bluuebunny/crossref_metadata_2025 huggingface dataset:
Is Smoking Delayed Smoking Averted?
Authors: Glied Sherry
Published: December 2008

Antismoking efforts often target teenagers in the hope of producing a new generation of never smokers. Teenagers are more responsive to tobacco taxes than are adults.

The author summarizes recent evidence suggesting that delaying smoking initiation among teenagers through higher taxes does not generate proportionate reductions in prevalence rates through adulthood. In consequence, the impact of taxes on smoking among youths overstates the potential long-term public health effects of this tobacco control strategy.
Disparities in Trends of Hospitalization for Potentially Preventable Chronic Conditions Among African Americans During the 1990s: Implications and Benchmarks
Authors: Davis Sharon K. , Liu Yong , Gibbons Gary H.
Published: December 2008

Objectives. We compared trends in prevalence rates of preventable cardiovascular- and diabetes-related hospitalizations between African Americans and members of other major US racial/ethnic groups.

Methods. Standardized rates for 1991 to 1998 were derived from hospital and US census data for California.

Results. African Americans had significantly higher hospitalization rates in 1991, and discrepancies in rates continued to widen through 1998. Overall male and female rates were approximately 3 times higher for angina, 7 times higher for hypertension, between 7 and 8 times higher for congestive heart failure, and 10 times higher for diabetes.

Conclusions. Widening disparities in cardiovascular- and diabetes-related health conditions were observed in this study, possibly owing to racial inequalities in provision of effective primary care.
Neighborhood Physical Conditions and Health
Authors: Cohen Deborah A. , Mason Karen , Bedimo Ariane , Scribner Richard , Basolo Victoria , Farley Thomas A.
Published: December 2008

Objectives. We explored the relationship between boarded-up housing and rates of gonorrhea and premature mortality.

Methods. In this ecological study of 107 US cities, we developed several models predicting rates of gonorrhea and premature death before age 65 from all causes and from specific causes. We controlled for race, poverty, education, population change, and health insurance coverage.

Results. Boarded-up housing remained a predictor of gonorrhea rates, all-cause premature mortality, and premature mortality due to malignant neoplasms, diabetes, homicide, and suicide after control for sociodemographic factors.

Conclusions. Boarded-up housing may be related to mortality risk because of its potential adverse impact on social relationships and opportunities to engage in healthful behaviors. Neighborhood physical conditions deserve further consideration as a potential global factor influencing health and well-being.
Parental Smoking and Infant Respiratory Infection: How Important Is Not Smoking in the Same Room With the Baby?
Authors: Blizzard Leigh , Ponsonby Anne-Louise , Dwyer Terence , Venn Alison , Cochrane Jennifer A.
Published: December 2008

Objectives. We sought to quantify the effect of good smoking hygiene on infant risk of respiratory tract infection in the first 12 months of life.

Methods. A cohort of 4486 infants in Tasmania, Australia, was followed from birth to 12 months of age for hospitalization with respiratory infection. Case ascertainment was 98.2%.

Results. Relative to the infants of mothers who smoked postpartum but never in the same room with their infants, risk of hospitalization was 56% (95% confidence interval [CI] = 13%, 119%) higher if the mother smoked in the same room with the infant, 73% (95% CI = 18%, 157%) higher if the mother smoked when holding the infant, and 95% (95% CI = 28%, 298%) higher if the mother smoked while feeding the infant.

Conclusions. Parents who smoke should not smoke with their infants present in the same room.
Outbreak of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis Associated With Mebendazole and Metronidazole Use Among Filipino Laborers in Taiwan
Authors: Chen Kow-Tong , Twu Shiing-Jer , Chang Hong-Jen , Lin Ruey-Shiung
Published: December 2008

Objectives. This study sought to identify the risk factors associated with an outbreak of Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) among Filipino laborers in Taiwan.

Methods. Forty-six SJS/TEN patients were matched to 92 controls according to month of arrival in Taiwan, sex, and age.

Results. The odds ratio for development of SJS/TEN was 9.5 (95% confidence interval [CI] = 3.9, 23.9) among workers who had used both metronidazole and mebendazole sometime in the preceding 6 weeks. In addition, a gradient increase in the occurrence of SJS/TEN was found with an increasing level of exposure to metronidazole.

Conclusions. This outbreak highlights the risk of SJS/TEN resulting from the use of both metronidazole and mebendazole and the need for control measures.
An Integrative Medicine Clinic in a Community Hospital
Authors: Scherwitz Larry , Stewart William , McHenry Pamela , Wood Claudia , Robertson Lailah , Cantwell Michael
Published: December 2008

We report on the creation of an integrative medicine clinic within the setting of a medical research and tertiary care hospital.

The clinical audit used a prospective case series of 160 new patients who were followed by telephone interviews over a 6-month period. Patients’ demographic characteristics, presenting symptoms and diagnoses, physician treatment recommendations, extent of understanding and adherence to treatment recommendations, changes in symptom intensity, and progress toward achieving health objectives were recorded. Patients at the clinic showed significant reductions in the severity of symptoms and made significant progress toward achieving their health objectives at the 6-month follow-up.

