bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Health Status Indicators in Chicago: Are Black–White Disparities Worsening?
Authors: Margellos Helen , Silva Abigail , Whitman Steven 
Published: December 2008

Objectives. This study examined Chicago residents’ progress toward the Healthy People 2000 goal of reducing racial disparities in health and compared the results with a recent analysis of US data. Methods. Non-Hispanic Black–to–non-Hispanic White rate ratios were computed for 14 health status indicators for 1990 and for 1998. Results. Nationally and in Chicago, indicators for both Blacks and Whites improved between 1990 and 1998; however, Whites consistently fared better. Nationally, gaps narrowed on 10 indicators; for Chicago, they widened on 10 indicators. Conclusions. Nationally, there is apparent progress in reducing Black–White disparities; this is not true for Chicago. Whether failure to reduce racial disparities is unique to Chicago or is common to other urban centers remains an open question with important implications.
Racial/Ethnic Differences in Cigarette Smoking Initiation and Progression to Daily Smoking: A Multilevel Analysis
Authors: Kandel Denise B. , Kiros Gebre-Egziabher , Schaffran Christine , Hu Mei-Chen 
Published: December 2008

Objectives. We sought to identify individual and contextual predictors of adolescent smoking initiation and progression to daily smoking by race/ethnicity. Methods. We used data from the National Longitudinal Study of Adolescent Health to estimate the effects of individual (adolescent, family, peer) and contextual (school and state) factors on smoking onset among nonsmokers (n = 5374) and progression to daily smoking among smokers (n = 4474) with multilevel regression models. Results. Individual factors were more important predictors of smoking behaviors than were contextual factors. Predictors of smoking behaviors were mostly common across racial/ethnic groups. Conclusions. The few identified racial/ethnic differences in predictors of smoking behavior suggest that universal prevention and intervention efforts could reach most adolescents regardless of race/ethnicity. With 2 exceptions, important contextual factors remain to be identified.
Family Planning in the Balance
Authors: Hwang Ann C. , Stewart Felicia H. 
Published: December 2008

Family planning has long been acknowledged as an effective public health intervention. In recent years, however, family planning has come under increased scrutiny from conservative politicians and constituents. National US policies instituted since 2001 are resulting in cutbacks in family planning programs worldwide. In the long run, these conservative initiatives may set back several decades of progress in reproductive health and reproductive rights. In promoting an ideologically driven approach to sexual and reproductive health, the recent policy developments threaten to subvert ethical standards of medical care and the principle of evidence-based policy.
Using Peer Recruitment and OraSure to Increase HIV Testing
Authors: Vargo Sue , Agronick Gail , O’Donnell Lydia , Stueve Ann 
Published: December 2008

We describe a community-based pilot study to boost HIV testing in a minority community through social network recruitment and a noninvasive HIV testing methodology. Over an 11-month period, the number of test takers at the intervention site increased by 71.7%, and the proportions of test takers with risk factors similar to those of peer recruiters (heterosexual sex and multiple partners) increased by 24.2% and 19.5%, respectively. At a comparison site, testing remained stable, while the proportion of test takers reporting heterosexual sex and multiple partners decreased by 42.5% and 21.8%, respectively. The use of a social network recruitment strategy in combination with an oral HIV test shows promise in increasing testing and in targeting populations.
Ethnicity/Race, Paranoia, and Hospitalization for Mental Health Problems Among Men
Authors: Whaley Arthur L. 
Published: December 2008

Objectives. I tested the hypothesis that Black men with high levels of distrust (i.e., mild paranoia) are at greater risk of hospitalization for mental health problems than their White counterparts. Methods. Secondary analysis was conducted of data from a subsample of 180 men in an epidemiological study. Mental health hospitalization was the outcome and ethnicity/race, mild paranoia, and their interaction were main predictors in a logistic regression analysis. The ethnicity/race by mild paranoia interaction tested the study hypothesis. Results. The ethnicity/race by mild paranoia interaction was statistically significant. Contrary to the hypothesis, Black men with mild paranoia were less likely to be hospitalized. Conclusions. Black men’s lack of trust regarding the mental health system may cause them not to seek services. Factors critical to increasing their trust are acknowledgment of racial biases in the mental health system and sincere efforts to eliminate racial disparities in mental health treatment.
Aiming at “De Feet” and Diabetes: A Rural Model to Increase Annual Foot Examinations
Authors: Beem Susie E. , Machala Margaret , Holman Craig , Wraalstad Randal , Bybee Ann 
Published: December 2008

