bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving the Health of Workers in Indoor Environments: Priority Research Needs for a National Occupational Research Agenda
Authors: Mendell Mark J. , Fisk William J. , Kreiss Kathleen , Levin Hal , Alexander Darryl , Cain William S. , Girman John R. , Hines Cynthia J. , Jensen Paul A. , Milton Donald K. , Rexroat Larry P. , Wallingford Kenneth M.
Published: December 2008

Indoor nonindustrial work environments were designated a priority research area through the nationwide stakeholder process that created the National Occupational Research Agenda. A multidisciplinary research team used member consensus and quantitative estimates, with extensive external review, to develop a specific research agenda. The team outlined the following priority research topics: building-influenced communicable respiratory infections, building-related asthma/allergic diseases, and nonspecific building-related symptoms; indoor environmental science; and methods for increasing implementation of healthful building practices. Available data suggest that improving building environments may result in health benefits for more than 15 million of the 89 million US indoor workers, with estimated economic benefits of $5 to $75 billion annually. Research on these topics, requiring new collaborations and resources, offers enormous potential health and economic returns.
Relationships Between Welfare Status, Health Insurance Status, and Health and Medical Care Among Children With Asthma
Authors: Wood Pamela R. , Smith Lauren A. , Romero Diana , Bradshaw Patrick , Wise Paul H. , Chavkin Wendy
Published: December 2008

Objectives. This study evaluated the relationships between health insurance and welfare status and the health and medical care of children with asthma.

Methods. Parents of children with asthma aged 2 to 12 years were interviewed at 6 urban clinical sites and 2 welfare offices.

Results. Children whose families had applied for but were denied welfare had more asthma symptoms than did children whose families had had no contact with the welfare system. Poorer mental health in parents was associated with more asthma symptoms and higher rates of health care use in their children. Parents of uninsured and transiently insured children identified more barriers to health care than did parents whose children were insured.

Conclusions. Children whose families have applied for welfare and children who are uninsured are at high risk medically and may require additional services to improve health outcomes.
Effectiveness of a Worksite Intervention to Reduce an Occupational Exposure: The Minnesota Wood Dust Study
Authors: Lazovich DeAnn , Parker David L. , Brosseau Lisa M. , Milton F. Thomas , Dugan Siobhan K. , Pan Wei , Hock Lynette
Published: December 2008

Objectives. This study assessed the effectiveness of an intervention to reduce wood dust, a carcinogen, by approximately 26% in small woodworking businesses.

Methods. We randomized 48 businesses to an intervention (written recommendations, technical assistance, and worker training) or comparison (written recommendations alone) condition. Changes from baseline in dust concentration, dust control methods, and worker behavior were compared between the groups 1 year later.

Results. At follow-up, workers in intervention relative to comparison businesses reported greater awareness, increases in stage of readiness, and behavioral changes consistent with dust control. The median dust concentration change in the intervention group from baseline to follow-up was 10.4% (95% confidence interval = –28.8%, 12.7%) lower than the change in comparison businesses.

Conclusions. We attribute the smaller-than-expected reduction in wood dust to the challenge of conducting rigorous intervention effectiveness research in occupational settings.
National Health Insurance, Physician Financial Incentives, and Primary Cesarean Deliveries in Taiwan
Authors: Tsai Yi-Wen , Hu Teh-wei
Published: December 2008

Objectives. Taiwan’s National Health Insurance Program (NHI) was implemented on March 1, 1995. This study analyzed the influences of the Case Payment method of reimbursement for inpatient care and of physician financial incentives on a woman’s choice for primary cesarean delivery.

Methods. Logistic regressions were used to analyze 11 788 first-time deliveries in a nonprofit hospital system between March 1, 1994, and February 29, 1996.

Results. After implementation of the NHI’s Case Payment scheme, the likelihood that a woman would choose primary cesarean delivery increased by four to five times compared with the choice behavior of uninsured individuals prior to NHI (P < .0001).

Conclusion. Out-of-pocket payment discourages the selection of primary cesarean delivery. No robust statistics were found relating physician financial incentives to delivery choice.
Suicide and Marital Status in the United States, 1991–1996: Is Widowhood a Risk Factor?
Authors: Luoma Jason B. , Pearson Jane L.
Published: December 2008

Objectives. This study examined whether marital status is associated with suicide rates among various age, sex, and racial groups, in particular with widowhood among young adults of both sexes.

Methods. US national suicide mortality data were compiled for the years 1991–1996, and suicide rates were broken down by race, 5-year age groups, sex, and marital status.

Results. Data on suicide rates indicated an approximately 17-fold increase among young widowed White men (aged 20–34 years), a 9-fold increase among young widowed African American men, and lesser increases among young widowed White women compared with their married counterparts.

Conclusions. National data suggest that as many as 1 in 400 White and African American widowed men aged 20–35 years will die by suicide in any given year (compared with 1 in 9000 married men in the general population).
The Movement for Universal Health Insurance: Finding Common Ground
Authors: Bodenheimer Thomas
Published: December 2008

Before 1971, all proposals for universal health insurance were based on private sector financing and administration. After 1971, universal health insurance plans relying on the private sector complicated efforts of the universal health insurance movement.