Thus far, the clinic’s experience suggests that an integrative medicine clinic can face current health care financial challenges and thrive in a conventional medical center.
Symptom Patterns Among Gulf War Registry Veterans
Authors: Hallman William K. , Kipen Howard M. , Diefenbach Michael , Boyd Kendal , Kang Han , Leventhal Howard , Wartenberg Daniel
Published: December 2008

Objectives. We identify symptom patterns among veterans who believe they suffer from Gulf War–related illnesses and characterize groups of individuals with similar patterns.

Methods. A mail survey was completed by 1161 veterans drawn from the Gulf War Health Registry.

Results. An exploratory factor analysis revealed 4 symptom factors. A K-means cluster analysis revealed 2 groups: (1) veterans reporting good health and few moderate/severe symptoms, and (2) veterans reporting fair/poor health and endorsing an average of 37 symptoms, 75% as moderate/severe. Those in Cluster 2 were more likely to report having 1 or more of 24 medical conditions.

Conclusions. These findings are consistent with previous investigations of symptom patterns in Gulf War veterans. This multisymptom illness may be more fully characterized by the extent, breadth, and severity of symptoms reported.
Complementary Therapy for Addiction: “Drumming Out Drugs”
Authors: Winkelman Michael
Published: December 2008

Objectives. This article examines drumming activities as complementary addiction treatments and discusses their reported effects.

Methods. I observed drumming circles for substance abuse (as a participant), interviewed counselors and Internet mailing list participants, initiated a pilot program, and reviewed literature on the effects of drumming.

Results. Research reviews indicate that drumming enhances recovery through inducing relaxation and enhancing theta-wave production and brain-wave synchronization. Drumming produces pleasurable experiences, enhanced awareness of preconscious dynamics, release of emotional trauma, and reintegration of self. Drumming alleviates self-centeredness, isolation, and alienation, creating a sense of connectedness with self and others. Drumming provides a secular approach to accessing a higher power and applying spiritual perspectives.

Conclusions. Drumming circles have applications as complementary addiction therapy, particularly for repeated relapse and when other counseling modalities have failed.
Relative or Absolute Standards for Child Poverty: A State-Level Analysis of Infant and Child Mortality
Authors: Hillemeier Marianne M. , Lynch John , Harper Sam , Raghunathan Trivellore , Kaplan George A.
Published: December 2008

Objectives. The purpose of the present study was to compare the associations of state-referenced and federal poverty measures with states’ infant and child mortality rates.

Methods. Compressed mortality and Current Population Survey data were used to examine relationships between mortality and (1) state-referenced poverty (percentage of children below half the state median income) and (2) percentage of children below the federal poverty line.

Results. State-referenced poverty was not associated with mortality among infants or children, whereas poverty as defined by national standards was strongly related to mortality.

Conclusions. Infant and child mortality is more closely tied to families’ capacity for meeting basic needs than to relative position within a state’s economic hierarchy.
Do Canadian Civil Servants Care About the Health of Populations?
Authors: Lavis John N. , Ross Suzanne E. , Stoddart Gregory L. , Hohenadel Joanne M. , McLeod Christopher B. , Evans Robert G.
Published: December 2008

Objectives. This article describes Canadian civil servants’ awareness of, attitudes toward, and self-reported use of ideas about the determinants of health.

Methods. Federal and provincial civil servants in departments of finance, labor, social services, and health were surveyed.

Results. With civil servants in finance departments a notable exception, most Canadian civil servants see the health of populations as a relevant outcome for their sectors. Many (65%) report that ideas about the determinants of health have already influenced policymaking in their sector, but most (83%) say they need more information about the health consequences of the policy alternatives their departments face.

Conclusions. Civil servants should consider developing accountability structures for health and researchers should consider producing and transferring more policy-relevant research.
Authors’ Financial Relationships With the Food and Beverage Industry and Their Published Positions on the Fat Substitute Olestra
Authors: Levine Jane , Gussow Joan Dye , Hastings Diane , Eccher Amy
Published: December 2008

Objectives. This study examined the association between authors’ published positions on the safety and efficacy in assisting with weight loss of the Procter & Gamble (P&G) fat substitute olestra and their financial relationships with the food and beverage industry.

Methods. Journal articles about olestra, and their authors, were classified as supportive, critical, or neutral with respect to its use. Authors not known to have industry affiliations were surveyed about their financial relationships.

Results. Supportive authors were significantly more likely than critical or neutral authors to have financial relationships with P&G (80% vs 11% and 21%, respectively; P < .0001). All authors disclosing an affiliation with P&G were supportive.

Conclusions. Because authors’ published opinions were associated with their financial relationships, obtaining noncommercial funding may be more essential to maintaining objectivity than disclosing personal financial interests.
Formative Evaluation of a Men’s Health Center
Authors: Ekundayo Olugbemiga T. , Bronner Yvonne , Johnson-Taylor Wendy L. , Dambita Nkossi , Squire Sean
Published: December 2008

We describe an innovative approach for evaluating a men’s health center.

