Template-Type: ReDIF-Article 1.0
Title: Trends in crime and the introduction of a needle exchange program
Journal: American Journal of Public Health
Author-Name: Marx, M.A.
Author-Name: Crape, B.
Author-Name: Brookmeyer, R.S.
Author-Name: Junge, B.
Author-Name: Latkin, C.
Author-Name: Vlahov, D.
Author-Name: Strathdee, S.A.
Year: 2000
Volume: 90
Issue: 12
Pages: 1933-1936
Abstract: Objectives. This study sought to determine whether introduction of a needle exchange program would be associated with increased crime rates. Methods. Trends in arrests were compared in program and nonprogram areas before and after introduction of a needle exchange program in Baltimore. Trends were modeled and compared via Poisson regression. Results. No significant differences in arrest trends emerged. Over the study period, increases in category-specific arrests in program and nonprogram areas, respectively, were as follows: drug possession, 17.7% and 13.4%; economically motivated offenses, 0.0% and 20.7%; resistance to police authority, 0.0% and 5.3%; and violent offenses, 7.2% and 8.0%. Conclusions. The lack of association of overall and type-specific arrest data with program implementation argues against the role of needle exchange programs in increasing crime rates.
Handle: RePEc:aph:ajpbhl:2000:90:12:1933-1936_3

Template-Type: ReDIF-Article 1.0
Title: Depression and the association of smoking and suicide
Journal: American Journal of Public Health
Author-Name: Sheikh, K.
Author-Name: Miller, M.J.
Author-Name: Hemenway, D.
Author-Name: Rimm, E.
Year: 2000
Volume: 90
Issue: 12
Pages: 1952
Handle: RePEc:aph:ajpbhl:2000:90:12:1952_5

Template-Type: ReDIF-Article 1.0
Title: Type of health insurance and the quality of primary care experience
Journal: American Journal of Public Health
Author-Name: Shi, L.
Year: 2000
Volume: 90
Issue: 12
Pages: 1848-1855
Abstract: Objectives. This study examined the association between type of health insurance coverage and quality of primary care as measured by its distinguishing attributes - first contact, longitudinality, comprehensiveness, and coordination. Methods. The household component of the 1996 Medical Expenditure Panel Survey was used for this study. The analysis primarily focused on subjects aged younger than 65 years who identified a usual source of care. Logistic regressions were used to examine the independent effects of insurance status on primary care attributes while individual sociodemographic characteristics were controlled for. Results. The experience of primary care varies according to insurance status. The insured are able to obtain better primary care than the uninsured, and the privately insured are able to obtain better primary care than the publicly insured. Those insured through fee-for-service coverage experience better longitudinal care and less of a barrier to access than those insured through health maintenance organizations (HMOs). Conclusions. While expanding insurance coverage is important for establishing access to care, efforts are needed to enhance the quality of primary health care, particularly for the publicly insured. Policymakers should closely monitor the quality of primary care provided by HMOs.
Handle: RePEc:aph:ajpbhl:2000:90:12:1848-1855_4

Template-Type: ReDIF-Article 1.0
Title: A survey of men who have sex with men: Mainland China
Journal: American Journal of Public Health
Author-Name: Beichuan, Z.
Author-Name: Dianchang, L.
Author-Name: Xiufang, L.
Author-Name: Tiezhong, H.
Year: 2000
Volume: 90
Issue: 12
Pages: 1949-1950
Handle: RePEc:aph:ajpbhl:2000:90:12:1949-1950_2

Template-Type: ReDIF-Article 1.0
Title: After Cairo: Women's reproductive and sexual health, rights, and empowerment
Journal: American Journal of Public Health
Author-Name: Rosenfield, A.G.
Year: 2000
Volume: 90
Issue: 12
Pages: 1838-1840
Handle: RePEc:aph:ajpbhl:2000:90:12:1838-1840_5

Template-Type: ReDIF-Article 1.0
Title: The Social Security Administration 'presumed living' search
Journal: American Journal of Public Health
Author-Name: Doody, M.M.
Author-Name: Chimes, K.
Year: 2000
Volume: 90
Issue: 12
Pages: 1948-1949
Handle: RePEc:aph:ajpbhl:2000:90:12:1948-1949_8

Template-Type: ReDIF-Article 1.0
Title: Length of stay and hospital readmission for persons with disabilities
Journal: American Journal of Public Health
Author-Name: Ottenbacher, K.J.
Author-Name: Smith, P.M.
Author-Name: Illig, S.B.
Author-Name: Fiedler, R.C.
Author-Name: Granger, C.V.
Year: 2000
Volume: 90
Issue: 12
Pages: 1920-1923
Abstract: Objectives. Length of stay (LOS) and hospital readmission for persons receiving medical rehabilitation were examined. Methods. A total of 96473 patient records (1994-1998) were analyzed. Mean age of patients was 68.97 years; 61% were female and 83% were non-Hispanic White. Results. A decrease in LOS of 6.07 days (SD=3.23) and increase in hospital readmission were found across all impairment groups (P<.001). Readmission increases tanged from 6.7% for amputations to 1.4% for orthopedic conditions. LOS was longer (2.1 days) for readmitted patients (P<.01). Age was not a significant predictor of rehospitalization. Conclusions. Understanding variables associated with rehospitalization is important as prospective payment systems are introduced for postacute care.
Handle: RePEc:aph:ajpbhl:2000:90:12:1920-1923_9

Template-Type: ReDIF-Article 1.0
Title: Epidemiology of fetal alcohol syndrome in a South African community in the Western Cape Province
Journal: American Journal of Public Health
Author-Name: May, P.A.
Author-Name: Brooke, L.
Author-Name: Gossage, J.P.
Author-Name: Croxford, J.
Author-Name: Adnams, C.
Author-Name: Jones, K.L.
Author-Name: Robinson, L.
Author-Name: Viljoen, D.
Year: 2000
Volume: 90
Issue: 12
Pages: 1905-1912
Abstract: Objectives. This study determined the characteristics of fetal alcohol syndrome in a South African community, and methodology was designed for the multidisciplinary study of fetal alcohol syndrome in developing societies. Methods. An active case ascertainment, 2-tier methodology was used among 992 first-grade pupils. A case-control design, using measures of growth, development, dysmorphology, and maternal risk, delineated characteristics of children with fetal alcohol syndrome. Results. A high rate of fetal alcohol syndrome was found in the schools - 40.5 to 46.4 per 1000 children aged 5 to 9 years - and age-specific community rates (ages 6-7) were 39.2 to 42.9. These rates are 18 to 141 times greater than in the United States. Rural residents had significantly more fetal alcohol syndrome. After control for ethnic variation, children with fetal alcohol syndrome had traits similar to those elsewhere: poor growth and development, congruent dysmorphology, and lower intellectual functioning. Conclusions. This study documented the highest fetal alcohol syndrome rate to date in an overall community population. Fetal alcohol syndrome initiatives that incorporate innovative sampling and active case ascertainment methods can be used to obtain timely and accurate data among developing populations.
Handle: RePEc:aph:ajpbhl:2000:90:12:1905-1912_5

Template-Type: ReDIF-Article 1.0
Title: The effects of race/ethnicity, income, and family structure on adolescent risk behaviors
Journal: American Journal of Public Health
Author-Name: Blum, R.W.
Author-Name: Beuhring, T.
Author-Name: Shew, M.L.
Author-Name: Bearinger, L.H.
Author-Name: Sieving, R.E.
Author-Name: Resnick, M.D.
Year: 2000
Volume: 90
Issue: 12
Pages: 1879-1884
Abstract: Objectives. The study examined the unique and combined contributions of race/ethnicity, income, and family structure to adolescent cigarette smoking, alcohol use, involvement with violence, suicidal thoughts or attempts, and sexual intercourse. Methods. Analyses were based on the National Longitudinal Study of Adolescent Health. A nationally representative sample of 7th to 12th graders participated in in-home interviews, as did a resident parent for 85.6% of the adolescent subjects. The final sample included 10803 White, Black, and Hispanic 7th to 12th graders. Results. White adolescents were more likely to smoke cigarettes, drink alcohol, and attempt suicide in the younger years than were Black and Hispanic youths. Black youths were more likely to have had sexual intercourse; both Black and Hispanic youths were more likely than White teens to engage in violence. Controlling for gender, race/ethnicity, income, and family structure together explained no more than 10% of the variance in each of the 5 risk behaviors among younger adolescents and no more than 7% among older youths. Conclusions. Findings suggest that when taken together, race/ethnicity, income, and family structure provide only limited understanding of adolescent risk behaviors.
Handle: RePEc:aph:ajpbhl:2000:90:12:1879-1884_6

Template-Type: ReDIF-Article 1.0
Title: Latino child health: Need for inclusion in the US national discourse
Journal: American Journal of Public Health
Author-Name: Zambrana, R.E.
Author-Name: Logie, L.A.
Year: 2000
Volume: 90
Issue: 12
Pages: 1827-1833
Abstract: The 'rediscovery' of poverty, as echoed in concepts of social inequality, has contributed to the goal of eliminating racial/ethnic and social class disparities in the United States. This commentary focuses on what we know about the pressing health care needs and issues relevant to Latino children and families and how extant knowledge can be linked to priority policy recommendations to ensure the inclusion of Latino health issues in the national discourse. A systematic review of the literature on Latino children and of expert opinion revealed 4 evidence-based themes focused on poverty: economic factors, family and community resources, health system factors, and pitfalls in Latino subgroup data collection. Consensus was found on 4 priority policy recommendations: (1) reduce poverty and increase access to health care coverage, (2) increase funding in targeted primary and preventive health care services, (3) provide funds needed to fully implement relevant health legislation, and (4) improve measurement and quality of data collection. If these recommendations are not instituted, the goals of Healthy People 2010 will not be achieved for the Latino population.
Handle: RePEc:aph:ajpbhl:2000:90:12:1827-1833_6

Template-Type: ReDIF-Article 1.0
Title: Serving street-dwelling individuals with psychiatric disabilities: Outcomes of a psychiatric rehabilitation clinical trial
Journal: American Journal of Public Health
Author-Name: Shern, D.L.
Author-Name: Tsemberis, S.
Author-Name: Anthony, W.
Author-Name: Lovell, A.M.
Author-Name: Richmond, L.
Author-Name: Felton, C.J.
Author-Name: Winarski, J.
Author-Name: Cohen, M.
Year: 2000
Volume: 90
Issue: 12
Pages: 1873-1878
Abstract: Objectives. This study tested a psychiatric rehabilitation approach for organizing and delivering services to street-dwelling persons with severe mental illness. Methods. Street-dwelling persons with severe mental illness were randomly assigned to the experimental program (called Choices) or to standard treatment in New York City. We assessed study participants at baseline and at 6-month intervals over 24 months, using measures of service use, quality of life, health, mental health, and social psychological status. The average deviation from baseline summary statistic was employed to assess change. Results. Compared with persons in standard treatment (n=77), members of the experimental group (n=91) were more likely to attend a day program (53% vs 27%), had less difficulty in meeting their basic needs, spent less time on the streets (55% vs 28% reduction), and spent more time in community housing (21% vs 9% increase). They showed greater improvement in life satisfaction and experienced a greater reduction in psychiatric symptoms. Conclusions. With an appropriate service model, it is possible to engage disaffiliated populations, expand their use of human services, and improve their housing conditions, quality of life, and mental health status.
Handle: RePEc:aph:ajpbhl:2000:90:12:1873-1878_2

Template-Type: ReDIF-Article 1.0
Title: Parental employment and health insurance coverage among school-aged children with special health care needs
Journal: American Journal of Public Health
Author-Name: Heck, K.E.
Author-Name: Makuc, D.M.
Year: 2000
Volume: 90
Issue: 12
Pages: 1856-1860
Abstract: Objectives. This study examined parental employment and health insurance coverage among children with and without special health care needs. Special needs were defined as conditions likely to require a high amount of parental care, potentially affecting parental employment. Methods. Data from the 1994 National Health Interview Survey were analyzed for 21415 children aged 5 to 17 years, including 1604 children with special needs. Logistic regression was used to estimate the effect of special needs on the odds of full-time parental employment and on the odds of a child's being uninsured, having Medicaid, or having employer-sponsored insurance. Results. Parents of children with special needs had less full-time employment. Their children had lower odds of having employer-sponsored insurance (adjusted odds ratio [OR]=0.7) than other children. Children with special needs had greater odds of Medicaid coverage (adjusted OR=2.3-5.1, depending on family income). Children with and without special needs were equally likely to be uninsured. Conclusions. Lower full-time employment among parents of children with special needs contributes to the children's being less likely to have employer-sponsored health insurance. Medicaid covers many children with special needs, but many others remain uninsured.
Handle: RePEc:aph:ajpbhl:2000:90:12:1856-1860_5

Template-Type: ReDIF-Article 1.0
Title: The great population debates: How relevant are they for the 21st century?
Journal: American Journal of Public Health
Author-Name: Sinding, S.W.
Year: 2000
Volume: 90
Issue: 12
Pages: 1841-1845
Abstract: Two great debates - whether population growth is a problem and how to address the problem if one exists - dominated population policy discussions in the 20th century. The debate about whether pitted those who saw rapid population growth as a problem against those who believed the cries of alarm were false. The debate about how was conducted between advocates of the direct delivery of contraceptives through family planning programs and those who counseled a broader, more holistic approach. The debate about how was largely resolved by the 1994 International Conference on Population and Development at Cairo; the debate about whether remains unresolved. Environmentalists, ecologists, and physical scientists generally support the view that rapid population growth is harmful, but economists remain largely unconvinced. Contemporary declines in fertility and the end of the population crisis mentality of the mid- to late 20th century could, ironically, diminish public support for precisely those programs that have been responsible for the rapid fertility decline of the past 3 decades - programs that will be required to complete the 'demographic transition' in those parts of the developing world where fertility remains very high.
Handle: RePEc:aph:ajpbhl:2000:90:12:1841-1845_7

Template-Type: ReDIF-Article 1.0
Title: The effect of capitated financing on mental health services for children and youth: The Colorado experience
Journal: American Journal of Public Health
Author-Name: Catalano, R.
Author-Name: Libby, A.
Author-Name: Snowden, L.
Author-Name: Cuellar, A.E.
Year: 2000
Volume: 90
Issue: 12
Pages: 1861-1865
Abstract: Objectives. This study tested 2 propositions concerning the effect of capitated financing on mental health services for Medicaid-eligible children and youth in Colorado. The first is that capitation reduces costs. The second is that shifting providers from fee-for-service to capitated financing will increase their efforts to prevent illness. Methods. Interrupted time-series designs were applied to a naturally occurring quasi experiment occasioned by the state of Colorado's reorganization of mental health services financing. Results. The cost of services was significantly lower in counties with capitated services compared with counties with fee-for-service financing. Findings also suggested that economic incentives may lead to greater efforts at secondary and tertiary prevention. Conclusions. Policymakers and the public can expect that capitation will reduce the costs of children's mental health services below those likely with fee-for-service financing. Capitation per se, however, may not increase prevention as surely or swiftly as it lowers costs.
Handle: RePEc:aph:ajpbhl:2000:90:12:1861-1865_3

Template-Type: ReDIF-Article 1.0
Title: Managed care and public health
Journal: American Journal of Public Health
Author-Name: Levi, J.
Year: 2000
Volume: 90
Issue: 12
Pages: 1823-1824
Handle: RePEc:aph:ajpbhl:2000:90:12:1823-1824_9

