bluuebunny/crossref_metadata_2025 huggingface dataset:
Childhood Overweight in a New York City WIC Population
Authors: Nelson Jennifer A. , Chiasson Mary Ann , Ford Viola
Published: December 2008

Objectives. We estimated the prevalence of overweight in a population of young children enrolled in a New York City Special Supplemental Nutrition Program for Women, Infants, and Children.

Methods. Administrative and survey data were collected from a sample of enrolled families. Body mass index (BMI) of 557 children aged 2, 3, and 4 years was compared by sociodemographic and nutrition characteristics.

Results. Forty percent of the children were overweight or at risk for overweight (BMI ≥ 85th percentile). Compared with other racial/ethnic groups combined, Hispanic children were more than twice as likely (odds ratio = 2.6; 95% confidence interval = 1.8, 3.8) to be overweight or at risk for overweight. Two-year-olds were less likely to be overweight than 3- and 4-year-olds.

Conclusions. Interventions to address childhood overweight should be culturally specific and target very young children.
Measuring the Environment for Friendliness Toward Physical Activity: A Comparison of the Reliability of 3 Questionnaires
Authors: Brownson Ross C. , Chang Jen Jen , Eyler Amy A. , Ainsworth Barbara E. , Kirtland Karen A. , Saelens Brian E. , Sallis James F.
Published: December 2008

Objectives. We tested the reliability of 3 instruments that assessed social and physical environments.

Methods. We conducted a test–retest study among US adults (n = 289). We used telephone survey methods to measure suitableness of the perceived (vs objective) environment for recreational physical activity and nonmotorized transportation.

Results. Most questions in our surveys that attempted to measure specific characteristics of the built environment showed moderate to high reliability. Questions about the social environment showed lower reliability than those that assessed the physical environment. Certain blocks of questions appeared to be selectively more reliable for urban or rural respondents.

Conclusions. Despite differences in content and in response formats, all 3 surveys showed evidence of reliability, and most items are now ready for use in research and in public health surveillance.
Socioeconomic Barriers to Informed Decisionmaking Regarding Maternal Serum Screening for Down Syndrome: Results of the French National Perinatal Survey of 1998
Authors: Khoshnood Babak , Blondel Béatrice , De Vigan Catherine , Bréart Gérard
Published: December 2008

Objectives. We sought to evaluate socioeconomic disparities in serum screening for Down syndrome and assess whether such disparities are more likely to reflect limits in access or information or, rather, informed decisionmaking.

Methods. A nationally representative sample of 12 869 French women completed interviews after giving birth.

Results. We found substantial disparities in the likelihood of (1) women not being offered screening, (2) screening not being offered as a result of late prenatal care, and (3) women not knowing whether or not they had undergone screening. Except in the case of nationality, there was essentially no evidence of differences in refusal of testing.

Conclusions. Rather than representing informed decisionmaking, socioeconomic disparities in screening for Down syndrome are mostly due to limits in access or to information.
Femur Fractures in Infants and Young Children
Authors: Brown Desmond , Fisher Elliott
Published: December 2008

Using an administrative database, we determined rates of femur fracture by year of age for children younger than 6 years and by month of age. The highest rate of femur fracture was in children younger than 1 year and in 2-year-olds; the greatest number of fractures occurred during the third month of life. While femur fractures in children are often due to accidental injury, the reasons for the peak in the first year and the subsequent decline are not clear.
The Impact of the SARS Epidemic on the Utilization of Medical Services: SARS and the Fear of SARS
Authors: Chang Hong-Jen , Huang Nicole , Lee Cheng-Hua , Hsu Yea-Jen , Hsieh Chi-Jeng , Chou Yiing-Jenq
Published: December 2008

Using interrupted time-series analysis and National Health Insurance data between January 2000 and August 2003, this study assessed the impacts of the severe acute respiratory syndrome (SARS) epidemic on medical service utilization in Taiwan. At the peak of the SARS epidemic, significant reductions in ambulatory care (23.9%), inpatient care (35.2%), and dental care (16.7%) were observed. People’s fears of SARS appear to have had strong impacts on access to care. Adverse health outcomes resulting from accessibility barriers posed by the fear of SARS should not be overlooked.
Health Effects Associated With Recreational Coastal Water Use: Urban Versus Rural California
Authors: Dwight Ryan H. , Baker Dean B. , Semenza Jan C. , Olson Betty H.
Published: December 2008

We compared rates of reported health symptoms among surfers in urban North Orange County (NOC) and rural Santa Cruz County (SCC), California, during 2 winters (1998 and 1999) to determine whether symptoms were associated with exposure to urban runoff. NOC participants reported almost twice as many symptoms as SCC participants during the 1998 winter. In both study years, risk increased across symptom categories by an average of 10% for each 2.5 hours of weekly water exposure. Our findings suggest that discharging untreated urban runoff onto public beaches can pose health risks.
Raised Speed Limits, Speed Spillover, Case-Fatality Rates, and Road Deaths in Israel: A 5-Year Follow-Up
Authors: Richter Elihu D. , Barach Paul , Friedman Lee , Krikler Samuel , Israeli Abraham
Published: December 2008

Objectives. We assessed the 5-year, nationwide impact on road deaths of the raise in the speed limit (November 1, 1993) on 3 major interurban highways in Israel from 90 to 100 kph.

