bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is Lipid-Lowering Therapy Underused by African Americans at High Risk of Coronary Heart Disease Within the VA Health Care System?
Authors: Woodard LeChauncy D. , Kressin Nancy R. , Petersen Laura A. 
Published: December 2008

Objectives. We examined whether racial differences exist in cholesterol monitoring, use of lipid-lowering agents, and achievement of guideline-recommended low-density lipoprotein (LDL) levels for secondary prevention of coronary heart disease. Methods. We reviewed charts for 1045 African American and White patients with coronary heart disease at 5 Veterans Affairs (VA) hospitals. Results. Lipid levels were obtained in 67.0% of patients. Whites and African Americans had similar screening rates and mean lipid levels. Among the 544 ideal candidates for therapy, rates of treatment and achievement of target LDL levels were similar. Conclusions. We found no disparities in cholesterol management. This absence of disparities may be the result of VA quality improvement initiatives or prescription coverage through the VA health care system.
An Approach to Studying Social Disparities in Health and Health Care
Authors: Braveman Paula A. , Egerter Susan A. , Cubbin Catherine , Marchi Kristen S. 
Published: December 2008

Objective. We explored methods and potential applications of a systematic approach to studying and monitoring social disparities in health and health care. Methods. Using delayed or no prenatal care as an example indicator, we (1) categorized women into groups with different levels of underlying social advantage; (2) described and graphically displayed rates of the indicator and relative group size for each social group; (3) identified and measured disparities, calculating relative risks and rate differences to compare each group with its a priori most-advantaged counterpart; (4) examined changes in rates and disparities over time; and (5) conducted multivariate analyses for the overall sample and “at-risk” groups to identify particular factors warranting attention. Results. We identified at-risk groups and relevant factors and suggest ways to direct efforts for reducing prenatal care disparities. Conclusions. This systematic approach should be useful for studying and monitoring disparities in other indicators of health and health care.
Hurling Alone? How Social Capital Failed to Save the Irish From Cardiovascular Disease in the United States
Authors: Kelleher C. Cecily , Lynch John , Harper Sam , Tay Joseph B. , Nolan Geraldine 
Published: December 2008

Objectives. We performed a historical review of cardiovascular risk profiles of Irish immigrants to the United States, 1850–1970, in regard to lifestyle, socio-economic circumstances, and social capital. Methods. We analyzed US Census data from 1850–1970, area-based social and epidemiological data from Boston, data from Ireland’s National Nutrition Surveillance Centre, and literature on Irish migration. Results. The Irish were consistently at increased risk of cardiovascular diseases, a risk that related initially to material deprivation, across the life course of at least 2 generations. Conclusions. The principal difference between the Irish and other disadvantaged immigrant groups, such as the Italians, was dietary habits influenced by experiences during the Irish famine. Although there was a psychosocial component to the disadvantage and discrimination they experienced as an ethnic group, the Irish also exhibited strong community networks and support structures that might have been expected to counteract discrimination’s negative effects. However, the Irish’s high levels of social capital were not protective for cardiovascular disease.
Socioeconomic Disadvantage, Parenting Responsibility, and Women’s Smoking in the United States
Authors: Jun Hee-Jin , Subramanian S.V. , Gortmaker Steven , Kawachi Ichiro 
Published: December 2008

Objectives. We carried out analyses of smoking in relation to poverty and child care responsibility among women aged 18–54 years residing in the United States. Methods. With data from the Behavioral Risk Factor Surveillance System, we assessed the interaction effects of poverty and living with young children on maternal smoking behavior among 61 700 women aged 18–54 years in 4 different racial/ethnic groups. Results. For non-White racial/ethnic groups, the prevalence of smoking among women with small children in the household was lower than that among women without small children. However, White women were more likely to smoke if they were poor and living with small children (odds ratio=1.14, 95% confidence interval=1.03, 1.26). Conclusions. These results suggest that child care responsibility confers an increased risk of smoking among low-income White women.
Undoing an Epidemiological Paradox: The Tobacco Industry’s Targeting of US Immigrants
Authors: Acevedo-Garcia Dolores , Barbeau Elizabeth , Bishop Jennifer Anne , Pan Jocelyn , Emmons Karen M. 
Published: December 2008

