pharmacists' job satisfaction. Finally, discrepancy exists among researchers in measuring job satisfaction as a single global indicator or as a composite measure derived from indices of satisfaction with key aspects of a job. Understanding the mechanisms that affect pharmacists' job satisfaction is important to employers in their pursuit to respond to practitioners' needs, decrease turnover, and increase productivity. As pharmacists' response to work-related conditions and experiences depends on gender and age, a unique set of rewards and incentives may not be universally effective. Additional research into the dynamics of the forces shaping pharmacists' perceptions, opinions, and attitudes is needed in order to design and implement policies that allocate human resources more efficiently within the various pharmacy settings.

The association of vitamin D deficiency and glucose control among diabetic patients.

OBJECTIVE: To evaluate the association between the level of vitamin D and glycemic control among patients with diabetes. RESEARCH DESIGN AND METHOD: We analyzed data collected from NHANES 2003-2006. We included only non-pregnant adult diabetic persons 18 years or older. Participants who had vitamin D level less than 20 ng/ml were considered as having vitamin D deficiency. Participants were considered to have a glucose control if the HbA1c level was less than 7% [53 mmol/L]. We used student's t test to compare the difference in HbA1c means between people with Diabetes with and without a vitamin D deficiency. We used a multivariate logistic regression model to predict the relationship between glucose control and vitamin D deficiency. We used race/ethnicity, BMI, age, gender, type of diabetic medication used, having health insurance or not, and comorbid conditions (hypertension, anemia, cholesterol, liver disease, and kidney disease) as control variables. RESULTS: The study population included a total of 929 non-institutionalized, non-pregnant, diabetic adult persons. About 57% of patients with diabetes had a vitamin D deficiency. Blacks (non-Hispanic patients) with diabetes had the highest rate of vitamin D deficiency (79%). The unadjusted means of HbA1c were significantly different between diabetic patients with no vitamin D deficiency and those with a vitamin D deficiency (7.06% [54 mmol/L], 7.56 % [59 mmol/L], respectively, P < 0.0001). Multivariate adjustment showed a small but not significant, increase in odds (11%) of having uncontrolled diabetes in patients with a vitamin D deficiency after adjustment for other factors. CONCLUSION: Vitamin D deficiency is very common in patients with diabetes. We found no significant association between vitamin D level and glycemic control in patients with diabetes after adjustment for control variables.

Are natural disasters in early childhood associated with mental health and substance use disorders as an adult?

Understanding factors that influence risk for mental health and substance use disorders is critical to improve population health and reduce social costs imposed by these disorders. We examine the impact of experiencing a natural disaster-a serious fire, tornado, flood, earthquake, or hurricane-by age five on adult mental health and substance use disorders. The analysis uses data from the 2004 to 2005 National Epidemiologic Survey of Alcohol and Related Conditions. The analysis sample includes 27,129 individuals ages 21-64 years. We also exploit information on parenting strategies to study how parents respond to natural disasters encountered by their children. We find that experiencing one or more of these natural disasters by age five increases the risk of mental health disorders in adulthood, particularly anxiety disorders, but not substance use disorders. Parents alter some, but not all, of their parenting strategies following a natural disaster experienced by their children. It is important to provide support, for example through counseling services and financial assistance, to families and children exposed to natural disasters to mitigate future mental health and substance use problems attributable to such exposure.