Template-Type: ReDIF-Article 1.0
Title: Attitudes and practices regarding varicella vaccination among physicians in Minnesota: Implications for public health and provider education
Journal: American Journal of Public Health
Author-Name: Ehresmann, K.R.
Author-Name: Mills, W.A.
Author-Name: Loewenson, P.R.
Author-Name: Moore, K.A.
Year: 2000
Volume: 90
Issue: 12
Pages: 1917-1920
Abstract: Objectives. This study sought to determine physicians' attitudes and practices regarding varicella vaccine. Methods. A sample of Minnesota family and pediatricians was surveyed in January 1997. Results. Of 255 physicians surveyed, 108 (42%) reported routinely offering varicella vaccine. Physicians who perceived their professional organization's recommendations as 'very important' were more likely to routinely offer varicella vaccine. Physicians who preferred natural disease over vaccination and those concerned about waning immunity were less likely to routinely offer vaccine. Conclusions. Recommendations of professional organizations have encouraged varicella vaccine use and may further enhance future use. Differences in pediatricians' and family physicians' attitudes and practices regarding this vaccine suggest that education of providers by specialty may be needed to increase acceptance of newly licensed vaccines.
Handle: RePEc:aph:ajpbhl:2000:90:12:1917-1920_2

Template-Type: ReDIF-Article 1.0
Title: The Ohio substance abuse monitoring network: Constructing and operating a statewide epidemiologic intelligence system
Journal: American Journal of Public Health
Author-Name: Siegal, H.A.
Author-Name: Carlson, R.G.
Author-Name: Kenne, D.R.
Author-Name: Starr, S.
Author-Name: Stephens, R.C.
Year: 2000
Volume: 90
Issue: 12
Pages: 1835-1837
Handle: RePEc:aph:ajpbhl:2000:90:12:1835-1837_2

Template-Type: ReDIF-Article 1.0
Title: Improving dental health [2] (multiple letters)
Journal: American Journal of Public Health
Author-Name: Doniger, A.S.
Author-Name: Allukian M., Jr.
Year: 2000
Volume: 90
Issue: 12
Pages: 1951
Handle: RePEc:aph:ajpbhl:2000:90:12:1951_9

Template-Type: ReDIF-Article 1.0
Title: Factors influencing a communitywide campaign to administer hepatitis A vaccine to men who have sex with men
Journal: American Journal of Public Health
Author-Name: Friedman, M.S.
Author-Name: Blake, P.A.
Author-Name: Koehler, J.E.
Author-Name: Hutwagner, L.C.
Author-Name: Toomey, K.E.
Year: 2000
Volume: 90
Issue: 12
Pages: 1942-1946
Abstract: Objectives. A hepatitis A outbreak among men who have sex with men (MSM) led to a publicly funded vaccination campaign. We evaluated the MSM community's response. Methods. A cohort of MSM from 5 community sites was surveyed. Results. Thirty-four (19%) of 178 potential vaccine candidates received the vaccine during the campaign. We found a linear relation between the number of exposures to campaign information and the likelihood of vaccination (P < .001). Vaccination was independently associated with awareness of the outbreak and the vaccine, having had sexual relations with men for 12 years or longer, having recently consulted a physician, and routinely reading a local gay newspaper. Conclusions. The difficult task of vaccinating MSM can be aided by repetitive promotional messages, especially via the gay media.
Handle: RePEc:aph:ajpbhl:2000:90:12:1942-1946_5

Template-Type: ReDIF-Article 1.0
Title: Population and reproductive health: Where do we go next?
Journal: American Journal of Public Health
Author-Name: Germain, A.
Year: 2000
Volume: 90
Issue: 12
Pages: 1845-1847
Handle: RePEc:aph:ajpbhl:2000:90:12:1845-1847_2

Template-Type: ReDIF-Article 1.0
Title: Not-so-strange bedfellows: Public health and managed care
Journal: American Journal of Public Health
Author-Name: Koplan, J.P.
Author-Name: Harris, J.R.
Year: 2000
Volume: 90
Issue: 12
Pages: 1824-1826
Handle: RePEc:aph:ajpbhl:2000:90:12:1824-1826_8

Template-Type: ReDIF-Article 1.0
Title: An International comparison of cancer survival: Metropolitan Toronto, Ontario, and Honolulu, Hawaii
Journal: American Journal of Public Health
Author-Name: Gorey, K.M.
Author-Name: Holowaty, E.J.
Author-Name: Fehringer, G.
Author-Name: Laukkanen, E.
Author-Name: Richter, N.L.
Author-Name: Meyer, C.M.
Year: 2000
Volume: 90
Issue: 12
Pages: 1866-1872
Abstract: Objectives. Comparisons of cancer survival in Canadian and US metropolitan areas have shown consistent Canadian advantages. This study tests a health insurance hypothesis by comparing cancer survival in Toronto, Ontario, and Honolulu, Hawaii. Methods. Ontario and Hawaii registries provided a total of 9190 and 2895 cancer cases (breast and prostate, 1986-1990, followed until 1996). Socioeconomic data for each person's residence at the time of diagnosis were taken from population censuses. Results. Socioeconomic status and cancer survival were directly associated in the US cohort, but not in the Canadian cohort. Compared with similar patients in Honolulu, residents of low-income areas in Toronto experienced 5-year survival advantages for breast and prostate cancer. In support of the health insurance hypothesis, between-country differences were smaller than those observed with other state samples and the Canadian advantage was larger among younger women. Conclusions. Hawaii seems to provide better cancer care than many other states, but patients in Toronto still enjoy a significant survival advantage. Although Hawaii's employer-mandated health insurance coverage seems an effective step toward providing equitable health care, even better care could be expected with a universally accessible, single-payer system.
Handle: RePEc:aph:ajpbhl:2000:90:12:1866-1872_4

Template-Type: ReDIF-Article 1.0
Title: The relation of socioeconomic factors and racial/ethnic differences in US asthma mortality
Journal: American Journal of Public Health
Author-Name: Grant, E.N.
Author-Name: Lyttle, C.S.
Author-Name: Weiss, K.B.
Year: 2000
Volume: 90
Issue: 12
Pages: 1923-1925
Abstract: Objectives. This study described relations between socioeconomic factors and race/ethnicity as risk factors for asthma mortality. Methods. A cross-sectional study was conducted of US mortality records from 1991 through 1996. Results. Higher standardized mortality ratios were seen for Blacks vs Whites (3.34 vs 0.65), low vs high educational level (1.51 vs 0.69), and low vs high income (1.46 vs 0.71). Excess mortality for Blacks vs Whites was present in the highest and lowest quintiles of median county income and educational level. The disparity in asthma mortality rates according to median county income and education remained after control for race/ethnicity. Conclusions. Black race/ethnicity appears to be associated, independently from low income and low education, with an elevated risk for asthma mortality.
Handle: RePEc:aph:ajpbhl:2000:90:12:1923-1925_3

Template-Type: ReDIF-Article 1.0
Title: Lessons learned from the tobacco industry's efforts to prevent the passage of a workplace smoking regulation
Journal: American Journal of Public Health
Author-Name: Mangurian, C.V.
Author-Name: Bero, L.A.
Year: 2000
Volume: 90
Issue: 12
Pages: 1926-1930
Abstract: Objectives. This study assessed the implementation of tobacco industry strategies to prevent a workplace smoking regulation. Methods. Tobacco industry internal documents were identified; hearing transcripts for the affiliations, arguments, and positions regarding the regulation of testifiers were coded; and media coverage was analyzed. Results. Tobacco industry strategies sought to increase business participation and economic discussions at public hearings and to promote unfavorable media coverage of the reugulation. The percentage of business representatives opposing the regulation grew from 18% (5 of 28) to 57% (13 of 23) between the hearings. Economic arguments opposing the regulation rose from 25% (7 of 28) to 70% (16 of 23). Press coverage was neutral and did not increase during the period of the regulatory hearings. Conclusions. The tobacco industry was successful in implementing 2 of its 3 strategies but was not able to prevent passage of the comprehensive workplace regulation.
Handle: RePEc:aph:ajpbhl:2000:90:12:1926-1930_4

Template-Type: ReDIF-Article 1.0
Title: Excess mortality among urban residents: How much, for whom, and why?
Journal: American Journal of Public Health
Author-Name: House, J.S.
Author-Name: Lepkowski, J.M.
Author-Name: Williams, D.R.
Author-Name: Mero, R.P.
Author-Name: Lantz, P.M.
Author-Name: Robert, S.A.
Author-Name: Chen, J.
Year: 2000
Volume: 90
Issue: 12
Pages: 1898-1904
Abstract: Objectives. The goals of this study were to estimate prospective mortality risks of city residence, specify how these risks vary by population subgroup, and explore possible explanations. Methods. Data were derived from a probability sample of 3617 adults in the coterminous United States and analyzed via cross-tabular and Cox proportional hazards methods. Results. After adjustment for baseline sociodemographic and health variables, city residents had a mortality hazard rate ratio of 1.62 (95% confidence interval [CI] = 1.21, 2.18) relative to rural/small-town residents; suburbanites had an intermediate but not significantly elevated hazard rate ratio. This urban mortality risk was significant among men (hazard rate ratio: 2.25), especially non-Black men, but not among women. Among Black men, and to some degree Black women, suburban residence carried the greatest risk. All risks were most evident for those younger than 65 years. Conclusions. The mortality risk of city residence, at least among men, rivals that of major psychosocial risk factors such as race, low income, smoking, and social isolation and merits comparable attention in research and policy.
Handle: RePEc:aph:ajpbhl:2000:90:12:1898-1904_6

Template-Type: ReDIF-Article 1.0
Title: Self-reported health and prior health behaviors of newly admitted correctional inmates
Journal: American Journal of Public Health
Author-Name: Conklin, T.J.
Author-Name: Lincoln, T.
Author-Name: Tuthill, R.W.
Year: 2000
Volume: 90
Issue: 12
Pages: 1939-1941
Abstract: Objectives. This study obtained comprehensive health information from newly admitted correctional inmates. Methods. Interviews were conducted with 1198 inmates on day 3 of their incarceration. Results. Interviewers found a high prevalence of chronic medical and mental health issues, limited access to health care, high rates of infections and sexually transmitted diseases, substantial substance abuse, other unhealthy behaviors and violence, and a strong desire for help with health-related problems. Conclusions. The data document the need to apply the public health approach to correctional health care, including detection and early treatment of disease, education and prevention to facilitate health and behavior change, and continuity of care into the community.
Handle: RePEc:aph:ajpbhl:2000:90:12:1939-1941_0

Template-Type: ReDIF-Article 1.0
Title: The effect of income inequality on the health of selected US demographic groups
Journal: American Journal of Public Health
Author-Name: LeClere, F.B.
Author-Name: Soobader, M.-J.
Year: 2000
Volume: 90
Issue: 12
Pages: 1892-1897
Abstract: Objectives. This study assessed whether documented effects of income inequality on health are consistent across demographic subgroups of the US population. Methods. Data from the National Health Interview Survey on White and Black non-Hispanics were used. Logistic regression models were estimated with SUDAAN software. Perceived health was the outcome variable. Results. The results of the multivariate analysis, in which individual family income and county-level poverty rates were included, were not consistent with existing research. In the presence of covariates, the conditional effects of inequality were restricted to Whites aged 18-44 years in the 2 highest income inequality quartiles and middle-aged Whites in counties with the highest level of income inequality. The health of Blacks of all ages, elderly Whites, and middle-aged Whites outside of the areas of highest inequality was unaffected when controls for individual characteristics and county-level poverty were in place. Conclusions. For the United States, the independent and direct contribution of income inequality to the determination of self-perceived health net of individual income and county income levels is restricted to certain demographic groups.
Handle: RePEc:aph:ajpbhl:2000:90:12:1892-1897_6

Template-Type: ReDIF-Article 1.0
Title: Combating dental disease [1]
Journal: American Journal of Public Health
Author-Name: Hayes, M.D.
Year: 2000
Volume: 90
Issue: 12
Pages: 1951
Handle: RePEc:aph:ajpbhl:2000:90:12:1951_1

Template-Type: ReDIF-Article 1.0
Title: Evaluation of Medicaid managed care for children: Access and satisfaction
Journal: American Journal of Public Health
Author-Name: Ganz, M.L.
Author-Name: Sisk, J.E.
Year: 2000
Volume: 90
Issue: 12
Pages: 1947-1948
Handle: RePEc:aph:ajpbhl:2000:90:12:1947-1948_4

Template-Type: ReDIF-Article 1.0
Title: Outreach developmental services to children of patients in treatment for substance abuse
Journal: American Journal of Public Health
Author-Name: Shulman, L.H.
Author-Name: Shapira, S.R.
Author-Name: Hirshfield, S.
Year: 2000
Volume: 90
Issue: 12
Pages: 1930-1933
Abstract: Objectives. This report describes a model for delivering developmental services to children of patients in treatment for substance abuse. Methods. A multidisciplinary team provides developmental evaluations of children at a substance abuse treatment clinic. Results. In 3 years of operation, 85% of 117 children completed individualized developmental evaluations. Cognitive limitations were diagnosed in 69%, speech and language impairments in 68%, emotional or behavioral problems in 16%, and medical problems in 83%. Follow-up information on children completing evaluation indicated that 72% of eligible children are receiving services as recommended. Conclusions. This high-risk population of children of substance-abusing parents can be effectively served by providing developmental services at a substance abuse treatment program.
Handle: RePEc:aph:ajpbhl:2000:90:12:1930-1933_5

Template-Type: ReDIF-Article 1.0
Title: Suicide acts in 8 states: Incidence and case fatality rates by demographics and method
Journal: American Journal of Public Health
Author-Name: Spicer, R.S.
Author-Name: Miller, T.R.
Year: 2000
Volume: 90
Issue: 12
Pages: 1885-1891
Abstract: Objectives. This study examined incidence rates of medically identified suicide acts (self-inflicted injuries, either fatal or nonfatal) and case fatality rates by age, sex, race, and method used. Methods. The authors analyzed data on 10892 suicides and 57439 attempted suicides among hospital-admitted individuals in 8 states, along with 6219 attempted suicides among individuals released from emergency departments in 2 states. Results. The 8 states experienced a mean of 11 suicides and 119 attempted suicides per 100 000 residents each year. Groups with high suicide rates were men, the elderly, and Whites; groups with high attempted suicide rates were teenagers, young adults, women, and Blacks and Whites aged 25 to 44 years. Blacks aged 15 to 44 years evidenced high attempted suicide rates undocumented in previous studies. Poisoning and firearm were the most common methods used among those attempting suicide and those completing suicide acts, respectively. The most lethal method was firearm. Conclusions. The characteristics of suicides and attempted suicides differ dramatically. Method used is important in the lethality of the act.
Handle: RePEc:aph:ajpbhl:2000:90:12:1885-1891_9

Template-Type: ReDIF-Article 1.0
Title: Working together? Organizational and market determinants of collaboration between public health and medical care providers
Journal: American Journal of Public Health
Author-Name: Halverson, P.K.
Author-Name: Mays, G.P.
Author-Name: Kaluzny, A.D.
Year: 2000
Volume: 90
Issue: 12
Pages: 1913-1916
Abstract: Objectives. This study examines organizational characteristics and market conditions likely to influence collaborative relationships between public health agencies and community medical care providers. Methods. Public health directors in 60 US counties were surveyed by telephone concerning their relationships with area community hospitals (n=263) and community health centers (n=85). Multivariate models were used to estimate the effects of organizational and market characteristics on collaboration. Results. Collaboration was reported among 55% of the hospitals and 64% of the health centers. Certain forms of collaboration were more likely in markets characterized by higher HMO penetration and lower HMO competition. Conclusions. Targeted efforts to facilitate collaboration may be required in settings where institutional and market incentives are lacking.
Handle: RePEc:aph:ajpbhl:2000:90:12:1913-1916_6

