bluuebunny/crossref_metadata_2025 huggingface dataset:
Childhood victimization and subsequent risk for promiscuity, prostitution, and teenage pregnancy: a prospective study.
Authors: Widom C S , Kuhns J B
Published: November 2008

OBJECTIVES: This study examined the extent to which being abused and/or neglected in childhood increases a person's risk for promiscuity, prostitution, and teenage pregnancy. METHODS: A prospective cohorts design was used to match, on the basis of age, race, sex, and social class, cases of abused and/or neglected children from 1967 to 1971 with nonabused and nonneglected children; subjects were followed into young adulthood. From 1989 to 1995 1196 subjects (676 abused and/or neglected and 520 control subjects were located and interviewed. RESULTS: Early childhood abuse and/or neglect was a significant predictor of prostitution for females (odds ratio [OR] = 2.96). For females, sexual abuse (OR = 2.54) and neglect (OR = 2.58) were associated with prostitution, whereas physical abuse was only marginally associated. Childhood abuse and neglect were not associated with increased risk for promiscuity or teenage pregnancy. CONCLUSIONS: These findings strongly support a relationship between childhood victimization and subsequent prostitution. The presumed causal sequence between childhood victimization and teenage pregnancy may need to be reevaluated.
Illicit drug use by persons with disabilities: insights from the National Household Survey on Drug Abuse.
Authors: Gilson S F , Chilcoat H D , Stapleton J M
Published: November 2008

OBJECTIVES: This study sought to evaluate the association of drug use with disability in a representative sample of the US household population. METHODS: The use of illicit drugs and alcohol reported by respondents in the 1991 National Household Survey on Drug Abuse who identified themselves as "disabled, unable to work" was compared with respondents without disabilities. RESULTS: Among younger adults (18-24 years), persons with disabilities were more likely than those without disabilities to report that they had used heroin (adjusted odds ratio [OR] = 6.89; 95% confidence interval [CI] = 1.35, 35.1) or crack cocaine (OR = 6.38; 95% CI = 1.05, 38.6). Among older adults (35 years and older), persons with disabilities were more likely to report the use of sedatives (OR = 2.46; 95% CI = 1.21, 4.94) or tranquilizers (OR = 2.18: 95% CI = 1.08; 4.42) not medically prescribed. CONCLUSIONS: These results suggest that use of illicit drugs is a potentially serious problem among persons with disabilities and requires both research and clinical attention.
HIV risk behaviors and obstacles to condom use among Puerto Rican men in New York City who have sex with men.
Authors: Carballo-Diéguez A , Dolezal C
Published: November 2008

OBJECTIVES: This paper describes the sexual risk behaviors of Puerto Rican men who have sex with men and their perceived obstacles to condom use. METHODS: Interviews were conducted with 182 Puerto Rican men living in New York, NY. RESULTS: Condoms were used inconsistently or not at all by half of the men who had anal sex with other men, by two thirds of the men who had vaginal sex, and by three fifths of those who had anal sex with women. Most of the men had had unprotected oral sex and more than one sexual partner in the previous year. Three of 10 were positive for the human immunodeficiency virus (HIV). Dislike of condoms was the most frequently cited obstacle, followed by perception of low risk, trust in and emotional connection with partner, unavailability and inconvenience of condom use, lack of control, and indifference. CONCLUSIONS: Barrier methods other than condoms, such as a microbicidal, gel, need to be developed.
Assessing substance abuse treatment needs among the homeless: a telephone-based interactive voice response system.
Authors: Aiemagno S A , Cochran D , Feucht T E , Stephens R C , Butts J M , Wolfe S A
Published: November 2008

OBJECTIVES: We report on a pilot project that used a telephone-based interactive voice response system accessed by cellular phones at diverse sites, to interview homeless persons on their need for alcohol and other drug treatment. METHODS: Using this technique we surveyed 207 homeless adults at eight shelters in Cleveland, Ohio. RESULTS: The cellular approach was comparable to human-administered interviews in reliability and validity and yielded higher self-reported levels of drug use. CONCLUSIONS: Cellular telephones and interactive voice response interviewing systems can be useful tools in assessing for the health-service needs of difficult-to-reach populations.
Exposure to varying levels of contaminants and symptoms among workers in two office buildings.
Authors: Menzres D , Tamblyn R M , Nunes F , Hanley J , Tamblyn R T
Published: November 2008

OBJECTIVES: We hypothesized that exposure to contaminants would be associated with symptoms reported by office workers. METHODS: In two mechanically ventilated office buildings in. Montreal, the outdoor air supply was manipulated for 6 weeks, while symptoms were reported and environmental parameters were measured at multiple sites. RESULTS: Contaminant concentrations varied considerably, in part related to experimental changes in outdoor air supply. Eye symptoms were reported with higher dust and with higher concentrations of nitrogen dioxide. Mucosal symptoms were increased with higher TVOCs, higher nitrogen dioxide, and higher total contaminant load. Systemic symptoms were associated with higher dust levels. CONCLUSIONS: Symptoms reported by the workers were associated with increased concentrations of several contaminants and a summary measure of all contaminants.
From genes to public health: the applications of genetic technology in disease prevention. Genetics Working Group.
Authors: Khoury M J
Published: November 2008