Using observation and interview, we assessed patient flow, referral patterns, patient satisfaction, and perceptions of the services’ usefulness. Student assistants designed evaluation tools, hired and trained research assistants, supervised data collection, interacted with city and center officials, analyzed data, and drafted a report.

To ensure patient confidentiality and anonymity, we designed an innovative observation system. The men had unique perceptions of family, requiring culturally sensitive approaches to engage them in the study. Of patients reporting to the center, 20.3% received referral services. Average satisfaction level was 5.2 (scale = 1–10).

Perceived benefits to the family for 23% of respondents included cost savings, improved access, and higher service quality.
The Health of Men: Structured Inequalities and Opportunities
Authors: Williams David R.
Published: December 2008

I have summarized in this article data on the magnitude of health challenges faced by men in the United States.

Across a broad range of indicators, men report poorer health than women. Although men in all socioeconomic groups are doing poorly in terms of health, some especially high-risk groups include men of low socioeconomic status (SES) of all racial/ethnic backgrounds, low-SES minority men, and middle-class Black men. Multiple factors contribute to the elevated health risks of men. These include economic marginality, adverse working conditions, and gendered coping responses to stress, each of which can lead to high levels of substance use, other health-damaging behaviors, and an aversion to health-protective behaviors.

The forces that adversely affect men’s health are interrelated, unfold over the life course, and are amenable to change.
Male Prisoners and HIV Prevention: A Call for Action Ignored
Authors: Braithwaite Ronald L. , Arriola Kimberly R. J.
Published: December 2008

US prison inmates are disproportionately indigent young men of color. These individuals are severely affected by HIV/AIDS, largely owing to the high-risk behavior that they engage in prior to incarceration.

Researchers and practitioners have issued a call for the importance of offering HIV prevention services in prison settings. However, this call has largely been ignored.

In this article, we outline reasons why these recommendations have been largely ignored, discuss innovative HIV prevention programs that are currently being implemented in prison settings, and offer recommendations for securing support for HIV prevention services in correctional settings.
Slowing the Epidemic of Tobacco Use Among Asian Americans and Pacific Islanders
Authors: Lew Rod , Tanjasiri Sora Park
Published: December 2008

Data on tobacco use among the Asian American/Pacific Islander (AAPI) population remain limited, although existing studies indicate that tobacco use prevalence among males from specific AAPI groups is significantly higher than in the general US male population.

This high prevalence of tobacco use and the disparities in use result from social norms, targeted marketing by the tobacco industry, lack of culturally and linguistically tailored prevention and control programs, and limited impact of mainstream tobacco control programs for AAPIs.

We review the available literature on tobacco use among AAPI men and women, highlight a national agenda that promotes tobacco prevention and control for AAPI communities, and acknowledge recent trends including the increase of tobacco use among AAPI women and girls.
Addressing Urban Health in Detroit, New York City, and Seattle Through Community-Based Participatory Research Partnerships
Authors: Metzler Marilyn M. , Higgins Donna L. , Beeker Carolyn G. , Freudenberg Nicholas , Lantz Paula M. , Senturia Kirsten D. , Eisinger Alison A. , Viruell-Fuentes Edna A. , Gheisar Bookda , Palermo Ann-Gel , Softley Donald
Published: December 2008

Objective. This study describes key activities integral to the development of 3 community-based participatory research (CBPR) partnerships.

Methods. We compared findings from individual case studies conducted at 3 urban research centers (URCs) to identify crosscutting adaptations of a CBPR approach in the first 4 years of the partnerships’ development.

Results. Activities critical in partnership development include sharing decisionmaking, defining principles of collaboration, establishing research priorities, and securing funding. Intermediate outcomes were sustained CBPR partnerships, trust within the partnerships, public health research programs, and increased capacity to conduct CBPR. Challenges included the time needed for meaningful collaboration, concerns regarding sustainable funding, and issues related to institutional racism.

Conclusions. The URC experiences suggest that CBPR can be successfully implemented in diverse settings.
Leisure Time Physical Activity and Disease-Specific Mortality Among Men With Chronic Bronchitis: Evidence From the Whitehall Study
Authors: Batty G. David , Shipley Martin J. , Marmot Michael G. , Davey Smith George
Published: December 2008

Objectives. This study examined the association between leisure time physical activity and cause-specific mortality among male Whitehall Study participants with chronic bronchitis.

Methods. Rate ratios were calculated for 4 mortality outcomes, according to level of activity and baseline bronchitis status, in a 25-year follow-up of 6479 men.

Results. After multiple adjustment for potential confounding or mediating variables, activity was inversely related to all-cause, cardiovascular, coronary heart disease, and noncardiovascular mortality among men free of chronic bronchitis. Among men with bronchitis, weak, nonsignificant positive associations were observed between activity and these outcomes, with the exception of noncardiovascular mortality.

Conclusions. The suggestion of a positive activity–mortality association among individuals with chronic bronchitis—albeit weak and nonsignificant—requires further investigation.
R.J. Reynolds’ Targeting of African Americans: 1988–2000
Authors: Balbach Edith D. , Gasior Rebecca J. , Barbeau Elizabeth M.
Published: December 2008

Objectives. The purpose of this study was to describe RJ Reynolds (RJR) Tobacco Company’s strategy for targeting African Americans, as revealed in tobacco industry documents and magazine advertisements.

