bluuebunny/crossref_metadata_2025_split huggingface dataset:
Autopsy Study of Motorcyclist Fatalities: The Effect of the 1992 Maryland Motorcycle Helmet Use Law
Authors: Auman Kimberly M. , Kufera Joseph A. , Ballesteros Michael F. , Smialek John E. , Dischinger Patricia C. 
Published: December 2008

Objectives. This study sought to determine the impact of Maryland’s all-rider motorcycle helmet law (enacted on October 1, 1992) on preventing deaths and traumatic brain injuries among motorcyclists. Methods. Statewide motorcyclist fatalities occurring during seasonally comparable 33-month periods immediately preceding and following enactment of the law were compared. Results. The motorcyclist fatality rate dropped from 10.3 per 10 000 registered motorcycles prelaw to 4.5 postlaw despite almost identical numbers of registered motorcycles. Motorcyclists wearing helmets had a lower risk of traumatic brain injury than those not wearing helmets (odds ratio = 0.31, 95% confidence interval = 0.14, 0.68). Conclusions. Maryland’s controversial motorcycle helmet law appears to be an effective public health policy and may be responsible for saving many lives.
Occupational Injury and Illness Surveillance: Conceptual Filters Explain Underreporting
Authors: Azaroff Lenore S. , Levenstein Charles , Wegman David H. 
Published: December 2008

Occupational health surveillance data are key to effective intervention. However, the US Bureau of Labor Statistics survey significantly underestimates the incidence of work-related injuries and illnesses. Researchers supplement these statistics with data from other systems not designed for surveillance. The authors apply the filter model of Webb et al. to underreporting by the Bureau of Labor Statistics, workers’ compensation wage-replacement documents, physician reporting systems, and medical records of treatment charged to workers’ compensation. Mechanisms are described for the loss of cases at successive steps of documentation. Empirical findings indicate that workers repeatedly risk adverse consequences for attempting to complete these steps, while systems for ensuring their completion are weak or absent.
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.