Background/Objectives: Sugar-sweetened beverage (SSB) consumption is associated with child obesity, an understudied issue in the southern United States, where obesity rates are the highest in the country. We examined the factors associated with high SSB intakes among children aged 2–12 years in two major cities in Louisiana, New Orleans and Baton Rouge. Methods: We conducted a cross-sectional study using an online survey. The sample consisted of caregivers of children aged 2–12 years who eat restaurant meals (either dine-in, delivery, or take-out) at least once a month and reside in or near New Orleans or Baton Rouge, LA. Multivariable logistic regression was used to examine factors associated with high child SSB intake frequency (≥4 times/week), including restaurant use, caregiver attitudes towards SSB, and their demographics (n = 1006). Results: Most caregivers reported weekly child SSB consumption (74.6% ≥ 1×/week; 38.1% ≥ 4+/week) and restaurant use (58.8% ≥ 1×/week). High SSB frequency (≥4+/week) was associated with a higher frequency of restaurant use, lower caregiver education, agreement with the statement that SSBs are an important part of family meals, and disagreement with the statement that restaurants should not offer SSBs with children’s meals (p < 0.05). Conclusions: Our results revealed a high frequency of SSB consumption among children who dine at restaurants monthly, with significant associations observed between SSB intake, restaurant meals, and pro-SSB attitudes. These findings may support the need for regulations, such as healthy default beverage policies for children’s menus, to potentially reduce SSB intake and shift social norms, particularly in regions with high childhood obesity rates like Louisiana and the southern USA.

Objective: On June 17, 2021, Louisiana launched a lottery campaign to reward residents who received a COVID-19 vaccination. We investigated the association between the lottery and vaccination uptake by characteristics of parishes. Methods: We constructed an interrupted time series based on daily parish-level data on COVID-19 vaccinations to analyze the association with the lottery. We used recursive partitioning to separate vaccination uptake due to the Delta variant from vaccination uptake due to the lottery and limited our study period to May 25 through July 20, 2021. We performed subanalyses that grouped parishes by political affiliation, hesitancy toward COVID-19 vaccines, race and ethnicity, and socioeconomic status to detect heterogeneous responses to the lottery by these characteristics. We ran models separately for parishes in the top and bottom tertiles of each sociodemographic indicator and used a z test to check for differences. Results: The lottery was associated with an additional 1.03 (95% CI, 0.61-1.45; P < .001) first doses per parish per day. Comparing lottery impacts between top and bottom tertiles, we found significantly larger associations in parishes with lower vaccine hesitancy rates, higher percentage of Hispanic population, higher median annual household income, and more people with a college degree. Conclusions: Results suggest that the lottery was associated with increased COVID-19 vaccination uptake in Louisiana. However, larger associations were observed in parishes with an already higher likelihood of accepting vaccines, which raises equity issues about the opportunity created by the lottery and its effectiveness as a long-term behavioral incentive.

Objectives. To assess the impact of state COVID-19 vaccine mandates for health care workers (HCWs) on health sector employment in the United States. Methods. Using monthly state-level employment data from the Quarterly Census of Employment and Wages between January and October 2021, we employed a partially pooled synthetic control method that accounted for staggered mandate adoption and heterogeneous treatment effects. We conducted analyses separately for the 4 health care subsectors—ambulatory health care services, hospitals, nursing and residential care, and social assistance—with an additional analysis of 2 industry groups—skilled nursing care and community care for the elderly—under the nursing and residential care subsector. We further explored possible heterogeneous impacts according to the test-out option availability. Results. Mandate impact estimates were statistically indistinguishable from zero. Results further ruled out a mandate-associated decrease in employment larger than 2.1% of premandate employment levels for the 6 health care domains examined and for states with no test-out option. Conclusions. State COVID-19 vaccine mandates for HCWs were not found to be associated with significant adverse impacts on health sector employment even in states without a testing alternative to vaccination. The findings support vaccine mandates as a viable preventive measure without material disruption to the health care workforce, including in times of public health emergencies. ( Am J Public Health. 2025;115(3):344–348. https://doi.org/10.2105/AJPH.2024.307906 )

This study examined the nutritional environments of restaurants offering children’s menus and their association with neighborhood-level factors in a southern United States city with disproportionately high childhood obesity rates. On-site assessments were conducted to generate nutrition environment scores for restaurants offering children’s menus in New Orleans, Louisiana ( n = 191). Restaurants were geocoded and linked to neighborhood characteristics, including racial/ethnic composition and socioeconomic opportunity measured by the Social and Economic Child Opportunity Index (COI-SE). Multivariate linear regressions assessed associations between nutrition environment scores and neighborhood characteristics, adjusting for restaurant-specific attributes. Restaurants located in neighborhoods with COI-SEs above the median had significantly higher nutrition environment scores (+ 2.41 points; 95% CI 0.47, 4.35; p = 0.015). This relationship appears to be driven by the associations with the healthy options and facilitators to healthy eating sub-scores. Neighborhood racial/ethnic composition was not associated with nutrition environment scores. Restaurant characteristics were associated with nutrition environment quality: sit-down restaurants had lower scores than fast-food restaurants (− 2.35 points; 95% CI −4.45, −0.24; p = 0.029), while chain restaurants scored higher than independent establishments (+ 2.13 points; 95% CI 0.44, 3.82; p = 0.014). These findings suggest that neighborhood socioeconomic opportunity and restaurant characteristics shape children’s exposure to healthier restaurant food environments. Health strategies that prioritize place-based policies and support healthier children’s menu offerings, particularly in lower-opportunity neighborhoods, may help address inequities in food environments and reduce disparities in child health.