Methods. We compared before–after trends in deaths as well as case fatality—an outcome independent of exposure (defined as vehicle-kilometers traveled).

Results. After the raise, speeds rose by 4.5%–9.1%. Over 5 years, there was a sustained increase in deaths (15%) and case fatality rates (38%) on all interurban roads. Corresponding increases in deaths (13%) and case fatality (24%) on urban roads indicated “speed spillover.”

Conclusions. Immediate increases in case fatality predicted and tracked the sustained increase in deaths from increased speeds of impact. Newtonian fourth power models predicted the effects of “small” increases in speed on large rises in case fatality rates. Countermeasures and congestion reduced the impact on deaths and case-fatality rates by more than half.
Knee Pain and Driving Duration: A Secondary Analysis of the Taxi Drivers’ Health Study
Authors: Chen Jiu-Chiaun , Dennerlein Jack T. , Shih Tung-Sheng , Chen Chiou-Jong , Cheng Yawen , Chang Wushou P. , Ryan Louise M. , Christiani David C.
Published: December 2008

Objectives. We explored a postulated association between daily driving time and knee pain.

Methods. We used data from the Taxi Drivers’ Health Study to estimate 1-year prevalence of knee pain as assessed by the Nordic musculoskeletal questionnaire.

Results. Among 1242 drivers, the prevalence of knee pain, stratified by duration of daily driving (≤ 6, > 6 through 8, > 8 through 10, and > 10 hours), was 11%, 17%, 19%, and 22%, respectively. Compared with driving 6 or fewer hours per day, the odds ratio of knee pain prevalence for driving more than 6 hours per day was 2.52 (95% confidence interval = 1.36, 4.65) after we adjusted for socioeconomic, work-related, and personal factors in the multiple logistic regression.

Conclusions. The dose-related association between driving duration and knee pain raises concerns about work-related knee joint disorders among professional drivers.
Somali and Oromo Refugees: Correlates of Torture and Trauma History
Authors: Jaranson James M. , Butcher James , Halcon Linda , Johnson David Robert , Robertson Cheryl , Savik Kay , Spring Marline , Westermeyer Joseph
Published: December 2008

Objectives. This cross-sectional, community-based, epidemiological study characterized Somali and Ethiopian (Oromo) refugees in Minnesota to determine torture prevalence and associated problems.

Methods. A comprehensive questionnaire was developed, then administered by trained ethnic interviewers to a nonprobability sample of 1134. Measures assessed torture techniques; traumatic events; and social, physical, and psychological problems, including posttraumatic stress symptoms.

Results. Torture prevalence ranged from 25% to 69% by ethnicity and gender, higher than usually reported. Unexpectedly, women were tortured as often as men. Torture survivors had more health problems, including posttraumatic stress.

Conclusions. This study highlights the need to recognize torture in African refugees, especially women, identify indicators of posttraumatic stress in torture survivors, and provide additional resources to care for tortured refugees.
Gender Differences in Long-Term Health Consequences of Physical Abuse of Children: Data From a Nationally Representative Survey
Authors: Thompson Martie P. , Kingree J. B. , Desai Sujata
Published: December 2008

Objectives. This study investigated the effects of physical abuse in childhood on health problems in adulthood and assessed gender differences in these associations.

Methods. We used data from 8000 men and 8000 women who were interviewed in the National Violence Against Women Survey. We used multivariate logistic regression to test for main and interactive effects and conducted post hoc probing of significant moderational effects.

Results. Men were more likely than women to have experienced physical abuse during childhood. Whereas abuse had negative consequences for both boys and girls, it was generally more detrimental for girls.

Conclusions. Findings suggest the need to consider gender differences and long-term adverse health consequences in the development of intervention strategies to address physical abuse in childhood.
Prevalence and 3-Year Incidence of Abuse Among Postmenopausal Women
Authors: Mouton Charles P. , Rodabough Rebecca J. , Rovi Susan L. D. , Hunt Julie L. , Talamantes Melissa A. , Brzyski Robert G. , Burge Sandra K.
Published: December 2008

Objectives. We examined prevalence, 3-year incidence, and predictors of physical and verbal abuse among postmenopausal women.

Methods. We used a cohort of 91 749 women aged 50 to 79 years from the Women’s Health Initiative. Outcomes included self-reported physical abuse and verbal abuse.

Results. At baseline, 11.1% reported abuse sometime during the prior year, with 2.1% reporting physical abuse only, 89.1% reporting verbal abuse only, and 8.8% reporting both physical and verbal abuse. Baseline prevalence was associated with service occupations, having lower incomes, and living alone. At 3-year follow-up, 5.0% of women reported new abuse, with 2.8% reporting physical abuse only, 92.6% reporting verbal abuse only, and 4.7% reporting both physical and verbal abuse.