To forge as broad a movement for universal health insurance as possible, it may be worthwhile for universal health insurance advocates of different persuasions to seek common ground on the basis of a set of goals for a new health care system. The goals can serve as a measuring stick to determine which health insurance plans are worthy of support.
Vulnerability and the Patient–Practitioner Relationship: The Roles of Gatekeeping and Primary Care Performance
Authors: Shi Leiyu , Forrest Christopher B. , von Schrader Sarah , Ng Judy
Published: December 2008

Objectives. We examined whether patients’ perceptions of their relationships with primary care practitioners (PCPs) vary by vulnerability status and assessed the extent to which gatekeeping arrangements and primary care performance moderate potential disparities.

Methods: We used the nationally representative 1996–1997 Community Tracking Study Household Survey as our data source.

Results. Whites reported better patient–practitioner relationships than minorities. Requirements that patients select a PCP and obtain referral authorization neither reduced nor exacerbated racial disparities in the patient–practitioner relationship. On the other hand, access to and continuity with a PCP substantively reduced disparities, especially for the most vulnerable group.

Conclusions. Enhancing primary care performance may reduce some of the barriers to care experienced by vulnerable populations, thereby improving patients’ relationships with their PCPs.
Child Participation in WIC: Medicaid Costs and Use of Health Care Services
Authors: Buescher Paul A. , Horton Stephanie J. , Devaney Barbara L. , Roholt Sarah J. , Lenihan Alice J. , Whitmire J. Timothy , Kotch Jonathan B.
Published: December 2008

Objectives. We used data from birth certificates, Medicaid, and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) to examine the relationship of child participation in WIC to Medicaid costs and use of health care services in North Carolina.

Methods. We linked Medicaid enrollment, Medicaid paid claims, and WIC participation files to birth certificates for children born in North Carolina in 1992. We used multiple regression analysis to estimate the effects of WIC participation on the use of health care services and Medicaid costs.

Results. Medicaid-enrolled children participating in the WIC program showed greater use of all types of health care services compared with Medicaid-enrolled children who were not WIC participants.

Conclusions. The health care needs of low-income children who participate in WIC may be better met than those of low-income children not participating in WIC.
Health Care Reform: Lessons From Canada
Authors: Deber Raisa Berlin
Published: December 2008

Although Canadian health care seems to be perennially in crisis, access, quality, and satisfaction in Canada are relatively high, and spending is relatively well controlled. The Canadian model is built on a recognition of the limits of markets in distributing medically necessary care.

Current issues in financing and delivering health care in Canada deserve attention. Key dilemmas include intergovernmental disputes between the federal and provincial levels of government and determining how to organize care, what to pay for (comprehensiveness), and what incentive structures to put in place for payment.

Lessons for the United States include the importance of universal coverage, the advantages of a single payer, and the fact that systems can be organized on a subnational basis.
What Other Programs Can Teach Us: Increasing Participation in Health Insurance Programs
Authors: Remler Dahlia K. , Glied Sherry A.
Published: December 2008

Many uninsured Americans are already eligible for free or low-cost public coverage through Medicaid or Children’s Health Insurance Program (CHIP) but do not “take up” that coverage. However, several other public programs, such as food stamps and unemployment insurance, also have less-than-complete take-up rates, and take-up rates vary considerably among programs.

This article examines the take-up literature across a variety of programs to learn what effects nonfinancial features, such as administrative complexity, have on take-up. We find that making benefit receipt automatic is the most effective means of ensuring high take-up, while there is little evidence that stigma is important.
Health Care Reform and Social Movements in the United States
Authors: Hoffman Beatrix
Published: December 2008

Because of the importance of grassroots social movements, or “change from below,” in the history of US reform, the relationship between social movements and demands for universal health care is a critical one.

National health reform campaigns in the 20th century were initiated and run by elites more concerned with defending against attacks from interest groups than with popular mobilization, and grassroots reformers in the labor, civil rights, feminist, and AIDS activist movements have concentrated more on immediate and incremental changes than on transforming the health care system itself.

However, grassroots health care demands have also contained the seeds of a wider critique of the American health care system, leading some movements to adopt calls for universal coverage.
APHA Policies on Universal Health Care: Health for a Few or Health for All?
Authors: Akhter Mohammad N.
Published: December 2008

The American Public Health Association (APHA) has long advocated the development of a system of universal health care for all US residents. APHA has adopted several policies on this topic that stress the financing of the system of universal health care under a single-payer mechanism. However, this approach has never been adopted by US policymakers.