Methods. The authors searched industry documents to determine RJR’s strategies and analyzed magazine advertising during 2 periods: the time of the launch of the company’s Uptown cigarette (1989–1990) and a decade later (1999–2000).

Results. RJR’s efforts to target the African American market segment existed before and after Uptown, and the company’s strategy was largely implemented via other RJR brands. Advertisements featured mentholated cigarettes, fantasy/escape, expensive objects, and nightlife.

Conclusions. To help all populations become tobacco-free, tobacco control practitioners must understand and counter tobacco industry strategies.
African Americans’ Attitudes Toward Cigarette Excise Taxes
Authors: King Gary , Mallett Robyn K. , Kozlowski Lynn T. , Bendel Robert B.
Published: December 2008

Objectives. This study examined African Americans’ opinions regarding cigarette excise taxes and other tobacco control issues.

Methods. A stratified cluster sample of US congressional districts represented by African Americans was selected. African Americans from 10 districts were interviewed.

Results. Forty-seven percent of respondents stated that taxes on tobacco products should be increased, whereas about 30% believed that they should be reduced. Almost 75% disagreed that raising taxes on tobacco products is unfair to African Americans, and 57.9% reported that they would not be opposed to increasing taxes on cigarettes even if low-income smokers would be hit the hardest.

Conclusions. The present results indicate substantial support for cigarette excise taxes among African Americans.
Anthropological Assessment for Culturally Appropriate Interventions Targeting Men Who Have Sex With Men
Authors: Silenzio Vincent M. B.
Published: December 2008

Although social and cultural factors play a fundamental role in the health of sexual minority populations and the development of culturally appropriate interventions, public health activities and research have sometimes lacked appropriate sophistication or attention to issues of cultural competency.

In areas such as HIV prevention for men who have sex with men (MSM), biomedical interpretations of same-sex phenomena should be applied with caution. Communities and societies may broadly understand same-sex desire, attraction, behavior, and identity through age-structured/initiatory, gender-defined, profession/social role–defined, or egalitarian/gay frameworks.

When more detailed, locally specific information is required, such as for youth, ethnic minorities, or urban versus rural populations, the approach to rapid anthropological assessment presented can provide nuanced insights for effective health programs targeting MSM.
HIV Infections and Associated Costs Attributable to Syphilis Coinfection Among African Americans
Authors: Chesson Harrell W. , Pinkerton Steven D. , Voigt Richard , Counts George W.
Published: December 2008

Objectives. We estimated the number and cost of syphilis-attributable HIV cases among African Americans.

Methods. A mathematical model of HIV transmission was used to estimate the number of partnerships consisting of HIV-discordant African Americans in which infectious syphilis was present and the number of new HIV cases attributable to syphilis in these partnerships.

Results. In 2000, an estimated 545 new cases of HIV infection among African Americans could be attributed to the facilitative effects of infectious syphilis, at a cost of about $113 million.

Conclusions. Syphilis prevention could reduce HIV incidence rates and the disproportionate burden of HIV/AIDS on the African American community, resulting in substantial reductions in future HIV/AIDS medical costs.
The Efficacy of a Relationship-Based HIV/STD Prevention Program for Heterosexual Couples
Authors: El-Bassel Nabila , Witte Susan S. , Gilbert Louisa , Wu Elwin , Chang Mingway , Hill Jennifer , Steinglass Peter
Published: December 2008

Objectives. This study examined the efficacy of a relationship-based HIV/sexually transmitted disease prevention program for heterosexual couples and whether it is more effective when delivered to the couple or to the woman alone.

Methods. Couples (n = 217) were recruited and randomized to (1) 6 sessions provided to couples together (n = 81), (2) the same intervention provided to the woman alone (n = 73), or (3) a 1-session control condition provided to the woman alone (n = 63).

Results. The intervention was effective in reducing the proportion of unprotected and increasing the proportion of protected sexual acts. No significant differences in effects were observed between couples receiving the intervention together and those in which the woman received it alone.

Conclusions. This study demonstrates the efficacy of a relationship-based prevention program for couples at risk for HIV infection.
The Outing of Philip Morris: Advertising Tobacco to Gay Men
Authors: Smith Elizabeth A. , Malone Ruth E.
Published: December 2008

Objectives. This case study describes the events surrounding the first time a major tobacco company advertised in gay media.

Methods. We analyzed internal tobacco company documents, mainstream newspapers, and the gay press.

Results. Philip Morris was unprepared for the attention its entry into the gay market received. The company’s reaction to this incident demonstrates that its approach to the gay community both parallels and diverges from industry strategies toward other marginalized communities.