OBJECTIVES: With advances in the Human Genome Project, the implications of genetic technology in disease prevention should be assessed. METHODS: The paradigm suggested in The Future of Public Health--assessment, policy development, and assurance--was used to examine the continuum from genetic technology to public health practice. RESULTS: First, important public health functions are to (1) assess the impact of genes and their interactions with modifiable disease risk factors on the health status of the population and (2) assess the impact and safety of genetic testing on the population. Second, given the many implications of genetic testing, the public health community should participate in policy development related to the timing and use of genetic testing in disease prevention. Third, whenever appropriate, the public health community needs to ensure the development of public health genetics programs (e.g. newborn screening) and evaluate the quality and effectiveness of the use of genetic testing in disease prevention. CONCLUSIONS: Although most current genetic tests are not ready for disease prevention, there is an important role for the public health community in translating genetic technology into disease prevention.
Estimating the indirect cost of illness: an assessment of the forgone earnings approach.
Authors: Glied S
Published: November 2008

OBJECTIVES: This study attempted to assess (1) the accuracy of estimates of the indirect cost of illness and death computed with the human capital (forgone earnings) method and (2) the sensitivity of these estimates to key assumptions and parameters. METHODS: The study used data from the annual Current Population Surveys of 1964 through 1988 to compare the earnings experience of cohorts of White men aged 18 through 65 with predictions made with the human capital method. The study then assessed the sources and magnitude of the observed differences. RESULTS: Predictions of forgone earnings can be as much as 18% greater or 20% smaller than actual earnings, under identical assumptions, depending on the data used. While in most cases errors are quite small, alternative, equally plausible estimates of forgone earnings may differ by as much as 50%. Estimates differed mainly because of (1) the cross section chosen to make the predictions and (2) assumptions about future earnings growth. However, other factors, such as cohort size, also contributed to variation. CONCLUSIONS: Researchers and policymakers should be very careful in making and interpreting estimates of the indirect cost of illness and death.
The timing of preventive services for women and children: the effect of having a usual source of care.
Authors: Ettner S L
Published: November 2008

OBJECTIVES: This study investigated the causal effect of having a usual source of medical care on the timing of preventive services by women and children. METHODS: Data on 17,110 children and 23,488 women from the 1988 and 1990 National Health Interview Surveys were used to estimate ordered probit models of the effect of having a usual source of medical care on the time since the last receipt of each preventive service (routine checkups for children; blood pressure checks, Pap smears, and breast exams for adult women; mammograms for older women). Two-stage instrumental variables methods were used to eliminate simultaneity bias. RESULTS: The existence of a usual source of medical care was strongly correlated with the earlier receipt of preventive services, and the relationship appears to be causal for Pap smears, breast exams, and mammograms. However, there was little evidence that having a regular provider caused an increased rate of routine checkups for children or blood pressure checks for adult women. CONCLUSIONS: Delivery systems that encourage the development of long-term relationships with medical providers may increase cancer screening rates among women.
An adolescent tobacco-use prevention trial in orthodontic offices.
Authors: Hovell M F , Slymen D J , Jones J A , Hofstetter C R , Burkham-Kreitner S , Conway T L , Rubin B , Noel D
Published: November 2008

OBJECTIVES: This study examined the effect of an orthodontist-delivered tobacco-use prevention program for adolescents. METHODS: Southern California orthodontic offices were randomly assigned to experimental (n = 77) and control (n = 77) groups. Randomly selected adolescents were interviewed at baseline and 2 years later (n = 15,644). Experimental offices received tobacco prevention training, anti-tobacco materials, and 50 cents for each anti-tobacco "prescription" written. RESULTS: The 30-day tobacco use 2-year incidence rates for the control and experimental groups were 12.6% and 12.0%, respectively; incidence rates for using tobacco more than 100 times were 7.6% and 6.8%. Differences between the groups did not reach significance. Mean prescription compliance was 64.4%. A multivariate logistic model, showed a significant dose response: patients who received more prescriptions had lower incidence rates than those who received few or none (10% vs 14%). CONCLUSIONS: Training, payment, and support did not ensure clinician compliance with prevention services. The dose effect suggests that replication under conditions that would ensure clinician compliance and statistical power would more thoroughly test clinicians' ability to prevent tobacco use.
Promoting abstinence among relapsed chronic smokers: the effect of telephone support.
Authors: Lando H A , Pirie P L , Roski J , McGovern P G , Schmid L A
Published: November 2008

