bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emergency Department Use Among the Homeless and Marginally Housed: Results From a Community-Based Study
Authors: Kushel Margot B. , Perry Sharon , Bangsberg David , Clark Richard , Moss Andrew R 
Published: December 2008

Objectives. This study examined factors associated with emergency department use among homeless and marginally housed persons. Methods. Interviews were conducted with 2578 homeless and marginally housed persons, and factors associated with different patterns of emergency department use were assessed in multivariate models. Results. Findings showed that 40.4% of respondents had 1 or more emergency department encounters in the previous year; 7.9% exhibited high rates of use (more than 3 visits) and accounted for 54.5% of all visits. Factors associated with high use rates included less stable housing, victimization, arrests, physical and mental illness, and substance abuse. Predisposing and need factors appeared to drive emergency department use. Conclusions. Efforts to reduce emergency department use among the homeless should be targeted toward addressing underlying risk factors among those exhibiting high rates of use.
Unraveling the Ecology of Risks for Early Childhood Asthma Among Ethnically Diverse Families in the Southwest
Authors: Klinnert Mary D. , Price Marcella R. , Liu Andrew H. , Robinson JoAnn L. 
Published: December 2008

Objectives. We describe the prevalence of asthma risk factors within racial/ethnic and language groups of infants participating in an intervention study for reducing chronic asthma. Methods. Low-income children aged 9 to 24 months with 3 or more episodes of wheezing illness were enrolled. Baseline information included family and medical histories, allergic status, environmental exposures, emotional environment, and caregiver psychosocial resources. Results. Racial/ethnic and language groups—European Americans, African Americans, high-acculturated Hispanics, and low-acculturated Hispanics—showed different patterns of risk factors for childhood asthma, with low-acculturated Hispanics showing the most distinctive pattern. Conclusions. Patterns of covariation of biological and psychosocial risk factors for childhood asthma were associated with racial/ethnic and language status among urban, low-income children.
Effects of Participation in the WIC Program on Birthweight: Evidence From the National Longitudinal Survey of Youth
Authors: Kowaleski-Jones Lori , Duncan Greg J. 
Published: December 2008

Objectives. This study sought to estimate the impact on birthweight of maternal participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Methods. WIC estimates were based on sibling models incorporating data on children born between 1990 and 1996 to women taking part in the National Longitudinal Survey of Youth. Results. Fixed-effects estimates indicated that prenatal WIC participation was associated with a 0.075 unit difference (95% confidence interval [CI] = –0.007, 0.157) in siblings' logged birthweight. At the 88-oz (2464-g) low-birthweight cutoff, this difference translated into an estimated impact of 6.6 oz (184.8 g). Conclusion. Earlier WIC impact estimates may have been biased by unmeasured characteristics affecting both program participation and birth outcomes. Our approach controlled for such biases and revealed a significant positive association between WIC participation and birthweight.
Body Mass Index and Disability in Adulthood: A 20-Year Panel Study
Authors: Ferraro Kenneth F. , Su Ya-ping , Gretebeck Randall J. , Black David R. , Badylak Stephen F. 
Published: December 2008

Objectives. This study examined whether body mass index (BMI) or change in BMI raises the risk of disability in adulthood. Methods. The relation between BMI and upper- and lower-body disability was examined among adult subjects from a national longitudinal survey (n = 6833). Tobit regression models were used to examine the effect of BMI on disability 10 and 20 years later. Results. Obesity (BMI ≥ 30) at baseline or becoming obese during the study was associated with higher levels of upper- and, especially, lower-body disability. In persons who began the study with a BMI of 30 or more and became normal weight, disability was not reduced. Underweight persons (BMI < 18.5) also manifested higher disability in most instances. Conclusions. Disability risk was higher for obese persons, but overweight was not consistently associated with higher disability.
Effect of Birth Cohort on Risk of Hip Fracture: Age-Specific Incidence Rates in the Framingham Study
Authors: Samelson Elizabeth J. , Zhang Yuqing , Kiel Douglas P. , Hannan Marian T. , Felson David T. 
Published: December 2008