Template-Type: ReDIF-Article 1.0
Title: Giving means receiving: The protective effect of social capital on binge drinking on college campuses
Journal: American Journal of Public Health
Author-Name: Weitzman, E.R.
Author-Name: Kawachi, I.
Year: 2000
Volume: 90
Issue: 12
Pages: 1936-1939
Abstract: Objectives. We tested whether higher levels of social capital on college campuses protected against individual risks of binge drinking. Methods. We used a nationally representative survey of 17 592 young people enrolled at 140 4-year colleges. Social capital was operationalized as individuals' average time committed to volunteering in the past month aggregated to the campus level. Results. In multivariate analyses controlling for individual volunteering, sociodemographics, and several college characteristics, individuals from campuses with higher-than-average levels of social capital had a 26% lower individual risk for binge drinking (P<.001) than their peers at other schools. Conclusions. Social capital may play an important rote in preventing binge drinking in the college setting.
Handle: RePEc:aph:ajpbhl:2000:90:12:1936-1939_9

Template-Type: ReDIF-Article 1.0
Title: "Children's clinic", by Mabel Dwight.
Journal: American Journal of Public Health
Author-Name: Helfand, W.H.
Author-Name: Lazarus, J.
Author-Name: Theerman, P.
Year: 2000
Volume: 90
Issue: 12
Pages: 1834
Handle: RePEc:aph:ajpbhl:2000:90:12:1834_2

Template-Type: ReDIF-Article 1.0
Title: Measuring our nation's diversity: Developing a common language for data on race/ethnicity
Journal: American Journal of Public Health
Author-Name: Wallman, K.K.
Author-Name: Evinger, S.
Author-Name: Schechter, S.
Year: 2000
Volume: 90
Issue: 11
Pages: 1704-1708
Abstract: During the 4-year period 1993 through 1997, the Office of Management and Budget (OMB) undertook a comprehensive review of the statistical standards that are used throughout the federal government to gather and publish data on race and ethnicity. The primary objective of this review was to ensure that our standards provide a common language that reflects the increasing diversity of the US population and maintains our ability to monitor compliance with civil rights laws. The review culminated with the October 1997 issuance of OMB's 'Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity.' In this article, we describe key aspects of the process that was undertaken to review and revise the 1977 standards. We also attempt to dispel some myths and misunderstandings that have been associated with these standards.
Handle: RePEc:aph:ajpbhl:2000:90:11:1704-1708_1

Template-Type: ReDIF-Article 1.0
Title: The contribution of risk factors to stroke differentials, by socioeconomic position in adulthood: The Renfrew/Paisley study
Journal: American Journal of Public Health
Author-Name: Hart, C.L.
Author-Name: Hole, D.J.
Author-Name: Smith, G.D.
Year: 2000
Volume: 90
Issue: 11
Pages: 1788-1791
Abstract: Objectives. This study investigated stroke differentials by socioeconomic position in adulthood. Methods. The relation of risk of stroke to deprivation category and social class was assessed among 6955 men and 7992 women who were aged 45 to 64 years and had been screened in 1972 to 1976. Results. A total of 594 men and 677 women had a hospital admission for stroke or died from stroke. There were large differences in stroke by deprivation category or social class. Adjustment for risk factors (smoking, blood pressure, height, respiratory function, body mass index cholesterol, diabetes, and preexisting heart disease) attenuated these differences. Conclusions. Risk factors for stroke can explain some of the socioeconomic differences in stroke risk. Women living in the most deprived areas seem particularly at risk of stroke.
Handle: RePEc:aph:ajpbhl:2000:90:11:1788-1791_8

Template-Type: ReDIF-Article 1.0
Title: History counts: A comparative analysis of racial/color categorization in US and Brazilian censuses
Journal: American Journal of Public Health
Author-Name: Nobles, M.
Year: 2000
Volume: 90
Issue: 11
Pages: 1738-1745
Abstract: Categories of race (ethnicity, color, or both) have appeared and continue to appear in the demographic censuses of numerous countries, including the United States and Brazil. Until recently, such categorization had largely escaped critical scrutiny, being viewed and treated as a technical procedure requiring little conceptual clarity or historical explanation. Recent political developments and methodological changes, in US censuses especially, have engendered a critical reexamination of both the comparative and the historical dimensions of categorization. The author presents a comparative analysis of the histories of racial/color categorization in American and Brazilian censuses and shows that racial (and color) categories have appeared in these censuses because of shifting ideas about race and the enduring power of these ideas as organizers of political, economic, and social life in both countries. These categories have not appeared simply as demographic markers. The author demonstrates that censuses are instruments at a state's disposal and are not simply detached registers of population and performance.
Handle: RePEc:aph:ajpbhl:2000:90:11:1738-1745_3

Template-Type: ReDIF-Article 1.0
Title: The children's bureau and public health at midcentury
Journal: American Journal of Public Health
Author-Name: Helfand, W.H.
Author-Name: Lazarus, J.
Author-Name: Theerman, P.
Year: 2000
Volume: 90
Issue: 11
Pages: 1703
Handle: RePEc:aph:ajpbhl:2000:90:11:1703_1

Template-Type: ReDIF-Article 1.0
Title: Racial differences in access to high-quality cardiac surgeons
Journal: American Journal of Public Health
Author-Name: Mukamel, D.B.
Author-Name: Murthy, A.S.
Author-Name: Weimer, D.L.
Year: 2000
Volume: 90
Issue: 11
Pages: 1774-1777
Abstract: Objectives. Racial differences in access to cardiac artery bypass graft (CABG) surgery are well documented. This study extends the literature by examining racial differences in access to high-quality cardiac surgeons. Methods. The analyses included 11296 CABG surgeries in New York State in 1996. Regression techniques were used to identify significant associations between a patient's race, health maintenance organization (HMO) enrollment, and the quality of the surgeon performing the surgery, measured by the surgeon's risk-adjusted mortality rate (RAMR). Results. Non-Whites were more likely than Whites to have access to surgeons of higher RAMR, by 11.7% among HMO enrollees (1-tailed P<.1) and by 5.4% among fee-for-service enrollees (1-tailed P<.05). Conclusions. Even when racial minorities do gain access to CABG services, they are more likely that non-Whites to receive care from lower-quality providers.
Handle: RePEc:aph:ajpbhl:2000:90:11:1774-1777_0

Template-Type: ReDIF-Article 1.0
Title: Effects of health insurance and race on colorectal cancer treatments and outcomes
Journal: American Journal of Public Health
Author-Name: Roetzheim, R.G.
Author-Name: Pal, N.
Author-Name: Gonzalez, E.C.
Author-Name: Ferrante, J.M.
Author-Name: Van Durme, D.J.
Author-Name: Krischer, J.P.
Year: 2000
Volume: 90
Issue: 11
Pages: 1746-1754
Abstract: Objectives. We hypothesized that health insurance payer and race might influence the care and outcomes of patients with colorectal cancer. Methods. We examined treatments received for all incident cases of colorectal cancer occurring in Florida in 1994 (n=9551), using state tumor registry data. We also estimated the adjusted risk of death (through 1997), using proportional hazards regression analysis controlling for other predictors of mortality. Results. Treatments received by patients varied considerably according to their insurance payer. Among non-Medicare patients, those in the following groups had higher adjusted risks of death relative to commercial fee-for-service insurance: commercial HMO (risk ratio [RR]=1.40; 95% confidence interval [CI]=1.18, 1.67; P=.0001), Medicaid (RR=1.44; 95% CI=1.06, 1.97; P=.02), and uninsured (RR=1.41; 95% CI=1.12, 1.77; P=.003). Non-Hispanic African Americans had higher mortality rates (RR=1.18; 95% CI=1.01, 1.37; P=.04) than non-Hispanic Whites. Conclusions. Patients with colorectal cancer who were uninsured or insured by Medicaid or commercial HMOs had higher mortality rates than patients with commercial fee-for-service insurance. Mortality was also higher among non-Hispanic African American patients.
Handle: RePEc:aph:ajpbhl:2000:90:11:1746-1754_0

Template-Type: ReDIF-Article 1.0
Title: Rate of illegal tobacco sales to minors varies by sign type in California
Journal: American Journal of Public Health
Author-Name: Cowling, D.W.
Author-Name: Robins, D.M.
Year: 2000
Volume: 90
Issue: 11
Pages: 1792-1793
Handle: RePEc:aph:ajpbhl:2000:90:11:1792-1793_1

Template-Type: ReDIF-Article 1.0
Title: Criollo, mestizo, mulato, latinegro, indigena, white, or black? The US Hispanic/Latino population and multiple responses in the 2000 census
Journal: American Journal of Public Health
Author-Name: Amaro, H.
Author-Name: Zambrana, R.E.
Year: 2000
Volume: 90
Issue: 11
Pages: 1724-1727
Abstract: Current dialogues on changes in collecting race and ethnicity data have not considered the complexity of tabulating multiple race responses among Hispanics. Racial and ethnic identification - and its public reporting - among Hispanics/Latinos in the United States is embedded in dynamic social factors. Ignoring these factors leads to significant problems in interpreting data and understanding the relationship of race, ethnicity, and health among Hispanics/Latinos. In the flurry of activity to resolve challenges posed by multiple race responses, we must remember the larger issue that looms in the foreground - the lack of adequate estimates of mortality and health conditions affecting Hispanics/Latinos. The implications are deemed important because Hispanics/Latinos will become the largest minority group in the United States within the next decade.
Handle: RePEc:aph:ajpbhl:2000:90:11:1724-1727_6

Template-Type: ReDIF-Article 1.0
Title: Contribution of chronic conditions to aggregate changes in old-age functioning
Journal: American Journal of Public Health
Author-Name: Freedman, V.A.
Author-Name: Martin, L.G.
Year: 2000
Volume: 90
Issue: 11
Pages: 1755-1760
Abstract: Objectives. This study explored the role of various chronic conditions in explaining recent improvements in functioning among older Americans. Methods. We used the Supplements on Aging to the 1984 and 1994 National Health Interview Surveys to examine changes among Americans 70 years and older in reports of chronic conditions and functional limitations. We decomposed functioning changes into condition-related components, controlling for demographic shifts. Results. The percentage of older Americans with upper- and lower-body limitations declined from 5.1% and 34.2%, respectively, in 1984 to 4.3% and 28.5% in 1995, and the average number of lower body limitations decreased. During the same period, reports of 8 of 9 chronic conditions increased, but many of these conditions had less debilitating effects on functioning. Reductions in the debilitating effects of various chronic conditions - particularly arthritis - are important in explaining declines in limitations experienced by older Americans. Conclusions. Earlier diagnosis and improved treatment and management of chronic conditions, rather than prevention, may be important contributing factors to improvements in upper- and lower-body functioning among older Americans.
Handle: RePEc:aph:ajpbhl:2000:90:11:1755-1760_3

Template-Type: ReDIF-Article 1.0
Title: The pursuit of equity in health: Reflections on race and public health data in Southern Africa
Journal: American Journal of Public Health
Author-Name: Bassett, M.T.
Year: 2000
Volume: 90
Issue: 11
Pages: 1690-1693
Abstract: The United States shares with Zimbabwe and South Africa a history of racial subjugation. A revision of the US racial classification to allow membership in more than one group means race may no longer be an exclusive characteristic. These issues also have been debated in southern Africa. In this commentary, the author reviews race classification in southern Africa and the use of race-specific public health data. Comparisons of illness and death rates across race groups have shown the health consequences of White privilege and Black disadvantage. But current public health data are not divided by race. The consequences of this policy are discussed.
Handle: RePEc:aph:ajpbhl:2000:90:11:1690-1693_2

Template-Type: ReDIF-Article 1.0
Title: Racial/ethnic differences in children's access to care
Journal: American Journal of Public Health
Author-Name: Weinick, R.M.
Author-Name: Krauss, N.A.
Year: 2000
Volume: 90
Issue: 11
Pages: 1771-1774
Abstract: Objectives. This study explored reasons for racial and ethnic differences in children's usual sources of care. Methods. Data from the 1996 Medical Expenditure Panel Survey were examined by means of logistic regression techniques. Results. Black and Hispanic children were substantially less likely than White children to have a usual source of care. These differences persisted after control for health insurance and socio-economic status. Control for language ability, however, eliminated differences between Hispanic and White children. Conclusions. Results suggest that the marked Hispanic disadvantage in children's access to care noted in earlier studies may be related to language ability.
Handle: RePEc:aph:ajpbhl:2000:90:11:1771-1774_0

Template-Type: ReDIF-Article 1.0
Title: Ethnic differences in the impact of advanced maternal age on birth prevalence of Down syndrome
Journal: American Journal of Public Health
Author-Name: Khoshnood, B.
Author-Name: Pryde, P.
Author-Name: Wall, S.
Author-Name: Singh, J.
Author-Name: Mittendorf, R.
Author-Name: Lee, K.-S.
Year: 2000
Volume: 90
Issue: 11
Pages: 1778-1781
Abstract: Objectives. This study explored whether ethnic differences in the impact of advanced maternal age on the risk of Down syndrome might reflect differences in use of prenatal diagnostic technologies. Methods. Maternal age-specific odds of Down syndrome and amniocentesis use were compared among African Americans, Mexican Americans and non-Hispanic Whites via birth data for the years 1989 to 1991. Results. The odds ratio and population attributable risk of Down syndrome due to maternal age of 35 years or older were highest for Mexican Americans, intermediate for African Americans, and lowest for non-Hispanic Whites. Conclusions. Advanced maternal age has a greater impact on the risk of Down syndrome for African American and, particularly, Mexican American women than for non-Hispanic White women. This difference in impact might reflect lower availability or use of prenatal diagnostic technologies.
Handle: RePEc:aph:ajpbhl:2000:90:11:1778-1781_5

Template-Type: ReDIF-Article 1.0
Title: Race/ethnicity and the 2000 census: Implications for public health
Journal: American Journal of Public Health
Author-Name: Sondik, E.J.
Author-Name: Lucas, J.W.
Author-Name: Madans, J.H.
Author-Name: Smith, S.S.
Year: 2000
Volume: 90
Issue: 11
Pages: 1709-1713
Abstract: Objectives. This article addresses the potential impact of the revised standards for race and ethnicity on data from the 2000 census and public health data sources, policies, and programs. Methods. The authors examine the relationship between race/ethnicity and health in selected measures, identify the factors that influence race/ethnicity identification, consider past experience in race/ethnicity reporting, and explore the challenges in understanding and managing the effects of new racial/ethnic categories in various data sets. Results. The multiple-race group seems to compose only a small percentage of the US population and may have little impact on data for single-race groups. Actual effects will vary according to a number of factors, including the size, composition, and geographic distribution of the group. Conclusions. More research is needed to support a thorough understanding of the reporting of multirace data and the development of techniques for analyzing these data. Given the importance of understanding the relationship between race/ethnicity and health, the ability to produce useful, comparable, and meaningful data is essential.
Handle: RePEc:aph:ajpbhl:2000:90:11:1709-1713_5

Template-Type: ReDIF-Article 1.0
Title: Learning to live with complexity: Ethnicity, socioeconomic position, and health in Britain and the United States
Journal: American Journal of Public Health
Author-Name: Smith, G.D.
Year: 2000
Volume: 90
Issue: 11
Pages: 1694-1698
Abstract: The relation between ethnicity, socioeconomic position, and health is complex, has changed over time, and differs between countries. In the United States there is a long tradition of treating ethnic group membership simply as a socio-economic measure, and differentials in health status between African Americans and groups of European origin have been considered purely socioeconomic. A contrary position sees the differences as either 'cultural' or due to inherent 'racial' differences. Although conventional socioeconomic indicators statistically explain much of the health difference between African Americans and Americans of European origin, they do not tell the full story. Incommensurate measures of socieconomic position across ethnic groups clearly contribute to this difference. Additional factors, such as the extent of racism, are also likely to be important. The interaction of ethnicity, social position, and health in Britain is similarly complex. Studies that inadequately account for socioeconomic circumstances when examining ethnic-group differences in health can reify ethinicity (and its supposed correlates); however, the reductionist attribution of all ethnic differences in health to socioeconomic factors is untenable. The only productive way forward is through studies that recognize the contingency of the relations between socioeconomic position, ethnicity, and particular health outcomes.
Handle: RePEc:aph:ajpbhl:2000:90:11:1694-1698_8