The need for universal health coverage in the United States is growing more acute, and failure to provide such coverage threatens the health status of the public. I propose an alternative approach to the single-payer system that is based on incremental extension of existing coverage mechanisms, accompanied by fundamental reform of the health care delivery system. This approach is in keeping with the traditional methods of policy development in the United States, and I urge APHA to assume leadership in advocating it.
A No-Name Tuberculosis Tracking System
Authors: Kim Dennis Y. , Ridzon Renee , Giles Beverly , Mireles Teresa , Garrity Kelli , Hathcock A. Leroy , Crowder David , Jackson Robert , Taylor Zachary
Published: December 2008

Foreign-born persons from countries where tuberculosis (TB) is endemic make up a significant percentage of poultry industry workers in Delaware, a leading poultry-producing state. Many of these workers enter the United States without documentation and assume multiple identities, making it difficult for public health staff to investigate TB contacts who work in the poultry plants.

The Sussex County Health Unit of the Delaware Division of Public Health developed a no-name TB tracking system to facilitate identification and treatment of poultry plant workers with TB infection and disease in a high-risk population whose members assume one or more aliases. Completion rates for treatment of latent TB infection in this group increased from 48% to 64% 2 years after the program’s implementation.
Tailored Interventions to Increase Influenza Vaccination in Neighborhood Health Centers Serving the Disadvantaged
Authors: Zimmerman Richard K. , Nowalk Mary Patricia , Raymund Mahlon , Tabbarah Melissa , Hall David G. , Wahrenberger J. Todd , Wilson Stephen A. , Ricci Edmund M.
Published: December 2008

Objectives. We designed and evaluated interventions to increase adult immunizations within inner-city health centers.

Methods. Interventions included reminders, standing orders, and walk-in “flu shot clinics.” Patients were surveyed and records evaluated.

Results. Records from 1 center showed that immunization rates increased from 24% to 30% (P < .001) for patients aged 50 to 64 years and from 45% to 53% for patients aged 65 years and older (P < .001). Self-reported vaccination rates did not increase. In logistic regression analyses, the strongest predictor of vaccination among patients aged 50 to 64 years was the belief that unvaccinated persons will contract influenza (odds ratio [OR] = 5.4; 95% confidence interval [CI] = 2.4, 12.0). Among patients aged 65 years and older, the strongest predictor of vaccination was the belief that friends/relatives thought that they should be vaccinated (OR = 9.7; 95% CI = 4.2, 22.3).

Conclusions. Tailored interventions can improve immunization rates at inner-city health centers.
Determinants of Mortality Following a Diagnosis of Prostate Cancer in Veterans Affairs and Private Sector Health Care Systems
Authors: Freeman Vincent L. , Durazo-Arvizu Ramon , Arozullah Ahsan M. , Keys LaShon C.
Published: December 2008

Objectives. We compared patterns of mortality among men with prostate cancer at 2 Department of Veterans Affairs (VA) and 2 private-sector hospitals in the Chicago area.

Methods. Mortality rates for 864 cases diagnosed between 1986 and 1990 were estimated using Cox proportional hazards models that incorporated age; income; cancer stage, differentiation, and treatments; and baseline comorbidity.

Results. Race tended to associate with all-cause mortality irrespective of health care setting (Blacks vs Whites: hazard rate ratio [HRR] = 1.68 [95% confidence interval (CI) = 1.06, 2.67]; P < .001 in the private sector; HRR = 1.50 [95% CI = 0.94, 2.38]; P = .088 in the VA). However, comorbidity determined risk in the VA, whereas age and income predicted risk in the private sector.

Conclusions. Determinants of all-cause mortality in men with prostate cancer vary according to health care setting.
Understanding Racial Disparities in HIV Using Data From the Veterans Aging Cohort 3-Site Study and VA Administrative Data
Authors: McGinnis Kathleen A. , Fine Michael J. , Sharma Ravi K. , Skanderson Melissa , Wagner Joseph H. , Rodriguez-Barradas Maria C. , Rabeneck Linda , Justice Amy C.
Published: December 2008

Objectives. We identified race-associated differences in survival among HIV-positive US veterans to examine possible etiologies for these differences.

Methods. We used national administrative data to compare survival by race and used data from the Veterans Aging Cohort 3-Site Study (VACS 3) to compare patients’ health status, clinical management, and adherence to medication by race.

Results. Nationally, minority veterans had higher mortality rates than did white veterans with HIV. Minority veterans had poorer health than white veterans with HIV. No significant differences were found in clinical management or adherence.

Conclusions. HIV-positive minority veterans experience poorer survival than white veterans. This difference may derive from differences in comorbidities and in the severity of illness of HIV-related disease.
Health Status, Health Insurance, and Health Care Utilization Patterns of Immigrant Black Men
Authors: Lucas Jacqueline W. , Barr-Anderson Daheia J. , Kington Raynard S.
Published: December 2008

Objectives. This study sought to describe the health status, health insurance, and health care utilization patterns of the growing population of immigrant Black men.

Methods. We used data from the 1997–2000 National Health Interview Survey to examine and then compare health variables of foreign-born Black men with those of US-born Black and White men. Logistic regression analyses were used to examine health outcomes.

Results. Foreign-born Black men were in better overall health than their US-born Black counterparts and were much less likely than either US-born Black or White men to report adverse health behaviors. Despite these health advantages, foreign-born Black men were more likely than either US-born Black or White men to be uninsured.

