bluuebunny/crossref_metadata_2025_split huggingface dataset:
Touched by Homelessness: An Examination of Hospitality for the Down and Out
Authors: Bolland John M. , McCallum Debra Moehle 
Published: December 2008

Objectives. This study investigated patterns of “doubled-up” homelessness using an indirect measure based on host households. Methods. In random household telephone surveys conducted in Alabama between 1990 and 2000 and nationally in 1997, respondents indicated whether any individual had stayed with them during the past year because that person was homeless. Results. The percentage of Alabama households providing shelter during the past year declined from 16.2% in 1990 to 7.1% in 2000. The national rate for providing shelter in 1997 was 18.0%. Conclusions. Many households provide shelter to people to prevent them from being literally homeless. As the economy has expanded, these rates have declined in Alabama.
Incomplete Birth Certificates: A Risk Marker for Infant Mortality
Authors: Gould Jeffrey B. , Chavez Gilberto , Marks Amy R. , Liu Hao 
Published: December 2008

Objectives. This study assessed the relationship between incomplete birth certificates and infant mortality. Methods. Birth certificates from California (n = 538 945) were assessed in regard to underreporting of 13 predictors of perinatal outcomes and mortality. Results. Of the birth certificates studied, 7.25% were incomplete. Underreporting was most common in the case of women at high risk for poor perinatal outcomes and infants dying within the first day. Increasing numbers of unreported items were shown to be associated with corresponding increases in neonatal and postneonatal mortality rates. Conclusions. Incomplete birth certificates provide an important marker for identifying high-risk women and vulnerable infants. Because data “cleaning” will result in the removal of mothers and infants at highest risk, birth certificate analyses should include incomplete records.
A Public Health Agenda for Traditional, Complementary, and Alternative Medicine
Authors: Bodeker Gerard , Kronenberg Fredi 
Published: December 2008

Traditional medicine (a term used here to denote the indigenous health traditions of the world) and complementary and alternative medicine (T/CAM) have, in the past 10 years, claimed an increasing share of the public’s awareness and the agenda of medical researchers. Studies have documented that about half the population of many industrialized countries now use T/CAM, and the proportion is as high as 80% in many developing countries. Most research has focused on clinical and experimental medicine (safety, efficacy, and mechanism of action) and regulatory issues, to the general neglect of public health dimensions. Public health research must consider social, cultural, political, and economic contexts to maximize the contribution of T/CAM to health care systems globally.
Health Status of People Using Complementary and Alternative Medical Practitioner Services in 4 English Counties
Authors: Ong Chi-Keong , Petersen Sophie , Bodeker Gerard C. , Stewart-Brown Sarah 
Published: December 2008

Objectives. This study was undertaken to establish the health status of users of complementary and alternative medicine (CAM) services in England. Methods. A postal questionnaire (response rate: 64%) covering long-standing illness, use of conventional medical and CAM services, and the United Kingdom Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) was sent to more than 14 000 adults in 4 counties. Results. Sixty percent of CAM users reported having a chronic illness or disability; back pain and bowel problems were the conditions most commonly reported. Regardless of whether chronic illness was reported, CAM users reported poorer health than nonusers, particularly in the dimensions of pain and physical disability, and made more visits to general practitioners. Conclusions. In England, users of CAM services have poorer physical health than nonusers and make more frequent use of conventional medical services.
Roots, Shoots, but Too Little Fruit: Assessing the Contribution of COPC in South Africa
Authors: Tollman Stephen M. , Pick William M. 
Published: December 2008

Community-oriented primary care (COPC) originated in South Africa during the 1940s and 1950s, where it served to inform local church-based and nongovernmental organization–based initiatives during the apartheid years. During the 1990s, COPC played an inspirational role in the process of national health policy formulation. Yet COPC’s contribution to current health practice remains more symbolic than substantive. Despite a policy framework that favors the widespread introduction of COPC, various political, structural, managerial, and human resource obstacles constrain its effective implementation. Notwithstanding a rapidly changing health care environment and well-established health transition from infections and nutritional disorders to non-communicable diseases and injury, COPC and its variants remain abidingly relevant to South Africa’s—and Africa’s—health care reality. (Am J Public Health. 2002;92:1725–1728)
Community-Oriented Primary Care in Action: A Dallas Story
Authors: Pickens Sue , Boumbulian Paul , Anderson Ron J. , Ross Samuel , Phillips Sharon 
Published: December 2008