Template-Type: ReDIF-Article 1.0
Title: Trends in incidence of pediatric injury hospitalizations in Pennsylvania
Journal: American Journal of Public Health
Author-Name: Durbin, D.R.
Author-Name: Schwarz, D.F.
Author-Name: Localio, A.R.
Author-Name: MacKenzie, E.J.
Year: 2000
Volume: 90
Issue: 11
Pages: 1782-1784
Abstract: Objectives. This study analyzed short-term trends in pediatric injury hospitalizations. Methods. We used a population-based retrospective cohort design to study all children 15 years or younger who were admitted to all acute care hospitals in Pennsylvania with traumatic injuries between 1991 and 1995. Results. Injuries accounted for 9% of all acute hospitalizations for children. Between 1991 and 1995, admissions of children with minor injuries decreased by 29% (P<.001). However, admissions for children with moderate (P=.69) or serious (P=.41) injuries did not change. Conclusions. Significant declines in pediatric admissions for minor injuries were noted and may reflect both real reductions in injury incidence and changes in admission practices over the period of the study.
Handle: RePEc:aph:ajpbhl:2000:90:11:1782-1784_2

Template-Type: ReDIF-Article 1.0
Title: Why genes don't count (for racial differences in health)
Journal: American Journal of Public Health
Author-Name: Goodman, A.H.
Year: 2000
Volume: 90
Issue: 11
Pages: 1699-1702
Abstract: There is a paradoxical relationship between 'race' and genetics. Whereas genetic data were first used to prove the validity of race, since the early 1970s they have been used to illustrate the invalidity of biological races. Indeed, race does not account for human genetic variation, which is continuous, complexly structured, constantly changing, and predominantly within 'races.' Despite the disproof of race-as-biology, genetic variation continues to be used to explain racial differences. Such explanations require the acceptance of 2 disproved assumptions: that genetic variation explains variation in disease and that genetic variation explains racial variation in disease. While the former is a form of geneticization, the notion that genes are the primary determinants of biology and behavior, the latter represents a form of racialization, an exaggeration of the salience of race. Using race as a proxy for genetic differences limits understandings of the complex interactions among political-economic processes, lived experiences, and human biologies. By moving beyond studies of racialized genetics, we can clarify the processes by which varied and interwoven forms of racialization and racism affect individuals 'under the skin'.
Handle: RePEc:aph:ajpbhl:2000:90:11:1699-1702_9

Template-Type: ReDIF-Article 1.0
Title: Psychosocial work environment and depression: Epidemiologic assessment of the demand-control model
Journal: American Journal of Public Health
Author-Name: Mausner-Dorsch, H.
Author-Name: Eaton, W.W.
Year: 2000
Volume: 90
Issue: 11
Pages: 1765-1770
Abstract: Objectives. This study examined the relation between occupational variables and 3 forms of depression (major depressive episode, depressive syndrome, and dysphoria). It was hypothesized that individuals working in occupations with high psychologic strain (high psychologic demands and low decision authority) would have a higher prevalence of depression relative to those working in occupations with the other 3 possible conditions. Methods. The analysis was based on data for 905 respondents who were employed full-time in the year before the follow-up interview for the Epidemiologic Catchment Area Program in Baltimore, Md, between 1993 and 1996. Psychosocial work environment, socio-demographic variables, and psycho-pathology were assessed in a household interview that included the National Institute of Mental Health Diagnostic Interview Schedule. Subscales for the demand-control model for psychosocial work environment were modified slightly after factor analysis. Results. High job strain was associated with greater prevalence of all 3 forms of depression, especially major depressive episode. The results were stronger for women; for men, being unmarried was the strongest prevalence correlate. Conclusions. Major depressive episode, depressive syndrome, and dysphoria are strongly associated with the psychosocial dimensions of the demand-control model.
Handle: RePEc:aph:ajpbhl:2000:90:11:1765-1770_9

Template-Type: ReDIF-Article 1.0
Title: Injury mortality in East Germany
Journal: American Journal of Public Health
Author-Name: Clark, D.E.
Author-Name: Wildner, M.
Author-Name: Bergmann, K.E.
Year: 2000
Volume: 90
Issue: 11
Pages: 1761-1764
Abstract: Objectives. This study determined the effects of social changes in East Germany since 1989 on patterns of injury mortality. Methods. Death certificate data regarding injuries from 1980 through 1995 and police data regarding traffic injuries in East Germany from 1980 through 1998 were compared with similar data from West Germany. Results. The number of motor vehicle-related injuries and deaths in East Germany increased dramatically between 1989 and 1991, whereas those in West Germany declined slightly. The increased mortality in the more rural East has especially involved young men driving automobiles on rural roads and has persisted since reunification of East and West Germany. Falls, other accidents, and suicides have shown no such effect. Homicide among East German men has increased but remains uncommon. Conclusions. Recent social changes in East Germany, including increased access to motor vehicles and decreased restrictions on personal freedom, have been associated with increased motor vehicle crashes and mortality, especially among young men and on rural roads.
Handle: RePEc:aph:ajpbhl:2000:90:11:1761-1764_8

Template-Type: ReDIF-Article 1.0
Title: Immigration, intermarriage, and the challenges of measuring racial/ethnic identities
Journal: American Journal of Public Health
Author-Name: Waters, M.C.
Year: 2000
Volume: 90
Issue: 11
Pages: 1735-1737
Abstract: This commentary reviews recent demographic trends in immigration and intermarriage that contribute to the complexity of measuring race and ethnicity. The census question on ancestry is proposed as a possible model for what we might expect with the race question in the 2000 census and beyond. Through the use of ancestry data, changes in ethnic identification by individuals over the course of their lives, by generation, and according to census question directions are documented. It is pointed out that the once-rigid lines that divided European-origin groups from one another have increasingly blurred. All of these changes are posited as becoming more likely for groups we now define as 'racial.' While it is acknowledged that race and ethnicity will become increasingly difficult to measure as multiple racial identities become more common and more likely to be reported, it is argued that monitoring discrimination is crucial for the continued collection of such data.
Handle: RePEc:aph:ajpbhl:2000:90:11:1735-1737_8

Template-Type: ReDIF-Article 1.0
Title: Cigarette consumption in rural China: Survey results from 3 provinces
Journal: American Journal of Public Health
Author-Name: Hu, T.-W.
Author-Name: Tsai, Y.-W.
Year: 2000
Volume: 90
Issue: 11
Pages: 1785-1787
Abstract: Objectives. This study assessed cigarette consumption and its main determinants in rural China. Methods. A logistic regression model was used to analyze status of smoking, daily amount of smoking, and expense of cigarettes in rural China. Results. Approximately 57.1% of the males and 3.1% of the females were current smokers. The daily amount of smoking among smokers was 15.23 cigarettes, and their annual expenses were 227 yuan. Conclusions. People in rural China consume fewer cigarettes and are less likely to smoke than those in urban areas. Education and occupation are 2 major factors that determine the likelihood of smoking in rural China.
Handle: RePEc:aph:ajpbhl:2000:90:11:1785-1787_7

Template-Type: ReDIF-Article 1.0
Title: Latino mortality rates [1] (multiple letters)
Journal: American Journal of Public Health
Author-Name: Landen, M.G.
Author-Name: Abraido-Lanza, A.F.
Author-Name: Dohrenwend, B.P.
Author-Name: Ng-Mak, D.S.
Author-Name: Turner, J.B.
Year: 2000
Volume: 90
Issue: 11
Pages: 1798-1799
Handle: RePEc:aph:ajpbhl:2000:90:11:1798-1799_8

Template-Type: ReDIF-Article 1.0
Title: Race/ethnicity and OMB directive 15: Implications for state public health practice
Journal: American Journal of Public Health
Author-Name: Friedman, D.J.
Author-Name: Cohen, B.B.
Author-Name: Averbach, A.R.
Author-Name: Norton, J.M.
Year: 2000
Volume: 90
Issue: 11
Pages: 1714-1719
Abstract: Objectives. This study assessed the impact of the Office of Management and Budget's (OMB's) 1997 revised standards for the collection of race and ethnicity data on state health departments, using the Massachusetts Department of Public Health (MDPH) as the primary example, and we make recommendations for states' implementation of these standards. Methods. After analyzing the revised OMB standards, existing MDPH data sets were assessed for the impact of the revised standards on data collection, tabulation, analysis, and reporting for state health departments. Results. The revised OMB standards will have an impact on the MDPH and other state health departments. Similarities and differences exist between federal and state health agencies regarding the purpose of data collection, tabulation, analysis, and reporting. These similarities and differences will affect state implementation of the revised OMB standards. Conclusions. States need to plan for the implementation of the revised OMB standards and to understand the impact of this revision on the collecting and reporting of public health data. The revised OMB standards will introduce added complexities to the collection and analysis of race and ethnicity data, but they will also produce a more nuanced understanding of the relationship of race and ethnicity to the health of the American people.
Handle: RePEc:aph:ajpbhl:2000:90:11:1714-1719_6

Template-Type: ReDIF-Article 1.0
Title: Genetic factors and alcoholism [2]
Journal: American Journal of Public Health
Author-Name: Koss, M.P.
Author-Name: Goldman, D.
Year: 2000
Volume: 90
Issue: 11
Pages: 1799
Handle: RePEc:aph:ajpbhl:2000:90:11:1799_0

Template-Type: ReDIF-Article 1.0
Title: Counting accountably: Implications of the new approaches to classifying race/ethnicity in the 2000 census
Journal: American Journal of Public Health
Author-Name: Krieger, N.
Year: 2000
Volume: 90
Issue: 11
Pages: 1687-1689
Handle: RePEc:aph:ajpbhl:2000:90:11:1687-1689_0

Template-Type: ReDIF-Article 1.0
Title: Toward improved health: Disaggregating Asian American and Native Hawaiian/Pacific Islander data
Journal: American Journal of Public Health
Author-Name: Srinivasan, S.
Author-Name: Guillermo, T.
Year: 2000
Volume: 90
Issue: 11
Pages: 1731-1734
Abstract: The 2000 census, with its option for respondents to mark 1 or more race categories, is the first US census to recognize the multiethnic nature of all US populations but especially Asian Americans and Native Hawaiians/Pacific Islanders. If Asian Americans and Native Hawaiians/Pacific Islanders have for the most part been 'invisible' in policy debates regarding such matters as health care and immigration, it has been largely because of a paucity of data stemming from the lack of disaggregated data on this heterogeneous group of peoples. Studies at all levels should adhere to these disaggregated classifications. Also, in addition to oversampling procedures, there should be greater regional/local funding for studies in regions where Asian American and Native Hawaiian/Pacific Islander populations are substantial.
Handle: RePEc:aph:ajpbhl:2000:90:11:1731-1734_2

Template-Type: ReDIF-Article 1.0
Title: Office of management and budget racial categories and implications for American Indians and Alaska Natives
Journal: American Journal of Public Health
Author-Name: Burhansstipanov, L.
Author-Name: Satter, D.E.
Year: 2000
Volume: 90
Issue: 11
Pages: 1720-1723
Abstract: This commentary provides a brief overview of American Indian and Alaskan populations in the United States and selected data issues. The focus of this commentary is an excerpt of recommendations related to Office of Management and Bugdet Directive 15 (racial categories) and American Indians and Alaska Natives. Of paramount concern is not only that all federal, state, and local agencies collect data on American Indians and Alaska Natives, but also that reports, findings, and peer-reviewed publications include data on American Indians and Alaska Natives. It is of no use to recruit American Indians and Alaska Natives into studies and projects if their race/ethnicity-specific data are not disseminated. Collapsing racial/ethnic categories, such as Asians, Native Hawaiians and Pacific Islanders, and American Indians and Alaska Natives, into a single racial category of 'other' is of no benefit to public health policymakers, researchers, and tribal planners. Likewise, tribal affiliation should be collected whenever it is feasible to do so. Insufficient inclusion and inaccurate identification of American Indians and Alaska Natives in national surveys has also resulted in a dearth of baseline data in significant reports such as Healthy People 2010.
Handle: RePEc:aph:ajpbhl:2000:90:11:1720-1723_7

Template-Type: ReDIF-Article 1.0
Title: Race/ethnicity and the 2000 census: Recommendations for African American and other Black populations in the United States
Journal: American Journal of Public Health
Author-Name: Williams, D.R.
Author-Name: Jackson, J.S.
Year: 2000
Volume: 90
Issue: 11
Pages: 1728-1730
Abstract: This commentary considers the implications of the assessment of racial/ethnic status for monitoring the health of African Americans and other Black populations in the United States. It argues that because racial disparities in health and other social indicators persist undiminished, the continued assessment of race is essential. However, efforts must be made to ensure that racial data are of the highest quality. This will require uniform assessment of racial status that includes identifiers for subgroups of the Black population. Research also indicates that the health of multiracial persons varies by maternal race. Thus, efforts to monitor multiracial status should assess the race of both parents. More attention should also be given to analysis and interpretation of racial data and to the collection of additional data that capture characteristics linked to race (such as socioeconomic factors and racism) that may adversely affect health.
Handle: RePEc:aph:ajpbhl:2000:90:11:1728-1730_0

Template-Type: ReDIF-Article 1.0
Title: Nonprescription pharmacy sales of needles and syringes
Journal: American Journal of Public Health
Author-Name: Trubatch, B.N.
Author-Name: Fisher, D.G.
Author-Name: Cagle, H.H.
Author-Name: Fenaughty, A.M.
Author-Name: Johnson, M.E.
Year: 2000
Volume: 90
Issue: 10
Pages: 1639-1640
Handle: RePEc:aph:ajpbhl:2000:90:10:1639-1640_2

Template-Type: ReDIF-Article 1.0
Title: Science and health policy: Can they cohabit or should they divorce?
Journal: American Journal of Public Health
Author-Name: Collins, C.
Author-Name: Coates, T.J.
Year: 2000
Volume: 90
Issue: 9
Pages: 1389-1390
Handle: RePEc:aph:ajpbhl:2000:90:9:1389-1390_1

Template-Type: ReDIF-Article 1.0
Title: Well child care in the United States: Racial differences in compliance with guidelines
Journal: American Journal of Public Health
Author-Name: Ronsaville, D.S.
Author-Name: Hakim, R.B.
Year: 2000
Volume: 90
Issue: 9
Pages: 1436-1443
Abstract: Objectives. This study sought to estimate the rate of compliance with American Academy of Pediatrics guidelines for well child care in the first 6 months of life and to determine risks for inadequate care. Methods. The study included 7776 infants whose mothers participated in both the 1988 National Maternal and Infant Health Survey and its 1991 longitudinal follow-up and whose mothers or pediatric providers supplied information about their medical care. Regression analysis was used to determine the probability of incomplete compliance with guidelines for well child care in relation to several socioeconomic risks. Results. Fifty-eight percent of White infants, 35% of African American infants, and 37% of Hispanic infants obtained all recommended well child care. African American race was the biggest risk for inadequate care (odds ratio=1.7, 95% confidence interval = 1.5, 1.9), followed by low levels of maternal education, low income, and poor prenatal care. The risk for African American infants persisted across socioeconomic levels. Conclusions. The racial disparities identified suggest that cultural barriers to seeking preventive care need further study and that programs tamed at reducing these barriers need to be developed.
Handle: RePEc:aph:ajpbhl:2000:90:9:1436-1443_9