OBJECTIVES: The present study used telephone support both to sustain abstinence and to encourage renewed quit attempts in smokers who had completed an intensive smoking cessation clinic. METHODS: Subjects were hard-core smokers (n = 1083) who had attended a multisession cessation clinic. They were then assigned randomly to receive telephone support (intervention calls 3, 9, and 21 months after the targeted cessation clinic quit date) or no further intervention. RESULTS: In the intervention condition, subjects who relapsed were significantly more likely to resume abstinence (that is, to recycle) than those in the comparison condition at follow-up (6 months: 17.8% vs 11.3%; 24 months: 25.7% vs 18.2%). Telephone support was not effective in preventing relapse, and overall differences in abstinence outcome were not significant. CONCLUSIONS: The major hypothesis of the current study--that telephone support would enhance the resumption of abstinence--received partial support. However, there was no evidence either of an overall treatment effect or of an effect in preventing relapse. Telephone outreach may be more effective in the context of self-help or other less intensive interventions.
The late-stage diagnosis of colorectal cancer: demographic and socioeconomic factors.
Authors: Mandelblatt J , Andrews H , Kao R , Wallace R , Kerner J
Published: November 2008

OBJECTIVES: This study described factors related to colorectal cancer stage at diagnosis. METHODS: Logistic regression analyses were used on data from the New York State Tumor Registry and US Census area-level social class indicators. RESULTS: After the effects of other predictors were controlled for, the odds of late-stage cancer increased as age decreased; women and African Americans were significantly more likely to have late stage than men and Whites; and individuals living in areas of low socioeconomic status (SES) were significantly more likely to be diagnosed at late stage than those living in higher SES areas. Stratified analyses showed that living in a low SES area was the most important determinant of stage for all age, race, gender and source-of-care groups. CONCLUSIONS: While all populations would benefit from the systematic use of screening socioeconomically disadvantaged groups may also benefit from targeted screening.
Assessing children's ultraviolet radiation exposure: the potential usefulness of a colorimeter.
Authors: Eckhardt L , Mayer J A , Creech L , Johnston M R , Lui K J , Sallis J F , Elder J P
Published: November 2008

OBJECTIVES: This study evaluated the colorimeter as an objective measure of children's ultraviolet (UV) radiation exposure. METHODS: Fifty-eight children, ages 6 to 9 years, attended two summer measurement sessions, with 46 attending a subsequent winter session. RESULTS: Comparisons between summer sessions for the L* scale showed that only the upper arm significantly changed in the tanner direction, while b* scale values indicated significant tanning for all body sites. All exposed body sites changed significantly in the less tan direction between summer and winter measurements. CONCLUSIONS: Using colorimeters to objectively measure children's UV exposure has potential applications for skin cancer prevention programs.
Compliance with antihypertensive therapy among elderly Medicaid enrollees: the roles of age, gender, and race.
Authors: Monane M , Bohn R L , Gurwitz J H , Glynn R J , Levin R , Avorn J
Published: November 2008

OBJECTIVES: This study measured compliance and related demographic factors in a retrospective cohort of 4068 elderly outpatients newly starting antihypertensive therapy from 1982 through 1988. METHODS: Logistic regression modeling of data from the New Jersey Medicaid program was used. RESULTS: These patients filled antihypertensive prescriptions covering an average of only 179 days in the 365-day follow-up period (49%) Good compliance (> or = 80%) was associated with advanced age (odds ratio [OR] = 2.12, for patients 85 or older) and White race (OR = 0.55 for Blacks). There was no relationship between compliance and gender. CONCLUSIONS: Despite the efficacy of antihypertensive therapy in preventing cardiovascular morbidity, such high rates of noncompliance may contribute to suboptimal patient outcomes.
Inappropriately timed immunizations: types, causes, and their relationship to record keeping.
Authors: Hamlin J S , Wood D , Pereyra M , Grabowsky M
Published: November 2008

OBJECTIVES: This study examined inappropriately timed immunizations and their relationship to record keeping practices in Los Angeles public health centers. METHODS: Records of children's visits were reviewed at four public health centers maintaining separate records. RESULTS: One third of all children seen at both immunization-only and well child clinics were given inappropriately timed immunizations. Almost half of the immunizations were not transferred between sets of records. Children seen in both clinics were more than twice as likely to receive at least one inappropriately timed immunization as those seen only at the well child clinic. CONCLUSIONS: Keeping separate immunization records at separate clinics leads to inappropriately timed immunizations.
Who administers? Who cares? Medical administrative and clinical employment in the United States and Canada.
Authors: Himmelstein D U , Lewontin J P , Woolhandler S
Published: November 2008

OBJECTIVES. We compared US and Canadian health administration costs using national medical care employment data for both countries. METHODS. Data from census surveys on hospital, nursing home, and outpatient employment in the United States (1968 to 1993) and Canada (1971 and 1986) were analyzed. RESULTS. Between 1968 and 1993, US medical care employment grew from 3.976 to 10.308 million full-time equivalents. Administration grew from 0.719 to 2.792 million full-time equivalents, or from 18.1% to 27.1% of the total employment. In 1986, the United States deployed 33,666 health care full-time equivalent personnel per million population, and Canada deployed 31,529. The US excess was all administrative; Canada employed more clinical personnel, especially registered nurses. Between 1971 and 1986, hospital employment per capita grew 29% in the United States (mostly because of administrative growth) and fell 14% in Canada. In 1986, Canadian hospitals still employed more clinical staff per million. Outpatient employment was larger and grew faster in the United States. Per capita nursing home employment was substantially higher in Canada. CONCLUSIONS. If US hospitals and outpatient facilities adopted Canada's staffing patterns, 1,407,000 fewer managers and clerks would be necessary. Despite lower medical spending, Canadians receive slightly more nursing and other clinical care than Americans, as measured by labor inputs.
The elimination of selected chronic diseases in a population: the compression and expansion of morbidity.
Authors: Nusselder W J , van der Velden K , van Sonsbeek J L , Lenior M E , van den Bos G A
Published: November 2008

