bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is There Progress toward Eliminating Racial/Ethnic Disparities in the Leading Causes of Death?
Authors: Keppel Kenneth G. , Pearcy Jeffrey N. , Heron Melonie P. 
Published: January 2017

Objectives. We examined changes in relative disparities between racial/ethnic populations for the five leading causes of death in the United States from 1990 to 2006. Methods. The study was based on age-adjusted death rates for four racial/ethnic populations from 1990–1998 and 1999–2006. We compared the percent change in death rates over time between racial/ethnic populations to assess changes in relative differences. We also computed an index of disparity to assess changes in disparities relative to the most favorable group rate. Results. Except for stroke deaths from 1990 to 1998, relative disparities among racial/ethnic populations did not decline between 1990 and 2006. Disparities among racial/ethnic populations increased for heart disease deaths from 1999 to 2006, for chronic obstructive pulmonary disease deaths from 1990 to 1998, and for chronic lower respiratory disease deaths from 1999 to 2006. Conclusions. Deaths rates for the leading causes of death are generally declining; however, relative differences between racial/ethnic groups are not declining. The lack of reduction in relative differences indicates that little progress is being made toward the elimination of racial/ethnic disparities.
Risk and Protective Factors for Unprotected Intercourse among Rural African American Young Adults
Authors: Kogan Steven M. , Brody Gene H. , Chen Yi-Fu , Grange Christina M. , Slater LaTrina M. , DiClemente Ralph J. 
Published: January 2017

Objectives. Despite increasing risk for human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs), few data are available concerning the factors associated with risky sexual behavior among African American young adults who do not attend college. Additionally, the possibility that different risk mechanisms affect men and women remains understudied. This article reports on the risk and protective factors associated with unprotected intercourse and gender differences in these factors' influence among this group. Predictors were derived from ecological and self-regulatory theories of risk behavior. Methods. African Americans aged 18–21 years were recruited via respondent-driven sampling (RDS) from seven contiguous rural counties. Risk and protective factors for unprotected intercourse were analyzed for 214 of 292 participants who reported sexual intercourse during the past three months. Results. Among sexually active participants, 62.6% used condoms inconsistently. The influence of leaving the parental home, perceived discrimination, risk-taking peers, family relationships, risk-taking propensity, and binge drinking on unprotected intercourse were moderated by gender. Positive attitudes toward condom use were associated with less unprotected intercourse controlling for the influence of risk variables for both men and women. Conclusions. Men and women have unique STI prevention needs. Additional research addressing these needs is necessary, particularly for rural African American men.
Tuberculosis and Stigmatization: Pathways and Interventions
Authors: Courtwright Andrew , Turner Abigail Norris 
Published: January 2017

The institutional and community norms that lead to the stigmatization of tuberculosis (TB) are thought to hinder TB control. We performed a systematic review of the literature on TB stigma to identify the causes and evaluate the impact of stigma on TB diagnosis and treatment. Several themes emerged: fear of infection is the most common cause of TB stigma; TB stigma has serious socioeconomic consequences, particularly for women; qualitative approaches to measuring TB stigma are more commonly utilized than quantitative surveys; TB stigma is perceived to increase TB diagnostic delay and treatment noncompliance, although attempts to quantify its impact have produced mixed results; and interventions exist that may reduce TB stigma. Future research should continue to characterize TB stigma in different populations; use validated survey instruments to quantify the impact of TB stigma on TB diagnostic delay, treatment compliance, and morbidity and mortality; and develop additional TB stigma-reduction strategies.
Associations of Sex Ratios and Male Incarceration Rates with Multiple Opposite-Sex Partners: Potential Social Determinants of HIV/STI Transmission
Authors: Pouget Enrique R. , Kershaw Trace S. , Niccolai Linda M. , Ickovics Jeannette R. , Blankenship Kim M. 
Published: January 2017