Conclusions. In the long term, immigrant Black men who are in poor health may be adversely affected by lack of health care coverage.
Occupational Risk Factors for Selected Cancers Among African American and White Men in the United States
Authors: Briggs Nathaniel C. , Levine Robert S. , Hall H. Irene , Cosby Otis , Brann Edward A. , Hennekens Charles H.
Published: December 2008

Objectives. This study examined occupational risks for non-Hodgkin’s lymphoma, Hodgkin’s disease, and soft-tissue sarcoma among African American and White men.

Methods. Race-specific multivariate logistic regression analyses were conducted using data from a large US population-based case–control study.

Results. Significant occupational risks were limited to African Americans; chromium was associated with non-Hodgkin’s lymphoma (odds ratio [OR] = 3.9, 95% confidence interval [CI] = 1.2, 12.9) and wood dust was associated with Hodgkin’s disease (OR = 4.6, 95% CI = 1.6, 13.3) and soft-tissue sarcoma (OR = 3.7, 95% CI = 1.6, 8.6).

Conclusions. Race-specific occupational risk factors for cancer were evident only among African American men. This may reflect racial disparities in levels of exposure to occupational carcinogens.
The American College of Obstetricians and Gynecologists and the Evolution of Abortion Policy, 1951–1973: The Politics of Science
Authors: Aries Nancy
Published: December 2008

The autonomy granted to physicians is based on the claim that their decisions are grounded in scientific principles. But a case study of the evolution of the American College of Obstetricians and Gynecologists’ abortion policy between 1951 and 1973 shows that decisions were only secondarily determined by science. The principal determinant was the need to preserve physician autonomy over the organization and delivery of services.

As a result, the organization representing physicians who specialized in women’s reproductive health was marginal to the struggle for legalized abortion. But, the profession was central to decisions about whether physicians would perform abortions and how they would be done.

This case study finding has implications for understanding the role that organized medicine might take in the ongoing debates about national health policy.
New Inroads in Preventing Adolescent Drug Use: Results From a Large-Scale Trial of Project ALERT in Middle Schools
Authors: Ellickson Phyllis L. , McCaffrey Daniel F. , Ghosh-Dastidar Bonnie , Longshore Douglas L.
Published: December 2008

Objectives. We evaluated the revised Project ALERT drug prevention program across a wide variety of Midwestern schools and communities.

Methods. Fifty-five South Dakota middle schools were randomly assigned to program or control conditions. Treatment group students received 11 lessons in 7th grade and 3 more in 8th grade. Program effects for 4276 8th-graders were assessed 18 months after baseline.

Results. The revised Project ALERT curriculum curbed cigarette and marijuana use initiation, current and regular cigarette use, and alcohol misuse. Reductions ranged from 19% to 39%. Program effects were not significant for initial and current drinking or for current and regular marijuana use.

Conclusions. School-based drug prevention programs can prevent occasional and more serious drug use, help low- to high-risk adolescents, and be effective in diverse school environments.
Adolescent Health in the Caribbean: A Regional Portrait
Authors: Halcón Linda , Blum Robert W. , Beuhring Trish , Pate Ernest , Campbell-Forrester Sheila , Venema Anneke
Published: December 2008

Objectives. This study assessed youth health in the Caribbean Community and Common Market countries and describes the prevalence of health-related factors.

Methods. We used a self-administered classroom questionnaire; questions addressed general health, health care, nutrition, sexual history, drug use, mental health, violence, family characteristics, and relationships with others.

Results. Most youths reported good health; however, 1 in 10 reported a limiting disability or significant health problems. Violence was a pervasive concern. Of those who reported history of sexual intercourse, many reported that their first intercourse was forced, and nearly half reported that they were aged 10 years or younger when they first had intercourse.

Conclusions. Although most young people are healthy, problems indicate the importance of monitoring trends and designing effective youth health programs.
Health and Behavior Risks of Adolescents with Mixed-Race Identity
Authors: Udry J. Richard , Li Rose Maria , Hendrickson-Smith Janet
Published: December 2008

Objectives. This study compared the health and risk status of adolescents who identify with 1 race with those identifying with more than 1 race.

Methods. Data are derived from self-reports of race, using the National Longitudinal Study of Adolescent Health (Add Health), which provides a large representative national sample of adolescents in grades 7 through 12. Respondents could report more than 1 race.

Results. Mixed-race adolescents showed higher risk when compared with single-race adolescents on general health questions, school experience, smoking and drinking, and other risk variables.

Conclusions. Adolescents who self-identify as more than 1 race are at higher health and behavior risks. The findings are compatible with interpreting the elevated risk of mixed race as associated with stress.
Female-Condom Use in a Gender-Specific Family Planning Clinic Trial
Authors: Hoffman Susie , Exner Theresa M. , Leu Cheng-Shiun , Ehrhardt Anke A. , Stein Zena
Published: December 2008

Objectives. We evaluated female-condom use among women participating in an HIV/STD intervention designed to reduce unprotected sex and expand prevention strategies.