OBJECTIVES. This study evaluates the effect of eliminating a specific disease on the mortality, long-term disability, and overall health status of a population. Primarily, it examines whether elimination leads to a compression of morbidity. METHODS. The Sullivan method was used to calculate disability-free life expectancy. Cause-deleted disability prevalence was estimated with a multiple logistic regression model that used data from the Dutch National Survey of General Practice. Cause-deleted probabilities of dying were derived with the cause-elimination life-table technique, assuming independence among competing causes of death. RESULTS. Eliminating disabling nonfatal diseases such as arthritis/back complaints results in a decline in life expectancy with disability--that is, an absolute compression of morbidity. Eliminating highly fatal diseases such as cancer leads to an increase in the number of years and the proportion of life with disability--that is, a relative expansion of morbidity. CONCLUSIONS. While eliminating fatal diseases leads to an increase in disability-free life expectancy, life expectancy with disability may increase as well. This represents an increasing burden to society. On the other hand, eliminating nonfatal disabling diseases leads to absolute compression of morbidity.
The prevalence of self-reported peptic ulcer in the United States.
Authors: Sonnenberg A , Everhart J E
Published: November 2008

OBJECTIVES. The purpose of this study was to draw a current picture of the sociodemographic characteristics of peptic ulcer in the United States. METHODS. During the National Health Interview Survey of 1989, a special questionnaire on digestive diseases was administered to 41,457 randomly selected individuals. Data were retrieved from public use tapes provided by the National Center for Health Statistics. Odds ratios were calculated by logistic regression after adjustment for sample weights in the survey. RESULTS. Of adult US residents, 10% reported having physician-diagnosed ulcer disease, and one third of these individuals reported having an ulcer in the past year. Old age, short education, low family income, being a veteran, and smoking acted as significant and independent risk factors. Gastric and duodenal ulcer occurred in both sexes equally often. Duodenal ulcer was more common in Whites than non-Whites, while gastric ulcer was more common in non-Whites. CONCLUSIONS. The age-related rise and socioeconomic gradients of peptic ulcer represent the historic scars of previous infection rates with Helicobacter pylori. The racial variations reflect different ages at the time of first infection; younger and older age at the acquisition of H. pylori appear to be associated with gastric and duodenal ulcer, respectively.
Preventing cardiovascular disease through community-based risk reduction: the Bootheel Heart Health Project.
Authors: Brownson R C , Smith C A , Pratt M , Mack N E , Jackson-Thompson J , Dean C G , Dabney S , Wilkerson J C
Published: November 2008

OBJECTIVES. The purpose of this study was to determine whether a community-based risk reduction project affected behavioral risk factors for cardiovascular disease. METHODS. Community-based activities (e.g., exercise groups, healthy cooking demonstrations, blood pressure and cholesterol screenings, and cardiovascular disease education) were conducted in six southeastern Missouri counties. Evaluation involved population-based, cross-sectional samples of adult residents of the state and the intervention region. Weighted prevalence estimates were calculated for self-reported physical inactivity, cigarette smoking, consumption of fruits and vegetables, overweight, and cholesterol screening. RESULTS. Physical inactivity decreased within the intervention region, that is, in communities where heart health coalitions were developed and among respondents who were aware of these coalitions. In addition, the prevalence rates for reports of cholesterol screening within the past 2 years were higher for respondents in areas with coalitions and among persons who were aware of the coalitions. CONCLUSIONS. Even with modest resources, community-based interventions show promise in reducing self-reported risk for cardiovascular disease within a relatively brief period.
Smoking cessation in young adults: age at initiation of cigarette smoking and other suspected influences.
Authors: Breslau N , Peterson E L
Published: November 2008

OBJECTIVES. Previous research has suggested that early smoking initiation predicts longer duration of smoking, heavier daily consumption, and increased chances of nicotine dependence. This report set out to estimate the relationship between smoking cessation and age of initiation, as well as nicotine dependence, sex, race, and education. METHODS. A sample of 1007 young adults was randomly selected from a large health maintenance organization in southeast Michigan. Hazard ratios of quitting associated with age at smoking initiation were estimated among 414 persons who smoked daily for 1 month or more. RESULTS. With potential confounders controlled for, the likelihood of cessation was significantly higher in smokers who initiated smoking after age 13. The hazard ratio for quitting associated with smoking initiation at ages 14 to 16 was 1.6 and with initiation at or after age 17 was 2.0, compared with initiation at or before 13 years of age. Factors that decreased the likelihood of cessation were nicotine dependence and low education. CONCLUSIONS. Public policy to discourage early smoking, if it succeeds in delaying the initiation of smoking, might contribute to the reduction of smoking-related mortality and morbidity by increasing the potential for quitting.
Youth access to tobacco: the effects of age, gender, vending machine locks, and "it's the law" programs.
Authors: DiFranza J R , Savageau J A , Aisquith B F
Published: November 2008