Conclusions. Postmenopausal women are exposed to abuse at similar rates to younger women; this abuse poses a serious threat to their health.
Assessing the Long-Term Effects of the Safe Dates Program and a Booster in Preventing and Reducing Adolescent Dating Violence Victimization and Perpetration
Authors: Foshee Vangie A. , Bauman Karl E. , Ennett Susan T. , Linder G. Fletcher , Benefield Thad , Suchindran Chirayath
Published: December 2008

Objectives. This study determined 4-year postintervention effects of Safe Dates on dating violence, booster effects, and moderators of the program effects.

Methods. We gathered baseline data in 10 schools that were randomly allocated to a treatment condition. We collected follow-up data 1 month after the program and then yearly thereafter for 4 years. Between the 2- and 3-year follow-ups, a randomly selected half of treatment adolescents received a booster.

Results. Compared with controls, adolescents receiving Safe Dates reported significantly less physical, serious physical, and sexual dating violence perpetration and victimization 4 years after the program. The booster did not improve the effectiveness of Safe Dates.

Conclusions. Safe Dates shows promise for preventing dating violence but the booster should not be used.
Social Disparities in Housing and Related Pediatric Injury: A Multilevel Study
Authors: Shenassa Edmond D. , Stubbendick Amy , Brown Mary Jean
Published: December 2008

Objectives. We conducted an ecologic analysis to determine whether housing characteristics mediate the associations between concentration of poverty and pediatric injury and between concentration of racial minorities and pediatric injury and whether the association between housing conditions and pediatric injury is independent of other risks.

Methods. We created a hierarchical data set by linking individual-level data for pediatric injury with census data. Effect sizes were estimated with a Poisson model.

Results. After adjustment for owner occupancy and the percentage of housing built before 1950, the association between concentration of poverty and pediatric injury was attenuated. For concentration of racial minorities, only percentage of owner occupancy had some mediating effect. In hierarchical models, housing characteristics remained independent and significant predictors of pediatric injury.

Conclusions. The association between community characteristics and pediatric injury is partially mediated by housing conditions. Risk of pediatric injury associated with housing conditions is independent of other risks.
Parental Social Determinants of Risk for Intentional Injury: A Cross-Sectional Study of Swedish Adolescents
Authors: Engström Karin , Diderichsen Finn , Laflamme Lucie
Published: December 2008

Objectives. We investigated the effect of family social and economic circumstances on intentional injury among adolescents.

Methods. We conducted a cross-sectional register study of youths aged 10 to 19 years who lived in Sweden between 1990 and 1994. We used socioeconomic status, number of parents in the household (1- or 2-parent home), receipt of welfare benefits, parental country of birth, and population density as exposures and compiled relative risks and population-attributable risks (PARs) for self-inflicted and interpersonal violence–related injury.

Results. For both genders and for both injury types, receipt of welfare benefits showed the largest crude and net relative risks and the highest PARs. The socioeconomic status–related PAR for self-inflicted injury and the PAR related to number of parents in the household for interpersonal violence–related injury also were high.

Conclusions. Intentional-injury prevention and victim treatment need to be tailored to household social circumstances.
A Matched Case–Control Study Evaluating the Effectiveness of Speed Humps in Reducing Child Pedestrian Injuries
Authors: Tester June M. , Rutherford George W. , Wald Zachary , Rutherford Mary W.
Published: December 2008

Objectives. We evaluated the protective effectiveness of speed humps in reducing child pedestrian injuries in residential neighborhoods.

Methods. We conducted a matched case–control study over a 5-year period among children seen in a pediatric emergency department after being struck by an automobile.

Results. A multivariate conditional logistic regression analysis showed that speed humps were associated with lower odds of children being injured within their neighborhood (adjusted odds ratio [OR] = 0.47) and being struck in front of their home (adjusted OR = 0.40). Ethnicity (but not socioeconomic status) was independently associated with child pedestrian injuries and was adjusted for in the regression model.

Conclusions. Our findings suggest that speed humps make children’s living environments safer.
Housing Characteristics and Children’s Respiratory Health in the Russian Federation
Authors: Spengler John D. , Jaakkola Jouni J. K. , Parise Helen , Katsnelson Boris A. , Privalova Larissa I. , Kosheleva Anna A.
Published: December 2008

Objectives. We studied housing characteristics, parental factors, and respiratory health conditions in Russian children.

Methods. We studied a population of 5951 children from 9 Russian cities, whose parents answered a questionnaire on their children’s respiratory health, home environment, and housing characteristics. The health outcomes were asthma conditions, current wheeze, dry cough, bronchitis, and respiratory allergy.

Results. Respiratory allergy and dry cough increased in association with the home being adjacent to traffic. Consistent positive associations were observed between some health conditions and maternal smoking during pregnancy, many health conditions and lifetime exposure to environmental tobacco smoke (ETS), and nearly all health conditions and water damage and molds in the home.

Conclusions. Vicinity to traffic, dampness, mold, and ETS are important determinants of children’s respiratory health in Russia.
Metropolitan-Area Estimates of Binge Drinking in the United States
Authors: Nelson David E. , Naimi Timothy S. , Brewer Robert D. , Bolen Julie , Wells Henry E.
Published: December 2008

Objectives. We estimated adult binge drinking prevalence in US metropolitan areas.