Conclusions. The tobacco industry’s relationship to the gay community is relatively undeveloped, a fact that may provide tobacco control advocates an opportunity for early intervention. The gay community’s particular vulnerabilities to the industry make development of gay tobacco control programs crucial to reducing gay smoking prevalence and industry presence in the community.
Co-Occurring Alcohol, Drug, and Other Psychiatric Disorders Among Mexican-Origin People in the United States
Authors: Vega William A. , Sribney William M. , Achara-Abrahams Ijeoma
Published: December 2008

We examined co-occurrence of (comorbid) alcohol, drug, and non–substance use psychiatric disorders in a population sample of Mexican-origin adults from rural and urban areas of central California.

Co-occurring lifetime rates of alcohol or other drug disorders with non–substance use psychiatric disorders, or both, were 8.3% for men and 5.5% for women and were 12.3% for the US born and 3.5% for immigrants.

Alcohol abuse or dependence with co-occurring psychiatric disorders is a primary disorder among Mexican-origin adult males (7.5% lifetime prevalence). US-born men and women are almost equally likely to have co-occuring disorders involving substances. Cobormidity is expected to increase in the Mexican-origin population owing to acculturation effects of both sexes.
A Longitudinal Perspective on Dating Violence Among Adolescent and College-Age Women
Authors: Smith Paige Hall , White Jacquelyn W. , Holland Lindsay J.
Published: December 2008

Objectives. We investigated physical assault in dating relationships and its co-occurrence with sexual assault from high school through college.

Methods. Two classes of university women (n = 1569) completed 5 surveys during their 4 years in college.

Results. Women who were physically assaulted as adolescents were at greater risk for revictimization during their freshman year (relative risk = 2.96); each subsequent year, women who have experienced violence remained at greater risk for revictimization than those who have not. Across all years, women who were physically assaulted in any year were significantly more likely to be sexually assaulted that same year. Adolescent victimization was a better predictor of college victimization than was childhood victimization.

Conclusions. There is a need for dating violence prevention/intervention programs in high school and college and for research on factors that reduce revictimization.
Overrepresentation of Women Veterans Among Homeless Women
Authors: Gamache Gail , Rosenheck Robert , Tessler Richard
Published: December 2008

Objectives. This study estimated the proportion of veterans among homeless women and their risk of homelessness relative to that of nonveterans.

Methods. Data came from 2 surveys of homeless women (1 clinical and 1 nonclinical) and 1 survey of domiciled women.

Results. The proportion of veterans (4.4%, 3.1%) among homeless women was greater than the proportion among domiciled women (1.3%, 1.2%). When we computed odds ratios for being a veteran among homeless women compared with nonhomeless women, homeless women were significantly more likely than nonhomeless women to be veterans.

Conclusions. Women veterans are at greater risk for homelessness than are nonveterans. Further study is needed to determine whether increased risks for veterans are a product of military service or reflect volunteers’ self-selection into the armed forces. (Am J Public Health. 2003;93:1132–1136)
Heat or Eat? Cold-Weather Shocks and Nutrition in Poor American Families
Authors: Bhattacharya Jayanta , DeLeire Thomas , Haider Steven , Currie Janet
Published: December 2008

Objectives. The authors sought to determine the effects of cold-weather periods on budgets and nutritional outcomes among poor American families.

Methods. The Consumer Expenditure Survey was used to track expenditures on food and home fuels, and the Third National Health and Nutrition Examination Survey was used to track calorie consumption, dietary quality, vitamin deficiencies, and anemia.

Results. Both poor and richer families increased fuel expenditures in response to unusually cold weather. Poor families reduced food expenditures by roughly the same amount as their increase in fuel expenditures, whereas richer families increased food expenditures.

Conclusions. Poor parents and their children spend less on and eat less food during cold-weather budgetary shocks. Existing social programs fail to buffer against these shocks.
Community-Based Participatory Research: Implications for Public Health Funding
Authors: Minkler Meredith , Blackwell Angela Glover , Thompson Mildred , Tamir Heather
Published: December 2008

Community-based participatory research (CBPR) increasingly is being recognized by health scholars and funders as a potent approach to collaboratively studying and acting to address health disparities.

Emphasizing action as a critical part of the research process, CBPR is particularly consistent with the goals of “resultsoriented philanthropy” and of government funders who have become discouraged by the often modest to disappointing results of more traditional research and intervention efforts in many lowincome communities of color.

Supporters of CBPR face challenging issues in the areas of partnership capacity and readiness, time requirements, funding flexibility, and evaluation. The authors suggest strategies for addressing such issues and make a case for increasing support of CBPR as an important tool for action-oriented and community-driven public health research.
The Duluth Clean Indoor Air Ordinance: Problems and Success in Fighting the Tobacco Industry at the Local Level in the 21st Century
Authors: Tsoukalas Theodore , Glantz Stanton A.
Published: December 2008

Case study methodology was used to investigate the tobacco industry’s strategies to fight local tobacco control efforts in Duluth, Minn.

The industry opposed the clean indoor air ordinance indirectly through allies and front groups and directly in a referendum. Health groups failed to win a strong ordinance because they framed it as a youth issue rather than a workplace issue and failed to engage the industry’s economic claims. Opponents’ overexploitation of weaknesses in the ordinance allowed health advocates to construct a stronger version.