Objectives. This study examined the effect of birth cohort on incidence rates of hip fracture among women and men in the Framingham Study. Methods. Age-specific incidence rates of first hip fracture were presented according to tertile of year of birth for 5209 participants of the Framingham Study, a population-based cohort followed since 1948. Sex-specific incidence rate ratios were calculated by Cox regression to assess the relation between birth cohort and hip fracture incidence. Results. An increasing trend in hip fracture incidence rates was observed with year of birth for women (trend, P = .05) and men (trend, P = .03). Relative to those born from 1887 to 1900 (incidence rate ratio [IRR] = 1.0), age-specific incidence rates were greatest in the most recent birth cohort, born from 1911 to 1921 (IRR = 1.4 for women, IRR = 2.0 for men), and intermediate in those born from 1901 to 1910 (IRR = 1.2 for women, IRR = 1.5 for men). Conclusions. Results suggest risk of hip fracture is increasing for successive birth cohorts. Projections that fail to account for the increase in rates associated with birth cohort underestimate the future public health impact of hip fracture in the United States.
Estimates of Global and Regional Smoking Prevalence in 1995, by Age and Sex
Authors: Jha Prabhat , Ranson M. Kent , Nguyen Son N. , Yach Derek 
Published: December 2008

Objectives. We calculated regional and sex- and age-specific smoking prevalence estimates worldwide in 1995. Methods. Sex-specific smoking prevalence data from studies in 139 countries and age distribution data from 7 studies were analyzed. Results. Globally, 29% of persons aged 15 years or older were regular smokers in 1995. Four fifths of the world's 1.1 billion smokers lived in low- or middle-income countries. East Asian countries accounted for a disproportionately high percentage (38%) of the world's smokers. Males accounted for four fifths of all smokers, and prevalence among males and females was highest among those aged 30 to 49 years (34%). Conclusions. Future decades will see dramatic increases in tobacco-attributable deaths in low- and middle-income regions. Although much of this excess mortality can be prevented if smokers stop smoking, quitting remains rare in low- and middle-income countries. (Am J Public Health. 2002;92:1002–1006)
Prevalence and Predictors of Tobacco Use Among Asian Americans in the Delaware Valley Region
Authors: Ma Grace X. , Shive Steve , Tan Yin , Toubbeh Jamil 
Published: December 2008

Objectives. This study examined tobacco use rates and potential predictors of use among Asian Americans residing in the Delaware Valley region. Methods. A cross-sectional survey design was used. The sample consisted of 1174 Chinese, Koreans, Vietnamese, and Cambodians. Results. Findings indicated that the mean age at initiation of tobacco use was 18.3 years. Among the respondents, 40.2% had a history of tobacco use, and 29.6% were current users. Men were more likely than women to smoke. There were significant differences between never smokers, current smokers, and ex-smokers in sex, ethnicity, educational attainment, and marital and employment status. Conclusions. The findings suggest that tobacco use is still a serious public health problem among Asian Americans, especially men.
Getting to the Truth: Evaluating National Tobacco Countermarketing Campaigns
Authors: Farrelly Matthew C. , Healton Cheryl G. , Davis Kevin C. , Messeri Peter , Hersey James C. , Haviland M. Lyndon 
Published: December 2008

Objectives. This study examines how the American Legacy Foundation's “truth” campaign and Philip Morris's “Think. Don't Smoke” campaign have influenced youths' attitudes, beliefs, and intentions toward tobacco. Methods. We analyzed 2 telephone surveys of 12- to 17-year-olds with multivariate logistic regressions: a baseline survey conducted before the launch of “truth” and a second survey 10 months into the “truth” campaign. Results. Exposure to “truth” countermarketing advertisements was consistently associated with an increase in anti-tobacco attitudes and beliefs, whereas exposure to Philip Morris advertisements generally was not. In addition, those exposed to Philip Morris advertisements were more likely to be open to the idea of smoking. Conclusions. Whereas exposure to the “truth” campaign positively changed youths' attitudes toward tobacco, the Philip Morris campaign had a counterproductive influence. (Am J Public Health. 2002;92:901–907)
Tobacco Industry Surveillance of Public Health Groups: The Case of STAT and INFACT
Authors: Malone Ruth E. 
Published: December 2008