Methods. We analyzed 1997 and 1999 Behavioral Risk Factor Surveillance System data for 120 metropolitan areas in 48 states and the District of Columbia.

Results. The prevalence of binge drinking varied substantially across metropolitan areas, from 4.1% in Chattanooga, Tenn, to 23.9% in San Antonio, Tex, (median = 14.5%). Seventeen of the 20 metropolitan areas with the highest estimates were located in the upper Midwest, Texas, and Nevada. In 13 of these areas, at least one third of persons aged 18 to 34 years were binge drinkers. There were significant intrastate differences for binge drinking among metropolitan areas in New York, Tennessee, and Utah.

Conclusions. Metropolitan-area estimates can be used to guide local efforts to reduce binge drinking.
Child Health: Reaching the Poor
Authors: Wagstaff Adam , Bustreo Flavia , Bryce Jennifer , Claeson Mariam ,   the Who–World Bank Child Health and Poverty Working Group
Published: December 2008

In most countries, rates of mortality and malnutrition among children continue to decline, but large inequalities between poor and better-off children exist, both between and within countries. These inequalities, which appear to be widening, call into question the strategies for child mortality reduction relied upon to date.

We review (1) what is known about the causes of socioeconomic inequalities in child health and where programs aimed at reducing inequalities may be most effectively focused and (2) what is known about the success of actual programs in narrowing these inequalities.

We end with lessons learned: the need for better evidence, but most of all for a new approach to improving the health of all children that is evidence based, broad, and multifaceted.
Swimmer’s Itch: Incidence and Risk Factors
Authors: Verbrugge Lois M. , Rainey Jeanette J. , Reimink Ronald L. , Blankespoor Harvey D.
Published: December 2008

Swimmer’s itch (cercarial dermatitis) affects people engaged in open-water activities. We report incidence and risk factors for a US lake. Water exposures and swimmer’s itch experience were reported daily for riparian household residents and guests at Douglas Lake, Michigan, in July 2000. Incidence of swimmer’s itch was 6.8 episodes per 100 water exposure days. Positive risks were (1) exposures in shallow water and in areas with onshore winds and (2) more days of lake use in July. Further epidemiological studies will help public health agencies address this bothersome problem at recreational lakes.
Cancer Burden From Arsenic in Drinking Water in Bangladesh
Authors: Chen Yu , Ahsan Habibul
Published: December 2008

We assessed the potential burden of internal cancers due to arsenic exposure in Bangladesh. We estimated excess lifetime risks of death from liver, bladder, and lung cancers using an exposure distribution, death probabilities, and cancer mortality rates from Bangladesh and dose-specific relative risk estimates from Taiwan. Results indicated at least a doubling of lifetime mortality risk from liver, bladder, and lung cancers (229.6 vs 103.5 per 100 000 population) in Bangladesh owing to arsenic in drinking water.
Computer Access and Internet Use Among Urban Youths
Authors: Bleakley Amy , Merzel Cheryl R. , VanDevanter Nancy L. , Messeri Peter
Published: December 2008

This report presents data on computer access, Internet use, and factors associated with health information seeking on the Internet among a sample of youths aged 15 to 30 years in New York City. Findings from street intercept surveys indicate substantial computer access at home (62%) and frequent (everyday or a few times a week) Internet use (66%). Fifty-five percent of the sample reported seeking health information on the Internet, which was associated with positive beliefs about getting a health checkup and frequent Internet use.
Oral Disease Burden in Northern Manhattan Patients With Diabetes Mellitus
Authors: Lalla Evanthia , Park David B. , Papapanou Panos N. , Lamster Ira B.
Published: December 2008

Objectives. We explored the association between diabetes mellitus and oral disease in a low-socioeconomic-status urban population.

Methods. Dental records of 150 adults with diabetes and 150 nondiabetic controls from the dental clinic at Columbia University in Northern Manhattan matched by age and gender were studied.

Results. There was a 50% increase in alveolar bone loss in diabetic patients compared with nondiabetic controls. Diabetes, increasing age, male gender, and use of tobacco products had a statistically significant effect on bone loss.

Conclusions. Our findings provide evidence that diabetes is an added risk for oral disease in this low-income, underserved population of Northern Manhattan. Oral disease prevention and treatment programs may need to be part of the standards of continuing care for patients with diabetes
Dental Insurance Visits and Expenditures Among Older Adults
Authors: Manski Richard J. , Goodman Harold S. , Reid Britt C. , Macek Mark D.
Published: December 2008

Objectives. We examined the effect of age, income, and coverage on dental service utilization during 1996.

Methods. We used data from the 1996 Medical Expenditure Panel Survey.

Results. Edentulous and poorer older adults are less likely to have coverage and less likely to report a dental visit than dentate or wealthier older adults.