Objectives. We sought to ascertain whether the tobacco industry has conceptualized the US immigrant population as a separate market. Methods. We conducted a content analysis of major tobacco industry documents. Results. The tobacco industry has engaged in 3 distinct marketing strategies aimed at US immigrants: geographically based marketing directed toward immigrant communities, segmentation based on immigrants’ assimilation status, and coordinated marketing focusing on US immigrant groups and their countries of origin. Conclusions. Public health researchers should investigate further the tobacco industry’s characterization of the assimilated and non-assimilated immigrant markets, and its specific strategies for targeting these groups, in order to develop informed national and international tobacco control countermarketing strategies designed to protect immigrant populations and their countries of origin.
Out of the Ashes: The Life, Death, and Rebirth of the “Safer” Cigarette in the United States
Authors: Fairchild Amy , Colgrove James 
Published: December 2008

From 1964 through the early 1980s, both federal and voluntary agencies endorsed the concept of “safer” cigarettes. Beginning in the mid-1980s, several factors, including revelations of tobacco industry malfeasance, the development of nicotine replacement therapy, and the reconceptualization of smoking as a chronic disease, led to “safer” cigarettes being discredited. In the past few years, some public health professionals have begun to reconsider the viability of developing such products. The issue before us is stark: will a commitment to limiting the toll exacted by smoking preclude the tolerance of a product that while not safe may possibly be safer?
Preventing 3 Million Premature Deaths and Helping 5 Million Smokers Quit: A National Action Plan for Tobacco Cessation
Authors: Fiore Michael C. , Croyle Robert T. , Curry Susan J. , Cutler Charles M. , Davis Ronald M. , Gordon Catherine , Healton Cheryl , Koh Howard K. , Orleans C. Tracy , Richling Dennis , Satcher David , Seffrin John , Williams Christine , Williams Larry N. , Keller Paula A. , Baker Timothy B. 
Published: December 2008

In August 2002, the Subcommittee on Cessation of the Interagency Committee on Smoking and Health (ICSH) was charged with developing recommendations to substantially increase rates of tobacco cessation in the United States. The subcommittee’s report, A National Action Plan for Tobacco Cessation, outlines 10 recommendations for reducing premature morbidity and mortality by helping millions of Americans stop using tobacco. The plan includes both evidence-based, population-wide strategies designed to promote cessation (e.g., a national quitline network) and a Smokers’ Health Fund to finance the programs (through a $2 per pack excise tax increase). The subcommittee report was presented to the ICSH (February 11, 2003), which unanimously endorsed sending it to Secretary Thompson for his consideration. In this article, we summarize the national action plan.
The “Global Settlement” With the Tobacco Industry: 6 Years Later
Authors: Givel Michael , Glantz Stanton A. 
Published: December 2008

On June 20, 1997 a group of attorneys and health advocates proposed a “global settlement” of all public and private litigation against the tobacco industry. This agreement was controversial, and the subsequent implementing legislation was defeated. We sought to determine whether the global settlement represented a “missed opportunity” or a dead end. We compared the global settlement with subsequent laws, regulations, settlements, and judgments against the tobacco industry and found that other than Food and Drug Administration regulation of tobacco, tobacco control advocates have achieved many of the policies included in the global settlement and several beyond it. The policies that have been developed since 1997 have advanced tobacco control substantially, often beyond the provisions of the global settlement.
Effects of Childhood Socioeconomic Circumstances on Persistent Smoking
Authors: Jefferis Barbara J. M. H. , Power Chris , Graham Hilary , Manor Orly 
Published: December 2008