Objectives. The goal of this study was to describe how the tobacco industry collects information about public health groups. Methods. Publicly available internal tobacco industry documents were reviewed and analyzed using a chronological case study approach. Results. The industry engaged in aggressive intelligence gathering, used intermediaries to obtain materials under false pretenses, sent public relations spies to the organizations' meetings, and covertly taped strategy sessions. Other industry strategies included publicly minimizing the effects of boycotts, painting health advocates as “extreme,” identifying and exploiting disagreements, and planning to “redirect the funding” of tobacco control organizations to other purposes. Conclusions. Public health advocates often make light of tobacco industry observers, but industry surveillance may be real, intense, and covert and may obstruct public health initiatives.
Independent Evaluation of the California Tobacco Control Program: Relationships Between Program Exposure and Outcomes, 1996–1998
Authors: Rohrbach Louise Ann , Howard-Pitney Beth , Unger Jennifer B. , Dent Clyde W. , Howard Kim Ammann , Cruz Tess Boley , Ribisl Kurt M. , Norman Gregory J. , Fishbein Howard , Johnson C. Anderson 
Published: December 2008

Objectives. This study sought to determine the effects of the California Tobacco Control Program on tobacco-related attitudes and behaviors. Methods. In 1996 and 1998, a telephone survey was conducted among adults in randomly selected households in 18 California counties. Tenth-grade youths in 84 randomly selected high schools completed a written survey. In analyses conducted at the county level, differences in outcomes were regressed on an index of program exposure. Results. Among adults, program exposure was associated with decreased smoking prevalence rates, increased no-smoking policies in homes, and decreased violations of workplace no-smoking policies. Among youths, there was no effect of program exposure on outcomes. Conclusions. These results suggest that the California Tobacco Control Program may have reduced adult smoking prevalence rates and exposure to environmental tobacco smoke. (Am J Public Health. 2002;92:975–983)
Benefits of Smoking Cessation for Longevity
Authors: Taylor Donald H. , Hasselblad Vic , Henley S. Jane , Thun Michael J. , Sloan Frank A. 
Published: December 2008

Objectives. This study determined the life extension obtained from stopping smoking at various ages. Methods. We estimated the relation between smoking and mortality among 877 243 respondents to the Cancer Prevention Study II. These estimates were applied to the 1990 US census population to examine the longevity benefits of smoking cessation. Results. Life expectancy among smokers who quit at age 35 exceeded that of continuing smokers by 6.9 to 8.5 years for men and 6.1 to 7.7 years for women. Smokers who quit at younger ages realized greater life extensions. However, even those who quit much later in life gained some benefits: among smokers who quit at age 65 years, men gained 1.4 to 2.0 years of life, and women gained 2.7 to 3.7 years. Conclusions. Stopping smoking as early as possible is important, but cessation at any age provides meaningful life extensions. (Am J Public Health. 2002;92:990–996)
Time, Place, and Consciousness: Three Dimensions of Meaning for US Institutional Review Boards
Authors: Putney Sarah B. , Gruskin Sofia 
Published: December 2008

In the past few years, US federal agencies governing research with human subjects and institutional review boards have taken a higher-profile path than ever before, both at home and internationally. This trend carries profound significance for US-based institutions and has implications also for the rest of the world. What does this critical moment of heightened federal scrutiny mean for the workings of US institutional review boards? We examined board activity across 3 dimensions: time, place, and consciousness. We conclude that although institutions in all areas of biomedical and social science research are adapting their practices, the field of public health is especially well positioned to adapt to, and succeed in, new efforts to ensure protection of human research subjects. (Am J Public Health. 2002;92:1067–1070)
The Impact of Genomics on Global Health
Authors: Pang Tikki 
Published: December 2008