OBJECTIVES. This study evaluated the influence of age, gender, vending machine lockout devices, and tobacco industry-sponsored voluntary compliance programs ("It's the Law" programs) on underage youths' ability to purchase tobacco. METHODS. Twelve youths made 480 attempts to purchase tobacco in Massachusetts from over-the-counter retailers and vending machines with and without remote control lockout devices. Half the vendors were participating in It's the Law programs. RESULTS. In communities with no requirements for lockout devices, illegal sales were far more likely from vending machines than from over-the-counter sources (odds ratio [OR] = 5.9, 95% confidence interval [CI] = 3.3, 10.3). Locks on vending machines made them equivalent to over-the-counter sources in terms of illegal sales to youths. Vendors participating in It's the Law programs were as likely to make illegal sales as nonparticipants (OR = 0.87, 95% CI = 0.57, 1.35). Girls and youths 16 years of age and older were more successful at purchasing tobacco. CONCLUSIONS. The It's the Law programs are ineffective in preventing illegal sales. While locks made vending machines equivalent to over-the-counter sources in their compliance with the law, they are not a substitute for law enforcement.
Smoking prevalence in US birth cohorts: the influence of gender and education.
Authors: Escobedo L G , Peddicord J P
Published: November 2008

OBJECTIVES. To assess long-term trends in cigarette smoking according to the combined influence of sex and education, this study examined smoking prevalence in successive US birth cohorts. METHODS. Data from nationally representative surveys were examined to assess smoking prevalence for six successive 10-year birth cohorts stratified by race or ethnicity, sex, and educational attainment. RESULTS. Substantial declines in smoking prevalence were found among men who had a high school education or more, regardless of race or ethnicity, and slight declines among women of the same educational background were revealed. However, little change was found in smoking prevalence among men of all race/ethnic groups with less than a high school education, and large increases were found among women with the same years of schooling, especially if they were White or African American. CONCLUSIONS. These data suggest that persons of low educational attainment have yet to benefit from policies and education about the health consequences of cigarette smoking.
Preconceptional and prenatal multivitamin-mineral supplement use in the 1988 National Maternal and Infant Health Survey.
Authors: Yu S M , Keppel K G , Singh G K , Kessel W
Published: November 2008

This paper examines the prevalence of multivitamin-mineral supplement use before and during pregnancy, as well as predictors of nonuse, in 9953 women who delivered live infants in the 1988 National Maternal and Infant Health Survey. Ninety-seven percent of the women were advised to take multivitamin-mineral supplements in prenatal care. Sixty-seven percent of Black mothers took supplements during pregnancy, as compared with 84% of White mothers. Multivariate analysis revealed that Black mothers; mothers who are less educated, younger, unmarried, and non-smokers; and mothers who participate in Women, Infants, and Children programs are at elevated risk for nonuse. These data help identify groups in need of supplementation guidance.
The validity of hospital administrative data in monitoring variations in breast cancer surgery.
Authors: Kahn L H , Blustein J , Arons R R , Yee R , Shea S
Published: November 2008

To assess the validity of using hospital administrative data to measure variations in surgery for early-stage breast cancer, ICD-9-CM coded information was compared with corresponding tumor registry data for 1293 breast cancer patients undergoing lumpectomy or mastectomy at a tertiary referral center from January 1989 to October 1993. Relative to "gold standard" tumor registry data, the administrative data proved 83.4% sensitive and 80.4% specific in identifying women with localized disease who would be potential candidates for lumpectomy. The proportion of women with localized disease undergoing lumpectomy in groups defined by race and insurance status was nearly identical, whichever data were used. Administrative data, which is often readily and publicly available, may be useful in studying variations in breast cancer treatment in key demographic groups.
Maternal smoking during pregnancy and the risk of congenital urinary tract anomalies.
Authors: Li D K , Mueller B A , Hickok D E , Daling J R , Fantel A G , Checkoway H , Weiss N S
Published: November 2008

To study maternal smoking during pregnancy and the risk of congenital urinary tract anomalies, we interviewed mothers of 118 affected infants born to residents of western Washington State during 1990 and 1991 and mothers of 369 control infants randomly selected from those without birth defects delivered during those years in five hospitals in King County, Washington. Maternal smoking was associated with an increased risk of congenital urinary tract anomalies in offspring (adjusted odds ratio [OR] = 2.3; 95% confidence interval [CI] = 1.2, 4.5). This risk was higher among light smokers (1-1000 cigarettes during the pregnancy) (OR = 3.7; 95% CI = 1.7, 8.6) than among heavy smokers (OR = 1.4; 95% CI = 0.6, 3.3). Our results corroborate previous findings and support the hypothesis of a causal relation.
How long will today's new adolescent smoker be addicted to cigarettes?
Authors: Pierce J P , Gilpin E
Published: November 2008