Objectives. We investigated whether socioeconomic circumstances at different life stages influence persistent smoking. Methods. We followed a British birth cohort (all births between March 3 and 9, 1958) for 41 years to examine the influence of childhood and adulthood socioeconomic position on persistent smoking in adulthood (n = 6541). Results. Persistent smoking (19% of participants, n = 1216) showed strong social gradients with both childhood and adulthood socioeconomic measures. Among men, the association with childhood socioeconomic circumstances was no longer significant after we adjusted for adulthood socioeconomic circumstances; however, among women, the adjusted odds of persistent smoking increased by 8% for each unit increase across a 16-point childhood score. Conclusions. Childhood socioeconomic circumstances predicted persistent smoking among women in our cohort, a finding that highlights the importance of influences on the development of persistent smoking across the life course.
Town-Level Characteristics and Smoking Policy Adoption in Massachusetts: Are Local Restaurant Smoking Regulations Fostering Disparities in Health Protection?
Authors: Skeer Margie , George Sarah , Hamilton William L. , Cheng Debbie M. , Siegel Michael 
Published: December 2008

Objectives. We identified and quantified differences in sociodemographic characteristics of communities relative to the strength of local restaurant smoking regulations in Massachusetts. Methods. We examined the relationship between the strength of the 351 local restaurant smoking regulations in Massachusetts and a number of town-level characteristics, using a multinomial logistic regression model. Results. Characteristics important to the adoption of stronger restaurant smoking regulations included higher education and per capita income, geographic region, voter support for a state cigarette tax initiative, board of health funding to promote clean indoor air policymaking, and the presence of a bordering town with a strong regulation. Conclusions. The current pattern of smoke-free restaurant policy enactment fosters socioeconomic and geographic disparities in health protection, undermining an important national health goal.
From Adolescence to Young Adulthood: Racial/Ethnic Disparities in Smoking
Authors: Ellickson Phyllis L. , Orlando Maria , Tucker Joan S. , Klein David J. 
Published: December 2008

Objectives. We used data gathered from 6259 youths between the ages of 13 and 23 years to compare trends in smoking among 4 racial/ethnic groups. Methods. We weighted trend data to represent baseline respondent characteristics and evaluated these data with linear contrasts derived from multiple regression analyses. Results. Although African Americans exhibited higher initiation rates than Whites, they exhibited consistently lower rates of regular smoking than both Whites and Hispanics. This seeming anomaly was explained by African Americans’ lower rates of transition to regular smoking and greater tendency to quit. Racial/ethnic disparities were accounted for by differences in pro-smoking influences. Conclusions. Reducing racial/ethnic disparities in smoking may require reducing differences in the psychosocial factors that encourage smoking.
Improving the Reporting Quality of Nonrandomized Evaluations of Behavioral and Public Health Interventions: The TREND Statement
Authors: Des Jarlais Don C. , Lyles Cynthia , Crepaz Nicole ,   the TREND Group
Published: December 2008

Developing an evidence base for making public health decisions will require using data from evaluation studies with randomized and nonrandomized designs. Assessing individual studies and using studies in quantitative research syntheses require transparent reporting of the study, with sufficient detail and clarity to readily see differences and similarities among studies in the same area. The Consolidated Standards of Reporting Trials (CONSORT) statement provides guidelines for transparent reporting of randomized clinical trials. We present the initial version of the Transparent Reporting of Evaluations with Nonrandomized Designs (TREND) statement. These guidelines emphasize the reporting of theories used and descriptions of intervention and comparison conditions, research design, and methods of adjusting for possible biases in evaluation studies that use nonrandomized designs.
Design and Analysis of Group-Randomized Trials: A Review of Recent Practices
Authors: Varnell Sherri P. , Murray David M. , Janega Jessica B. , Blitstein Jonathan L. 
Published: December 2008