Objectives. Racial/ethnic disparities in heterosexual transmission of human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs) have been hypothesized to be related to the high rate of incarceration and the shortage of men in black communities. This study tested associations of having multiple sex partners with these factors. Methods. Racial/ethnic-specific Census data on the sex ratio and the male incarceration rate were categorized into tertiles and matched with individual data from the National Health and Nutrition Examination Survey 1999–2004 by county of residence for non-Hispanic black, non-Hispanic white, and Mexican American participants. We used logistic regression analyses to examine whether these factors were associated with having multiple opposite-sex partners in the past year. Results. Sex ratios and incarceration rates varied greatly by race/ethnicity; however, we observed significant associations within each racial/ethnic group. Non-Hispanic black men in counties with a greater shortage of males (adjusted odds ratio [AOR] = 1.9; 95% confidence interval [CI] 1.1, 3.5) and a greater number of incarcerated males (AOR=1.6; 95% CI 1.1, 2.3) in the non-Hispanic black population had significantly greater odds of having two or more partners. Those in two low sex-ratio categories (AOR=2.4; 95% CI 1.0, 5.8 and AOR=4.1; 95% CI 1.6, 10.0) and one high incarceration-rate category (AOR=2.1; 95% CI 1.2, 3.6) had significantly greater odds of having five or more partners. Conclusion. Sex ratios and incarceration rates were associated with the number of opposite-sex partners in some groups. Because the risk of HIV/STI transmission depends, in part, on the number of partners, it is important to determine the causal relationships among these associations to help better understand racial/ethnic HIV/STI disparities and improve prevention programs and interventions.
The Context of Economic Insecurity and its Relation to Violence and Risk Factors for HIV among Female Sex Workers in Andhra Pradesh, India
Authors: Reed Elizabeth , Gupta Jhumka , Biradavolu Monica , Devireddy Vasavi , Blankenship Kim M. 
Published: January 2017

Objective. We examined the context of economic insecurity and debt among female sex workers (FSWs), how this context varies among FSWs, and its association with experiences of violence and sexual risk factors for human immunodeficiency virus (HIV). Methods. We recruited FSWs aged ≥18 years ( n=673) through respondent-driven sampling for a survey on HIV risk in this region. Using logistic regression models (adjusted for partner status, education, financial support, and literacy), we assessed the relation between debt and sexual and physical victimization as well as sexual risk. We also conducted qualitative interviews with a subsample of the survey participants and examined these for related themes. Results. In adjusted logistic regression models, FSWs who reported debt were more likely to report the following: recent physical violence (adjusted odds ratio [AOR] = 2.4, 95% confidence interval [CI] 1.5, 3.9), unprotected sex with occasional clients in the past week (AOR=2.3, 95% CI 1.2, 4.3), anal sex with clients in the past 30 days (AOR=2.0, 95% CI 1.1, 3.9), and at least one sexually transmitted infection symptom in the past six months (AOR=1.6, 95% CI 1.1, 2.4). FSWs with debt were more likely to report current husbands or other male partners, and less likely to report condom use with these partners, further increasing their sexual risk. Qualitative data elaborated on these findings. Conclusion. Findings indicate the violence- and HIV-related vulnerability of FSWs who report debt and further highlight how male partners may contribute to the debt and economic insecurity of FSWs.
A Comparison of Registered and Unregistered Female Sex Workers in Tijuana, Mexico
Authors: Sirotin Nicole , Strathdee Steffanie A. , Lozada Remedios , Nguyen Lucie , Gallardo Manuel , Vera Alicia , Patterson Thomas L. 
Published: January 2017

