Spatiotemporal analysis of HPV vaccination and associated neighborhood-level disparities in Texas-an ecological study.

Background: HPV is responsible for most cervical, oropharyngeal, anal, vaginal, and vulvar cancers. The HPV vaccine has decreased cervical cancer incidence, but only 49% of Texas adolescents have initiated the vaccine. Texas shows great variation in HPV vaccination rates. We used geospatial analysis to identify areas with high and low vaccination rates and explored differences in neighborhood characteristics. Methods: Using Anselin's Local Moran's I statistic, we conducted an ecological analysis of hot and cold spots of adolescent HPV vaccination coverage in Texas from 2017 to 2021. Next, we utilized a Mann-Whitney U test to compare neighborhood characteristics of vaccination coverage in hot spots versus cold spots, leveraging data from the Child Opportunity Index (COI) and American Community Survey. Results: In Texas, there are 64 persistent vaccination coverage hotspots and 55 persistent vaccination coverage cold spots. The persistent vaccination coverage hot spots are characterized by ZIP codes with lower COI scores, higher percentages of Hispanic residents, higher poverty rates, and smaller populations per square mile compared to vaccine coverage cold spots. We found a more pronounced spatial clustering pattern for male adolescent vaccine coverage than we did for female adolescent vaccine coverage. Conclusion: In Texas, HPV vaccination coverage rates differ depending on the community's income level, with lower-income areas achieving higher success rates. Notably, there are also gender-based discrepancies in vaccination coverage rates, particularly among male adolescents. This knowledge can aid advocates in customizing their outreach initiatives to address these disparities.

Climate Change is an Emerging Threat to Perinatal Mental Health.

OBJECTIVE: In this discussion, we build the case for why climate change is an emerging threat to perinatal mental health. METHOD: A search of current literature on perinatal and maternal mental health and extreme weather events was conducted in PubMed/MEDLINE and Web of Science databases. Only articles focusing on maternal mental health were included in this narrative review. RESULTS: The perinatal period represents a potentially challenging timeframe for women for several reasons. Necessary role adjustments (reprioritization), changes in one's ability to access pre-birth levels (and types) of social support, fluctuating hormones, changes in body shape, and possible complications during pregnancy, childbirth, or postpartum are just a few of the factors that can impact perinatal mental health. Trauma is also a risk factor for negative mood symptoms and can be experienced as the result of many different types of events, including exposure to extreme weather/natural disasters. CONCLUSION: While the concepts of "eco-anxiety," "climate despair," and "climate anxiety" have garnered attention in the mainstream media, there is little to no discussion of how the climate crisis impacts maternal mental health. This is an important omission as the mother's mental health impacts the family unit as a whole.

Effects of extreme weather events on child mood and behavior.

Extreme weather events (EWEs) are increasing in frequency and severity as the planet continues to become warmer. Resulting disasters have the potential to wreak havoc on the economy, infrastructure, family unit, and human health. Global estimates project that children will be disproportionately impacted by the changing climate - shouldering 88% of the related burdens. Exposure to EWEs in childhood is traumatic, with ramifications for mental health specifically. Symptoms of posttraumatic stress, depression, and anxiety have all been associated with childhood EWE exposure and have the potential to persist under certain circumstances. Conversely, many childhood survivors of EWE also demonstrate resilience and experience only transient symptoms. While the majority of studies are focused on the effects resulting from one specific type of disaster (hurricanes), we have synthesized the literature across the various types of EWEs. We describe psychological symptoms and behavior, the potential for long-term effects, and potential protective factors and risk factors. What this paper adds Climate change-related phenomena such as extreme weather events (EWEs) have the potential to impact mood and behavior in children. Posttraumatic stress (PTS) is the most common mental health consequence in child survivors of EWEs. PTS is often comorbid with depression and/or anxiety in this group.