The role of trust in using healthcare and uptake of preventive behaviors Trust in healthcare systems constitutes an integral element of determining how individuals use and interact with those systems, as well as participate in recommended health behaviors such as heathy eating and vaccination. Trust is key to positive health outcomes [18] and has been shown to predict health behaviors, such as childhood [19] and COVID-19 vaccinations [20-22]. Moreover, trust is associated with following advice from healthcare professionals [23,24] and accepting differing care modalities such as telehealth [25] and mobile health (mHealth) [26]. These issues have been brought to the forefront by the pandemic [8], particularly regarding whether people trust in and follow advice from healthcare professionals. Changes in household finances and healthcare use and health-related behaviors. Shifts in household finances during and immediately after the COVID-19 pandemic also likely influenced interactions with healthcare systems and health-related behaviors. Some patients with COVID-19 experienced a significant economic burden due to increased medical costs [27,28]. As emergency benefits ended, some US residents experienced a post-pandemic healthcare affordability crisis [29]. Moreover, the pandemic brought economic burdens related to job loss, inflation, and shifts in childcare responsibilities resulting in changing workforce involvement [4,30,31]. Individual and household finances also play a key role in health behaviors. Healthy eating, diet quality, and income are linked, such that those with lower income are more likely to have poorer diet quality partly due to the cost of nutrient-dense foods relative to less nutritious alternatives [32], with variation in this finding by race and ethnicity [33]. Exercise has also been shown to be associated with income [34,35] though this relationship is complex [36]. For instance, individuals with lower incomes have lower rates of sedentary behavior, and those with higher income undertake less frequent but more intense exercise and are more likely to meet daily physical activity guidelines [36]. Therefore, we expect that exercise and healthy eating may be less likely to occur in households experiencing financial difficulty during and immediately post-COVID-19.

The COVID-19 pandemic brought a shock both to individual lives and broader systems in the United States (US) and across the globe [1]. Societal shifts have occurred since the pandemic's onset (e.g., increase in remote work, masking during times of high viral transmission). There were also major impacts on household finances through COVID-19-related morbidity and mortality, labor market shifts (e.g., layoffs), and stimulus payments [2-4]. Given the environment of risk and uncertainty inherent in a pandemic, trust in institutions responsible for managing pandemic response is likely to play an important role in individuals' behaviors during and immediately post-pandemic [5-8]. The COVID-19 pandemic rapidly changed individuals' interactions with health systems, including through shifts in public health policy, pandemic-related impacts to healthcare service availability, and socio-behavioral factors (e.g., changes in attitudes, perceptions, and behaviors). Restrictions on in-person services, including both preventive and elective care, resulted in reductions in healthcare use overall [9], even with waivers for telehealth services and increased telehealth use in general [10]. Also, uptake of pharmacy-based care increased, particularly for COVID-19 testing and vaccination, due to regulatory and reimbursement changes [11]. After the pandemic, some shifts appear to have lasted. There is enhanced capacity for telehealth [12] as well as reimbursement changes [13,14] to finance such care delivery. There is also evidence that people's likelihood of engaging in health-related behaviors changed during the COVID-19 pandemic. The COVID-19 pandemic is generally considered to have had negative impacts on healthy eating [15] and exercise [16]. Influenza vaccination rates also may have had spillover effects from COVID-19 vaccination rates such that during the period September 2021- January 2022, states with higher COVID-19 vaccine uptake also experienced higher flu vaccine uptake, and similarly, states with lower COVID-19 vaccine uptake saw lower flu vaccine uptake in comparison to the flu vaccination season before the COVID-19 pandemic (September 2019 to January 2020) [17].