This study estimated the expected smoking duration for young smokers who have started recently. Data from National Health Interview Surveys were combined to model the ages at which smoking prevalence will decline to various percentages of the peak smoking prevalence for each successive birth cohort. Smoking-cessation ages were then estimated for the males and females born from 1975 through 1979. The median cessation age for those in this cohort who start smoking as adolescents is expected to be 33 years for males and 37 years for females. Thus, 50% of these adolescent males may smoke for at least 16 years and 50% of these adolescent females may smoke for at least 20 years, based on a median age of initiation of 16 to 17 years. Despite the decline in the median age of US smokers who quit, these data predict that smoking will be a long-term addiction for many adolescents who start now.
Long-term psychosocial work environment and cardiovascular mortality among Swedish men.
Authors: Johnson J V , Stewart W , Hall E M , Fredlund P , Theorell T
Published: November 2008

OBJECTIVES. This study examined the effect of cumulative exposure to work organization--psychological demands, work control, and social support on prospectively measured cardiovascular disease mortality risk. METHODS. The source population was a national sample of 12517 subjects selected from the Swedish male population by Statistics Sweden in annual surveys between 1977 and 1981. Over a 14-year follow-up period, 521 deaths from cardiovascular disease were identified. A nested case-control design was used. Work environment exposure scores were assigned to cases and controls by linking lifetime job histories with a job exposure matrix. RESULTS. Conditional logistic regression analysis was used in examining cardiovascular mortality risk in relation to work exposure after adjustment for age, year last employed, smoking, exercise, education, social class, nationality, and physical job demands. In the final multi-variable analysis, workers with low work control had a relative risk of 1.83 (95% confidence interval [CI] = 1.19, 2.82) for cardiovascular mortality. Workers with combined exposure to low control and low support had a relative risk of 2.62 (95% CI=1.22, 5.61). CONCLUSIONS. These results indicate that long-term exposure to low work control is a risk factor for cardiovascular disease mortality.
Psychosocial work environment and sickness absence among British civil servants: the Whitehall II study.
Authors: North F M , Syme S L , Feeney A , Shipley M , Marmot M
Published: November 2008

OBJECTIVES. This study sought to examine the association between the psychosocial work environment and subsequent rates of sickness absence. METHODS. The analyses were based on a cohort of male and female British civil servants (n=9072). Rates of short spells (7 days) of sickness absence were calculated for different aspects of the psychosocial work environment, as measured by self-reports and personnel managers' ratings (external assessments). RESULTS. Low levels of work demands, control, and support were associated with higher rates of short and long spells of absence in men and, to a lesser extent, in women. The differences were similar for the self-reports and external assessments. After adjustment for grade of employment, the differences were diminished but generally remained significant for short spells. The combination of high demands and low control was only associated with higher rates of short spells in the lower grades. CONCLUSIONS. The psychosocial work environment predicts rates of sickness absence. Increased levels of control and support at work could have beneficial effects in terms of both improving the health and well-being of employees and increasing productivity.
Cigarette smoking and its risk factors among elementary school students in Beijing.
Authors: Zhu B P , Liu M , Shelton D , Liu S , Giovino G A
Published: November 2008

OBJECTIVES. This study investigated patterns of and risk factors for smoking among elementary school children in Beijing, China. METHODS. In 1988, anonymous questionnaires were administered to a multistage stratified cluster sample of 16996 students, aged mostly 10 to 12, in 479 fourth- to sixth-grade classes from 122 Beijing elementary schools. RESULTS. Approximately 28% of boys and 3% of girls had smoked cigarettes. The most frequently cited reasons for smoking initiation were "to imitate others' behavior" and "to see what it was like." Girls were more likely to get cigarettes from home than to purchase their own. Having close friends who smoked and being encouraged by close friends to smoke were strong risk factors for smoking. Smoking was also associated with lower parental socioeconomic status; having parents, siblings, or teachers who smoked; buying cigarettes for parents; performing poorly in school; and not believing that smoking is harmful to health. CONCLUSIONS. Gender differences in smoking prevalence among adolescents in China are larger than those among US teenagers, whereas the proximal risk factors for smoking are similar. Major efforts are needed to monitor and prevent smoking initiation among Chinese adolescents, particularly girls.
Home injuries among adults in Stavanger, Norway.
Authors: Kopjar B , Wickizer T M
Published: November 2008

Norwegian injury register data were analyzed to examine unintentional home injuries among persons ages 25 to 64 years residing in Stavanger, Norway, during 1992. A total of 782 persons received medical treatment for injury during 1992 (15.4 per 1000 population). The incidence was similar for males and females (15.8 and 14.9 per 1000 population); however, the exposure-specific injury rate was significantly higher for males (6.0 vs 4.1 per 1 million person-hours). This difference was entirely due to the much higher injury rate among males aged 25 to 44 years. The estimated first year cost (direct and indirect) per injury was $2700. Home injuries among adults appear to be an overlooked public health problem that warrants increased attention.
Body mass index in young adults: Associations with parental body size and education in the CARDIA Study.
Authors: Greenlund K J , Liu K , Dyer A R , Kiefe C I , Burke G L , Yunis C
Published: November 2008