Conclusions. These analyses help to describe the needs of older adults as they cope with diminishing resources as a consequence of retirement, including persons previously accustomed to accessing oral health services with dental insurance.
Does Supplemental Private Insurance Affect Care of Medicare Recipients Hospitalized for Myocardial Infarction?
Authors: Fang Jing , Alderman Michael H.
Published: December 2008

Objectives. We sought to determine whether supplemental private insurance coverage among Medicare recipients alters patterns of health care or outcomes associated with acute myocardial infarction.

Methods. Medicare patients hospitalized after a myocardial infarction were identified from New York City hospitalization records. Patients who had only Medicare coverage were compared with those who had supplemental private or public insurance coverage.

Results. Patients with supplemental private insurance exhibited increased rates of revascularization and decreased rates of in-hospital mortality relative to patients with either Medicare only or Medicare and public insurance. Moreover, Blacks and women were less likely to undergo revascularization and exhibited higher in-hospital mortality rates.

Conclusions. Despite Medicare, private insurance coverage appears to influence the likelihood of coronary revascularization among older patients hospitalized for acute myocardial infarction.
Assessment of Household Food Security Among Food Stamp Recipient Families in Maryland
Authors: Oberholser Cheryl A. , Tuttle Cynthia Reeves
Published: December 2008

Objectives. We assessed the relationship between food security status and various sociodemographic characteristics among households that include children and that receive food stamps.

Methods. A modified version of the US Food Security Survey Module was implemented by telephone survey with Maryland food stamp recipients.

Results. Of the 245 households, 66% experienced food insecurity. Food security status was associated with participation in the Special Supplemental Food Program for Women, Infants, and Children, the summer food program, and a food bank. Food security status was not associated with the number of months households received food stamps. There was no difference between the food security status of households living in urban and rural counties.

Conclusions. A gap exists between the food stamp support provided and some households’ nutritional and economic needs.
Racial Differences in Survival Among Men With Prostate Cancer and Comorbidity at Time of Diagnosis
Authors: Freeman Vincent L. , Durazo-Arvizu Ramon , Keys LaShon C. , Johnson Marc P. , Schafernak Kristian , Patel Vikas K.
Published: December 2008

Objectives. This study evaluated the effect of comorbidity at diagnosis on racial differences in survival among men with prostate cancer.

Methods. Clinical and demographic data were abstracted from records of 864 patients diagnosed at 4 Chicago area hospitals between 1986 and 1990. Comorbidity was scored on the basis of clinical information in the Charlson index. Cause-specific relative mortality adjusted for age, stage, differentiation, and treatment was compared across Charlson scores with Cox proportional hazards functions.

Results. Blacks had significantly greater mortality from prostate cancer and other causes (vs Whites, relative risk [95% confidence interval] = 1.84 [1.22, 2.79] and 1.69 [1.33, 2.29], respectively; P < .001). However, differences disappeared as initial comorbidity increased (1.75 [1.33, 2.31] vs 0.90 [0.59, 1.29] for scores = 0 and ≥ 5, respectively).

Conclusions. Absence of a significant preexisting medical diagnosis is associated with a higher risk for excess mortality among Black men diagnosed with prostate cancer.
Effect of Discrimination on Mental Health Service Utilization Among Chinese Americans
Authors: Spencer Michael S. , Chen Juan
Published: December 2008

Objectives. We examined the association between discrimination and mental health service use among a representative sample of Chinese Americans.

Methods. Our data were derived from the 2-wave Chinese American Psychiatric Epidemiological Survey, a strata-cluster survey conducted in 1993 and 1994 in a western American city.

Results. Language-based discrimination was associated with higher levels of use of informal services and seeking help from friends and relatives for emotional problems. Negative attitudes toward professional mental health services were associated with greater use of informal services.

Conclusions. The findings suggest that language-based discrimination influences patterns of mental health service use among Chinese Americans. Implications for service providers and policymakers are discussed.
Vision Impairment and Hearing Loss Among Community-Dwelling Older Americans: Implications for Health and Functioning
Authors: Crews John E. , Campbell Vincent A.
Published: December 2008

Objectives. We investigated the health, activity, and social participation of people aged 70 years or older with vision impairment, hearing loss, or both.

Methods. We examined the 1994 Second Supplement on Aging to determine the health and activities of these 3 groups compared with those without sensory loss. We calculated odds ratios and classified variables according to the International Classification of Functioning, Disability and Health framework.

Results. Older people with only hearing loss reported disparities in health, activities, and social roles; those with only vision impairment reported greater disparities; and those with both reported the greatest disparities.

Conclusions. A hierarchical pattern emerged as impairments predicted consistent disparities in activities and social participation. This population’s patterns of health and activities have public health implications.
Self-Reported Changes in Drug and Alcohol Use After Becoming Homeless
Authors: O'Toole Thomas P. , Gibbon Jeanette L. , Hanusa Barbara H. , Freyder Paul J. , Conde Alicia M. , Fine Michael J.
Published: December 2008

Objectives. We identified substance use patterns and factors associated with increased substance use after users become homeless.

Methods. We carried out a 2-city, community-based survey that used population-proportionate sampling of 91 sites with random selection at each site.