Health advocates should assume that the tobacco industry will oppose all local tobacco control measures indirectly, directly, or both. Clean indoor air ordinances should be framed as workplace safety issues.
Public Health, Law, and Local Control: Destruction of the US Chemical Weapons Stockpile
Authors: Greenberg Michael R.
Published: December 2008

Destruction of US chemical weapons has begun at one of the 8 sites in the continental United States, was completed on Johnston Island in the Pacific Ocean, and is scheduled to begin in at least 3 other locations during the upcoming year. About 25% of the stockpile and 38% of the munitions had been destroyed as of December 31, 2002.

However, the program has become controversial with regard to choice of technology, emergency management, and cost. This controversy is in large part due to efforts by some state and local governments and activist groups to play a more central role in a decisionmaking process that was once fully controlled by the US Army.
Public Health’s Response to a Changed World: September 11, Biological Terrorism, and the Development of an Environmental Health Tracking Network
Authors: Marmagas Susan West , King Laura Rasar , Chuk Michelle G.
Published: December 2008

Historically, the importance of public health has often been recognized during or as a result of major tragedy. The attacks that occurred in the United States in 2001 are no exception.

These events have raised awareness of our vulnerability and the need for emergency preparedness, the need for a flexible and sustainable public health infrastructure, and the importance of linkages between environmental exposures and health outcomes.

The authors encourage the public health community, along with policymakers, to develop a national environmental health tracking system that can improve our overall public health capacity and prepare us to investigate the critical issues of the day, whether they be emerging infectious diseases, terrorist attacks, or chronic illnesses.
Student Leadership in Public Health Advocacy: Lessons Learned From the Hepatitis B Initiative
Authors: Hsu Leslie D. , DeJong William , Hsia Renee , Chang Michael , Ryou Marvin , Yeh Ellen
Published: December 2008

Increasing hepatitis B vaccination rates for Asian Americans and Pacific Islanders is a priority. Laws requiring vaccination prior to school enrollment have helped, yet many youths remain unvaccinated.

The Hepatitis B Initiative (HBI), launched in 1997 and operated by public health and medical school students, provides free screenings and vaccinations to Boston’s Asian American/Pacific Islander community, with a focus on youths.

By October 2002, 997 HBI patients from Boston’s Chinatown had received free hepatitis B screenings. Of these, 384 patients (39%) were deemed susceptible to the hepatitis B virus and provided with free vaccination.
Declining Trends in Work-Related Morbidity and Disability, 1993–1998: A Comparison of Survey Estimates and Compensation Insurance Claims
Authors: Mustard Cam , Cole Donald , Shannon Harry , Pole Jason , Sullivan Terry , Allingham Richard
Published: December 2008

Objectives. This study compared trends in the incidence of work-related morbidity and disability across 3 sources of surveillance data in a Canadian province.

Methods. Time series estimates of workplace injuries and work-related disability based on 2 panel surveys in the province of Ontario, Canada, for the period 1993–1998 were compared with rates of work-related injury and illness compensation claims during the same period.

Results. Lost-time compensation claims declined by 28.8% over this 6-year period. The incidence of self-reported work-related injury declined by 28.2%, and the selfreported incidence of work absence for work-related causes declined by 32.2%.

Conclusions. Parallel reductions in work-related morbidity were seen in 3 independent data sources. These results support an interpretation that there has been an important reduction in injury risk in Ontario workplaces over the past decade.
Trends in Risk Factors for Lifestyle-Related Diseases by Socioeconomic Position in Geneva, Switzerland, 1993–2000: Health Inequalities Persist
Authors: Galobardes Bruna , Costanza Michael C. , Bernstein Martine S. , Delhumeau Cecile , Morabia Alfredo
Published: December 2008

Objectives. We report on trends in risk factors for lifestyle-related diseases among socioeconomic position (SEP) groups.

Methods. We continuously surveyed the adult population of Geneva, Switzerland, for 8 years (1993–2000) with independent, cross-sectional surveys of representative samples (4207 men and 3987 women aged 35–74 years). Age-adjusted linear regression slopes estimated annual risk factor trends. Interaction terms were tested for trend differences between SEP groups.

Results. Overall, low-SEP persons had the worst risk factor profiles. Eight-year trends indicate that (1) number of pack-years smoked decreased by half a pack-year among high-SEP female current smokers only; (2) obesity prevalence more than doubled from 5% to 11% among high-SEP men only; (3) systolic and diastolic blood pressures decreased similarly in all SEP groups; (4) unsaturated-to-saturated dietary fat ratio declined in the low-SEP group only; and (5) physical inactivity and current/former cigarette smoking prevalences remained unchanged in all SEP groups.

Conclusions. Smoking, obesity, high blood pressure, and physical inactivity are more prevalent among low-SEP persons. Most socioeconomic risk factor differences remained stable in the 1990s. Thus, social inequalities in chronic disease morbidity and mortality will persist in the next decades.
The Relationship of Health Insurance to the Diagnosis and Management of Asthma and Respiratory Problems in Children in a Predominantly Hispanic Urban Community
Authors: Freeman Natalie C. G. , Schneider Dona , McGarvey Patricia
Published: December 2008

Objectives. As part of an asthma screening study, we evaluated the relationship of health care insurance coverage to the diagnosis and treatment of elementary school children for asthma and related respiratory problems from 1998 through 2001.