Something is afoot in south central Idaho. After 2 years of work, the percentage of people with diabetes receiving recommended annual foot examinations has increased by 13.8%, exceeding the state average. This turnaround, from being the region with the lowest percentage of foot examinations in the state, was made possible when South Central District Health joined diabetes coalition members to develop a comprehensive program that maximizes limited resources in the rural, 8-county service area. Key program components include (1) development of a curriculum on CD-ROM called 2 Minute Diabetes Foot Examination, (2) training area physicians and nurses in the curriculum, (3) incorporating the curriculum into the nursing program at the local college, (4) offering free foot-screening clinics to targeted populations, and (5) conducting public education and outreach.
Rural Health Disparities, Population Health, and Rural Culture
Authors: Hartley David 
Published: December 2008

In this commentary, I place the maturing field of rural health research and policy in the context of the rural health disparities documented in Health United States, 2001, Urban and Rural Health Chartbook. Because of recent advances in our understanding of the determinants of health, the field must branch out from its traditional focus on access to health care services toward initiatives that are based on models of population health. In addition to presenting distinct regional differences, the chartbook shows a pattern of risky health behaviors among rural populations that suggest a “rural culture” health determinant. This pattern suggests that there may be environmental and cultural factors unique to towns, regions, or United States Department of Agriculture (USDA) economic types that affect health behavior and health.
Person and Place: The Compounding Effects of Race/Ethnicity and Rurality on Health
Authors: Probst Janice C. , Moore Charity G. , Glover Saundra H. , Samuels Michael E. 
Published: December 2008

Rural racial/ethnic minorities constitute a forgotten population. The limited research addressing rural Black, Hispanic, and American Indian/Alaska Native populations suggests that disparities in health and in health care access found among rural racial/ethnic minority populations are generally more severe than those among urban racial/ethnic minorities. We suggest that disparities must be understood as both collective and contextual phenomena. Rural racial/ethnic minority disparities in part stem from the aggregation of disadvantaged individuals in rural areas. Disparities also emerge from a context of limited educational and economic opportunity. Linking public health planning to the education and economic development sectors will reduce racial/ethnic minority disparities while increasing overall well-being in rural communities.
Fatal Occupational Injury Rates in Southern and Non-Southern States, by Race and Hispanic Ethnicity
Authors: Richardson David B. , Loomis Dana , Bena James , Bailer A. John 
Published: December 2008

Objectives. We investigated fatal occupational injury rates in the United States by race and Hispanic ethnicity during the period 1990–1996. Methods. Fatalities were identified by means of the national traumatic occupational fatalities surveillance system. Fatal occupational injury rates were calculated by race/ethnicity and region using US-census–based workforce estimates. Results. Non-Hispanic Black men in the South had the highest fatal occupational injury rate (8.5 per 100000 worker-years), followed by Hispanic men in the South (7.9 per 100000 worker-years). Fatal injury rates for Hispanic men increased over the study period, exceeding rates for non-Hispanic Black men in the latter years of observation. Conclusions. These data suggest a change in the demographics of fatal occupational injuries in the United States. Hispanic men in the South appear to be emerging as the group with the nation’s highest unintentional fatal occupational injury rate.
Barriers to Health Care Access Among the Elderly and Who Perceives Them
Authors: Fitzpatrick Annette L. , Powe Neil R. , Cooper Lawton S. , Ives Diane G. , Robbins John A. 
Published: December 2008