Ensuring that advances in genomics are applied to the health improvement of people living in developing countries is an important contemporary challenge. In the near term, such advances are likely to alleviate infectious diseases, with longer-term benefits envisaged for chronic disorders. To ensure that benefits are shared by developing countries, attention must be paid to complex ethical, legal, social, and economic issues, as well as to public education and engagement. Creative and equitable international mechanisms and goodwill are needed to turn high hopes into reality and allow the use of genomics to reduce health inequities between rich and poor nations. (Am J Public Health. 2002;92:1077–1079)
Use of Topical Sunscreens and the Risk of Malignant Melanoma: A Meta-Analysis of 9067 Patients From 11 Case–Control Studies
Authors: Huncharek Michael , Kupelnick Bruce 
Published: December 2008

Objectives. This study examined the methodology of epidemiological studies that suggest use of topical sunscreen preparations is associated with increased risk of malignant melanoma. Methods. We pooled data from observational studies using a general variance–based meta-analytic method that employed confidence intervals (previously described). The outcome of interest was a summary relative risk (RR) reflecting the risk of melanoma associated with sunscreen use versus nonuse. Sensitivity analyses were performed when necessary to explain any observed statistical heterogeneity. Results. Combining studies that used nonheterogeneous data yielded a summary RR of 1.01, indicating no association between sunscreen use and development of malignant melanoma. Conclusions. The available epidemiological data do not support the existence of a relationship between topical sunscreen use and an increased risk of cutaneous malignant melanoma. (Am J Public Health. 2002;92:1173–1177)
The Perceived Impact of Privatization on Local Health Departments
Authors: Keane Christopher , Marx John , Ricci Edmund , Barron Gerald 
Published: December 2008

Objectives. This article presents nationally representative data on the effects of privatization on local health departments (LHDs). Methods. A stratified representative national sample of 380 LHDs was drawn from a national list of 2488 departments. Telephone interviews were conducted with 347 LHD directors. Results. One half of the directors of LHDs with privatized services reported that privatization helped the performance of core functions. Privatization often resulted in increased time needed for management and administration. More than a third of LHD directors reported concern about loss of control over the performance of privatized functions and services. Conclusions. Privatization is part of a broader shift toward “managing” rather than directly providing public health services, yet privatization often reduces LHDs' control over the performance of services. (Am J Public Health. 2002;92:1178–1180)
Impact of Generosity Level of Outpatient Prescription Drug Coverage on Prescription Drug Events and Expenditure Among Older Persons
Authors: Artz Margaret B. , Hadsall Ronald S. , Schondelmeyer Stephen W. 
Published: December 2008

Objectives. This study examined the impact of drug coverage generosity on older persons’ prescription events (fills) and expenditures. Methods. A cross-sectional study was conducted of 6237 older persons from the 1995 Medicare Current Beneficiary Survey. Dependent variables were per capita prescription events and expenditures. Independent variables were insurance type and drug coverage generosity. Control variables included sociodemographic and health status factors. Results. Regardless of insurance type, per capita prescription events increased as drug coverage generosity improved and then decreased at the most generous level. Per capita prescription expenditures increased as generosity improved; with generous prescription coverage, prescription expenditures were approximately 3 times those with Medicare only. Conclusions. Even when factors that affect drug use and insurance selection are controlled, prescription coverage generosity influences prescription use. (Am J Public Health. 2002;92:1257–1263)
Stability and Change in Health Insurance Among Older Mexican Americans: Longitudinal Evidence From the Hispanic Established Populations for Epidemiologic Study of the Elderly
Authors: Angel Ronald J. , Angel Jacqueline L. , Markides Kyriakos S. 
Published: December 2008

Objectives. This study examined the association between health insurance coverage, medical care use, limitations in activities of daily living, and mortality among older Mexican-origin individuals. Methods. We analyzed longitudinal data from the Hispanic Established Populations for Epidemiologic Study of the Elderly (H-EPESE). Results. The uninsured tend to be younger, female, poor, and foreign born. They report fewer health care visits, are less likely to have a usual source of care, and more often receive care in Mexico. Conversely, those with private health insurance are economically better off and use more health care services. Over time, the data reveal substantial changes in type of insurance coverage. Conclusions. The data reveal serious vulnerabilities among older Mexican Americans that result from a lack of private Medigap supplemental coverage. (Am J Public Health. 2002;92:1264–1271)
Socioeconomic Position, Health, and Possible Explanations: A Tale of Two Cohorts
Authors: Fuhrer R. , Shipley M. J. , Chastang J. F. , Schmaus A. , Niedhammer I. , Stansfeld S. A. , Goldberg M. , Marmot M. G. 
Published: December 2008