Template-Type: ReDIF-Article 1.0
Title: Excess female mortality in India: The case of Himachal Pradesh: Editorial
Journal: American Journal of Public Health
Author-Name: Cohen, A.
Year: 2000
Volume: 90
Issue: 9
Pages: 1369
Handle: RePEc:aph:ajpbhl:2000:90:9:1369_5

Template-Type: ReDIF-Article 1.0
Title: Autoimmune diseases: A leading cause of death among young and middle-aged women in the United States
Journal: American Journal of Public Health
Author-Name: Walsh, S.J.
Author-Name: Rau, L.M.
Year: 2000
Volume: 90
Issue: 9
Pages: 1463-1466
Abstract: Objectives. This study assessed the effect of autoimmune diseases on mortality among women. Methods. Counts of autoimmune disease deaths were compared with frequencies of the 10 'official' leading causes of death among women in the United States in 1995. Results. Autoimmune disease deaths exceeded the frequency of the 10th leading cause in every age category of women younger than 65 years and exceeded that for the eighth leading cause in the 15 to 24, 25 to 44, and 45 to 64 years age groups. Conclusions. Autoimmune diseases constitute a leading cause of death among young and middle-aged women. This fact is obscured by current methods used to identify leading causes.
Handle: RePEc:aph:ajpbhl:2000:90:9:1463-1466_6

Template-Type: ReDIF-Article 1.0
Title: Accuracy of patients' recall of Pap and cholesterol screening
Journal: American Journal of Public Health
Author-Name: Newell, S.
Author-Name: Girgis, A.
Author-Name: Sanson-Fisher, R.
Author-Name: Ireland, M.
Year: 2000
Volume: 90
Issue: 9
Pages: 1431-1435
Abstract: Objectives. This study was undertaken in mid-1994 and assessed how accurately patients recall the recency and result of their most recent cholesterol and Papanicolaou (Pap) tests. Methods. A cross-sectional, door-to-door community survey was used to gather self-report and, subsequently, pathology laboratory data for 195 individuals. Results. In regard to cholesterol screening, 30% of individuals who reported being adequately screened were actually inadequately screened, 45% who reported normal cholesterol levels actually had elevated levels, and 21% of inadequately screened individuals and 56% of individuals with elevated levels were not identified by self-report. In terms of Pap screening, 28% of women who reported being adequately screened were actually inadequately screened, 11% of patients who reported a normal Pap rest actually had abnormal or inadequate results, and 55% of inadequately screened individuals and 53% of individuals with abnormal or inadequate results were not identified by self-report. Conclusions. This study revealed self-report to be a less-than-adequate measure of individuals' recall of cholesterol and Pap screening. Relying exclusively on self-report surveys as indicators of screening coverage is likely to result in significant underestimations of the proportion of people who are inadequately screened or whose results indicate a need for intervention.
Handle: RePEc:aph:ajpbhl:2000:90:9:1431-1435_0

Template-Type: ReDIF-Article 1.0
Title: The role of epidemiology in needle exchange programs
Journal: American Journal of Public Health
Author-Name: Vlahov, D.
Year: 2000
Volume: 90
Issue: 9
Pages: 1390-1392
Handle: RePEc:aph:ajpbhl:2000:90:9:1390-1392_9

Template-Type: ReDIF-Article 1.0
Title: Organizational predictors of prenatal HIV counseling and testing
Journal: American Journal of Public Health
Author-Name: Ethier, K.A.
Author-Name: Fox-Tierney, R.
Author-Name: Nicholas, W.C.
Author-Name: Salisbury, K.M.
Author-Name: Ickovics, J.R.
Year: 2000
Volume: 90
Issue: 9
Pages: 1448-1451
Abstract: Objectives. Efforts to prevent perinatal transmission of HIV include implementation of prenatal counseling and testing programs. The objective of this study was to assess organizational predictors of HIV counseling and testing. Methods. Surveillance records were collected on 5900 prenatal patients from 9 hospital and community clinics in Connecticut. Results. Some organizational factors (e.g., type of clinic, dedicated staff) that enhanced counseling rates had the opposite effect on test acceptance. For instance, patients were more likely to be counseled when counseling was conducted by providers; however, test acceptance was more likely when dedicated counselors were available. Conclusions. These results provide important information concerning clinic resources needed as HIV counseling and testing services continue to be incorporated into prenatal care.
Handle: RePEc:aph:ajpbhl:2000:90:9:1448-1451_7

Template-Type: ReDIF-Article 1.0
Title: Biosocial determinants of hysterectomy in New Zealand
Journal: American Journal of Public Health
Author-Name: Dharmalingam, A.
Author-Name: Pool, I.
Author-Name: Dickson, J.
Year: 2000
Volume: 90
Issue: 9
Pages: 1455-1458
Abstract: Objectives. This study examined the prevalence and biosocial correlates of hysterectomy. Methods. Data were from a 1995 national survey of women aged 20 to 59 years. We applied piecewise non-parametric exponential hazards models to a subsample aged 25 to 59 to estimate the effects of biosocial correlates on hysterectomy likelihood. Results. Risks of hysterectomy for 1991 through 1995 were lower than those before 1981. University-educated and professional women were less likely to undergo hysterectomy. Higher parity and intrauterine device side effects increased the risk. Conclusions. This study confirms international results, especially those on education and occupation, but also points to ethnicity's mediating role. Education and occupation covary independently with hysterectomy. Analysis of time variance and periodicity showed declines in likelihood from 1981.
Handle: RePEc:aph:ajpbhl:2000:90:9:1455-1458_4

Template-Type: ReDIF-Article 1.0
Title: Sexual and fertility behaviors of American females aged 15-19 years: 1985, 1990, and 1995
Journal: American Journal of Public Health
Author-Name: Hogan, D.P.
Author-Name: Sun, R.
Author-Name: Cornwell, G.T.
Year: 2000
Volume: 90
Issue: 9
Pages: 1421-1425
Abstract: Objectives. This study characterized changes in sexual and reproductive behaviors from 1985 through 1995 among American females aged 15 to 19 years and related these changes to family factors. Methods. Nationally representative sample survey of Family Growth were analyzed with weibull hazards models of age at first intercourse and first pregnancy and with logistic regression models of contraceptive use at first intercourse and pregnancy outcome. Results. Improvements in the family socioeconomic situations of young women have lessened the risk of teen motherhood, while changes in family structure have increased the risk. Young women whose parents have more than a high school education, who live with both parents, and who attend church delay the the timing of first sexual intercourse and are more likely to use a contraceptive. Conclusions. The trend of increases in teenage motherhood has ended owing to a halt in increases in the proportion of sexually active young women and substantial improvement in contraception, with the greatest improvements among those from advantageous family situations.
Handle: RePEc:aph:ajpbhl:2000:90:9:1421-1425_8

Template-Type: ReDIF-Article 1.0
Title: Patterns of contraceptive use in 5 European countries
Journal: American Journal of Public Health
Author-Name: Spinelli, A.
Author-Name: Talamanca, I.F.
Author-Name: Lauria, L.
Year: 2000
Volume: 90
Issue: 9
Pages: 1403-1408
Abstract: Objectives. The use of contraception in Denmark, Germany, Poland, Italy, and Spain is described. Methods. Data were drawn from a population-based cross-sectional study, the European Study of Infertility and Subfecundity. Interviews were conducted with 6630 women aged 25 to 44 years. Logistic regression was used to estimate the effect of factors associated with contraceptive use. Results. Residents of Northern European countries tended to use more effective methods of contraception than residents of Southern European countries. The use of contraception was generally more common among single women, the more highly educated, those with children, and those with a previous induced abortion. These characteristics were also the main determinants of the use of more effective methods. Periodic abstinence and withdrawal were more common among older women. Conclusions. The European countries are in different phases of contraceptive practice: in Northern and Western Europe, use of more modern methods has been stable over the past 10 years, whereas these methods am less common in Southern and Eastern Europe. The results suggest the need for information, education, and provision of contraceptive services in Eastern and Southern Europe.
Handle: RePEc:aph:ajpbhl:2000:90:9:1403-1408_7

Template-Type: ReDIF-Article 1.0
Title: A prospective study of whole-grain intake and risk of type 2 diabetes mellitus in US women
Journal: American Journal of Public Health
Author-Name: Liu, S.
Author-Name: Manson, J.E.
Author-Name: Stamfer, M.J.
Author-Name: Hu, F.B.
Author-Name: Giovannucci, E.
Author-Name: Colditz, G.A.
Author-Name: Hennekens, C.H.
Author-Name: Willett, W.C.
Year: 2000
Volume: 90
Issue: 9
Pages: 1409-1415
Abstract: Objectives. This study examined the association between intake of whole vs refined grain and the risk of type 2 diabetes mellitus. Methods. We used a food frequency questionnaire for repeated dietary assessments to prospectively evaluate the relation between whole-grain intake and the risk of diabetes mellitus in a cohort of 75521 women aged 38 to 63 years without a previous diagnosis of diabetes or cardiovascular disease in 1984. Results. During the 10-year follow-up, we confirmed 1879 incident cases of diabetes mellitus. When the highest and the lowest quintiles of intake were compared, the age and energy-adjusted relative risks were 0.62 (95% confidence interval [CI] =0.53, 0.71, P trend<.0001) for whole grain, 1.31 (95% CI= 1.12, 1.53, P trend=.0003) for refined grain, and 1.57 (95% CI = 1.36, 1.82, P trend <.0001) for the ratio of refined- to whole-grain intake. These findings remained significant in multivariate analyses. The findings were most evident for women with a body mass index greater than 25 and were not entirely explained by dietary fiber, magnesium, and vitamin E. Conclusions. These findings suggest that substituting whole- for refined-grain products may decrease the risk of diabetes mellitus.
Handle: RePEc:aph:ajpbhl:2000:90:9:1409-1415_7

Template-Type: ReDIF-Article 1.0
Title: 'For God's sake, don't show this letter to the President...'
Journal: American Journal of Public Health
Author-Name: Moss, A.R.
Year: 2000
Volume: 90
Issue: 9
Pages: 1395-1396
Handle: RePEc:aph:ajpbhl:2000:90:9:1395-1396_7

Template-Type: ReDIF-Article 1.0
Title: Informed consent for emergency contraception: Variability in hospital care of rape victims
Journal: American Journal of Public Health
Author-Name: Smugar, S.S.
Author-Name: Spina, B.J.
Author-Name: Merz, J.F.
Year: 2000
Volume: 90
Issue: 9
Pages: 1372-1376
Abstract: There is growing concern that rape victims are not provided with emergency contraceptives in many hospital emergency rooms, particularly in Catholic hospitals. In a small pilot study, we examined policies and practices relating to providing information, prescriptions, and pregnancy prophylaxis in emergency rooms. We held structured telephone interviews with emergency department personnel in 58 large urban hospitals, including 28 Catholic hospitals, from across the United States. Our results showed that some Catholic hospitals have policies that prohibit the discussion of emergency contraceptives with rape victims, and in some of these hospitals, a victim would learn about the treatment only by asking. Such policies and practices are contrary to Catholic teaching. More seriously, they undermine a victim's right to information about her treatment options and jeopardize physicians' fiduciary responsibility to act in their patients' best interests. We suggest that institutions must reevaluate their restrictive policies. If they fail to do so, we believe that state legislation requiring hospitals to meet the standard of care for treatment of rape victims is appropriate.
Handle: RePEc:aph:ajpbhl:2000:90:9:1372-1376_1

Template-Type: ReDIF-Article 1.0
Title: Pattern of smoking initiation in Catalonia, Spain, from 1948 to 1992
Journal: American Journal of Public Health
Author-Name: Borras, J.M.
Author-Name: Fernandez, E.
Author-Name: Schiaffino, A.
Author-Name: Borrell, C.
Author-Name: La Vecchia, C.
Year: 2000
Volume: 90
Issue: 9
Pages: 1459-1462
Abstract: Objectives. This study analyzed the pattern of smoking initiation by sex and educational level in Catalonia, Spain. Methods. Data from the 1994 Catalan Health Interview Survey were used (n = 12245). The age and smoking stares of each subject were reconstructed for each calendar period. Age-specific smoking initiation rates were calculated. Results. Smoking initiation among females was rare until the 1960s, but from the period 1968-1972 onward a converging pattern was observed between the genders. Women with higher levels of education started smoking before other women, but the gradient of educational level has changed in recent years, with higher initiation rates among less-educated women. Conclusions. These results are consistent with diffusion-of-innovations theory and could be related to social and economic changes from the 1960s onward in Spain.
Handle: RePEc:aph:ajpbhl:2000:90:9:1459-1462_9

Template-Type: ReDIF-Article 1.0
Title: Effect of an administrative intervention on rates of screening for domestic violence in an urban emergency department
Journal: American Journal of Public Health
Author-Name: Larkin, G.L.
Author-Name: Rolniak, S.
Author-Name: Hyman, K.B.
Author-Name: Macleod, B.A.
Author-Name: Savage, R.
Year: 2000
Volume: 90
Issue: 9
Pages: 1444-1448
Abstract: Objectives. This study measured the effects of an administrative intervention on health care provider compliance with universal domestic violence screening protocols. Methods. We used a simple, interrupted-time-series design in a stratified random sample of female emergency department patients 18 years or older (n = 1638 preintervention, n = 1617 postintervention). The intervention was a 4-tiered hospital-approved disciplinary action, and the primary outcome was screening compliance. Results. Preintervention and post-intervention screening rates were 29.5% and 72.8%, respectively. Before the intervention, screening was worse on the night shift (odds ratio [OR]=0.46, 95% confidence interval [CI]=0.31, 0.68) and with psychiatric patients (OR=0.34, 95 % CI=0.14, 0.85); after the intervention, no previous screening barriers remained significant. Conclusions. An administrative intervention significantly enhanced compliance with universal domestic violence screening.
Handle: RePEc:aph:ajpbhl:2000:90:9:1444-1448_2

Template-Type: ReDIF-Article 1.0
Title: Putting a new face on self-sufficiency programs: In Charleston, SC, campus, community, and business organizations unite to help low-income women make the transition into the workplace
Journal: American Journal of Public Health
Author-Name: Brown, S.G.
Author-Name: Davis, R.S.
Year: 2000
Volume: 90
Issue: 9
Pages: 1383-1384
Handle: RePEc:aph:ajpbhl:2000:90:9:1383-1384_1

Template-Type: ReDIF-Article 1.0
Title: Adolescent perceptions of maternal approval of birth control and sexual risk behavior
Journal: American Journal of Public Health
Author-Name: Jaccard, J.
Author-Name: Dittus, P.J.
Year: 2000
Volume: 90
Issue: 9
Pages: 1426-1430
Abstract: Objectives. This study examined the relationship between adolescent perceptions of maternal approval of the use of birth control and sexual outcomes across a 12-month period. Methods. A subsample of the Longitudinal Study of Adolescent Health database was used in the context of a prospective design. Approximately 10 000 students in grades 7 to 11 were interviewed twice, 1 year apart. Results. Adolescent perceptions of maternal approval of birth control were associated with an increased likelihood of sexual intercourse over the next 12 months for virgins at wave 1. The perceptions also were related to an increase in birth control use but showed an ambiguous relation to the probability of pregnancy. High relationship satisfaction between adolescents and mothers was associated with a higher probability of birth control use and a lower probability of both sexual intercourse and pregnancy. Conclusions. The results suggest that perceived parental approval of birth control may increase the probability of sexual activity in some adolescents. 'Safer sex' messages must be conveyed by parents with thought and care.
Handle: RePEc:aph:ajpbhl:2000:90:9:1426-1430_8

