OBJECTIVES: This study examined the health insurance status of the US foreign-born population and the influence of race, ethnicity, and length of residence on health insurance status. METHODS: Data were obtained from the 1989 and 1990 National Health Interview Surveys, including the Insurance and Family Resource Supplements. RESULTS: In 1989 and 1990, the foreign-born population was twice as likely as the US-born population to be uninsured (26.2% vs 13.0%). The highest rate of uninsured status, 40.8%, was found among foreign-born Hispanics. Persons who had lived in the United States for less than 15 years were 1.5 to 4.7 times more likely to be uninsured than were US-born Whites. CONCLUSIONS: Foreign-born US residents-especially Hispanics and persons residing in the United States for less than 15 years-are vulnerable to not having health insurance, which may limit their access to medical services. The administrative criteria for public programs may explain the high rates of uninsured status among recent immigrants. Recently enacted federal legislation could substantially increase the number of uninsured among the US foreign-born population, with profound public health implications.

The relative contributions of needle use practices and sexual behaviors to human immunodeficiency virus (HIV) antibody seropositivity among 394 women incarcerated in Quebec were determined by risk factor assessment and serology with a nonnominal methodology. HIV positivity was found in 6.9% (95% confidence interval [CI] = 4.6, 9.9) of all participants and in 13% (95% CI = 8.6, 18.6) of women with a history of injection drug use. HIV seropositivity among women with a history of injection drug use was predicted by sexual or needle contact with a seropositive person, self-reported genital herpes, and having had a regular sexual partner who injected drugs, but it was not predicted by prostitution. Nonnominal testing is an ethical alternative to mandatory and anonymous unlinked testing among correctional populations.

Ensuring access to and promoting use of effective contraception have been identified as important strategies for preventing unintended pregnancy (1). The importance of ensuring resources to prevent unintended pregnancy in the context of public health emergencies was highlighted during the 2016 Zika virus outbreak when Zika virus infection during pregnancy was identified as a cause of serious birth defects (2). Accordingly, CDC outlined strategies for state, local, and territorial jurisdictions to consider implementing to ensure access to contraception (3). To update previously published contraceptive use estimates* among women at risk for unintended pregnancy† and to estimate the number of women with ongoing or potential need for contraceptive services,§,¶ data on contraceptive use were collected during September–December 2016 through the Behavioral Risk Factor Surveillance System (BRFSS). Results from 21 jurisdictions indicated that most women aged 18–49 years were at risk for unintended pregnancy (range across jurisdictions = 57.4%–76.8%). Estimates of the number of women with ongoing or potential need for contraceptive services ranged from 368 to 617 per 1,000 women aged 18–49 years. The percentage of women at risk for unintended pregnancy using a most or moderately effective contraceptive method** ranged from 26.1% to 65.7%. Jurisdictions can use this information to estimate the number of women who might seek contraceptive services and to plan and evaluate efforts to increase contraceptive use. This information is particularly important in the context of public health emergencies, such as the recent Zika virus outbreak, which have been associated with increased risk for adverse maternal-infant outcomes (2,4–6) and have highlighted the importance of providing women and their partners with resources to prevent unintended pregnancy.

A rising concern is the COVID-19 pandemic effect on adverse childhood experiences (ACEs) due to increased parental stress and social/physical isolation. These pandemic effects are likely to be higher in already marginalized communities. The objective of this ecological study was to examine the relationship between COVID-19 cases and deaths, race/ethnicity, and the estimated number of adults with ACEs using data from South Carolina (SC). COVID-19 reported cases and death data were obtained from the SC Department of Health and Environmental Control. ACE data was used from the 2014–2016 SC Behavioral Risk Factor Surveillance System. Census data were used to obtain county population data. To measure the relationship between these variables, the Spearman rank-order correlation test was used because the data distribution was non-normal. There was a moderate relationship between the estimated number of adults with one or more ACEs and deaths (ρ = 0.89) and race/ethnicity-specific COVID-19 case counts by county (Black: ρ = 0.76; =White: ρ = 0.96; Hispanic: ρ = 0.89). Further, the Spearman correlation test showed the strongest relationship between COVID-19 deaths and race-ethnicity-specific county populations was with the Black adult population (ρ = 0.90). Given the known link between existing health inequities and exposure to COVID-19, these results demonstrate that the current pandemic could have unintended consequences on the well-being of children and caregivers. Response efforts should consider promoting protective factors for children and families and advocating for equitable policies and systems that serve children.

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