Methods. Women (n = 360) were recruited from a family-planning clinic and were randomized into an 8- or 4-session intervention group or a control group. We conducted follow-up interviews at 1, 6, and 12 months.

Results. At 1 month, the odds ratios of first-time female-condom use were 9.49 (95% confidence interval [CI] = 4.01, 22.20) in the 8-session group and 4.39 (95% CI = 1.84, 10.49) in the 4-session group relative to controls. Repeated use (n = 21) was predicted by perceived ability to use, by self and partner satisfaction, by dislike of male condoms, and by previous diaphragm use.

Conclusions. Gender sensitive cognitive-behavioral interventions can influence women to try the female condom. To increase long-term use, interventions may need to include self-insertion practice and involvement of male partners.
Trends in Antimicrobial Prescribing for Bronchitis and Upper Respiratory Infections Among Adults and Children
Authors: Mainous Arch G. , Hueston William J. , Davis Matthew P. , Pearson William S.
Published: December 2008

Objectives. This study examined antimicrobial prescribing patterns for adults and children with bronchitis or upper respiratory infections (URIs) before and after release of nationally disseminated pediatric practice recommendations.

Methods. Data from the 1993, 1995, 1997, and 1999 National Ambulatory Medical Care Survey were used to evaluate prescriptions for antimicrobials for URIs and bronchitis.

Results. From 1993 to 1999, the proportion of children receiving antimicrobials after visits for URIs and bronchitis decreased. However, the use of broad-spectrum antimicrobials rose from 10.6% of bronchitis visits to 40.5%. Prescriptions of antimicrobials for adults with URIs or bronchitis showed a decrease between 1993 and 1999.

Conclusions. Although antimicrobial prescribing for URIs and bronchitis has decreased for both children and adults, the prescribing of broad-spectrum antibiotics among children has shown a proportional rise.
Funding Public Health: The Public’s Willingness to Pay for Domestic Violence Prevention Programming
Authors: Sorenson Susan B.
Published: December 2008

Objectives. The author investigated the willingness of the general public to pay for domestic violence prevention programs.

Methods. An experimental design was used in a telephone survey of 522 California adults. One of 11 funding methods and one of 4 dollar amounts were randomly assigned to each respondent.

Results. Most respondents (79.4%) reported support for domestic violence prevention programming. They were most willing to pay $5 or less via “user fees” (e.g., increased fines for batterers) and humanitarian “donations” (e.g., sales of special postage stamps).

Conclusions. Health departments that want to increase their domestic violence prevention programming need to identify widely accepted methods by which funds can be raised. The methods used here can be applied to numerous public health activities and issues.
Latin American Social Medicine and Global Social Medicine
Authors: Yamada Seiji
Published: December 2008

A fundamental change in the theory underlying public health and medicine is needed. Latin American social medicine (LASM), originating in a region of the world that has been subjected to colonial and postcolonial influence, will be part of this change.

To the extent that the social production of disease among people in other regions is a consequence of various large-scale forms of domination, LASM offers a relevant analysis, models of resistance, and exemplars of social medicine in practice. I draw upon LASM to examine the social production of disease in the Marshall Islands and Iraq.

I suggest a basis for a global social medicine in the shared experience of suffering and describe implications for public health theory and practice.
Low Breastfeeding Rates and Public Health in the United States
Authors: Wolf Jacqueline H.
Published: December 2008

The medical community has orchestrated breastfeeding campaigns in response to low breastfeeding rates twice in US history. The first campaigns occurred in the early 20th century after reformers linked diarrhea, which caused the majority of infant deaths, to the use of cows’ milk as an infant food.

Today, given studies showing that numerous diseases and conditions can be prevented or limited in severity by prolonged breastfeeding, a practice shunned by most American mothers, the medical community is again inaugurating efforts to endorse breastfeeding as a preventive health measure.

This article describes infant feeding practices and resulting public health campaigns in the early 20th and 21st centuries and finds lessons in the original campaigns for the promoters of breastfeeding today.
What Does Latin American Social Medicine Do When It Governs? The Case of the Mexico City Government
Authors: Laurell Asa Cristina
Published: December 2008

Latin American social medicine (LASM) emerged as a movement in the 1970s and played an important role in the Brazilian health care reform of the 1980s, both of which focused on decentralization and on health care as a social right. The dominant health care reform model in Latin America has included a market-driven, private subsystem for the insured and a public subsystem for the uninsured and the poor.

In contrast, the Mexico City government has launched a comprehensive policy based on social rights and redistribution of resources. A universal pension for senior citizens and free medical services are financed by grants, eliminating routine government corruption and waste.

The Mexico City policy reflects the influence of Latin American social medicine. In this article, I outline the basic traits of LASM and those of the prevailing health care reform model in Latin America and describe the Mexico City social and health policy, emphasizing the influence of LASM in values, principles, and concrete programs.
Research on Health Inequalities in Latin America and the Caribbean: Bibliometric Analysis (1971–2000) and Descriptive Content Analysis (1971–1995)
Authors: Almeida-Filho Naomar , Kawachi Ichiro , Filho Alberto Pellegrini , Dachs J. Norberto W.
Published: December 2008

We conducted a bibliometric and content analysis of research on health inequalities produced in Latin American and Caribbean countries. In our bibliometric analysis (n = 576), we used indexed material published between 1971 and 2000. The content analysis (n = 269) covered the period 1971 to 1995 and included unpublished material.