Objectives. We evaluated self-perceived access to health care in a cohort of Medicare beneficiaries. Methods. We identified patterns of use and barriers to health care from self-administered questionnaires collected during the 1993–1994 annual examination of the Cardiovascular Health Study. Results. The questionnaires were completed by 4889 (91.1%) participants, with a mean age of 76.0 years. The most common barriers to seeing a physician were the doctor’s lack of responsiveness to patient concerns, medical bills, transportation, and street safety. Low income, no supplemental insurance, older age, and female gender were independently related to perceptions of barriers. Race was not significant after adjustment for other factors. Conclusions. Psychological and physical barriers affect access to care among the elderly; these may be influenced by poverty more than by race.
Changes in Racial Differences in Use of Medical Procedures and Diagnostic Tests Among Elderly Persons: 1986–1997
Authors: Escarce José J. , McGuire Thomas G. 
Published: December 2008

Objectives. We used 1997 Medicare data to replicate an earlier study that used data from 1986 to examine racial differences in usage of specific medical procedures or tests among elderly persons. Methods. We used 1997 physician claims data to obtain a random sample of 5% of Medicare beneficiaries aged 65 years and older. We used this sample to study 30 procedures and tests that were analyzed in the 1986 study, as well as several new procedures that became more widely used in the early 1990s. Results. Racial differences remain in the rates of use of these procedures; in general, Blacks have lower rates of use than do Whites. Between 1986 and 1997, the ratio of White to Black use moved in favor of Blacks for all but 4 of the established procedures studied. Conclusions. The White–Black gap in health care use under Medicare is narrowing.
Predictors of Beginning and Ending Caregiving During a 3-Year Period in a Biracial Community Population of Older Adults
Authors: McCann Judith J. , Hebert Liesi E. , Bienias Julia L. , Morris Martha Clare , Evans Denis A. 
Published: December 2008

Objectives. We sought to identify predictors of beginning and ending caregiving. Methods. At baseline and 3-year follow-up, we interviewed 4245 community residents (61.4% Black, 38.4% White, 0.20% other) aged 65 years or older. We used logistic regression to test predictors of beginning caregiving among baseline noncaregivers and of continuing caregiving among baseline caregivers. Results. After control for demographic variables, physically healthier individuals were significantly more likely to become caregivers and to continue caregiving. Mental health had little influence on beginning caregiving, but declining mental heath was associated with continuing caregiving. Conclusions. Maintenance of physical health and function is essential to the ability of older adults to begin and to continue caregiving. Studies that compare the health of current caregivers with that of noncaregivers may substantially underestimate the impact of caregiving on health.
PLUMBISM REINVENTED
Authors: Fassin Didier , Naudé Anne-Jeanne 
Published: December 2008

Although the history of childhood lead poisoning started a century ago in the United States, the first French cases were identified in 1985. Instead of merely adopting knowledge accumulated for decades, the public health professionals and activists involved had to reestablish, against incredulity from medical authorities and resistance from policymakers, all the evidence: that children were the main group concerned; that cases were not isolated but part of an epidemic; that wall paint in old, dilapidated apartments was the source of contamination; and that poor housing conditions, and not cultural practices, were responsible for the high incidence in African families. This “reinvention” illustrates more general sociological phenomena: discontinuities in medical history, strength of culturalist prejudices toward immigrants, resistance to socioeconomic interpretations of disease, and struggles between different perspectives in public health. The history shows that public health is the product of intellectual and political struggles to impose visions of the world.
The Making and Breaking of Yugoslavia and Its Impact on Health
Authors: Kunitz Stephen J. 
Published: December 2008

The creation of nation-states in Europe has generally been assumed to be intrinsic to modernization and to be irreversible. The disintegration of Czechoslovakia, the Soviet Union, and Yugoslavia demonstrates that the process is not irreversible. I argue that in the case of Yugoslavia, (1) disintegration was caused by the interaction between domestic policies with regard to nationalities and integration into the global economy and (2) the impact of the disintegration of the federation on health care and public health systems has been profound. Improving and converging measures of mortality before the collapse gave way to increasing disparities afterward. The lesson is that processes of individual and social modernization do not result in improvements in health and well-being that are necessarily irreversible or shared equally.
Occupational Health Research in Developing Countries: A Partner for Social Justice
Authors: Nuwayhid Iman A. 
Published: December 2008

