On August 23, 2021, the US Food and Drug Administration (FDA) gave its first full approval of a COVID-19 vaccine, the BNT162b2 mRNA vaccine (Pfizer-BioNTech).¹ Previously, a Kaiser Family Foundation survey² found that many unvaccinated individuals were concerned the vaccine was unsafe, and some remained unvaccinated because they did not trust the government. It is unclear whether FDA approval allayed this hesitancy. To examine this notion, we conducted a cross-sectional analysis of the association between the FDA full approval of BNT162b2 mRNA vaccine with subsequent US COVID-19 vaccinations of any kind.

Veterans commonly experience both poor health and employment difficulty. However, the research examining potential relationships between chronic physical and mental health conditions and employment in veterans has important limitations. This study examines those potential relationships using large-scale, nationally representative data. The authors' hypothesis was that veterans experiencing these conditions would be less likely to be employed than veterans without the conditions and, further, that there may be differences in these relationships when comparing male veterans with female veterans. The study team conducted a pooled cross-sectional analysis of nationally representative data from the 2004-2019 administrations of the Medical Expenditures Panel Survey, which had items addressing health conditions, employment, and military experience. The authors assessed the relationship between health conditions and employment using multivariate logistic regression. Control variables included demographics, SES, family size, and survey year. Veterans experiencing diabetes, high blood pressure, stroke, emphysema, arthritis, serious hearing loss, poor self-reported mental health, poor self-reported health, depression, or psychological distress were less likely to be employed than veterans without those conditions, even after adjusting for potential confounding factors. Veterans with diabetes had 25% lesser odds of being employed than veterans without the condition (95% CI=0.65, 0.85). Veterans with increased likelihood of depression had 35% lesser odds of being employed than veterans without depression (95% CI=0.52, 0.81). This study adds evidence to the understanding of the role of chronic health conditions in employment status of veterans. The results support arguments for programs that aid veterans with both their health and their employment.

Background/Objectives: U.S. telehealth utilization increased substantially during the COVID-19 pandemic; however, post-pandemic utilization patterns and associated characteristics remain unclear. This study examined national trends in telehealth use and identified factors associated with its utilization from 2020 to 2023. Methods: Data from the Medical Expenditure Panel Survey (2020–2023) Office-Based Medical Provider Visits and Outpatient Visits files were used to identify national telehealth use. Descriptive statistics and generalized linear regression were used to examine telehealth utilization, visit type, service type, and potential predictors of utilization. Results: The proportion of U.S. health care visits made via telehealth increased sharply from 2020 (1.84%; 95% CI, 1.67–2.01) to 2021 (4.53%; 95% CI, 4.11–4.94) and then stabilized through 2023. The proportion of the U.S. population with at least one telehealth visit followed a similar trend (7.15% in 2020; 12.09% in 2021; 12.05% in 2022; 12.12% in 2023). Telehealth visits were primarily for outpatient care and were most commonly used for mental health services (4.20% in 2021; 4.13% in 2022; and 4.18% in 2023). Sex, health insurance status, age, and family income were significant predictors of telehealth utilization. Conclusions: Pandemic-related increases in telehealth use have persisted beyond the COVID-19 period. Continued support from health care systems and policymakers is necessary to sustain and expand access to telehealth services.

Introduction: Post-9/11 U.S. veterans experience disproportionately high rates of mental health conditions. They are also more likely than non-veterans to be unemployed. Many studies have examined potential relationships between those phenomena. We aimed to systematically review this literature. Materials and Methods: Articles published between September 2001 and September 2021 were identified using PubMed, Web of Science, and Google Scholar. These studies were cohort, cross-sectional, mixed methods, or qualitative studies that reported associations between mental health status or diagnoses and employment and were published in English. Primary mental health conditions of interest were post-traumatic stress disorder (PTSD), alcohol use disorder, bipolar disorder, depression, and other mood, psychiatric, or eating disorders. Two authors screened identified articles for inclusion, and disagreements were resolved by a third author. Results: Twenty-eight articles met inclusion criteria. Three reported PTSD to be positively associated with unemployment, although 7 found null results. Seven of 9 studies examining depression found positive associations between depression and unemployment, with 2 studies showing null findings. One study reported impaired job performance among veterans with alcohol or substance use disorder, but 2 studies on alcohol use disorder reported no significant association with unemployment. Study methodologies varied significantly, including in their populations, employment definitions, and choice of potential confounders. Conclusions: The review suggests a relationship between depression and employment status, but evidence for relationships between other conditions and employment status is mixed, which may be because of significant methodological differences between individual studies. Future work should address this by using a generalizable sample of post-9/11 veterans, a standardized definition of unemployment, and base the statistical model on a theoretical framework describing the relationship between mental health and employment.

This study aimed to explore public sympathy toward individuals with substance misuse, including relationships between that phenomenon and demographic, socioeconomic, and health factors in a single U.S. state. Weighted summary statistics and logistic regression analyses were conducted using data from the 2021 Utah Behavioral Risk Factor Surveillance System. The outcome measure was derived from a unique question which asked about sympathy toward those misusing substances, which may reflect behaviors indicative of or preceding substance use disorder (SUD). Other measures included standard demographics; education; religious affiliation; veteran status; LGBTQ+ status; history of cigarette, alcohol, and marijuana use; and health status. Older age, Hispanic race/ethnicity, affiliation with several Christian religions, residence in rural counties, and lack of health insurance were negatively related to sympathy toward individuals misusing substances. Those with past-month marijuana use, higher education, and current poor mental health were significantly more likely than their counterparts to express this sympathy. This state-level measure of sympathy toward those misusing substances allowed for detection of both previously known and potentially newly identified predictors of sympathy around substance misuse and, potentially, disorders. Efforts should be made to measure SUD sympathy or stigma in nationally-representative datasets. The knowledge derived from such data could be used to increase SUD sympathy and reduce SUD stigma. In addition, further research in this area should focus on education level and religion.