Methods. A bilingual questionnaire assessing health care coverage, asthma diagnosis, respiratory symptoms, and use of medications was distributed to parents of 6235 public and private school children in grades 2 through 5 in Passaic, NJ.

Results. Responses for 4380 children (70%) revealed disparities in health care coverage and asthma diagnosis among racial and ethnic groups. Mexican and Dominican children had significant increases in health care coverage over the 4 years.

Conclusions. The percentage of children with health insurance grew from 67% in 1998 to 81% in 2001, and the increase was related to NJ KidCare. Diagnosis of asthma and treatment were related to health care coverage.
Primary Care Attributes and Care for Depression Among Low-Income African American Women
Authors: O’Malley Ann S. , Forrest Christopher B. , Miranda Jeanne
Published: December 2008

Objectives. We examined the association between attributes of primary care providers and care for depression, from a patients’ perspective, among a sample of predominantly low-income African American women.

Methods. Computer-assisted telephone interviews were conducted among a population-based sample of 1202 women residing in Washington, DC.

Results. Respondents whose primary care physicians provided more comprehensive medical services were more likely to be asked about and treated for depressive symptoms than women whose providers were less medically comprehensive. Women who rated their providers as having more respect for them also were more likely to be asked about and treated for depression.

Conclusions. More comprehensive primary care delivery and a physician–patient relationship focused on mutual respect are associated with greater rates of physician inquiry about and treatment for depression among vulnerable women.
Urban Form, Health, and the Law’s Limits
Authors: Buzbee William W.
Published: December 2008

Urban form, the law, and health are undoubtedly linked. However, nonlegal factors such as 20th-century reliance on the automobile as well as associated governmental actions and private investment choices have greatly influenced urban form, especially urban sprawl.

The American system of federalism, with its traditional allocation of land-use legal authority to local governments, and resulting fragmented legal authority over causes and effects of urban sprawl, renders difficult legal efforts to reshape urban form. Legal frameworks and the dynamics and effects of urban sprawl are largely mismatched.

Still, existing legal frameworks and modest legal reforms provide means to encourage or at least allow urban forms that are more conducive to health. However, the law will not easily transform urban form and deter urban sprawl.
Breathless in Los Angeles: The Exhausting Search for Clean Air
Authors: Künzli Nino , McConnell Rob , Bates David , Bastain Tracy , Hricko Andrea , Lurmann Fred , Avol Ed , Gilliland Frank , Peters John
Published: December 2008

Population growth and the proliferation of roadways in Southern California have facilitated a glut of mobile air pollution sources (cars and trucks), resulting in substantial atmospheric pollution.

Despite successful efforts over the past 40 years to reduce pollution, an alarming set of health effects attributable to air pollution have been described in Southern California. The Children’s Health Study indicates that reduced lung function growth, increased school absences, asthma exacerbation, and new-onset asthma are occurring at current levels of air pollution, with sizable economic consequences.

We describe these findings and urge a more aggressive effort to reduce air pollution exposures to protect our children’s health. Lessons from this “case study” have national implications.
Public Health Effects of Inadequately Managed Stormwater Runoff
Authors: Gaffield Stephen J. , Goo Robert L. , Richards Lynn A. , Jackson Richard J.
Published: December 2008

Objectives. This study investigated the scale of the public health risk from stormwater runoff caused by urbanization.

Methods. We compiled turbidity data for municipal treated drinking water as an indication of potential risk in selected US cities and compared estimated costs of waterborne disease and preventive measures.

Results. Turbidity levels in other US cities were similar to those linked to illnesses in Milwaukee, Wis, and Philadelphia, Pa. The estimated annual cost of waterborne illness is comparable to the long-term capital investment needed for improved drinking water treatment and stormwater management.

Conclusions. Although additional data on cost and effectiveness are needed, stormwater management to minimize runoff and associated pollution appears to make sense for protecting public health at the least cost.
Conventional Development Versus Managed Growth: The Costs of Sprawl
Authors: Burchell Robert W. , Mukherji Sahan
Published: December 2008

Objectives. We examined the effects of sprawl, or conventional development, versus managed (or “smart”) growth on land and infrastructure consumption as well as on real estate development and public service costs in the United States.

Methods. Mathematical impact models were used to produce US estimates of differences in resources consumed according to each growth scenario over the period 2000–2025.

Results. Sprawl produces a 21% increase in amount of undeveloped land converted to developed land (2.4 million acres) and approximately a 10% increase in local road lane-miles (188 300). Furthermore, sprawl causes about 10% more annual public service (fiscal) deficits ($4.2 billion) and 8% higher housing occupancy costs ($13 000 per dwelling unit).