Objective. Sex work is regulated in Tijuana, Mexico, but only half of the city's female sex workers (FSWs) are registered with the municipal health department, which requires regular screening for sexually transmitted infections (STIs) and human immunodeficiency virus (HIV). We examined correlates of registration to determine if it confers measurable health benefits. Methods. From 2004 to 2006, we interviewed FSWs in Tijuana ≥18 years of age who reported recent unprotected sex with at least one client and were not knowingly HIV-positive, and tested them for HIV, syphilis, gonorrhea, and chlamydia. Logistic regression identified factors associated with registration. Results. Of 410 FSWs, 44% were registered, 69% had been tested for HIV, 6% were HIV-positive, and 44% tested positive for any STI. Compared with unregistered FSWs, registered FSWs were more likely to have had HIV testing (86% vs. 56%, p<0.001) and less likely to test positive for any STI (33% vs. 53%, p<0.001) or HIV (3% vs. 8%, p=0.039). Factors independently associated with registration included ever having an HIV test (adjusted odds ratio [AOR] 5 4.19) and earning >$30 per transaction without a condom (AOR52.41), whereas working on the street (AOR50.34), injecting cocaine (AOR50.06), snorting or smoking methamphetamine (AOR50.27), and being born in the Mexican state of Baja California (AOR50.35) were inversely associated with registration. Conclusion. Registered FSWs were more likely than unregistered FSWs to have had HIV testing and to engage in less drug use, but did not have significantly lower HIV or STI prevalence after adjusting for confounders. Current regulation of FSWs in Tijuana should be further examined to enhance the potential public health benefits of registration.
Does Education Matter? Examining Racial Differences in the Association between Education and STI Diagnosis among Black and White Young Adult Females in the U.S.
Authors: Annang Lucy , Walsemann Katrina M. , Maitra Debeshi , Kerr Jelani C. 
Published: January 2017

Objectives. Education has long been considered a protective factor against sexual risk behaviors and sexually transmitted infections (STIs) among adolescents; however, few have explored this association and determined differences across racial/ethnic groups of young adult females on a national scale. The purpose of this study was to (1) describe the association between education and STI diagnosis among a national sample of black and white young adult females and (2) examine racial differences in this association. Methods. We used data from the National Longitudinal Study of Adolescent Health (Add Health) to assess the association between education and chlamydia, gonorrhea, and/or trichomoniasis (self-reported and assay-diagnosed) in 2001–2002 using logistic regression analysis. Results. After adjustment for risk behaviors, education was inversely associated with any assay-diagnosed STI, but this association was nonsignificant among black women for self-reported STI. Additionally, black females enrolled in, or who graduated from, college had significantly higher predicted probabilities of having an STI (12.4% self-reported; 13.4% assay-diagnosed) compared with white females who had less than a high school diploma (6.4% self-reported; 2.3% assay-diagnosed). Conclusions. Educational status was not uniformly protective against STIs for black and white females in this sample. Particularly for young black women, other factors may play a more prominent role in determining STI risk. Social determinants, such as education, should be viewed as important factors associated with STI prevalence, but their differential impact on various racial/ethnic groups should also be considered when addressing the disproportionate rates of STIs in the U.S.
Sensitivity of Birth Certificate Reports of Birth Defects in Atlanta, 1995–2005: Effects of Maternal, Infant, and Hospital Characteristics
Authors: Boulet Sheree L. , Shin Mikyong , Kirby Russell S. , Goodman David , Correa Adolfo 
Published: January 2017

Objectives. We assessed variations in the sensitivity of birth defect diagnoses derived from birth certificate data by maternal, infant, and hospital characteristics. Methods. We compared birth certificate data for 1995–2005 births in Atlanta with data from the Metropolitan Atlanta Congenital Defects Program (MACDP). We calculated the sensitivity of birth certificates for reporting defects often discernable at birth (e.g., anencephaly, spina bifida, cleft lip, clubfoot, Down syndrome, and rectal atresia or stenosis). We used multivariable logistic regression models to examine associations with sociodemographic and hospital factors. Results. The overall sensitivity of birth certificates was 23% and ranged from 7% for rectal atresia/stenosis to 69% for anencephaly. Non-Hispanic black maternal race/ethnicity, less than a high school education, and preterm birth were independently associated with a lower probability of a birth defect diagnosis being reported on a birth certificate. Sensitivity also was lower for hospitals with >1,000 births per year. Conclusions. The underreporting of birth defects on birth certificates is influenced by sociodemographic and hospital characteristics. Interpretation of birth defects prevalence estimates derived from birth certificate reports should take these issues into account.
Secular Trends in Hospital Emergency Department Visits for Dental Care in Kansas City, Missouri, 2001–2006
Authors: Hong Liang , Ahmed Arif , McCunniff Michael , Liu Yifei , Cai Jinwen , Hoff Gerald 
Published: January 2017