Occupational health remains neglected in developing countries because of competing social, economic, and political challenges. Occupational health research in developing countries should recognize the social and political context of work relations, especially the fact that the majority of developing countries lack the political mechanisms to translate scientific findings into effective policies. Researchers in the developing world can achieve tangible progress in promoting occupational health only if they end their professional isolation and examine occupational health in the broader context of social justice and national development in alliance with researchers from other disciplines. An occupational health research paradigm in developing countries should focus less on the workplace and more on the worker in his or her social context.
Environmental Justice, Cumulative Environmental Risk, and Health Among Low- and Middle-Income Children in Upstate New York
Authors: Evans Gary W. , Marcynyszyn Lyscha A. 
Published: December 2008

Objectives. We documented inequitable, cumulative environmental risk exposure and health between predominantly White low-income and middle-income children residing in rural areas in upstate New York. Methods. Cross-sectional data for 216 third- through fifth-grade children included overnight urinary neuroendocrine levels, noise levels, residential crowding (people/room), and housing quality. Results. After control for income, maternal education, family structure, age, and gender, cumulative environmental risk exposure (0–3) (risk >1 SD above the mean for each singular risk factor [0, 1]) was substantially greater for low-income children. Cumulative environmental risk was positively correlated with elevated overnight epinephrine, norepinephrine, and cortisol in the low-income sample but not in the middle-income sample. Conclusions. Cumulative environmental risk exposure among low-income families may contribute to bad health, beginning in early childhood.
High-Intensity Targeted Screening for Elevated Blood Lead Levels Among Children in 2 Inner-City Chicago Communities
Authors: Dignam Timothy A. , Evens Anne , Eduardo Eduard , Ramirez Shokufeh M. , Caldwell Kathleen L. , Kilpatrick Nikki , Noonan Gary P. , Flanders W. Dana , Meyer Pamela A. , McGeehin Michael A. 
Published: December 2008

Objectives. We assessed the prevalence of elevated blood lead levels (≥ 10 micrograms of lead per deciliter of blood), risk factors, and previous blood lead testing among children in 2 high-risk Chicago, Ill, communities. Methods. Through high-intensity targeted screening, blood lead levels were tested and risks were assessed among a representative sample of children aged 1 to 5 years who were at risk for lead exposure. Results. Of the 539 children who were tested, 27% had elevated blood lead levels, and 61% had never been tested previously. Elevated blood lead levels were associated with chipped exterior house paint. Conclusions. Most of the children who lived in these communities—where the prevalence for elevated blood lead levels among children was 12 times higher than the national prevalence—were not tested for lead poisoning. Our findings highlight the need for targeted community outreach that includes testing blood lead levels in accordance with the American Academy of Pediatrics’ recommendations.
Racial and Ethnic Differences in the Seroprevalence of 6 Infectious Diseases in the United States: Data From NHANES III, 1988–1994
Authors: McQuillan Geraldine M. , Kruszon-Moran Deanna , Kottiri Benny J. , Curtin Lester R. , Lucas Jacqueline W. , Kington Raynard S. 
Published: December 2008

Objectives. We examined racial/ethnic differences in the seroprevalence of selected infectious agents in analyses stratified according to risk categories to identify patterns and to determine whether demographic, socioeconomic, and behavioral characteristics explain these differences. Methods. We analyzed data from the third National Health and Nutrition Examination Survey, comparing differences among groups in regard to the prevalence of infection with hepatitis A, B, and C viruses, Toxoplasma gondii, Helicobacter pylori, and herpes simplex virus type 2. Results. Racial/ethnic differences were greater among those in the low-risk category. In the case of most infectious agents, odds associated with race/ethnicity were almost 2 times greater in that category than in the high-risk category. Conclusions. Stratification and adjustment for socioeconomic factors reduced or eliminated racial/ethnic differences in the prevalence of infection in the high-risk but not the low-risk group, wherein race/ethnicity remained significant and might have been a surrogate for unmeasured risk factors.
Effects of Restaurant and Bar Smoking Regulations on Exposure to Environmental Tobacco Smoke Among Massachusetts Adults
Authors: Albers Alison B. , Siegel Michael , Cheng Debbie M. , Rigotti Nancy A. , Biener Lois 
Published: December 2008