Censorship Should Not Be Allowed in Any Form According to the National Coalition Against Censorship, removing an author from an event because someone disagrees with their ideas or content in their books meets the definition of censorship. And in protest, five of the seven other festival authors—Pete Hautman, Melissa de la Cruz, Matt de la Pena, Tera Lynn Childs and Brian Meehl—withdrew. Our books are all very different. But our voices are united against allowing one person, or a handful of people, to speak for an entire community. If you don't like content in a book, don't read it. If you don't want your child to read a book, take it away. But you do not have the right to decide "appropriateness" for everyone. This year's TeenLitFest was canceled. None of us authors wanted that, or to punish the teens who wanted to see us. But this is a valuable lesson to the young people who are our future. Censorship cannot be allowed to flourish in America. If you don't like content in a book, don't read it. If you don't want your child to read a book, take it away. But you do not have the right to decide "appropriateness" for everyone. What's perhaps not right for one child is necessary to another. Ignorance is no armor. And those whose lives are touched by the issues I write about deserve to know they are not alone. And so, in honor of Banned Books Week 2010, I give you: To you zealots and bigots and false patriots who live in fear of discourse. You screamers and banners and burners who would force books off shelves in your brand name of greater good.You say you're afraid for children, innocents ripe for corruptionby perversion or sorcery on the page. But sticks and stones do break bones, and ignorance is no armor. You do not speak for me, and will not deny my kids magic in favor of miracles.You say you're afraid for America, the red, white, and blue corroded by terrorists, socialists, the sexually confused. But we are a vast quilt of patchwork cultures and multi-gendered identities. You cannot speak for those whose ancestors braved different seas.You say you're afraid for God, the living word eroded by Muhammed and Darwin and Magdalene. But the omnipotent sculptor of heaven and earth designed intelligence. Surely you dare not speak for the father, who opens his arms to all.A word to the unwise. Torch every book. Char every page. Burn every word to ash. Ideas are incombustible. And therein lies your real fear.

My first dis-invitation was last year in Norman, Oklahoma. I had donated a school visit to a charity auction. The winning bid came from a middle school librarian, who was excited to have me talk to her students about poetry, writing process, and reaching for their dreams. Except, two days before the visit, a parent challenged one of my books for "inappropriate content." She demanded it be pulled from all middle school libraries in the district. And also that no student should hear me speak. The superintendent, who hadn't read my books, agreed, prohibiting me from speaking to any school in the district. The librarian scrambled and I spoke community-wide at the nearby Hillsdale Baptist Freewill College. (The challenged book, by the way, was later replaced in the middle school libraries.) The timing was exceptional, if unintentional. It was Banned Books Week 2009, and my publisher, Simon & Schuster, had recently created a broadside of a poem I'd written for the occasion. My "Manifesto" was currently being featured in bookstores and libraries across the country. Segue to August 2010. Simon & Schuster repackaged "Manifesto" just about the time another dis-invitation took place. Humble, Texas is a suburb of Houston, and every other year the Humble Independent School District organizes a teen literature festival. I was invited to headline the January 2011 event. The term "invitation" would later be debated, as no formal contract was signed. But through a series of email exchanges, the invitation was extended, I agreed, we settled on an honorarium, and I blocked out the date on my calendar (thus turning down other invitations). According to the National Coalition Against Censorship, removing an author from an event because someone disagrees with their ideas or content in their books meets the definition of censorship. This time it was a middle school librarian who initiated the dis-invitation. Apparently concerned about my being in the vicinity of her students, she got a couple of parents riled and they approached two members of the school board. Again, no one read my books. Rather, according to the superintendent, he relied on his head librarian's research—a website that rates content. He ordered my "removal" from the festival roster, despite several librarians rallying in my defense.

On Tuesday [Sept. 28, 2010] I spoke to a packed house in Columbus, Georgia. I talked about my journey to New York Times bestselling author—a road pitted with pain. (My first novel, Crank, was inspired by my daughter's descent into the hell that is methamphetamine addiction.) Afterward, I signed books, and as the room emptied one lovely young woman remained. She came forward and when I asked her name, she crumbled into tears. Then she shared her own story. How she started getting high in middle school, mostly as a way to deal with her alcoholic mother's absence. Didn't care about the trajectory she was on—straight down into the same hell my book represented so well. But one day, she found that book. She saw herself in those pages, and suddenly knew she didn't want to be there. That book turned her around. Today she's been sober two years, is graduating high school and has embarked on a modeling career.