We found recent rapid growth in overall output. Brazil, Chile, and Mexico contributed mostly empirical research, while Ecuador and Argentina produced more conceptual studies.

We found, in the literature reviewed, a relative neglect of gender, race, and ethnicity issues. We also found remarkable diversity in research designs, however, along with strong consideration of ecological and ethnographic methods absent in other research traditions.
Depression in Adult Women: Age Changes and Cohort Effects
Authors: Kasen Stephanie , Cohen Patricia , Chen Henian , Castille Dorothy
Published: December 2008

Objectives. We sought to separate age and cohort associations with depression, assessed 3 times within a 10-year period in 701 women born between 1928 and 1958.

Methods. We used regression analysis to examine age differences in women with depression in 2 birth cohorts, pre-1945 and post-1944, who were assessed at comparable ages. Multilevel modeling was used to estimate changes with age in successive birth year cohorts.

Results. An age by cohort interaction indicated more depression among younger than older women in the post-1944 cohort but a flat age profile in the pre-1945 cohort. Longitudinal analyses indicated declines in depression with age in more recent cohorts but increases in earlier ones.

Conclusions. Increases in depression in younger women in successive cohorts may be offset by decreases in middle age.
Delivering Equitable Care: Comparing Preventive Services in Manitoba
Authors: Gupta Sumit , Roos Leslie L. , Walld Randy , Traverse Dawn , Dahl Matthew
Published: December 2008

Objectives. This study examined preventive care delivered in Manitoba during the 1990s by 3 different methods —childhood immunizations (by physicians and public health nurses under a government program), screening mammography (through a government program introduced in 1995), and cervical cancer screening (no program).

Methods. Longitudinal administrative data, an immunization monitoring system, and Canadian census databases were used.

Results. Cervical cancer screening rates remained static and showed strong socioeconomic differences; childhood immunization rates remained high with small socioeconomic gradients. The introduction of the Manitoba Breast Screening Program resulted in rising rates of screening and vanishing socioeconomic gradients.

Conclusions. Manitoba government programs in childhood immunization and screening mammography actively helped the provision of preventive care. Organized programs that target population groups, recognize barriers to access, and facilitate self-evaluation are critical for equitable delivery.
Healthy People 2010 and Asian Americans/Pacific Islanders: Defining a Baseline of Information
Authors: Ghosh Chandak
Published: December 2008

Objectives. Healthy People 2010: Understanding and Improving Health lists 6 areas of disparity in minority health services: infant mortality, cancer, cardiovascular disease, HIV/AIDS, diabetes, and immunizations. This study compiles existing Asian American and Pacific Islander (AAPI) health data to establish a baseline.

Methods. For federally-sponsored research (1986–2000), the Computer Retrieval of Information on Specific Projects (CRISP) database was analyzed. AAPI initiatives were divided by subpopulation and disparity area. MEDLINE articles (1966–2000) were similarly scrutinized.

Results. Few federal health-related grants (0.2%) and MEDLINE articles (0.01%) mention AAPIs. For the 6 disparity areas, significant AAPI data gaps remain.

Conclusions. To reach the Healthy People 2010 goals and have useful data, researchers and grant makers must focus on obtaining baseline data for disaggregated AAPI subgroups. (Am J Public Health. 2003;93:2093–2098)
Patient Attitudes, Insurance, and Other Determinants of Self-Referral to Medical and Chiropractic Physicians
Authors: Sharma Rajiv , Haas Mitchell , Stano Miron
Published: December 2008

Objectives. This study identified predictors of patient choice of a primary care medical doctor or chiropractor for treatment of low back pain.

Methods. Data from initial visits were derived from a prospective, longitudinal, nonrandomized, practice-based observational study of patients who self-referred to medical and chiropractic physicians (n = 1414).

Results. Logistic regression showed differences between patients who sought care from medical doctors vs chiropractors in terms of patient health status, sociodemographic characteristics, insurance, and attitudes. Disability, insurance, and trust in provider types were particularly important predictors.

Conclusions. The study highlights the importance of patient attitudes, health status, and insurance in self-referral decisions. The significance of patient attitudes suggests that education might be used to shape attitudes and encourage cost-effective care choices.
Risk Factors for Sporadic Campylobacter jejuni Infections in Rural Michigan: A Prospective Case–Control Study
Authors: Potter Rachel Church , Kaneene John B. , Hall William N.
Published: December 2008

Objectives. This case–control study investigated risk factors for campylobacteriosis in a rural population. Exposure to live farm animals was hypothesized to increase the risk for Campylobacter jejuni enteritis.

Methods. Incident cases from rural counties reported to the Michigan Department of Community Health and matched controls completed a self-administered postal questionnaire.

