North Carolina Medical Journal

Despite the stark decline in North Carolina's teen birth rates over the past three decades, rates remain disproportionately highest amongst Black, Latinx, and Native American teens in comparison to white teens. Numerous upstream factors continue to drive racial inequities, creating greater disparities in birth rates among teens of color.

Many states and localities in the United States are implementing evidence-based tobacco control policies at the retail level, including Tobacco 21 laws, tobacco retailer licensing, restrictions on point-of-sale promotions, and bans on flavored tobacco products. With the passage of new point-of-sale tobacco control policies, North Carolina could reduce youth tobacco use rates.

Excise taxes can raise the price of unhealthy products, reducing consumption and associated health risks and costs. Raising state excise taxes on tobacco, alcohol, and sugary drinks and allowing local governments to do the same are win-win strategies for achieving three Healthy North Carolina 2030 health behavior targets while increasing state revenues.

No abstract text is available yet for this article.

Before the onset of the COVID-19 pandemic, North Carolina had seen encouraging reductions in opioid overdose deaths. In the years since, this trend has unfortunately reversed. In this interview, Guest Editor Carrie Rosario talks with North Carolina Attorney General Josh Stein about how the state will use settlement funds to prevent future overdose deaths.

No abstract text is available yet for this article.

Harm reduction is a practice-oriented approach to reducing harms from drug use, including overdose and injection-related infections. North Carolina has a legacy of harm reduction innovation, yet our history includes sustained racist and harmful drug policies. People with lived experience are central to the creation of next-generation strategies for prevention.

Commercial tobacco products have been protected from regulation, yet are designed to addict, are deadly, and are promoted to young people whose brains are not yet fully developed. Until everyone is protected from addiction and exposure, we must keep working toward fairness and value-based policy, systems, and environmental change.

Excessive alcohol use, already problematic in North Carolina, has increased markedly during COVID-19. Alcohol-related morbidity and mortality have also increased.

BACKGROUND Coal combustion releases a number of airborne toxins. The North Carolina Clean Smokestacks Act (CSA) of 2002 required North Carolina coal-fired power plants (CFPP) to reduce nitrogen oxides (NOX ) emissions by 2009 and sulfur dioxide (SO2 ) emissions to 2 benchmarks by 2009 and 2013. METHODS We utilized publicly available databases from the Energy Information Administration and the Environmental Protection Agency to characterize North Carolina's electricity generation profile from 2000 until 2019 and evaluate corresponding NOx and SO2 emissions by sector over the same time period...

Consuming sugar-sweetened beverages is one of the main concerns in addressing obesity in North Carolina. Many interventions have been developed to limit their consumptionwhile promoting drinking more water. Major sugarsweetened beverage producers take no accountability for the harm they cause to communities.

No abstract text is available yet for this article.

BACKGROUND Inadequate access to opioid use disorder (OUD) treatment is a public health concern. Rates of opioid-related poisoning deaths are increasing in North Carolina and access to OUD treatment is especially sparse in rural areas. DEA-X-waivered providers that can prescribe buprenorphine as a medication for opioid use disorder (MOUD) play an essential role in treating OUD. Increased workforce capacity to treat OUD in an evidence-based, equitable, and patient-centered way is needed. Gaps persist in continuing professional education and academic training...

BACKGROUND Our objectives were to evaluate geographic access to lung cancer treatment modalities in North Carolina and to characterize how practice patterns are changing over time. We hypothesized that rural patients would be less likely to undergo treatment compared to urban patients, with widening disparities over time. METHODS We identified patients with Stage I non-small cell lung cancer (NSCLC) from 2006 to 2015 using the North Carolina Central Cancer Registry linked with Medicaid, Medicare, and private insurance claims...

Pre-exposure prophylaxis (PrEP) is a biomedical HIV innovation designed to reduce HIV transmission. Unfortunately, PrEP uptake is suboptimal within many communities in the US South. Innovative interventions that integrate evidence-based strategies (e.g., mHealth and peer navigation through cyber health educators) are needed to increase PrEP uptake in North Carolina.

The following is a review of current policy and proposed legislation related to health behavior indicators in North Carolina. It is not an endorsement of any policy or bill; it is meant to serve as a resource for policy makers, health care stakeholders, and other readers of the NCMJ.

Healthy behaviors contribute to healthy people and communities, and a prosperous state. They are, however, more than simply individual choices. This issue of the North Carolina Medical Journal contextualizes current behavioral trends, progress toward advancing healthy behaviors, and policy levers to address substance use, sugary drink consumption, and sexual health practices.

No abstract text is available yet for this article.

Advanced practice providers comprise an increasing percentage of the health care and primary care workforce. This paper evaluates the weighted contribution of advanced practice providers to the primary care workforce in well-served and underserved counties across North Carolina using age- and sex-adjusted population measures of access.

Clinical care makes a modest contribution to well-being, but adequate access to high-quality care is a necessary, if insufficient, condition for health. This issue of the North Carolina Medical Journal focuses on the Healthy North Carolina 2030 clinical indicators, the impact of health disparities, and the COVID-19 pandemic.