Dallas County, Texas, is the site of the largest urban application of the community-oriented primary care (COPC) model in the United States. We summarize the development and implementation of Dallas’s Parkland Health & Hospital System COPC program. The complexities of implementing and managing this comprehensive community-based program are delineated in terms of Dallas County’s political environment and the components of COPC (assessment, prioritization, community collaboration, health care system, evaluation, and financing). Steps to be taken to ensure the future growth and development of the Dallas program are also considered. The COPC model, as implemented by Parkland, is replicable in other urban areas.
Pursuing Community-Oriented Primary Care in a Russian Closed Nuclear City: The Sarov–Los Alamos Community Health Partnership
Authors: Rhyne Robert L. , Hertzman Philip A. 
Published: December 2008

The Russian health care system historically has not relied on medical evidence to guide practice, uses centralized management, and is burdened by overspecialization. In 1999, a community health partnership was established between Sarov, Russia, and Los Alamos, NM, 2 cities linked by their nuclear weapons histories. Health problems addressed include asthma and diabetes, pediatric dental caries, low prevalence of breastfeeding, and adolescent drug abuse and sexually transmitted diseases. A community-oriented primary care approach was adopted that includes (1) implementing a “train the trainers” strategy to educate health professionals and lay people, (2) adapting established clinical practice guidelines based on local resources, (3) restricting use of expensive or limited resources, and (4) securing commitments from local government for expendable supplies and medications.
Community-Oriented Primary Care: New Relevance in a Changing World
Authors: Mullan Fitzhugh , Epstein Leon 
Published: December 2008

Since its inception in rural, pre-apartheid South Africa, community-oriented primary care (COPC) has intrigued and informed public health and primary care leaders worldwide. COPC has influenced such programs as the US community health center movement, the general practice movement in the United Kingdom, and recent reforms in the public health system of South Africa. We provide a global overview of COPC, tracing its conceptual roots, reviewing its many manifestations, and exploring its future prospects as an organizational paradigm for the democratic organization of community health services. We examine the pitfalls and paradoxes of COPC and suggest its future utility. COPC has important values and methods to offer disparate but powerful movements in public health worldwide.
The Contextual Effect of the Local Food Environment on Residents’ Diets: The Atherosclerosis Risk in Communities Study
Authors: Morland Kimberly , Wing Steve , Roux Ana Diez 
Published: December 2008

Objectives. We studied the association between the local food environment and residents’ report of recommended dietary intake. Methods. Recommended intakes of foods and nutrients for 10 623 Atherosclerosis Risk in Communities participants were estimated from food frequency questionnaires. Supermarkets, grocery stores, and full-service and fast-food restaurants were geocoded to census tracts. Results. Black Americans’ fruit and vegetable intake increased by 32% for each additional supermarket in the census tract (relative risk [RR] = 1.32; 95% confidence interval [CI] = 1.08, 1.60). White Americans’ fruit and vegetable intake increased by 11% with the presence of 1 or more supermarket (RR = 1.11; 95% CI = 0.93, 1.32). Conclusions. These findings suggest the local food environment is associated with residents’ recommended diets.
Chewing Tobacco: Who Uses and Who Quits? Findings From NHANES III, 1988–1994
Authors: Howard-Pitney Beth , Winkleby Marilyn A. 
Published: December 2008