Results. Five hundred thirty-one adults were interviewed; 78.3% of them met Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition criteria for substance abuse or dependence. Most of those who met the criteria reported using drugs and alcohol less since they became homeless, commonly because they were in recovery. Factors independently associated with increased use were no health insurance (odds ratio [OR] = 1.6; 95% confidence interval [CI] = 1.02, 2.58), alcohol abuse or dependence (OR = 3.5; 95% CI = 1.85, 6.78), and selling plasma (OR = 2.6; 95% CI = 1.32, 5.14) or panhandling (OR = 3.0; 95% CI = 1.65, 5.55) to acquire drugs.

Conclusions. Becoming homeless plays a role in self-reported substance use. Multiservice treatment programs and tailored interventions for homeless persons are needed.
Highway Repair: A New Silicosis Threat
Authors: Valiante David J. , Schill Donald P. , Rosenman Kenneth D. , Socie Edward
Published: December 2008

Objectives. We describe an emerging public health concern regarding silicosis in the fast-growing highway repair industry.

Methods. We examined highway construction trends, silicosis surveillance case data, and environmental exposure data to evaluate the risk of silicosis among highway repair workers. We reviewed silicosis case data from the construction industry in 3 states that have silicosis registries, and we conducted environmental monitoring for silica at highway repair work sites.

Results. Our findings indicate that a large population of highway workers is at risk of developing silicosis from exposure to crystalline silica.

Conclusions. Exposure control methods, medical screenings, protective health standards, and safety-related contract language are necessary for preventing future occupational disease problems among highway repair workers.
Evaluation of a Community-Based Intervention to Promote Rear Seating for Children
Authors: Greenberg-Seth Jennifer , Hemenway David , Gallagher Susan S. , Ross Julie B. , Lissy Karen S.
Published: December 2008

Objectives. We evaluated the short-term effect of a community-based effort to promote child rear seating in a low-income Hispanic community.

Methods. Child seating patterns were observed pre- and postintervention at intersections in 1 intervention and 2 control cities. Brief interviews assessed exposure to program messages.

Results. Child rear seating increased from 33% to 49% in the intervention city (P < .0001), which represented a greater increase than that in the control cities (P < .0001). The greatest improvement was observed in relatively higher-income areas. Rear seating was significantly correlated with reported program exposure. Incentives and exposure to the program across multiple channels seemed to have the greatest effect.

Conclusions. Independent of legislation, community-based programs incorporating incentives can increase child rear seating.
Health Programs in Faith-Based Organizations: Are They Effective?
Authors: DeHaven Mark J. , Hunter Irby B. , Wilder Laura , Walton James W. , Berry Jarett
Published: December 2008

Objectives. We examined the published literature on health programs in faith-based organizations to determine the effectiveness of these programs.

Methods. We conducted a systematic literature review of articles describing faith-based health activities. Articles (n = 386) were screened for eligibility (n = 105), whether a faith-based health program was described (n = 53), and whether program effects were reported (28).

Results. Most programs focused on primary prevention (50.9%), general health maintenance (25.5%), cardiovascular health (20.7%), or cancer (18.9%). Significant effects reported included reductions in cholesterol and blood pressure levels, weight, and disease symptoms and increases in the use of mammography and breast self-examination.

Conclusions. Faith-based programs can improve health outcomes. Means are needed for increasing the frequency with which such programs are evaluated and the results of these evaluations are disseminated.
Individual Health Status and Racial Minority Concentration in US States and Counties
Authors: Mellor Jennifer M. , Milyo Jeffrey D.
Published: December 2008

Objectives. We examined whether the positive association between mortality rates and racial minority concentration documented in ecological studies would be found for health status after control for race/ethnicity, socioeconomic status, and region of residence.

Methods. We estimated least squares and probit models using aggregate and individual health status data from the 1995, 1997, and 1999 versions of the Current Population Survey merged with data from the US Bureau of the Census regarding state- and county-level racial minority concentration.

Results. Except in the case of older Whites, racial minority concentration was not associated with health status after control for individual characteristics and fixed regional factors.

Conclusions. Racial minority concentration may not be a determinant of individual health; differential migration patterns may explain the anomalous result for older Whites.
Ethics, Practice, and Research in Public Health
Authors: MacQueen Kathleen M. , Buehler James W.
Published: December 2008

Ethical issues that can arise in distinguishing public health research from practice are highlighted in 2 case studies—an investigation of a tuberculosis outbreak in a prison and an evaluation of a program for improving HIV prevention services.

Regardless of whether such public health investigations represent research or practice, we see a need for ethics oversight procedures that reflect actual risks and enable timely responses to crises.

Such oversight should accommodate the perspectives of persons and communities affected by public health threats and by governmental responses to those threats; it should further recognize that public health ethics is a distinct field combining bioethics, political philosophy, human rights, and law.
“Only the Best Class of Immigration”
Authors: Abel Emily K.
Published: December 2008

Public health officials contributed to the early 20thcentury campaign against Mexicans and Filipinos in Los Angeles. In 1914, the newly established city and county health departments confronted the overwhelming task of building a public health infrastructure for a rapidly growing population spread over a large area. However, for several years public health reports focused almost exclusively on the various infectious diseases associated with Mexican immigrants.