We reviewed group-randomized trials (GRTs) published in the American Journal of Public Health and Preventive Medicine from 1998 through 2002 and estimated the proportion of GRTs that employ appropriate methods for design and analysis. Of 60 articles, 9 (15.0%) reported evidence of using appropriate methods for sample size estimation. Of 59 articles in the analytic review, 27 (45.8%) reported at least 1 inappropriate analysis and 12 (20.3%) reported only inappropriate analyses. Nineteen (32.2%) reported analyses at an individual or subgroup level, ignoring group, or included group as a fixed effect. Hence increased vigilance is needed to ensure that appropriate methods for GRTs are employed and that results based on inappropriate methods are not published.
Evidence-Based Public Health: Moving Beyond Randomized Trials
Authors: Victora Cesar G. , Habicht Jean-Pierre , Bryce Jennifer 
Published: December 2008

Randomized controlled trials (RCTs) are essential for evaluating the efficacy of clinical interventions, where the causal chain between the agent and the outcome is relatively short and simple and where results may be safely extrapolated to other settings. However, causal chains in public health interventions are complex, making RCT results subject to effect modification in different populations. Both the internal and external validity of RCT findings can be greatly enhanced by observational studies using adequacy or plausibility designs. For evaluating large-scale interventions, studies with plausibility designs are often the only feasible option and may provide valid evidence of impact. There is an urgent need to develop evaluation standards and protocols for use in circumstances where RCTs are not appropriate.
The Multi-Country Evaluation of the Integrated Management of Childhood Illness Strategy: Lessons for the Evaluation of Public Health Interventions
Authors: Bryce Jennifer , Victora Cesar G. , Habicht Jean-Pierre , Vaughan J. Patrick , Black Robert E. 
Published: December 2008

The Multi-Country Evaluation of the Integrated Management of Childhood Illness (IMCI) includes studies of the effectiveness, cost, and impact of the IMCI strategy in Bangladesh, Brazil, Peru, Tanzania, and Uganda. Seven questions were addressed when the evaluation was designed: who would be in charge, through what mechanisms IMCI could affect child health, whether the focus would be efficacy or effectiveness, what indicators would be measured, what types of inference would be made, how costs would be incorporated, and what elements would constitute the plan of analysis. We describe how these questions were answered, the challenges encountered in implementing the evaluation, and the 5 study designs. The methodological insights gained can improve future evaluations of public health programs.
Pitfalls of and Controversies in Cluster Randomization Trials
Authors: Donner Allan , Klar Neil 
Published: December 2008

It is now well known that standard statistical procedures become invalidated when applied to cluster randomized trials in which the unit of inference is the individual. A resulting consequence is that researchers conducting such trials are faced with a multitude of design choices, including selection of the primary unit of inference, the degree to which clusters should be matched or stratified by prognostic factors at baseline, and decisions related to cluster subsampling. Moreover, application of ethical principles developed for individually randomized trials may also require modification. We discuss several topics related to these issues, with emphasis on the choices that must be made in the planning stages of a trial and on some potential pitfalls to be avoided.
Relative Weight and Income at Different Levels of Socioeconomic Status
Authors: Sarlio-Lähteenkorva Sirpa , Silventoinen Karri , Lahelma Eero 
Published: December 2008

Objectives. We examined the association of relative weight with individual income at different levels of socioeconomic status among gainfully employed Finnish women and men. Methods. We used a population-based survey including 2068 women and 2314 men with linked income data from a taxation register. Regression analysis was used to calculate mean income levels within educational and occupational groups. Results. Compared with their normal-weight counterparts, obese women with higher education or in upper white-collar positions had significantly lower income; a smaller income disadvantage was seen in overweight women with secondary education and in manual workers. Excess body weight was not associated with income disadvantages in men. Conclusions. Obesity is associated with a clear income disadvantage, particularly among women with higher socioeconomic status.
Policies of Inclusion
Authors: Fairchild Amy L. 
Published: December 2008