OBJECTIVES: Associations of parental education, parental body size, and offspring's education with body mass index and 7-year change in body mass index were examined among participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study. METHODS: CARDIA is a study of coronary artery disease risk factors in 5115 Black and White persons aged 18 to 30 at baseline. Analyses of covariance were carried out with body mass index and change in body mass index as the dependent variables, and with parental education, parental body size, and participant education as the major independent variables. RESULTS: Father's body size was positively associated with participant's baseline body mass index among Black men, White men, and White women. Mother's body size was positively associated with baseline body mass index among all race-sex groups, and with change in body mass index among White women. Father's education was inversely associated with baseline body mass index among Black men and White women, and with change among White women. CONCLUSIONS: Parental education may influence body mass index and changes in young adulthood, especially among White women. Such associations may be both genetic and environmental and may be important for obesity prevention efforts.
Socioeconomic differentials in mortality risk among men screened for the Multiple Risk Factor Intervention Trial: I. White men.
Authors: Smith G D , Neaton J D , Wentworth D , Stamler R , Stamler J
Published: November 2008

OBJECTIVES: This study examined socioeconomic differentials in risk of death from a number of specific causes in a large cohort of White men in the United States. METHODS: For 300 685 White men screened for the Multiple Risk Factor Intervention Trial between 1973 and 1975, data were collected on median income of White households in the zip code of residence, age, cigarette smoking, blood pressure, serum cholesterol, previous myocardial infarction, and drug treatment for diabetes. The 31 737 deaths that occurred over the 16-year follow-up period were grouped into specific causes and related to median White family income. RESULTS: There was an inverse association between age- adjusted all-cause mortality and median family income. There was no attenuation of this association over the follow-up period, and the association was similar for the 22 clinical centers carrying out the screening. The gradient was seen for many-but not all-of the specific causes of death. Other risk factors accounted for some of the association between income and coronary heart disease and smoking-related cancers. CONCLUSIONS: Socioeconomic position, as measured by median family income of area of residence, is an important determinant of mortality risk in White men.
US childhood mortality, 1950 through 1993: Trends and socioeconomic diffferentials.
Authors: Singh G K , Yu S M
Published: November 2008

OBJECTIVES: This study examined trends and differentials in US childhood mortality from 1950 through 1993 according to sex, race/ethnicity, education, family income, and cause of death. METHODS: Log-linear, multiple regression, and Cox proportional hazards regression models were applied to the data from the National Vital Statistics System, the National Longitudinal Mortality Study, and the Area Resource File. RESULTS: Substantial declines in US childhood mortality have occurred in the past 4 decades, primarily due to decreases in mortality from unintentional injuries, cancer, pneumonia and influenza, and congenital anomalies. The overall declining trend, however, has been dampened by a twofold to threefold increase in the suicide and homicide rates among children since 1968. Male, Black, American Indian, Hawaiian, and Puerto Rican children and those in the lower socioeconomic strata were at an increased risk of death. CONCLUSIONS: Increasing trends in mortality from violence, firearm injuries, and human immunodeficiency virus/acquired immunodeficiency syndrome pose a major obstacle to continued declines in US childhood mortality. Reducing socioeconomic disparities and improving access to and use of health care may bring about further declines in overall and injury-related childhood mortality.
Morbidity and mortality among US adolescents: An overview of data and trends.
Authors: Sells C W , Blum R W
Published: November 2008

OBJECTIVES: This article reviews the health status of adolescents in the United States 1979 through 1994. METHODS: An extensive array of data from federal agencies, private organizations, and published literature was reviewed, analyzed, and cross-validated. RESULTS: Significant shifts in mortality and morbidity among America's youth have occurred over the past decade. Adolescents have recorded significant reductions in motor vehicle deaths,; alcohol, cigarette, and illicit substance use; and gonorhea and syphilis. Overall, mortality in the second decade of life has declined by 13%. However, reductions in unintentional injuries have been largely offset by increases in teenage homicide, while worsening poverty as well as risk-taking behavior continue to influence the morbidities of teenagers adversely. Violence, suicide, and teenage pregnancy continue to be overwhelming problems for young people. CONCLUSIONS: After years of downward spiral in the health of America's youth, there have been significant improvements in morbidity and mortality. These findings refute the myth that nothing can be done.
Physician use in Ontario and the United States: The impact of socioeconomic status and health status.
Authors: Katz S J , Hofer T P , Manning W G
Published: November 2008