Objectives. We examined whether the social gradient for measures of morbidity is comparable in English and French public employees and investigated risk factors that may explain this gradient. Methods. This longitudinal study of 2 occupational cohorts—5825 London civil servants and 6818 French office-based employees—used 2 health outcomes: long spells of sickness absence during a 4-year follow-up and self-reported health. Results. Strong social gradients in health were observed in both cohorts. Health behaviors showed different relations with socioeconomic position in the 2 samples. Psychosocial work characteristics showed strong gradients in both cohorts. Cohort-specific significant risk factors explained between 12% and 56% of the gradient in sickness absence and self-reported health. Conclusions. Our cross-cultural comparison suggests that some common susceptibility may underlie the social gradient in health and disease, which explains why inequalities occur in cultures with different patterns of morbidity and mortality.
Life-Course Socioeconomic and Behavioral Influences on Cardiovascular Disease Mortality: The Collaborative Study
Authors: Smith George Davey , Hart Carole 
Published: December 2008

Objectives. This study sought to demonstrate life-course influences on cardiovascular disease (CVD). Methods. Data were derived from a prospective observational study in which the main outcome measure was death resulting from CVD. Results. Combining 4 socioeconomic and behavioral risk indicators into a measure of life-course exposure produced 5 groups whose relative risks of CVD mortality ranged from 1.00 (the group with the most favorable life-course exposures) to 4.55 (the group with the least favorable life-course exposures). If the entire study population had had the CVD mortality risk of the subsample with the most favorable risk factor profile, approximately two thirds of cardiovascular deaths would not have occurred. Conclusions. CVD risk is influenced in a cumulative fashion by socioeconomic and behavioral factors acting throughout the life course.
Active Surveillance of Maternal Mortality in New York City
Authors: Pallin Daniel J. , Sundaram Vandana , Laraque Fabienne , Berenson Louise , Schomberg David R. 
Published: December 2008

Objectives. This study examined the usefulness of computer-assisted active surveillance in identifying maternal deaths in New York City. Methods. Computerized searches of hospital discharge and autopsy record databases were conducted for maternal deaths occurring in 1997. Results. Active surveillance revealed 14 new maternal deaths not previously reported, an 88% increase. Nine of these deaths were found through the hospital discharge database search, 1 was found through the autopsy record search, and 4 were found in both searches. Overall maternal mortality ratios associated with active surveillance and routine surveillance were 24.3 and 13.0 deaths per 100 000 live births, respectively. Conclusions. Active surveillance of maternal mortality is useful in identifying new maternal deaths. Existing databases can be used relatively easily to augment routine surveillance of maternal mortality.
The Impact of the Increasing Number of Multiple Births on the Rates of Preterm Birth and Low Birthweight: An International Study
Authors: Blondel Béatrice , Kogan Michael D. , Alexander Greg R. , Dattani Nirupa , Kramer Michael S. , Macfarlane Alison , Wen Shi Wu 
Published: December 2008

Objectives. We studied the effects of twins and triplets on perinatal health indicators in the overall population in the 1980s and 1990s in Canada, England and Wales, France, and the United States. Methods. Data were derived mostly from live birth registration. We used rates, relative risks, and population attributable risks for twins and triplets separately. Results. In each country, the increase in multiple births, and the increase in preterm delivery among multiple births, contributed almost equally to the rise in or stabilization of the overall rates of preterm delivery. Twins contributed a much larger proportion of the preterm deliveries and low-birthweight newborns than did triplets. Conclusions. Twins have a major population-based impact on the trends of perinatal health indicators. (Am J Public Health. 2002;92:1323–1330)