Objectives. We examined the association of local restaurant and bar regulations with self-reported exposure to environmental tobacco smoke among adults. Methods. Data were derived from a telephone survey involving a random sample of Massachusetts households. Results. Compared with adults from towns with no restaurant smoking restrictions, those from towns with strong regulations had more than twice the odds of reporting nonexposure to environmental tobacco smoke (odds ratio [OR]=2.74; 95% confidence interval [CI]=1.97, 3.80), and those from towns with some restrictions had 1.62 times the odds of reporting nonexposure (OR=1.62; 95% CI=1.29, 2.02). Bar smoking bans had even greater effects on exposure. Conclusions. Strong local clean indoor air regulations were associated with lower levels of reported exposure to environmental tobacco smoke in restaurants and bars.
Disparities in Smoking Cessation Between African Americans and Whites: 1990–2000
Authors: King Gary , Polednak Anthony , Bendel Robert B. , Vilsaint My C. , Nahata Sunny B. 
Published: December 2008

Objectives. We examined disparities in smoking cessation rates between African Americans and Whites from 1990 through 2000. Methods. We performed an analysis of smoking cessation with data from the National Health Interview Surveys of 30660 African Americans and 209828 Whites, 18 to 64 years old, with adjustment for covariates in multiple logistic regression models. Results. Whites were significantly more likely than African Americans to be former smokers, and this disparity in the quit ratio persisted from 1990 through 2000. After adjustment for covariates, disparities were substantially reduced especially among women. Among former smokers, African Americans were significantly more likely than Whites to have quit successfully within the past 10 years. Conclusions. Statistical adjustment for covariates reduces African American–White disparities in quit ratios, and recent cessation patterns suggest possible future reductions in disparities.
Correlates of Sex Trading Among Drug-Using Men Who Have Sex With Men
Authors: Newman Peter A. , Rhodes Fen , Weiss Robert E. 
Published: December 2008

Objectives. We examined correlates of trading sex for money, drugs, and shelter, or food among drug-using men who have sex with men (MSM). Methods. Audio computer-assisted self-interviewing questionnaires were completed by 387 MSM. The association of predictors with sex trading was assessed with χ2 tests and multiple logistic regression. Results. Sex-trading prevalence was 62.5% (95% confidence interval=57.7%, 67.4%). Sex trading was associated with crack use, injection drug use, childhood maltreatment, nongay self-identification, and homelessness (adjusted odds ratios=3.72, 2.28, 2.62, 2.21, and 1.88, respectively). Conclusions. Multiple risk factors are associated with sex trading among MSM. Interventions may need to address crack and injection drug use, homelessness, and childhood maltreatment and target non–gay-identified MSM who engage in sex trading.
Effects of Macroeconomic Trends on Social Security Spending Due to Sickness and Disability
Authors: Khan Jahangir , Gerdtham Ulf-G. , Jansson Bjarne 
Published: December 2008

Objectives. We analyzed the relationship between macroeconomic conditions, measured as unemployment rate and social security spending, from 4 social security schemes and total spending due to sickness and disability. Methods. We obtained aggregated panel data from 13 Organization for Economic Cooperation and Development member countries for 1980–1996. We used regression analysis and fixed effect models to examine spending on sickness benefits, disability pensions, occupational-injury benefits, survivor’s pensions, and total spending. Results. A decline in unemployment increased sickness benefits spending and reduced disability pension spending. These effects reversed direction after 4 years of unemployment. Inclusion of mortality rate as an additional variable in the analysis did not affect the findings. Conclusions. Macroeconomic conditions influence some reimbursements from social security schemes but not total spending.