Although the segregation of Mexicans was illegal in California until 1935, county officials established separate clinics for Whites and Mexicans during the 1920s. With assistance from state officials, local health authorities participated actively in efforts to restrict Mexican immigration throughout the 1920s and to expel both Mexicans and Filipinos during the 1930s.
Uncertain Benefit: The Public Policy of Approving Smallpox Vaccine Research
Authors: Quigley Rosemary B
Published: December 2008

Without an accurate assessment of the prospect of bioterrorist attack, it is especially challenging to evaluate the protocols for testing smallpox vaccines in the pediatric population. Usual regulatory mechanisms cannot shepherd research protocols with benefits that can only be characterized as “uncertain” in the face of more than minimal risk.

When a protocol is placed in a government forum for analysis, the public has a unique opportunity to debate the balancing of research risks and benefits on behalf of children who are unable to assent to research themselves, as well as to express views about vaccination policy broadly. This model for review of pediatric research that may be without benefit will be especially important as challenging studies of various vaccines against a range of infectious properties, such as anthrax and severe acute respiratory syndrome (SARS), emerge.
Enhancing Public Confidence in Vaccines Through Independent Oversight of Postlicensure Vaccine Safety
Authors: Salmon Daniel A. , Moulton Lawrence H. , Halsey Neal A.
Published: December 2008

The National Immunization Program of the Centers for Disease Control and Prevention is responsible for controlling infectious diseases through vaccination, but the program also plays a key role in postlicensure vaccine safety assessment. The time has come to separate postlicensure vaccine safety assessment from vaccine risk management as recommended by the National Research Council of the National Academy of Sciences.

The National Transportation Safety Board offers a useful model for developing an independent National Vaccine Safety Board that would have the authority to leverage resources and expertise of various government agencies, academia, and industry to oversee postlicensure vaccine safety investigations. Such a board would have been useful in recent vaccine safety concerns, and its independence from government programs would ensure optimal vaccine safety and enhance public confidence in vaccines.
Impact of PCV7 on Invasive Pneumococcal Disease Among Children Younger Than 5 Years: A Population-Based Study
Authors: Ramani Revathi R. , Hall William N. , Boulton Matthew , Johnson David R. , Zhu Bao-Ping
Published: December 2008

We examined the impact of the heptavalent pneumococcal conjugate vaccine (PCV7) on hospital discharge rates for invasive pneumococcal disease among Michigan children younger than 5 years old. After the introduction of PCV7, the hospital discharge rate for children younger than 1 years old was significantly lower than before introduction. We correlated the decreased rates with the introduction and rapid uptake of PCV7. Lack of change in the hospital discharge rates for other age groups likely represents a slower uptake of PCV7 compared with that for children aged younger than 1 year.
Racial/Ethnic Disparities in Preschool Immunizations: United States, 1996–2001
Authors: Chu Susan Y. , Barker Lawrence E. , Smith Philip J.
Published: December 2008

Objectives. We examined current racial/ethnic differences in immunization coverage rates among US preschool children.

Methods. Using National Immunization Survey data from 1996 through 2001, we compared vaccination coverage rates between non-Hispanic White, non-Hispanic Black, Hispanic, and Asian preschool children.

Results. During the 6-year study period, the immunization coverage gap between White and Black children widened by an average of 1.1% each year, and the gap between White and Hispanic children widened by an average of 0.5% each year. The gap between White and Asian children narrowed by an average of 0.8% each year.

Conclusions. Racial/ethnic disparities in preschool immunization coverage rates have increased significantly among some groups; critical improvements in identifying, understanding, and addressing race/ethnicity-specific health care differences are needed to achieve the Healthy People 2010 goal of eliminating disparities.
Vaccine Risk Perception Among Reporters of Autism After Vaccination: Vaccine Adverse Event Reporting System 1990–2001
Authors: Woo Emily Jane , Ball Robert , Bostrom Ann , Shadomy Sean V. , Ball Leslie K. , Evans Geoffrey , Braun Miles
Published: December 2008

Objectives. We investigated vaccine risk perception among reporters of autism to the Vaccine Adverse Event Reporting System (VAERS).

Methods. We conducted structured interviews with 124 parents who reported autism and related disorders to VAERS from 1990 to 2001 and compared results with those of a published survey of parents in the general population.

Results. Respondents perceived vaccine-preventable diseases as less serious than did other parents. Only 15% of respondents deemed immunization extremely important for children’s health; two thirds had withheld vaccines from their children.

Conclusions. Views of parents who believe vaccines injured their children differ significantly from those of the general population regarding the benefits of immunization. Understanding the factors that shape this perspective can improve communication among vaccine providers, policymakers, and parents/patients.
“Street Medicine”: Collaborating With a Faith-Based Organization to Screen At-Risk Youths for Sexually Transmitted Diseases
Authors: Moss Nicholas J. , Gallaread Alonzo , Siller Jacqueline , Klausner Jeffrey D.
Published: December 2008

Chlamydia and gonorrhea rates among African American youths in San Francisco are far higher than those among young people of the city’s other racial and ethnic groups.