Results. Persons engaged in poultry husbandry had increased odds of campylobacteriosis (odds ratio = 6.884; 95% confidence interval (CI) = 1.438, 32.954). There was evidence for a dose–response relationship between the number of types of poultry contact and campylobacteriosis.

Conclusions. We estimate that 18% (95% CI = 6%, 30%) of Campylobacter cases occurring in rural populations are attributable to poultry husbandry. Cases occurred in individuals who were not poultry farmers by occupation.
Future Directions in Residential Segregation and Health Research: A Multilevel Approach
Authors: Acevedo-Garcia Dolores , Lochner Kimberly A. , Osypuk Theresa L. , Subramanian S. V.
Published: December 2008

The authors examine the research evidence on the effect of residential segregation on health, identify research gaps, and propose new research directions.

Four recommendations are made on the basis of a review of the sociological and social epidemiology literature on residential segregation: (1) develop multilevel research designs to examine the effects of individual, neighborhood, and metropolitan-area factors on health outcomes; (2) continue examining the health effects of residential segregation among African Americans but also initiate studies examining segregation among Hispanics and Asians; (3) consider racial/ethnic segregation along with income segregation and other metropolitan area factors such as poverty concentration and metropolitan governance fragmentation; and (4) develop better conceptual frameworks of the pathways that may link various segregation dimensions to specific health outcomes.
Sick and Tired of Being Sick and Tired: Scientific Evidence, Methods, and Research Implications for Racial and Ethnic Disparities in Occupational Health
Authors: Murray Linda Rae
Published: December 2008

The extent of racial/ethnic disparities in occupational health have not been well studied. The author reviews the evidence about workers of color and occupational injuries and disease.

Patterns of employment in the U.S. workforce according to education, gender, and race/ethnicity are discussed, and how these patterns might cause disproportionate exposure leading to disproportionate disease and injury. Methodological issues are explored that have hampered research about occupational health disparities, and future research needs are identified.
Prejudice as Stress: Conceptual and Measurement Problems
Authors: Meyer Ilan H.
Published: December 2008

In the field of social sciences, there has been a renewed interest in studying prejudice and discrimination as stressors and assessing their impact on various health outcomes. This raises a need for theoretically based and psychometrically sound measures of prejudice.

As researchers approach this task, there are several conceptual issues that need to be addressed. The author describes 3 such issues related to (1) individual versus structural measures of the impact of prejudice, (2) objective versus subjective assessments of stress, and (3) measures of major events versus everyday discrimination.

How researchers approach the problem of measurement depends on the specific study aims, but they must consider these conceptual issues and understand the advantages and limitations of various approaches to the study of prejudice as stress.
The Structuring of Ethnic Inequalities in Health: Economic Position, Racial Discrimination, and Racism
Authors: Nazroo James Y.
Published: December 2008

Differences in health across ethnic groups have been documented in the United States and the United Kingdom. The extent to which socioeconomic inequalities underlie such differences remains contested, with many instead focusing on cultural or genetic explanations. In both the United States and the United Kingdom, data limitations have greatly hampered investigations of ethnic inequalities in health. Perhaps foremost of these is the inadequate measurement of ethnicity, but also important is the lack of good data on socioeconomic position, particularly data that address life-course issues. Other elements of social disadvantage, particularly experiences of racism, are also neglected.

The author reviews existing evidence and presents new evidence to suggest that social and economic inequalities, underpinned by racism, are fundamental causes of ethnic inequalities in health.
Cancer-Related Health Disparities in Women
Authors: Glanz Karen , Croyle Robert T. , Chollette Veronica Y. , Pinn Vivian W.
Published: December 2008

Objectives. This article synthesizes information about cancer in 9 populations of minority women: Mexican American, Puerto Rican, Cuban American, African American, Asian American, Native Hawaiian, American Samoan, American Indian, and Alaska Native.

Methods. Cancer registry data, social indicators, government sources, and published articles were searched for information on the background and cancer experience of these 9 racial/ethnic groups.

Results. Approximately 35 million women in these racial/ethnic groups live in the United States, and their numbers are increasing rapidly. Since 1992, incidence rates for major cancer sites have slowed or decreased among these groups, but declines in mortality have not occurred or have been smaller than for Whites. Gaps in early detection have narrowed, but minority women still lag behind Whites. Smoking and obesity remain common in these populations.

Conclusions. More culturally appropriate interventions and research are needed, and these efforts must involve the community and raise the quality of health services.
Hysterectomy Prevalence by Hispanic Ethnicity: Evidence From a National Survey
Authors: Brett Kate M. , Higgins Jenny A.
Published: December 2008

Objectives. We investigated hysterectomy prevalence among Hispanic women.

Methods. We obtained data from 4684 Hispanic women and 20 604 non-Hispanic White women from the 1998–1999 National Health Interview Survey. We calculated nationally representative odds ratios of previous hysterectomy, controlling for confounders.