Conclusions. Managed growth can save significant amounts of human and natural resources with limited effects on traditional development procedures.
Urban Sprawl as a Risk Factor in Motor Vehicle Occupant and Pedestrian Fatalities
Authors: Ewing Reid , Schieber Richard A. , Zegeer Charles V.
Published: December 2008

Objectives. We sought to determine the association between urban sprawl and traffic fatalities.

Methods. We created a sprawl index by applying principal components analysis to data for 448 US counties in the largest 101 metropolitan areas. Regression analysis was used to determine associations between the index and traffic fatalities.

Results. For every 1% increase in the index (i.e., more compact, less sprawl), all-mode traffic fatality rates fell by 1.49% (P < .001) and pedestrian fatality rates fell by 1.47% to 3.56%, after adjustment for pedestrian exposure (P < .001).

Conclusions. Urban sprawl was directly related to traffic fatalities and pedestrian fatalities. Subsequent studies should investigate relationships at a finer geographic scale and should strive to improve on the measure of exposure used to adjust pedestrian fatality rates.
Neighborhood-Based Differences in Physical Activity: An Environment Scale Evaluation
Authors: Saelens Brian E. , Sallis James F. , Black Jennifer B. , Chen Diana
Published: December 2008

Objectives. This study evaluated a neighborhood environment survey and compared the physical activity and weight status of the residents in 2 neighborhoods.

Methods. On 2 occasions, 107 adults from neighborhoods with differing “walkability” were selected to complete a survey on their neighborhood environment. Physical activity was assessed by self-report and by accelerometer; height and weight were assessed by self-report.

Results. Neighborhood environment characteristics had moderate to high test–retest reliabilities. Residents of high-walkability neighborhoods reported higher residential density, land use mix, street connectivity, aesthetics, and safety. They had more than 70 more minutes of physical activity and had lower obesity prevalence (adjusted for individual demographics) than did residents of low-walkability neighborhoods.

Conclusions. The reliability and validity of self-reported neighborhood environment subscales were supported. Neighborhood environment was associated with physical activity and overweight prevalence.
Prevalence of School Policies, Programs, and Facilities That Promote a Healthy Physical School Environment
Authors: Everett Jones Sherry , Brener Nancy D. , McManus Tim
Published: December 2008

Objectives. We examined the extent to which schools in the United States have health-promoting policies, programs, and facilities.

Methods. We analyzed data from the School Health Policies and Programs Study 2000.

Results. We found that public schools (vs private and Catholic schools), urban schools (vs rural and suburban schools), and schools with larger enrollments (vs smaller schools) had more health-promoting policies, programs, and facilities in place. On average, middle schools had 11.0 and middle/junior and high schools had 10.4 out of a possible 18 policies, programs, and facilities.

Conclusions. Although some schools had many healthy physical environment features, room for improvement exists. Resources are available to help schools improve their health-promoting policies, programs, and facilities.
Maternal Smoking in Pregnancy, Fetal Development, and Childhood Asthma
Authors: Jaakkola Jouni J. K. , Gissler Mika
Published: December 2008

Objectives. We examined the relationships among maternal smoking in pregnancy, fetal development, and the risk of asthma in childhood.

Methods. We conducted a population-based cohort study, where all 58 841 singleton births were followed for 7 years using nationwide registries.

Results. Maternal smoking increased the risk of asthma (adjusted odds ratio = 1.35; 95% confidence interval = 1.13, 1.62 for high exposure). Low birthweight and preterm delivery increased the risk of asthma at the age of 7, whereas being small for gestational age did not.

Conclusions. Maternal smoking in pregnancy increases the risk of asthma during the first 7 years of life, and only a small fraction of the effect seems to be mediated through fetal growth.
Reducing the Public Health Burden From Elevated Blood Pressure Levels in the United States by Lowering Intake of Dietary Sodium
Authors: Havas Stephen , Roccella Edward J. , Lenfant Claude
Published: December 2008

Elevated blood pressure levels are a major cause of heart disease and stroke. Healthy People 2010 established objectives to reduce mortality from these diseases by 20% and to reduce the major causal factors associated with these elevated levels, such as excess sodium intake. The American public consumes far more sodium than is needed, most of which is added by food manufacturers and restaurants.

In November 2002, the American Public Health Association adopted a policy resolution calling for a 50% reduction in sodium in the nation’s food supply over the next 10 years. Such a reduction would greatly enhance the chances of attaining the Healthy People 2010 objectives and would save at least 150 000 lives annually. This issue warrants public health intervention.
If Suicide Is a Public Health Problem, What Are We Doing to Prevent It?
Authors: Knox Kerry L. , Conwell Yeates , Caine Eric D.
Published: December 2008

Although not a disease, suicide is a tragic endpoint of complex etiology and a leading cause of death worldwide.

Just as preventing heart disease once meant that specialists treated myocardial infarctions in emergency care settings, in the past decade, suicide prevention has been viewed as the responsibility of mental health professionals within clinical settings. By contrast, over the past 50 years, population-based risk reduction approaches have been used with varying levels of effectiveness to prevent morbidity and mortality associated with heart disease.

We examined whether the current urgency to develop effective interventions for suicide prevention can benefit from an understanding of the evolution of population-based strategies to prevent heart disease.