A geographically targeted sexually transmitted disease education and screening intervention performed in collaboration with a local faith-based organization was able to screen hundreds of at-risk youths. The screened individuals included friends and sex partners from an extensive social-sexual network that transcended the boundaries of the target population. The intervention also provided an excellent opportunity to practice “street medicine,” in which all screening and treatment was effectively conducted in the field.
HIV Topical Microbicides: Steer the Ship or Run Aground
Authors: Gross Michael
Published: December 2008

Six HIV candidate microbicides are scheduled to enter 6 large-scale effectiveness trials in the next year. The selection of products for testing and the design of this group of trials should be reconsidered to provide an answer to a key question now before the field: Does a sulfonated polyanion, delivered intravaginally as a gel, block HIV attachment to target cells with sufficient potency to protect women from sexually acquired HIV infection?

Paradoxically, entering more candidates into more trials may confuse or compromise efforts to identify an effective product. Instead, a single trial of the most promising product(s) best serves the current candidates while also preserving resources needed to promptly advance innovative new protective concepts into future large-scale trials.
Ethical Challenges in Preparing for Bioterrorism: Barriers Within the Health Care System
Authors: Wynia Matthew K. , Gostin Lawrence O.
Published: December 2008

Preparedness for bioterrorism poses significant ethical challenges. Although public health ethics and preparedness have received attention recently, health care ethics must also be considered.

In epidemics, the health care system assists public health in 3 tasks: detection, containment, and treatment. Detection might fail if all patients do not have access to care, or if physicians do not understand their obligation to report infectious diseases to public health authorities. Containment might fail if physicians view themselves only as advocates for individual patients, ignoring their social obligations as health professionals. Treatment might fail if physicians do not accept their professional duty to treat patients during epidemics.

Each of these potential ethical barriers to preparedness must be addressed by physicians and society.
Asthma Inhalers in Schools: Rights of Students with Asthma to a Free Appropriate Education
Authors: Jones Sherry Everett , Wheeler Lani
Published: December 2008

Students who possess and self-administer their asthma medications can prevent or reduce the severity of asthma episodes. In many states, laws or policies allow students to possess and self-administer asthma medications at school.

In the absence of a state or local law or policy allowing public school students to possess inhalers and selfmedicate to treat asthma, 3 federal statutes may require public schools to permit the carrying of such medications by students: the Individuals With Disabilities Education Act, Section 504 of the Rehabilitation Act of 1973, and Title II of the Americans with Disabilities Act. Local policies and procedures can be based on these federal laws to ensure that students with asthma can take their medicines as needed.
Characterizing Perceived Police Violence: Implications for Public Health
Authors: Cooper Hannah , Moore Lisa , Gruskin Sofia , Krieger Nancy
Published: December 2008

Despite growing recognition of violence’s health consequences and the World Health Organization’s recent classification of police officers’ excessive use of force as a form of violence, public health investigators have produced scant research characterizing police-perpetrated abuse.

Using qualitative data from a study of a police drug crackdown in 2000 in 1 New York City police precinct, we explored 40 injection drug using and 25 non–drug using precinct residents’ perceptions of and experiences with police-perpetrated abuse. Participants, particularly injection drug users and non–drug using men, reported police physical, psychological, and sexual violence and neglect; they often associated this abuse with crackdown-related tactics and perceived officer prejudice.

We recommend that public health research address the prevalence, nature, and public health implications of police violence.
Sociodemographic Differences in Access to Care Among Hispanic Patients Who Are HIV Infected in the United States
Authors: Morales Leo S. , Cunningham William E. , Galvan Frank H. , Andersen Ronald M. , Nakazono Terry T. , Shapiro Martin F.
Published: December 2008

This study evaluated associations between sociodemographic factors and access to care, use of highly active antiretroviral therapy, and patients’ ratings of care among Hispanic patients who are HIV infected; we used data from the HIV Cost and Services Utilization Study. Gender, insurance, mode of exposure, and geographic region were associated with access to medical care. Researchers and policymakers should consider sociodemographic factors among Hispanic patients who are HIV positive when designing and prioritizing interventions to improve access to care.
Psychosocial Characteristics of New York City HIV-Infected Women Before and After the Advent of HAART
Authors: Siegel Karolynn , Karus Daniel , Dean Laura
Published: December 2008

Objectives. We compared level of psychosocial distress of HIV-infected women living in New York City before the advent of highly active antiretroviral therapy (HAART) with level of psychosocial distress reported by women living with the disease after the use of HAART became widespread.

Methods. Data were from HIV-positive New York City women aged 18 to 50 years, enrolled through outreach and self-referral. We compared scores on measures of psychological state and psychosocial adjustment to illness of 74 women interviewed in 1994–1996 with scores of a matched group of 74 women interviewed in 2000–2002.

Results. A significant difference between groups was found only with regard to adjustment to illness in their domestic environment, with poorer adjustment reported, on average, by women in the 2000–2002 sample.

Conclusions. Although new treatments have significantly improved the physical health of those living with HIV/AIDS, no evidence was found that these treatments significantly improved psychological health for women, regardless of history of protease inhibitor use.