Template-Type: ReDIF-Article 1.0
Title: Large-scale hormone replacement therapy and life expectancy: Results from an international comparison among European and North American populations
Journal: American Journal of Public Health
Author-Name: Panico, S.
Author-Name: Galasso, R.
Author-Name: Celentano, E.
Author-Name: Ciardullo, A.V.
Author-Name: Frova, L.
Author-Name: Capocaccia, R.
Author-Name: Trevisan, M.
Author-Name: Berrino, F.
Year: 2000
Volume: 90
Issue: 9
Pages: 1397-1402
Abstract: Objectives. An analysis was performed to determine the risks and benefits of a 10-year hormone replacement therapy regimen that had been applied to all women at 50 years of age in 8 countries. Methods. Cumulative mortality with and without hormone replacement therapy over 20 years was estimated, with both current and predicted total and disease-specific secular mortality trends and the influence of a generational cohort effect taken into account. Results. In countries with high ischemic heart disease frequency and predictable relative predominance of ischemic heart disease rates over breast cancer rates for the next 20 years, hormone replacement therapy could result in benefits with regard to overall mortality; this advantage decreases in younger-generation cohorts. In countries in which breast cancer mortality predominates over ischemic heart disease in early post-menopause and in which the predictable trends for both diseases reinforce this condition, a negative effect on overall mortality would be observed. In the United States, the effect of large-scale hormone replacement therapy would change over time. Conclusions. The long-term effect of hormone replacement therapy on life expectancy of postmenopausal women may vary among countries.
Handle: RePEc:aph:ajpbhl:2000:90:9:1397-1402_4

Template-Type: ReDIF-Article 1.0
Title: Rates and relative risk of hospital admission among women in violent intimate partner relationships
Journal: American Journal of Public Health
Author-Name: Kernic, M.A.
Author-Name: Wolf, M.E.
Author-Name: Holt, V.L.
Year: 2000
Volume: 90
Issue: 9
Pages: 1416-1420
Abstract: Objectives. This study assessed the history of hospitalization among women involved in violent intimate relationships. Methods. In this 1-year retrospective cohort study, female residents of King County, Washington, who were aged 18 to 44 years and who had filed for a protection order were compared with nonabused women in the same age group. Outcome measures included overall and diagnosis-specific hospital admission rates and relative risk of hospitalization associated with abuse. Results. Women known to be exposed to a violent intimate relationship were significantly more likely to be hospitalized with any diagnosis (age-specific relative risks [RRs] ranging from 1.2 to 2.1), psychiatric diagnoses (RR=3.6, 95% confidence interval [CI] =2.8, 4.6), injury and poisoning diagnoses (RR= 1.8, 95% CI= 1.2, 2.8), digestive system diseases (RR= 1.9, 95% CI= 1.3, 2.9), and diagnoses of assault (RR=4.9,95% CI= 1.1, 22.1) or attempted suicide (RR= 3.7, 95% CI = 1.6, 9.2) in the year before filing a protection order. Conclusions. This study showed an increased relative risk of both overall and diagnosis-specific hospitalizations among abused women. Intimate partner violence has a significant impact on women's health and use of health care.
Handle: RePEc:aph:ajpbhl:2000:90:9:1416-1420_7

Template-Type: ReDIF-Article 1.0
Title: Objectives and activities of the genetic alliance [1] (multiple letters)
Journal: American Journal of Public Health
Author-Name: Weiss, J.
Author-Name: Davidson, M.E.
Year: 2000
Volume: 90
Issue: 9
Pages: 1477-1478
Handle: RePEc:aph:ajpbhl:2000:90:9:1477-1478_0

Template-Type: ReDIF-Article 1.0
Title: Monitoring disease burden and preventive behavior with data linkage: Cervical cancer among Aboriginal people in Manitoba, Canada
Journal: American Journal of Public Health
Author-Name: Young, T.K.
Author-Name: Kliewer, E.
Author-Name: Blanchard, J.
Author-Name: Mayer, T.
Year: 2000
Volume: 90
Issue: 9
Pages: 1466-1468
Abstract: Objectives. This study sought to estimates rates of cervical cancer and Papanicolaou testing among Aboriginal and non-Aboriginal women in Manitoba, Canada. Methods. Data were derived through linking of administrative database. Results. In comparison with non- Aboriginal women, Aboriginal women had 1.8 and 3.6 times the age- standardized incidence rates o and invasive cervical cancer, respectively. With the exception of those aged 15 to 19 years, Aboriginal women were less likely to have had at least 1 Papanicolaou test in the preceding 3 years. Conclusion. Data linkage provides a rapid and inexpensive means to estimate disease burden and preventive behavior in the absence of registries. There is an urgent need for an organized Papanicolaou test screening program in the Aboriginal population.
Handle: RePEc:aph:ajpbhl:2000:90:9:1466-1468_6

Template-Type: ReDIF-Article 1.0
Title: Maintaining mammography adherence through telephone counseling in a church-based trial
Journal: American Journal of Public Health
Author-Name: Duan, N.
Author-Name: Fox, S.A.
Author-Name: Derose, K.P.
Author-Name: Carson, S.
Year: 2000
Volume: 90
Issue: 9
Pages: 1468-1471
Abstract: Objectives. This study assessed the effectiveness of telephone counseling in a church-based mammography promotion interventional trial. Methods. Thirty churches were ran- domized to telephone counseling and control conditions; telephone interview data were used in assessing intervention effects on mammography adherence. Separate analyses were conducted for baseline-adherent participants (maintaining adherence) and baseline-nonadherent participants (conversion to adherence). Results. Year 1 follow-up data indicated that the telephone counseling intervention maintained mammography adherence among baselline-adherent participants and reduces the nonadherence rate from 23% to 16%. Conclusions. Partnerships between the public health and faith communities are potentially effective conduits to promote maintenance of widely endorsed health behaviors such as regular cancer screening.
Handle: RePEc:aph:ajpbhl:2000:90:9:1468-1471_1

Template-Type: ReDIF-Article 1.0
Title: Epidemiology and the politics of needle exchange
Journal: American Journal of Public Health
Author-Name: Moss, A.R.
Year: 2000
Volume: 90
Issue: 9
Pages: 1385-1387
Handle: RePEc:aph:ajpbhl:2000:90:9:1385-1387_7

Template-Type: ReDIF-Article 1.0
Title: Research, politics, and needle exchange
Journal: American Journal of Public Health
Author-Name: Des Jarlais, D.C.
Year: 2000
Volume: 90
Issue: 9
Pages: 1392-1394
Abstract: We now have had 15 years of public discussion of and research on needle exchange programs. The data have shown these programs to be usually, but not always, effective in limiting HIV transmission among injection drug users. Needle exchange programs are conceptualized within a larger framework of providing ready availability of sterile injection equipment for injection drug users. Continuing research is clearly needed regarding how to maximize the availability of sterile injection equipment and how to integrate this with other needed health and social services for drug users. Many initial opponents of needle exchange programs have become supporters of the programs. The number of programs in the United States has been increasing by about 20% per year,13 and this can be considered substantial progress in reducing HIV infection among injection drug users. Important opposition remains, however, based primarily on the symbolic values expressed in government support for the programs. These value conflicts over needle exchange, which have existed since it was first considered in the United States, cannot be resolved with data. In the late 1980s, the value conflicts greatly hampered the collection of relevant data - there was no federal funding of research on needle exchange programs. Currently, there is considerable research on needle exchange, but many researchers are quite concerned about possible misuse of findings. This may be considered progress to an important but modest degree. Whether current and future research will be used to improve HIV prevention efforts remains to be seen.
Handle: RePEc:aph:ajpbhl:2000:90:9:1392-1394_5

Template-Type: ReDIF-Article 1.0
Title: Subfertility and risk of spontaneous abortion
Journal: American Journal of Public Health
Author-Name: Gray, R.H.
Author-Name: Ling Yu Wu
Year: 2000
Volume: 90
Issue: 9
Pages: 1452-1454
Abstract: Objectives. The purpose of this study was to assess the association between subfertility and spontaneous abortion. Methods. A total of 1572 women in New York and Vermont reported 3269 pregnancies between 1980 and 1990 and were able to provide an estimate of the waiting time to conception for 2967. Subfertility was defined as a delay of 1 year or more before a recognized conception was achieved. Rates of spontaneous abortion were determined among women with and without subfertility, and adjusted odds rations (ORs) and 95% confidence intervals (CIs) were estimated via multiple logistic regression. Results. Spontaneous abortion rates were 23.0% in pregnancies preceded by subfertility and 14.0% in pregnancies without impaired fertility (adjusted OR = 1.71, 95% CI = 1.26, 2.94). The attributable risk of spontaneous abortion associated with subfertility was 6.2%. Conclusions. Subfertile women evidence an increased number of spontaneous abortions.
Handle: RePEc:aph:ajpbhl:2000:90:9:1452-1454_5

Template-Type: ReDIF-Article 1.0
Title: Breastfeeding and infant illness [2] (multiple letters)
Journal: American Journal of Public Health
Author-Name: Bonati, M.
Author-Name: Campi, R.
Year: 2000
Volume: 90
Issue: 9
Pages: 1478-1479
Handle: RePEc:aph:ajpbhl:2000:90:9:1478-1479_9

Template-Type: ReDIF-Article 1.0
Title: Needle exchange, pragmatism, and moralism
Journal: American Journal of Public Health
Author-Name: Coutinho, R.A.
Year: 2000
Volume: 90
Issue: 9
Pages: 1387-1388
Handle: RePEc:aph:ajpbhl:2000:90:9:1387-1388_9

Template-Type: ReDIF-Article 1.0
Title: Safe motherhood means: Social equity for women...
Journal: American Journal of Public Health
Author-Name: Helfand, W.H.
Author-Name: Lazarus, J.
Author-Name: Theerman, P.
Year: 2000
Volume: 90
Issue: 9
Pages: 1382
Handle: RePEc:aph:ajpbhl:2000:90:9:1382_7

Template-Type: ReDIF-Article 1.0
Title: The female condom: Tool for women's empowerment
Journal: American Journal of Public Health
Author-Name: Gollub, E.L.
Year: 2000
Volume: 90
Issue: 9
Pages: 1377-1381
Abstract: International and US experience with the female condom has shown that the device empowers diverse populations of women, helping them negotiate protection with their partners, promoting healthy behaviors, and increasing self-efficacy and sexual confidence and autonomy. This commentary reflects on some approaches that have been taken to study empowerment and makes several observations on the political and scientific initiatives needed to capitalize on this empowerment potential. Women's interest in the female condom indicates a need for more women's barrier methods to be made available. For some women, cultural proscriptions against touching the genitals may create initial hesitancy in trying these methods. But the disposition of regulatory agencies and the attitudes of health care providers has unfortunately exaggerated this reticence, thereby effectively reducing access to these methods. Also, lack of important detail in clinical studies restricts our capacity to introduce the female condom, or similar methods, under optimal conditions. Future trials should prioritize community-based designs and address a range of other critical health and social issues for women. Women's need for HIV/AIDS prevention technologies remains an urgent priority. Both political and scientific efforts are needed to realize the public health potential embodied in the female condom.
Handle: RePEc:aph:ajpbhl:2000:90:9:1377-1381_3

Template-Type: ReDIF-Article 1.0
Title: A national burden of disease calculation: Dutch disability-adjusted life-years
Journal: American Journal of Public Health
Author-Name: Melse, J.M.
Author-Name: Essink-Bot, M.-L.
Author-Name: Kramers, P.G.N.
Author-Name: Hoeymans, N.
Year: 2000
Volume: 90
Issue: 8
Pages: 1241-1247
Abstract: Objectives. This study estimated the burden of disease due to 48 major causes in the Netherlands in 1994 in disability-adjusted life-years (DALYs), using national epidemiologic data and disability weights, and explored associated problems and uncertainties. Methods. We combined data from Dutch vital statistics, registrations, and surveys with Dutcl disability weights to calculate disease-specific health loss in DALYs, which are the sum of years of life lost (YLLs) and years lived with disability (YLDs) weighted for severity. Results. YLLs were primarily lost by cardiovascular diseases and cancers, while YLDs were mostly lost by mental disorders and a range of chronic somatic disorders (such as chronic nonspecific lung disease and diabetes). These 4 diagnostic groups caused approximately equal numbers of DALYs. Sensitivity analysis calls for improving the accuracy of the epidemiologic data in connection with disability weights, especially for mild and frequent diseases. Conclusions. The DALY approach appeared to be feasible at a national Western European level and produced interpretable results, comparable to resuits from the Global Burden of Disease Study for the Established Market Economies. Suggestions for improving the methodology and its applicability are presented.
Handle: RePEc:aph:ajpbhl:2000:90:8:1241-1247_0

Template-Type: ReDIF-Article 1.0
Title: Predictors of cigarette smoking and smoking cessation among adults with asthma
Journal: American Journal of Public Health
Author-Name: Eisner, M.D.
Author-Name: Yelin, E.H.
Author-Name: Katz, P.P.
Author-Name: Shiboski, S.C.
Author-Name: Henke, J.
Author-Name: Blanc, P.D.
Year: 2000
Volume: 90
Issue: 8
Pages: 1307-1311
Abstract: Objectives. This study sought to determine the predictors of smoking and time until smoking cessation in a cohort of adults with asthma. Methods. Adults with asthma (n = 374) in northern California completed structured telephone interviews at baseline and 18-month follow-up. Results. Of the 374 subjects, 156 reported ever having smoked, and 39 indicated that they currently smoked. Earlier birth cohort, lower educational attainment, White race, and presence in childhood residence of an adult who smoked were associated with a greater risk of ever smoking. Lower educational attainment, early smoking initiation, higher daily cigarette consumption, and late- childhood-onset asthma were associated with a longer interval until smoking cessation. Conclusions. Persons with asthma at high risk of cigarette smoking and delayed quitting can be identified on the basis of clinical and demographic characteristics.
Handle: RePEc:aph:ajpbhl:2000:90:8:1307-1311_2

Template-Type: ReDIF-Article 1.0
Title: Applying burden of disease methods in developing countries: A case study from Pakistan
Journal: American Journal of Public Health
Author-Name: Hyder, A.A.
Author-Name: Morrow, R.H.
Year: 2000
Volume: 90
Issue: 8
Pages: 1235-1240
Abstract: Objectives. Disability-adjusted life-year (DALY) and healthy life-year (HeaLY) are composite indicators of disesase burden that combine mortality and, morbidity into a single measurement. This study examined the application of these methods in a developing country-to assess the loss of healthy life from prevalent conditions and their use in resource-poor national contexts. Methods A data set for Pakistan was constructed on the basis of 180 sources for population and disease parameters. The HeaLY approach was used to generate data on loss of healthy life from pre-mature mortality and disability in 1990, categorized by 58 conditions. Results. Childhood and infectious diseases were responsible for two thirds of the burden of disease in Pakistan. Condition-specific analysis revealed that chronic diseases and injuries were among the top 10 causes of HeaLY loss. Comparisson with regional estimates demonstrates consistency of disease trends in both communicable and chronic diseases. Conclusions. The burden of disease in countries such as Pakistan can be assessed by using composite indicators. The HeaLY method provides an explicit framework for national health information assessment. Obtaining disease- and population-based data of good quality is the main challenge for any method in the developing world.
Handle: RePEc:aph:ajpbhl:2000:90:8:1235-1240_0

Template-Type: ReDIF-Article 1.0
Title: Public health e-mentoring: An investment for the next millennium
Journal: American Journal of Public Health
Author-Name: Mahayosnand, P.P.
Year: 2000
Volume: 90
Issue: 8
Pages: 1317-1318
Handle: RePEc:aph:ajpbhl:2000:90:8:1317-1318_8