Objectives. We determined the trends, risk factors, and costs of emergency department (ED) visits for dental complaints during a six-year period in Kansas City, Missouri (KCMO). Methods. We used de-identified hospital discharge data from all facilities serving KCMO during 2001–2006. Using the International Classification of Diseases, Ninth Revision codes, we determined both counts and rates of ED visits related to toothache or tooth injury and analyzed the discharge diagnosis and costs of these visits. We used multivariable regression analysis to assess risk factors for the ED visits for dental complaints. Results. We found a significant increasing trend in dental complaint visits during the six-year period (from 13.1% to 19.0%, p<0.01). Dental caries accounted for 20.4%, pulpitis or periapical abscess accounted for 14.8%, dental injury accounted for 8.7%, temporomandibular joint (TMJ) disorders accounted for 1.5%, and all other unspecified dental diseases accounted for 54.6% of the ED visits for dental complaints. The mean charge was approximately $360 per visit and was highest for TMJ disorders ($747) and lowest for unspecified other dental diseases ($277). Self-pay (38.3%) and Medicaid (32.3%) constituted the majority of the payment sources. Multivariable regression analysis indicated that self-payers, nonwhite people, adults, people with lower family income, and weekends were associated with increased use of ED visits for dental complaints. Conclusions. There was a significant increasing trend in dental complaint-related ED visits. EDs have become an important site for people with dental problems to seek urgent care, particularly for individuals who self-pay or are on Medicaid.
Food Safety Perceptions and Practices of Older Adults
Authors: Anderson Amy L. , Verrill Linda A. , Sahyoun Nadine R. 
Published: January 2017

Objectives. Older adults are considered more vulnerable to foodborne illness due to lowered immune function. We compared the food safety perceptions and practices of older and younger adults and determined associations with demographic characteristics. Methods. We focused on 1,317 participants ≥60 years of age from the U.S. Food and Drug Administration's 2006 Food Safety Survey, a telephone survey of a nationally representative sample of American consumers. We used data on participants <60 years of age to compare younger and older adults, and used Pearson's Chi-square tests to determine whether perceptions and practices differed by age, gender, level of education, living arrangement, and race/ethnicity We conducted multiple logistic regression analysis to assess relationships of demographic characteristics and food safety perceptions with food safety practices of older adults. Results. We found that adults ≥60 years of age were more likely to follow recommended food safety practices than those <60 years of age. Sixty-six percent of adults ≥60 years of age reported eating potentially hazardous foods in the past year compared with 81% of adults <60 years of age. Among people ≥60 years of age, women, those with less education, and nonwhite individuals generally had better food safety practices and a greater awareness of food safety risk. Conclusions. These findings suggest that certain subsets of the older adult population are less likely to follow recommended food safety practices and, thus, are at greater risk of foodborne illness. Food safety education for older adults should target men and those with more education and higher incomes.
Health Outcomes and Green Renovation of Affordable Housing
Authors: Breysse Jill , Jacobs David E. , Weber William , Dixon Sherry , Kawecki Carol , Aceti Susan , Lopez Jorge 
Published: January 2017