Objectives. This study identified mutually exclusive groups of men at high and low risk for use of chewing tobacco and for quitting. Methods. Analyses used a national sample of 1340 non-Hispanic Black, 1358 Mexican American, and 1673 non-Hispanic White men, aged 25 to 64, who participated in the National Health and Nutrition Examination Survey III from 1988 to 1994. Signal detection analysis was used to delineate high- and low-risk subgroups; survival analysis was used to estimate hazard curves for comparing age at onset for chewing tobacco use with that for smoking. Results. Rural, lower-income Black and White men had the highest regular use of chewing tobacco (33.3%), followed by rural, higher-income men regardless of race/ethnicity (14.9%). Southern men who began using chewing tobacco during adulthood had the lowest quit rate (22.5%). In sharp contrast to smoking, chewing tobacco showed a continued onset throughout adulthood. Conclusions. Because subgroups of men show highly different chewing tobacco use and quit rates and because age at chewing tobacco onset occurs across the life span, prevention and cessation programs should be specific to different risk groups and distinct from smoking programs.
Cadmium Exposure in Pregnancy and Lactation in Relation to Iron Status
Authors: Åkesson Agneta , Berglund Marika , Schütz Andrejs , Bjellerup Per , Bremme Katarina , Vahter Marie 
Published: December 2008

Objectives. The purpose of this study was to determine the impact of iron status on cadmium dose among pregnant women. Methods. Iron status and cadmium concentration in blood, urine, and placenta were determined among women followed for 2 years from early pregnancy. Results. Blood cadmium and urinary cadmium were correlated with iron status throughout the study period. Urinary cadmium increased longitudinally among women with exhausted iron stores during their pregnancy. The increase in urinary cadmium with age was more pronounced in multiparous than in nulliparous women. Conclusions. Iron deficiency during pregnancy leads to increased cadmium absorption and body burden. Multiparous women exhibit additional increases with increasing age.
Analysis of a Population-Based Pneumocystis carinii Pneumonia Index as an Outcome Measure of Access and Quality of Care for the Treatment of HIV Disease
Authors: Arno Peter S. , Gourevitch Marc N. , Drucker Ernest , Fang Jing , Goldberg Clara , Memmott Margaret , Bonuck Karen , Deb Nandini , Schoenbaum Ellie 
Published: December 2008

Objectives. A population-based Pneumocystis carinii pneumonia (PCP) Index was developed in New York City to identify geographic areas and subpopulations at increased risk for PCP. Methods. A zip code–level PCP Index was created from AIDS surveillance and hospital discharge records and defined as (number of PCP-related hospitalizations)/(number of persons living with AIDS). Results. In 1997, there were 2262 hospitalizations for PCP among 39 740 persons living with AIDS in New York City (PCP Index = .05691). PCP Index values varied widely across neighborhoods with high AIDS prevalence (West Village = .02532 vs Central Harlem = .08696). Some neighborhoods with moderate AIDS prevalence had strikingly high rates (Staten Island = .14035; northern Manhattan = .08756). Conclusions. The PCP Index highlights communities in particular need of public health interventions to improve HIV-related service delivery. (Am J Public Health. 2002;92:395–398)
Improving the Health of Infants on Medicaid by Collocating Special Supplemental Nutrition Clinics With Managed Care Provider Sites
Authors: Kendal Alan P. , Peterson Alwin , Manning Claudine , Xu Fujie , Neville Loretta J. , Hogue Carol 
Published: December 2008

Objectives. This study tested whether collocation of Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinics at managed care provider sites improved health care for infants enrolled in Medicaid and WIC. Methods. Weights and immunization rates were studied for the 1997 birth cohort of African American infants enrolled in WIC and Medicaid in Detroit, Mich. Infants using traditional WIC clinics and health services were compared with those enrolled under Medicaid in 2 managed care organizations (MCOs), of whom about half obtained WIC services at MCO provider sites. Results. Compared with other infants, those who used collocated WIC sites either were closer to their age-appropriate weight or had higher immunization rates when recertified by WIC after their first birthday. Specific benefits (weight gain or immunizations) varied according to the priorities at the collocated sites operated by the 2 MCOs. Conclusions. Collocation of WIC clinics at MCO sites can improve health care of low-income infants. However specific procedures for cooperation between WIC staff and other MCO staff are required to achieve this benefit. (Am J Public Health. 2002;92:399–403)
Smooth Moves: Bar and Nightclub Tobacco Promotions That Target Young Adults
Authors: Sepe Edward , Ling Pamela M. , Glantz Stanton A. 
Published: December 2008