Template-Type: ReDIF-Article 1.0
Title: Effect of nonviable infants on the infant mortality rate in Philadelphia, 1992
Journal: American Journal of Public Health
Author-Name: Gibson, E.
Author-Name: Culhane, J.
Author-Name: Saunders, T.
Author-Name: Webb, D.
Author-Name: Greenspan, J.
Year: 2000
Volume: 90
Issue: 8
Pages: 1303-1306
Abstract: Objectives. This report measured the effect of births at 22 weeks' gestation or earlier on infant mortality in Philadelphia, Pa. Methods. The proportion of live-born deliveries at 22 weeks or earlier was calculated. Overall and race-specific infant mortality was calculated after excluding live-born deliveries at 22 weeks' gestation or earlier. Results. Of all deliveries, 1.5% were at 22 weeks or earlier. Of these, 68% were stillborn and 32% were live-born. Large hospital-to-hospital variation in the proportion of live-born deliveries at 22 weeks' gestation or earlier was noted. When nonviable births were excluded, overall infant mortality decreased 40%. Conclusions. The development of a standardized birth certificate policy is needed and will facilitate comparisons of infant mortality across spatial boundaries and racial/ethnic groups.
Handle: RePEc:aph:ajpbhl:2000:90:8:1303-1306_2

Template-Type: ReDIF-Article 1.0
Title: Outcomes of the learn, share and live breast cancer education program for older urban women
Journal: American Journal of Public Health
Author-Name: Skinner, C.S.
Author-Name: Arfken, C.L.
Author-Name: Waterman, B.
Year: 2000
Volume: 90
Issue: 8
Pages: 1229-1234
Abstract: Objectives. This study assessed whether the Learn, Share and Live breast cancer education program resulted in favorable, replicable, and sustainable outcomes: Methods. The program was implemented at index (year 1) and replication (year 2) sites. Baseline interviews (year 1; n= 240) and 2 follow-up telephone interviews (years 2 and 3; n=337 and 323) were used to assess postintervention changes. Results. From baseline to year 2, mammography adherence and stage of adoption improved at the index site relative to the replication site. Knowledge scores and percentages of respondents reporting that a friend had spoken with them about mammography improved significantly. Improvements were sustained through year 3 (2 years postintervention). In year 3, replication participants showed improvements in regard to knowledge and perceived mammnography benefits, and there was a trend toward increased adherence. Site differsences in postintervention adherence may have stemmed from respective choices of follow-up activities. Conclusions. The study outcomes affirm the impact of Learn, Share and Live, indicating a replicated and sustained program effect. Future studies should continue longer follow-up and explore the importance of providing mammography opportunities along with education.
Handle: RePEc:aph:ajpbhl:2000:90:8:1229-1234_8

Template-Type: ReDIF-Article 1.0
Title: A longitudinal study of drinking and cognitive performance in elderly Japanese American men: The Honolulu-Asia aging study
Journal: American Journal of Public Health
Author-Name: Galanis, D.J.
Author-Name: Joseph, C.
Author-Name: Masaki, K.H.
Author-Name: Petrovitch, H.
Author-Name: Ross, G.W.
Author-Name: White, L.
Year: 2000
Volume: 90
Issue: 8
Pages: 1254-1259
Abstract: Objectives. This study prospectively describes the relationships between alcohol intake and subsequent cognitive performance among participants in the Honolulu Heart Program (HHP). Methods. Alcohol intake was assessed at Exam III of the HHP, and cognitive performance was measured approximately 18 years later with the Cognitive Abilities Screening Instrument (CASI). Complete information was available for 3556 participants, aged 71 to 93 years at follow-up. Results. In multivariate analyses, the relationship between drinking and later cognitive performance appeared nonlinear, as nondrinkers and heavy drinkers (more than 60 ounces of alcohol per month) had the lowest CASI scores and the highest risks of poor and intermediate CASI outcomes. Compared with nondrinkers, the risk of a poor CASI score was lowered by 22% to 40% among men who consumed 1-60 ounces of alcohol per month. Conclusions. We report a positive association between moderate alcohol intake among middle-aged men and subsequent cognitive performance in later life. However, it is possible that the health risks associated with drinking outweight any potential benefits for many elderly persons.
Handle: RePEc:aph:ajpbhl:2000:90:8:1254-1259_4

Template-Type: ReDIF-Article 1.0
Title: Effects of traditional classroom and distance continuing education: A theory-driven evaluation of a vaccine-preventable diseases course
Journal: American Journal of Public Health
Author-Name: Umble, K.E.
Author-Name: Cervero, R.M.
Author-Name: Yang, B.
Author-Name: Atkinson, W.L.
Year: 2000
Volume: 90
Issue: 8
Pages: 1218-1224
Abstract: Objectives: This study evaluated the effects of a major federal immunization continuing education course, delivered in both traditional classroom and satellite broadcast versions, on public health professionals' knowledge, agreement, self-efficacy, and adherence in practice to recommendations. Methods. The study used a comparative time series design to determine whether the course influenced participants' knowledge, agreement, self-efficacy, and adherence in practice to general and polio-specific recommendations as measured immediately and 3 months after the course. It also compared the effects of the classroom and satellite broadcast versions and used path analysis to show how the outcomes were related to one another. Results. Both versions significantly improved knowledge, agreement self- efficacy, and adherence. Knowledge and agreement were significant predictors of self-efficacy, which directly predicted adherence. Vaccine availability and supportive clinic policies were also important adherence predictors. Conclusions. A well-designed training update can change provider knowledge, agreement, self-efficacy, and adherence. Traditional classroom and distance training can have comparable effects. The findings support incorporation of distance learning in national public health training, if the distance learning is used wisely in relation to training needs, goals, and practice contexts.
Handle: RePEc:aph:ajpbhl:2000:90:8:1218-1224_1

Template-Type: ReDIF-Article 1.0
Title: Type 2 diabetes is prevalent and poorly controlled among Hispanic elders of Caribbean origin
Journal: American Journal of Public Health
Author-Name: Tucker, K.L.
Author-Name: Bermudez, O.I.
Author-Name: Castaneda, C.
Year: 2000
Volume: 90
Issue: 8
Pages: 1288-1293
Abstract: Objectives. We estimated prevalence and control of type 2 diabetes in Puerto Rican, Dominican, and non-Hispanic White(NHW)elders and associated them with sociodemographic and health behavior variables and with body mass index (BMI)and waist circumference. Method. We used a cross-sectional analysis with a sample of Hispanic elders in Massachusetts and a comparison group of NHWs (1991-1997). The analysis included 379. Puerto Ricans, 113 Dominicans, and 164 NHWs. aged 60 to 96 years, with complete questionnaires and blood samples. Results. Type 2 diabetes was significantly more prevalent among Puerto Ricans (38%) and Dominicans (35%) than among NHWs (23%). Differences remained after covariates were adjusted for. Hispanics with diabetes were approximately 3 times more likely to use insulin than NHWs. Puerto Ricans were 2 times, and Dominicans 3 times, more likely to have glycosylated hemoglobin concentrations of 7% or above than NHWs. BMI and waist circumference were individually associated with diabetes. When included in the model together, waist circumference, but not BMI, remained independently associated with diabetes. Conclusions. Ethnicity was more strongly associated with diabetes status and control than were socioeconomic or measured health behavior variables, suggesting that genetic or other culturally related factors may explain these differences.
Handle: RePEc:aph:ajpbhl:2000:90:8:1288-1293_7

Template-Type: ReDIF-Article 1.0
Title: Educational level, relative body weight, and changes in their association over 10 years: An international perspective from the WHO MONICA Project
Journal: American Journal of Public Health
Author-Name: Molarius, A.
Author-Name: Seidell, J.C.
Author-Name: Sans, S.
Author-Name: Tuomilehto, J.
Author-Name: Kuulasmaa, K.
Year: 2000
Volume: 90
Issue: 8
Pages: 1260-1268
Abstract: Objectives. This study assessed the consistency and magnitude of the association between educational level and relative body weight in populations with widely different prevalences of over-weight and investigated possible changes in the association over 10 years. Methods. Differences in age- adjusted mean body mass index (BMI) between the highest and the lowest tertiles of years of schooling were calculated for 26 populations in the initial and final surveys of the World Health Organization (WHO) MONICA (Monitoring Trends and Determinants in Cardiovascular Disease) Project. The data are derived from random population samples, including more than 42 000 men and women aged 35 to 64 years in the initial survey (1979-1989) and almost 35000 in the final survey (1989-1996). Results. For women, almost all populations showed a statistically significant inverse association between educational level and BMI; the difference between the highest and the lowest educational tertiles ranged from -3.3 to 0.4 kg/m2. For men, the difference ranged from -1.5 to 2.2 kg/m2. In about two thirds of the populations, the differences in BMI between the educational levels increased over the 10-year period. Conclusion. Lower education was associated with higher BMI in about half of the male and in almost all of the female populations, and the differences in relative body weight between educational levels increased over the study period. Thus, socioeconomic inequality in health consequences of obesity may increase in many countries.
Handle: RePEc:aph:ajpbhl:2000:90:8:1260-1268_9

Template-Type: ReDIF-Article 1.0
Title: Agricultural work-related injuries among farmers in Hubei, People's Republic of China
Journal: American Journal of Public Health
Author-Name: Xiang, H.
Author-Name: Wang, Z.
Author-Name: Stallones, L.
Author-Name: Keefe, T.J.
Author-Name: Huang, X.
Author-Name: Fu, X.
Year: 2000
Volume: 90
Issue: 8
Pages: 1269-1276
Abstract: Objectives. This population-based study evaluated patterns of, and risk factors for, agricultural injuries among farmers in the People's Republic of China. Methods. A multistage sample of 1500 Chinese farmers was selected from 14 villages. Face-to-face interviews with 1358 farmers were conducted between July 1997 and September 1997 (response rate = 91%). Agricultural work-related injuries that occurred in the previous 24 months and the associated factors were evaluated. Results. A total of 33% of the farmers reported at least 1 work-related injury in the 24 months before the survey. Major external causes of the injuries were hand tools (50%), falls (26%), and heavy falling objects (10%), The statistically significant risk factors for injury were low family income, 1 to 6 school years of education, self-reported pesticide exposure, tension in relationships with neighbors, and stress in life. The most notable result was the relation between self-reported pesticide exposure and injury, with farmers with greater pesticide exposure at significantly greater risk for injury. Conclusions. The results of this study indicated that injuries occurring among Chinese farmers may have unique patterns and potential risk factors.
Handle: RePEc:aph:ajpbhl:2000:90:8:1269-1276_0

Template-Type: ReDIF-Article 1.0
Title: Disability and the curriculum in US graduate schools of public health
Journal: American Journal of Public Health
Author-Name: Tanenhaus, R.H.
Author-Name: Meyers, A.R.
Author-Name: Harbison, L.A.
Year: 2000
Volume: 90
Issue: 8
Pages: 1315-1316
Handle: RePEc:aph:ajpbhl:2000:90:8:1315-1316_4

Template-Type: ReDIF-Article 1.0
Title: Bias in proxies' reports of disability: Data from the National Health Interview Survey on disability
Journal: American Journal of Public Health
Author-Name: Todorov, A.
Author-Name: Kirchner, C.
Year: 2000
Volume: 90
Issue: 8
Pages: 1248-1253
Abstract: Objectives. These studies examined whether differences between self- reports and proxy reports of disabilities reflect proxy response biases or only respon-debt selection factors. Methods. The data Were from the National Health Interview Survey on Disability (1994-1995, phases 1 and 2). In study 1, reports of disabilities were regressed on respondent status, self vs proxy, and demographic factors. In study 2, the ratios of the proportions of self-reports and proxy reports of disabilities were regressed on independent lay ratings of observability of these disabilities and their 'finteractional' nature. In study 3, the disability reports for people who differed in respondent status in one phase but self-reported the same disability in the Other phase were compared. Results. In study 1, proxies under reported disabilities for people aged 18 to 64 years but overreported for people 65 years or older. In study 2, the observability and interactional scores accounted for more than 60% of the variance of self and proxy differences in an inverse relationship. Study 3 confirmed the basic findings of study 1. Conclusions. Use of proxies in representative surveys on disability introduces systematic biases, affecting national disability estimates.
Handle: RePEc:aph:ajpbhl:2000:90:8:1248-1253_4

Template-Type: ReDIF-Article 1.0
Title: Needs assessment and a model agenda for training the public health workforce
Journal: American Journal of Public Health
Author-Name: Potter, M.A.
Author-Name: Pistella, C.L.
Author-Name: Fertman, C.I.
Author-Name: Dato, V.M.
Year: 2000
Volume: 90
Issue: 8
Pages: 1294-1296
Abstract: Objectives. A training needs assessment project tested the use of 'universal' competencies for establishing a model training agenda for the public health workforce. Methods. Agency supervisor selected competencies for training priorities. Regional and national public health leaders used these selections to design the model training agenda. Results. The competencies given high priority by supervisors varied among state and local agencies and include some not within the universal set. The model training agenda reflected supervisor's priorities as well as leader's perspectives. Conclusions. The universal competencies provide a useful starting point, but not necessary an exclusive framework, for assessing and meeting the training needs of the public health workforce.
Handle: RePEc:aph:ajpbhl:2000:90:8:1294-1296_5

Template-Type: ReDIF-Article 1.0
Title: Anthrax vaccination is based on medical evidence [2] (multiple letters)
Journal: American Journal of Public Health
Author-Name: Blanck, R.B.
Author-Name: Cohen, H.W.
Author-Name: Gould, R.M.
Author-Name: Sidel, V.W.
Year: 2000
Volume: 90
Issue: 8
Pages: 1326-1327
Handle: RePEc:aph:ajpbhl:2000:90:8:1326-1327_3

Template-Type: ReDIF-Article 1.0
Title: A 'call to arms' for a National Reporting System on firearm injuries
Journal: American Journal of Public Health
Author-Name: Barber, C.
Author-Name: Hemenway, D.
Author-Name: Hargarten, S.
Author-Name: Kellermann, A.
Author-Name: Azrael, D.
Author-Name: Wilt, S.
Year: 2000
Volume: 90
Issue: 8
Pages: 1191-1193
Handle: RePEc:aph:ajpbhl:2000:90:8:1191-1193_4

Template-Type: ReDIF-Article 1.0
Title: Levels of racism: A theoretic framework and a gardener's tale
Journal: American Journal of Public Health
Author-Name: Jones, C.P.
Year: 2000
Volume: 90
Issue: 8
Pages: 1212-1215
Abstract: The author presents a theoretic framework for understanding racism on 3 levels: institutionalized, personally mediated, and internalized. This framework is useful for raising new hypotheses about the basis of race- associated differences in health outcomes, as well as for designing effective interventions to eliminate those differences. She then presents an allegory about a gardener with 2 flower boxes, rich and poor soil, and red and pink flowers. This allegory illustrates the relationship between the 3 levels of racism and may guide our thinking about how to intervene to mitigate the impacts of racism on health. It may also serve as a tool for starting a national conversation on racism.
Handle: RePEc:aph:ajpbhl:2000:90:8:1212-1215_4

Template-Type: ReDIF-Article 1.0
Title: The health-damaging potential of new types of flexible employment: A challenge for public health researchers
Journal: American Journal of Public Health
Author-Name: Benach, J.
Author-Name: Benavides, F.G.
Author-Name: Platt, S.
Author-Name: Diez-Roux, A.
Author-Name: Muntaner, C.
Year: 2000
Volume: 90
Issue: 8
Pages: 1316-1317
Handle: RePEc:aph:ajpbhl:2000:90:8:1316-1317_0

Template-Type: ReDIF-Article 1.0
Title: Measuring smokers' perceptions of the health risks from smoking light cigarettes
Journal: American Journal of Public Health
Author-Name: Kozlowski, L.T.
Author-Name: Goldberg, M.E.
Author-Name: Yost, B.A.
Year: 2000
Volume: 90
Issue: 8
Pages: 1318-1319
Handle: RePEc:aph:ajpbhl:2000:90:8:1318-1319_4