Objective. This study sought to determine whether renovating low-income housing using “green” and healthy principles improved resident health and building performance. Methods. We investigated resident health and building performance outcomes at baseline and one year after the rehabilitation of low-income housing using Enterprise Green Communities green specifications, which improve ventilation; reduce moisture, mold, pests, and radon; and use sustainable building products and other healthy housing features. We assessed participant health via questionnaire, provided Healthy Homes training to all participants, and measured ventilation, carbon dioxide, and radon. Results. Adults reported statistically significant improvements in overall health, asthma, and non-asthma respiratory problems. Adults also reported that their children's overall health improved, with significant improvements in non-asthma respiratory problems. Post-renovation building performance testing indicated that the building envelope was tightened and local exhaust fans performed well. New mechanical ventilation was installed (compared with no ventilation previously), with fresh air being supplied at 70% of the American Society of Heating, Refrigerating, and Air-Conditioning Engineers standard. Radon was <2 picocuries per liter of air following mitigation, and the annual average indoor carbon dioxide level was 982 parts per million. Energy use was reduced by 45% over the one-year post-renovation period. Conclusions. We found significant health improvements following low-income housing renovation that complied with green standards. All green building standards should include health requirements. Collaboration of housing, public health, and environmental health professionals through integrated design holds promise for improved health, quality of life, building operation, and energy conservation.
Attitudes about Carbon Monoxide Safety in the United States: Results from the 2005 and 2006 HealthStyles Survey
Authors: King Michael E. , Damon Scott A. 
Published: January 2017

Objectives. We sought to identify attitudes and behaviors related to carbon monoxide (CO) safety that can be targeted with public health prevention strategies in the U.S. Methods. The Centers for Disease Control and Prevention added questions about ( 1) proper placement of gas-powered generators, ( 2) maintenance of fuel-burning appliances, and ( 3) use of CO detectors to the 2005 and 2006 HealthStyles national health marketing surveys. Results. In 2005, 63.3% of HealthStyles respondents agreed with or were uncertain about the incorrect statement, “It is safe to run a generator in a garage as long as the door is open,” while 43.1% agreed with or were uncertain about the incorrect statement, “It is safe to run a generator in the basement.” Most of the 2006 respondents (63.5%) agreed that it is important to have their furnace inspected annually. However, fewer than half of the 2006 respondents (42.0%)—most of whom were homeowners—reported owning a CO detector. Conclusions. A large proportion of adults in the U.S. reported attitudes and behaviors that may place them at increased risk for unintentional, non-firerelated CO poisoning, suggesting that current safety messages may not be reaching much of the public. Prevention messages should continue to promote proper generator placement, maintenance of fuel-burning appliances, and use of CO detectors. Development of a comprehensive national strategy for CO surveillance and communication may help identify populations at increased risk and prevent future poisonings.
Carbon Monoxide Poisoning after an Ice Storm in Kentucky, 2009
Authors: Lutterloh Emily C. , Iqbal Shahed , Clower Jacquelyn H. , Spiller Henry A. , Riggs Margaret A. , Sugg Tennis J. , Humbaugh Kraig E. , Cadwell Betsy L. , Thoroughman Douglas A. 
Published: January 2017

Objectives. Carbon monoxide (CO) poisoning is a leading cause of morbidity and mortality during natural disasters. On January 26–27, 2009, a severe ice storm occurred in Kentucky, causing widespread, extended power outages and disrupting transportation and communications. After the storm, CO poisonings were reported throughout the state. The objectives of this investigation were to determine the extent of the problem, identify sources of CO poisoning, characterize cases, make recommendations to reduce morbidity and mortality, and develop prevention strategies. Methods. We obtained data from the Kentucky Regional Poison Center (KRPC), hyperbaric oxygen treatment (HBOT) facilities, and coroners. Additionally, the Kentucky Department for Public Health provided statewide emergency department (ED) and hospitalization data. Results. During the two weeks after the storm, KRPC identified 144 cases of CO poisoning; exposure sources included kerosene heaters, generators, and propane heaters. Hospitals reported 202 ED visits and 26 admissions. Twenty-eight people received HBOT. Ten deaths were attributed to CO poisoning, eight of which were related to inappropriate generator location. Higher rates of CO poisoning were reported in areas with the most ice accumulation. Conclusions. Although CO poisonings are preventable, they continue to occur in postdisaster situations. Recommendations include encouraging use of CO alarms, exploring use of engineering controls on generators to decrease CO exposure, providing specific information regarding safe use and placement of CO-producing devices, and using multiple communication methods to reach people without electricity.