The racial politics of immigration have punctuated national discussions about immigration at different periods in US history, particularly when concerns about losing an American way of life or American population have coincided with concerns about infectious diseases. Nevertheless, the main theme running through American immigration policy is one of inclusion. The United States has historically been a nation reliant on immigrant labor and, accordingly, the most consequential public policies regarding immigration have responded to disease and its economic burdens by seeking to control the behavior of immigrants within our borders rather than excluding immigrants at our borders.
Ranking of Cities According to Public Health Criteria: Pitfalls and Opportunities
Authors: Ham Sandra A. , Levin Sarah , Zlot Amy I. , Andrews Richard R. , Miles Rebecca 
Published: December 2008

Popular magazines often rank cities in terms of various aspects of quality of life. Such ranking studies can motivate people to visit or relocate to a particular city or increase the frequency with which they engage in healthy behaviors. With careful consideration of study design and data limitations, these efforts also can assist policymakers in identifying local public health issues. We discuss considerations in interpreting ranking studies that use environmental measures of a city population’s public health related to physical activity, nutrition, and obesity. Ranking studies such as those commonly publicized are constrained by statistical methodology issues and a lack of a scientific basis in regard to design.
Cost Analysis of the Built Environment: The Case of Bike and Pedestrian Trials in Lincoln, Neb
Authors: Wang Guijing , Macera Caroline A. , Scudder-Soucie Barbara , Schmid Tom , Pratt Michael , Buchner David , Heath Gregory 
Published: December 2008

We estimated the annual cost of bike and pedestrian trails in Lincoln, Neb, using construction and maintenance costs provided by the Department of Parks and Recreation of Nebraska. We obtained the number of users of 5 trails from a 1998 census report. The annual construction cost of each trail was calculated by using 3%, 5%, and 10% discount rates for a period of useful life of 10, 30, and 50 years. The average cost per mile and per user was calculated. Trail length averaged 3.6 miles (range = 1.6–4.6 miles). Annual cost in 2002 dollars ranged from $25 762 to $248 479 (mean = $124 927; median = $171 064). The cost per mile ranged from $5735 to $54 017 (mean = $35 355; median = $37 994). The annual cost per user was $235 (range = $83–$592), whereas per capita annual medical cost of inactivity was $622. Construction of trails fits a wide range of budgets and may be a viable health amenity for most communities. To increase trail cost-effectiveness, efforts to decrease cost and increase the number of users should be considered.
Estimating Capacity Requirements for Mental Health Services After a Disaster Has Occurred: A Call for New Data
Authors: Siegel Carole E. , Laska Eugene , Meisner Morris 
Published: December 2008

Objectives. We sought to estimate the extended mental health service capacity requirements of persons affected by the September 11, 2001, terrorist attacks. Methods. We developed a formula to estimate the extended mental health service capacity requirements following disaster situations and assessed availability of the information required by the formula. Results. Sparse data exist on current services and supports used by people with mental health problems outside of the formal mental health specialty sector. There also are few systematically collected data on mental health sequelae of disasters. Conclusions. We recommend research-based surveys to understand service usage in non–mental health settings and suggest that federal guidelines be established to promote uniform data collection of a core set of items in studies carried out after disasters.
The Economic Burden of Hospitalizations Associated With Child Abuse and Neglect
Authors: Rovi Sue , Chen Ping-Hsin , Johnson Mark S. 
Published: December 2008

Objectives. This study assessed the economic burden of child abuse–related hospitalizations. Methods. We compared inpatient stays coded with a diagnosis of child abuse or neglect with stays of other hospitalized children using the 1999 National Inpatient Sample of the Healthcare Costs and Utilization Project. Results. Children whose hospital stays were coded with a diagnosis of abuse or neglect were significantly more likely to have died during hospitalization (4.0% vs 0.5%), have longer stays (8.2 vs 4.0 days), twice the number of diagnoses (6.3 vs 2.8), and double the total charges ($19 266 vs $9513) than were other hospitalized children. Furthermore, the primary payer was typically Medicaid (66.5% vs 37.0%). Conclusion. Earlier identification of children at risk for child abuse and neglect might reduce the individual, medical, and societal costs.