OBJECTIVES: This study compared physician use in Ontario and the midwestern and northeastern United States for persons of different socioeconomic status and health status. The distribution of health problems associated with the most recent physician visit also was compared. METHODS: The design of the study was cross sectional; data derived from the 1990 Ontario Health Survey and the 1990 US National Health Interview Survey were used in analyses. RESULTS: Overall, persons in Ontario averaged 19% more visits than US residents, but differences varied markedly across income and health status. At each level of health status, low- income Canadians had 25% to 33% more visits than their US counterparts. However, among higher income persons, those in excellent or very good health had 22% more visits than Americans, while those in good, fair, or poor health had 10% fewer visits than Americans. Higher visit rates in Ontario were not associated with a greater prevalence of low- priority visits. CONCLUSIONS: Under the Canadian single- payer system, medical care in Ontario has been redistributed to low-income persons and the elderly. Compared with the United States, there has been a lower intensity of medical care for the sick higher income population.
Medical care employment in the United States, 1968 to 1993: The importance of health sector jobs for African Americans and women.
Authors: Himmelstein D U , Lewontin J P , Woolhandler S
Published: November 2008

OBJECTIVES: The purpose of this study was to elucidate the social and economic impact of health sector employment. METHODS: US medical care employment was analyzed for each year between 1968 and 1993, with data from the March Current Population Survey. RESULTS: Between 1968 and 1993, medical care employment grew from 4.32 million to 11.40 million persons, accounting for 5.7% of all jobs in 1968 and 8.4% in 1993. Today, one seventh of employed women work in medical care; they hold 78% of medical care jobs. One fifth of all employed African-American women work in medical care. African-Americans hold 15.5% of jobs in the health sector: they hold 24.1% of the jobs in nursing homes, 15.9% of the jobs in hospitals, but only 5.6% of the jobs in practitioners' offices. Hispanics constitute 6.4% of medical care employees. Real wages rose 25% to 50% between 1968 and 1993 for most health occupations. Wages of registered nurses rose 86%; physicians' incomes rose 22%. Wages of nursing home workers were far lower than those of comparable hospital workers, and the gap has widened. In 1993, 11.7% of all medical care workers lacked health insurance and 597 000 lived in poverty. CONCLUSIONS: Hospital cuts and the continuing neglect of long-term care exacerbate unemployment and poverty among women and African Americans.
The health insurance status of US Latino women: A profile from the 1982-1984 HHANES.
Authors: de la Torre A , Friis R , Hunter H R , Garcia L
Published: November 2008

OBJECTIVES: This research studied the correlates of health insurance status among three major subpopulations (Mexican, Puerto Rican, and Cuban) of adult (ages of 20 to 64) Latino women. METHODS: Data from the Hispanic Health and Nutrition Examination Survey (HHANES), 1982-1984, were examined to determine the percentages of health insurance coverage among the sample populations and to assess the relationship between access to coverage and selected sociodemographic employment/income, ancestry, and acculturation variables. RESULTS: Variations in health insurance coverage existed by Latina subpopulation. While Puerto Rican women had the highest percentage of any health insurance coverage, Mexican-origin women (particularly those 50 to 64 years old) had the lowest. For all three Latina groups, health insurance coverage was greater among those who reported a family income above the poverty level than among those whose income fell below the poverty level; employment location, acculturation variables, and ancestry were also related to coverage. CONCLUSIONS: Eligibility requirements, particularly for Mexican-and Cuban-origin women, need to be streamlined, and innovative health insurance programs need to be developed to increase access of Latinas to health insurance.
Health status before and mortality after hip fracture.
Authors: Katelaris A G , Cumming R G
Published: November 2008

A cohort study was done to determine the direct impact of hip fracture on mortality in older people. Survival was compared between 211 hip fracture patients from a defined area and 201 non-hip fracture control subjects randomly selected from the same area. The mortality rate 1 year after hip fracture was 21.7%; 1-year mortality in the comparison group was 4.7%. The crude hazard ratio for hip fracture and mortality was 4.0 (95% confidence interval [CI] = 2.2, 7.4); adjusting for multiple health-related variables reduced it to 3.3 (95% CI = 1.7, 6.5). This finding suggests that the observed excess mortality after hip fracture is not explained by poor prefracture health status.
The ages of fathers in California adolescent births, 1993.
Authors: Males M , Chew K S
Published: November 2008

Officals, media coverage and prevention programs have assumed that fathers of infants born to US school-age (10-18 years old) mothers are school-age peers. This study analyzes fathers' ages in 46 500 California births to school-age mothers in 1993, for which 85% of the fathers' ages were stated and whose distribution is similar to that of less complete national samples. Adult, postschool men father two thirds of the infants born to school-age mothers and average 4.2 years older than the senior-high mothers and 6.7 years older than the junior-high mothers. The extensive involvement of adult males in both school-age motherhood and its precursors represents a significant, undiscussed factor deserving greater attention.
Carrying and using weapons: A survey of minority junior high school students in New York City.
Authors: Vaughan R D , McCarthy J F , Armstrong B , Walter H J , Waterman P D , Tiezzi L
Published: November 2008

To explore weapon carrying among young, inner-city adolescents, a survey was administered in fall 1993 to 2005 predominately Hispanic students (mean age = 12.8 years) in three New York City junior high schools. The survey revealed that 21% of students reported personally carrying a weapon; guns and knives were the weapons most commonly carried. Most of those who carried guns reported that they bought them. Forty-two percent indicated that they had a family member or close friend who had been shot. Boys and older students were more likely to report carrying weapons. Preventive efforts may need to begin before or on entry into junior high school rather than high school.