Objectives. This article describes the tobacco industry's use of bars and nightclubs to encourage smoking among young adults. Methods. Previously secret tobacco industry marketing documents were analyzed. Results. Tobacco industry bar and nightclub promotions in the 1980s and 1990s included aggressive advertising, tobacco brand–sponsored activities, and distribution of samples. Financial incentives for club owners and staff were used to encourage smoking through peer influence. Increased use of these strategies occurred concurrently with an increase in smoking among persons aged 18 through 24 years. Conclusions. The tobacco industry's bar and nightclub promotions are not yet politically controversial and are not regulated by the 1998 Master Settlement Agreement between the industry and the states. Tobacco control advocates should include young adults in research and advocacy efforts and should design interventions to counter this industry strategy to solidify smoking patterns and recruit young adult smokers.
Timing of Insurance Coverage and Use of Prenatal Care Among Low-Income Women
Authors: Egerter Susan , Braveman Paula , Marchi Kristen 
Published: December 2008

Objectives. This study examined the relationship between timing of insurance coverage and prenatal care among low-income women. Methods. Timeliness of prenatal care initiation and adequacy of number of visits were studied among 5455 low-income participants in a larger cross-sectional statewide survey of postpartum women in California during 1994–1995. Results. Although only 2% of women remained uninsured throughout pregnancy, one fifth lacked coverage during the first trimester. Rates of untimely care were highest (≥64%) among women who were uninsured throughout their pregnancy or whose coverage began after the first trimester; rates were lowest (about 10%) among women who obtained coverage during the first trimester. Women who first obtained Medi-Cal coverage during pregnancy were at low risk of having too few visits. Conclusions. Timing of prenatal coverage should be considered in research on the relationship between coverage and care use among low-income women. Earlier studies that relied solely on principal payer information, without data on when coverage began, may have led to inaccurate inferences about lack of coverage as a barrier to prenatal care.
Neighborhood Context and Youth Cardiovascular Health Behaviors
Authors: Lee Rebecca E. , Cubbin Catherine 
Published: December 2008

Objectives. This study sought to determine the relationships between race/ethnicity, socioeconomic status (SES), and cardiovascular health behaviors among youths and whether neighborhood characteristics are associated with such behaviors independently of individual characteristics. Methods. Linear models determined the effects of individual and neighborhood characteristics (SES, social disorganization, racial/ethnic minority concentration, urbanization) on dietary habits, physical activity, and smoking among 8165 youths aged 12 to 21 years. Results. Low SES was associated with poorer dietary habits, less physical activity, and higher odds of smoking. After adjustment for SES, Black race was associated with poorer dietary habits and lower odds of smoking. Hispanic ethnicity was associated with healthier dietary habits, lower levels of physical activity, and lower odds of smoking than non-Hispanic ethnicity. Low neighborhood SES and high neighborhood social disorganization were independently associated with poorer dietary habits, while high neighborhood Hispanic concentration and urbanicity were associated with healthier dietary habits. Neighborhood characteristics were not associated with physical activity or smoking. Conclusions. Changes in neighborhood social structures and policies that reduce social inequalities may enhance cardiovascular health behaviors. (Am J Public Health. 2002;92:428–436)
Subgroups of Refusers in a Disability Prevention Trial in Older Adults: Baseline and Follow-Up Analysis
Authors: Minder Christoph E. , Müller Tobias , Gillmann Gerhard , Beck John C. , Stuck Andreas E. 
Published: December 2008

Objectives. This study explored differences between refusers and participants in a longitudinal study with extensive baseline and follow-up information. Methods. Results of a trial comparing 791 participants and 401 community-residing older adults who refused to participate in a study concerning preventive home visits were examined. Information was collected from interviews, insurance records, and government files. Results. Despite similarities in terms of age, sex, and self-perceived health at baseline, 3-year follow-up data indicated that refusers had a 1.58-fold higher risk of entering a nursing home than participants. There were additional differences between refusers and participants when refusers were categorized in 4 subgroups based on self-reported reason for refusal (too ill, too healthy, no interest, and other reasons). Conclusions. Future studies should include follow-up data to allow comparisons between refusers and participants and should address the presence of multiple subgroups of refusers. (Am J Public Health. 2002;92:445–450)
Diabetes, Diversity, and Disparity: What Do We Do With the Evidence?
Authors: Black Sandra A. 
Published: December 2008