Results. Compared with non-Hispanic White women, the odds ratio for hysterectomy was 0.36 (95% confidence interval [CI] = 0.30, 0.44) for Hispanic women with no high school diploma, 0.57 (95% CI = 0.44, 0.74) for high school graduates, and 0.67 (95% CI = 0.42, 0.87) for college attenders. Country of origin had little influence on hysterectomy prevalence. Hysterectomy was positively associated with acculturation.

Conclusions. Hispanic women undergo fewer hysterectomies than do non-Hispanic White women. The reasons for this, as well as information on ethnicity-specific appropriateness of hysterectomy, should be explored.
A Synthesis of Perceptions About Physical Activity Among Older African American and American Indian Women
Authors: Henderson Karla A. , Ainsworth Barbara E.
Published: December 2008

Objectives. In this review of qualitative data from the Cross-Cultural Activity Participation Study (CAPS), we synthesize the major findings of studies designed to identify minority women’s perceptions of physical activity.

Methods. We interviewed 30 African American and 26 American Indian women with constant comparison techniques. We analyzed the data with a coding system developed from the data.

Results. The women led active, busy lives. Most perceived physical activity as being good for them, identified constraints to time and space for physical activity, and wanted social support for physical activity. Sociocultural issues also were related to physical activity.

Conclusions. Both personal and cultural values influenced the women’s physical activity behaviors. (Am J Public Health. 2003;93:313–317)
Relation of Dietary Quality, Physical Activity, and Smoking Habits to 10-Year Changes in Health Status in Older Europeans in the SENECA Study
Authors: Haveman-Nies Annemien , de Groot Lisette C.P.G.M. , van Staveren Wija A.
Published: December 2008

Objectives. This study investigated the effect of healthy lifestyle behaviors on self-rated health and self-care ability over a 10-year follow-up period in older persons in the SENECA study.

Methods. Health status and lifestyle behaviors were examined in 1988/1989, 1993, and 1999 in 216 men and 264 women, born between 1913 and 1918, from 7 European countries.

Results. Self-rated health and self-care ability declined in men and women with healthy and unhealthy lifestyle habits over the 10-year follow-up period. Inactive and smoking persons had an increased risk for a decline in health status as compared with active and nonsmoking people. No effect of a healthy, Mediterranean-like diet on the deterioration in health status was observed.

Conclusions. Being physically active and nonsmoking delayed deterioration in health status in older participants aged 70 to 75 years in the SENECA study. (Am J Public Health. 2003;93:318–323)
Does Assistive Technology Substitute for Personal Assistance Among the Disabled Elderly?
Authors: Hoenig Helen , Taylor Donald H. , Sloan Frank A.
Published: December 2008

Objectives. This study examined whether use of equipment (technological assistance) to cope with disability was associated with use of fewer hours of help from another person (personal assistance).

Methods. In a cross-sectional study of 2368 community dwellers older than 65 years with 1 or more limitations in basic activities of daily living (ADLs) from the 1994 National Long Term Care Survey, the relation between technological assistance and personal assistance was examined.

Results. Among people with ADL limitations, multivariate models showed a strong and consistent relation between technological assistance and personal assistance, whereby use of equipment was associated with fewer hours of help.

Conclusions. Among people with disability, use of assistive technology was associated with use of fewer hours of personal assistance.
Evolution of the Determinants of Health, Health Policy, and Health Information Systems in Canada
Authors: Glouberman Sholom , Millar John
Published: December 2008

The history of health determinants in Canada influenced both the direction of data gathering about population health and government policies designed to improve health. Two competing movements marked these changes.

The idea of health promotion grew out of the 1974 Lalonde report, which recognized that determinants of health went beyond traditional public health and medical care, and argued for the importance of socioeconomic factors. Research on health inequalities was led by the Canadian Institute for Advanced Research in the 1980s, which produced evidence of health inequalities along socioeconomic lines and argued for policy efforts in early child development.

Both movements have shaped current information gathering and the policies that have come to be labeled “population health.”
The Politics of Emergency Health Powers and the Isolation of Public Health
Authors: Colmers John M. , Fox Daniel M.
Published: December 2008

The Model State Emergency Health Powers Act became a contentious document in more than 30 states in 2001 and 2002. Controversy has focused on recommendations by the authors of the Model Act that seemed to accord higher priority to collective action in emergencies than to protecting privacy and property.

This situation has several causes that derive from the characteristics of public health emergencies during the past half century and the relative isolation of public health officials from both their colleagues in government and many members of the public.
Aligning Quality for Populations and Patients: Do We Know Which Way to Go?
Authors: Lubetkin Erica Ilene , Sofaer Shoshanna , Gold Marthe R. , Berger Marc L. , Murray James F. , Teutsch Steven M.
Published: December 2008

Both the medical care and public health systems have invested considerable resources to define, measure, and improve quality and health outcomes. A movement toward accountability has generated performance indicators from the medical arena and “leading health indicators” from the public health arena.

The focus on specific conditions by the medical care system has been at odds with public health’s emphasis on improving population health and has perpetuated a bifurcated system.

Aligning the goals of medical care with those of public health will require reformulation of performance measurement and accountability into a common language that is valued by both systems. Such a creation would amount to a whole that is stronger than the sum of the component parts.