The US Department of Health and Human Services has developed an initiative called “Eliminating Racial and Ethnic Disparities in Health,” which parallels Healthy People 2010, the nation's health goals for the next decade. The initiative focuses on areas of health disparity that are known to affect racially and ethnically diverse groups of the population yet hold the promise of improvement. The first step to addressing such health inequities is to understand the scope and nature of the diseases that contribute to such disparities. This commentary reviews the epidemiology and consequences of type 2 diabetes, particularly as it is manifested in socially and culturally diverse groups, and offers recommendations for actions to address the disparities resulting from diabetes.
Considerations for Community-Based Research With African American Women
Authors: Jackson Fleda Mask 
Published: December 2008

Although community-based research is intended to be culturally sensitive, more advanced consideration of the impact of race, gender, and class is needed for health disparity research involving women of color. Research processes must permit the simultaneous disclosures of the racial, gender, and class identities among women of color that are assumed and imposed. The authoritative knowledge that women of color have about their lives and their health should form the basis for collaboration between researchers and study participants. The dissemination of research findings to study participants, and dialogue on those findings, is imperative for the development of sustainable interventions.
Papanicolaou Test Use Among Reproductive-Age Women at High Risk for Cervical Cancer: Analyses of the 1995 National Survey of Family Growth
Authors: Hewitt Maria , Devesa Susan , Breen Nancy 
Published: December 2008

Objectives. This study assessed the relationship between risk factors for cervical cancer and Papanicolaou (Pap) test use within the past year among reproductive-age women. Methods. The 1995 National Survey of Family Growth, a demographic and reproductive health survey of 10 847 women aged 15 to 44, was analyzed with multiple logistic regression. Results. Of the women, 62% reported having had a Pap test within the past year. Use was significantly higher among women with risk factors and among African American women. Use was significantly lower among uninsured, poor, and foreign-born women and among women with lower educational attainment and of “other” race/ethnicity. Conclusions. Strategies to improve Pap test use include (1) educational campaigns that inform women of cervical cancer risk factors and encourage screening and (2) increased support for programs that expand access to Pap tests.
America's Affordable Housing Crisis: A Contract Unfulfilled
Authors: Freeman Lance 
Published: December 2008

For many poor Americans, having a decent home and suitable living environment remains a dream. This lack of adequate housing is not only a burden for many of the poor, but it is harmful to the larger society as well, because of the adverse effects of inadequate housing on public health. Not only is the failure to provide adequate housing shortsighted from a policy perspective, but it is also a failure to live up to societal obligations. There is a societal obligation to meet the housing needs of everyone, including the most disadvantaged. Housing assistance must become a federally-funded entitlement.
Clean Indoor Air: Advances in California, 1990–1999
Authors: Gilpin Elizabeth A. , Farkas Arthur J. , Emery Sherry L. , Ake Christopher F. , Pierce John P. 
Published: December 2008

Objectives. This study assessed progress in achieving clean indoor air in California. Methods. Data were from large, cross-sectional population-based surveys (1990–1999). Results. Indoor workers reporting smoke-free workplaces increased from 35.0% (95% confidence interval [CI] = 33.7, 36.3) in 1990 to 93.4% (95% CI = 92.6, 94.2) in 1999. Exposure of nonsmoking indoor workers to secondhand tobacco smoke decreased from 29.0% (95% CI = 27.2, 30.8) to 15.6% (95% CI = 14.1, 17.1). Adults with smoke-free homes increased from 37.6 % (95% CI = 35.1, 40.1) in 1992 to 73.7% (95% CI = 73.2, 74.2) in 1999; nearly half of smokers in 1999 had smoke-free homes. In 1999, 82.2% (95% CI = 81.5, 82.9) of children and adolescents (0–17 years) had smoke-free homes, up from 38.0% (95% CI = 35.1, 40.9) in 1992. Conclusions. California's advances highlight an important opportunity for tobacco control.