Template-Type: ReDIF-Article 1.0
Title: The impact of multiple predictors on generalist physicians' care of underserved populations
Journal: American Journal of Public Health
Author-Name: Rabinowitz, H.K.
Author-Name: Diamond, J.J.
Author-Name: Veloski, J.J.
Author-Name: Gayle, J.A.
Year: 2000
Volume: 90
Issue: 8
Pages: 1225-1228
Abstract: Objectives. This study examined the relative and incremental importance of multiple predictors of generalist physicians' care of underserved populations. Methods. Survey results from a 1993 national random sample of 2955 allopathic and osteopathic generalist physicians who graduated from medical school in 1983 or 1984 were analyzed. Results. Four independent predictors of providing care to underserved populations were (1) being a member of an underserved ethnic/minority group, (2) having participated in the National Health Service Corps, (3) having a strong interest in practicing in an underserved area prior to attending medical school, and (4) growing up in an underserved area. Eighty-six percent of physicians with all 4 predictors were providing substantial care to underserved populations, compared with 65% with 3 predictors, 49% with 2 predictors, 34% with 1 predictor, and 22% with no predictors. Sex, family income when growing up, and curricular exposure to underserved populations during medical school were not independently related to caring for the -underserved. Conclusions. A small number of factors appear to be highly predictive of generalist physicians' care for the underserved, and most of these predictive factors can be identified at the time of admission to medical school.
Handle: RePEc:aph:ajpbhl:2000:90:8:1225-1228_6

Template-Type: ReDIF-Article 1.0
Title: Social issues as public health: Promise and peril
Journal: American Journal of Public Health
Author-Name: Meyer, I.H.
Author-Name: Schwartz, S.
Year: 2000
Volume: 90
Issue: 8
Pages: 1189-1191
Handle: RePEc:aph:ajpbhl:2000:90:8:1189-1191_8

Template-Type: ReDIF-Article 1.0
Title: Socioeconomic status and multiple myeloma among US Blacks and Whites
Journal: American Journal of Public Health
Author-Name: Baris, D.
Author-Name: Brown, L.M.
Author-Name: Silverman, D.T.
Author-Name: Hayes, R.
Author-Name: Hoover, R.N.
Author-Name: Swanson, G.M.
Author-Name: Dosemeci, M.
Author-Name: Schwartz, A.G.
Author-Name: Liff, J.M.
Author-Name: Schoenberg, J.B.
Author-Name: Pottern, L.M.
Author-Name: Lubin, J.
Author-Name: Greenberg, J.S.
Author-Name: Fraumeni J.F., Jr.
Year: 2000
Volume: 90
Issue: 8
Pages: 1277-1281
Abstract: Objectives. This study examined the relation between socioeconomic status (SES) and risk of multiple myeloma among Blacks and Whites in the United States. Methods. This population-based case-control study included 573 cases (206 Blacks and 367 Whites) with new diagnoses of multiple myeloma identified between August 1, 1986, and April 30, 1989, and 2131 controls (967 Blacks and 1164 Whites) from 3 US geographic areas. Information on occupation, income, and education was obtained by personal interview. Results. Inverse gradients in risk were associated with occupation-based SES, income, and education. Risks were significantly elevated for subjects in the lowest categories of occupation-based SES (odds ratio [OR=1.71, 95% confidence interval [CI] = 1.16, 2.53), education (OR= 1.36, 95% CI = 1.06, 1.75), and income (OR = 1.43, 95% CI= 1.05, 1.93). Occupation-based low SES accounted for 37% of multiple myeloma in Blacks and 17% in Whites, as well as 49% of the excess incidence in Blacks. Low education and low income accounted for 17% and 28% of the excess incidence in Blacks, respectively. Conclusions. Our results indicate that the measured SES-related factors account for a substantial amount of the Black-White differential in multiple myeloma incidence.
Handle: RePEc:aph:ajpbhl:2000:90:8:1277-1281_7

Template-Type: ReDIF-Article 1.0
Title: Competency development in public health leadership
Journal: American Journal of Public Health
Author-Name: Wright, K.
Author-Name: Rowitz, L.
Author-Name: Merkle, A.
Author-Name: Reid, W.M.
Author-Name: Robinson, G.
Author-Name: Herzog, B.
Author-Name: Weber, D.
Author-Name: Carmichael, D.
Author-Name: Balderson, T.R.
Author-Name: Baker, E.
Year: 2000
Volume: 90
Issue: 8
Pages: 1202-1207
Abstract: The professional development of public health leaders requires competency-based instruction to increase their ability to address complex and changing demands for critical services. This article reviews the development of the Leadership Competency Framework by the National Public Health Leadership Development Network and discusses its significance. After reviewing pertinent literature and existing practice-based competency frameworks, network members developed the framework through sequential use of workgroup assignments and nominal group process. The framework is being used by network members to develop and refine program competency lists and content; to compare programs; to develop needs assessments, baseline measures, and performance standards; and to evaluate educational outcomes. It is a working document, to be continually refined and evaluated to ensure its continued relevance to performance in practice. Understanding both the applications and the limits of competency frameworks is important in individual, program, and organizational assessment. Benefits of using defined competencies in designing leadership programs include the integrated and sustained development of leadership capacity and the use of technology for increased access and quality control.
Handle: RePEc:aph:ajpbhl:2000:90:8:1202-1207_2

Template-Type: ReDIF-Article 1.0
Title: The history of health in Dayton: A community-academic partnership
Journal: American Journal of Public Health
Author-Name: Lemkau, J.P.
Author-Name: Ahmed, S.M.
Author-Name: Cauley, K.
Year: 2000
Volume: 90
Issue: 8
Pages: 1216-1217
Handle: RePEc:aph:ajpbhl:2000:90:8:1216-1217_6

Template-Type: ReDIF-Article 1.0
Title: Civilian protection measures against terrorist attack are the best preventive medicine [1] (multiple letters)
Journal: American Journal of Public Health
Author-Name: Brodsky, A.
Author-Name: Cohen, H.E.
Author-Name: Gould, R.B.
Author-Name: Sidel, V.W.
Year: 2000
Volume: 90
Issue: 8
Pages: 1325-1326
Handle: RePEc:aph:ajpbhl:2000:90:8:1325-1326_8

Template-Type: ReDIF-Article 1.0
Title: Bioterrorism initiatives: Public health support [3] (multiple letters)
Journal: American Journal of Public Health
Author-Name: Perrotta, D.M.
Author-Name: Ascher, M.S.
Author-Name: Layton, M.
Author-Name: Cohen, H.L.
Author-Name: Gould, R.M.
Author-Name: Sidel, W.V.
Year: 2000
Volume: 90
Issue: 8
Pages: 1327
Handle: RePEc:aph:ajpbhl:2000:90:8:1327_9

Template-Type: ReDIF-Article 1.0
Title: Toward a better educated public health workforce
Journal: American Journal of Public Health
Author-Name: Sommer, A.
Year: 2000
Volume: 90
Issue: 8
Pages: 1194-1195
Handle: RePEc:aph:ajpbhl:2000:90:8:1194-1195_2

Template-Type: ReDIF-Article 1.0
Title: Mastering the new public health
Journal: American Journal of Public Health
Author-Name: Clark, N.M.
Author-Name: Weist, E.
Year: 2000
Volume: 90
Issue: 8
Pages: 1208-1211
Abstract: The dramatic changes in the field of public health are reverberating in schools of public health in a number of ways, not the least of which is action by the deans of the Association of Schools of Public Health (ASPH) to ensure that graduates with master's of public health degrees are competent to meet the current challenges of practice. The conceptual framework at the center of this activity describes 3 domains-skills, perspectives, and applications-in which alumni of schools of public health may be required to demonstrate competency. ASPH work in this area is grounded in previous national and professional competency definitions and school- and department- specific competency development; it is distinct from earlier work, however, because its focus is on competency at the master's level across the graduate schools of public health.
Handle: RePEc:aph:ajpbhl:2000:90:8:1208-1211_8

Template-Type: ReDIF-Article 1.0
Title: Reliability and validity of disability questions for US census 2000
Journal: American Journal of Public Health
Author-Name: Andresen, E.M.
Author-Name: Fitch, C.A.
Author-Name: McLendon, P.M.
Author-Name: Meyers, A.R.
Year: 2000
Volume: 90
Issue: 8
Pages: 1297-1299
Abstract: Objectives. We investigated the validity and proxy reliability of 7 new disability questions from the 2000 US census ('Census 2000'). Methods. A total of 131 people with disabilities and their proxies from St Louis, Mo, and Massachusetts were interviewed, and responses were compared for concordance. Responses also were compared with responses to questions from the Behavioral Risk Factor Surveillance System (BRFSS) and the Activities of Daily Living (ADL) instrument. Results. Overall, proxies reported more impairment than did people with disabilities, and agreement was low (κg = 0.24-0.55). Concordance was moderate between the census questions and their BRFSS and ADL counterparts. Conclusions. The Census 2000 questions may not provide an accurate profile of disability in America.
Handle: RePEc:aph:ajpbhl:2000:90:8:1297-1299_9

Template-Type: ReDIF-Article 1.0
Title: Public requests for cancer cluster investigations: A survey of state health departments
Journal: American Journal of Public Health
Author-Name: Trumbo, C.W.
Year: 2000
Volume: 90
Issue: 8
Pages: 1300-1302
Abstract: Objectives. This study examined the frequency of requests that state health departments investigate cancer clusters, the nature of those requests, and the resources available for the investigations. Methods. A mail survey was sent to state health departments requesting data for 1997. Results. Approximately 1100 cluster investigation requests were made in 1997. Most requests were made by citizens, and no pattern emerged for types of cancer or hazards suspected. State rate this work as average in importance and feel satisfied with the successfulness of their communication efforts. Conclusions. Few cluster inquiries required further investigation. Nonetheless, this interaction represents resources well spent in terms of public service and education.
Handle: RePEc:aph:ajpbhl:2000:90:8:1300-1302_1

Template-Type: ReDIF-Article 1.0
Title: APHA offers new educational opportunities
Journal: American Journal of Public Health
Author-Name: Horton, M.
Year: 2000
Volume: 90
Issue: 8
Pages: 1193-1194
Handle: RePEc:aph:ajpbhl:2000:90:8:1193-1194_2

Template-Type: ReDIF-Article 1.0
Title: Medical schools, affirmative action, and the neglected role of social class
Journal: American Journal of Public Health
Author-Name: Magnus, S.A.
Author-Name: Mick, S.S.
Year: 2000
Volume: 90
Issue: 8
Pages: 1197-1201
Abstract: Medical schools affirmative action policies traditionally focus on race and give relatively little consideration to applicants' socioeconomic status or 'social class.' However, recent challenges to affirmative action have raised the prospect of using social class, instead of race, as the basis for preferential admissions decisions in an effort to maintain or increase student diversity. This article reviews the evidence for class-based affirmative action in medicine and concludes that it might be an effective supplement to, rather than a replacement for, race-based affirmative action. The authors consider the research literature on (1) medical students' socioeconomic background, (2) the impact of social class on medical treatment and physician-patient communication, and (3) correlations between physicians' socioeconomic origins and their service patterns to the disadvantaged. They also reference sociological literature on distinctions between race and class and Americans' discomfort with 'social class'.
Handle: RePEc:aph:ajpbhl:2000:90:8:1197-1201_7

Template-Type: ReDIF-Article 1.0
Title: A simulation of the effects of youth initiation policies on overall cigarette use
Journal: American Journal of Public Health
Author-Name: Levy, D.T.
Author-Name: Cummings, K.M.
Author-Name: Hyland, A.
Year: 2000
Volume: 90
Issue: 8
Pages: 1311-1314
Abstract: Objectives. We developed a simulation model to predict the effects of policies aimed at reducing smoking initiation by youths younger than 18 years. Methods. The model projected the number of smokers, never smokers, and ex-smokers by age, sex, and racial/ethnic group and the effects of reductions in youth initiation. Results. The model predicted that even if tobacco policies eliminated youth initiation, the number of smokers would not be halved for more than 30 years. If initiation were halved and some of the initiation were delayed rather than eliminated, substantially smaller reductions would result. Conclusions. Policies that increase cessation rates are needed to reduce the number of current smokers and the more near-term health problems.
Handle: RePEc:aph:ajpbhl:2000:90:8:1311-1314_8

Template-Type: ReDIF-Article 1.0
Title: A change in approach to prenatal HIV screening
Journal: American Journal of Public Health
Author-Name: Kass, N.
Year: 2000
Volume: 90
Issue: 7
Pages: 1026-1027
Handle: RePEc:aph:ajpbhl:2000:90:7:1026-1027_9

Template-Type: ReDIF-Article 1.0
Title: Further thoughts about vaginal microbicide testing [6] (multiple letters)
Journal: American Journal of Public Health
Author-Name: Wittkowski, K.M.
Author-Name: Potts, M.
Year: 2000
Volume: 90
Issue: 7
Pages: 1155-1156
Handle: RePEc:aph:ajpbhl:2000:90:7:1155-1156_5

Template-Type: ReDIF-Article 1.0
Title: The public health challenges of the HIV epidemic
Journal: American Journal of Public Health
Author-Name: Levi, J.
Year: 2000
Volume: 90
Issue: 7
Pages: 1023-1024
Handle: RePEc:aph:ajpbhl:2000:90:7:1023-1024_1

Template-Type: ReDIF-Article 1.0
Title: Prevention counseling for HIV-negative persons [1] (multiple letters)
Journal: American Journal of Public Health
Author-Name: Kamb, M.L.
Author-Name: Peterman, T.A.
Author-Name: Wolitski, R.J.
Author-Name: Weinhardt, L.S.
Author-Name: Carey, M.P.
Author-Name: Johnson, B.T.
Author-Name: Bickham, N.L.
Year: 2000
Volume: 90
Issue: 7
Pages: 1152-1153
Handle: RePEc:aph:ajpbhl:2000:90:7:1152-1153_2

Template-Type: ReDIF-Article 1.0
Title: Condom counseling in microbicide testing: A right of choice [3]
Journal: American Journal of Public Health
Author-Name: Pollack, A.
Author-Name: Pine, R.N.
Author-Name: Beattie, K.
Year: 2000
Volume: 90
Issue: 7
Pages: 1154
Handle: RePEc:aph:ajpbhl:2000:90:7:1154_4

Template-Type: ReDIF-Article 1.0
Title: Ignore AIDS and it will bury the rest of you
Journal: American Journal of Public Health
Author-Name: Helfand, W.H.
Author-Name: Lazarus, J.
Author-Name: Theerman, P.
Year: 2000
Volume: 90
Issue: 7
Pages: 1028
Handle: RePEc:aph:ajpbhl:2000:90:7:1028_2

Template-Type: ReDIF-Article 1.0
Title: Ethics require the inclusion of condoms and counseling in anti-HIV microbicide trials [4]
Journal: American Journal of Public Health
Author-Name: Lurie, P.
Author-Name: Wolfe, S.M.
Year: 2000
Volume: 90
Issue: 7
Pages: 1154-1155
Handle: RePEc:aph:ajpbhl:2000:90:7:1154-1155_4

Template-Type: ReDIF-Article 1.0
Title: Microbicide research and 'the investigator's dilemma' [5]
Journal: American Journal of Public Health
Author-Name: De Zoysa, I.
Author-Name: Elias, C.J.
Author-Name: Bentley, M.E.
Year: 2000
Volume: 90
Issue: 7
Pages: 1155
Handle: RePEc:aph:ajpbhl:2000:90:7:1155_3

Template-Type: ReDIF-Article 1.0
Title: Preaching to the choir: Preference for female-controlled methods of HIV and sexually transmitted disease prevention
Journal: American Journal of Public Health
Author-Name: Murphy, S.T.
Author-Name: Miller, L.C.
Author-Name: Moore, J.
Author-Name: Clark, L.F.
Year: 2000
Volume: 90
Issue: 7
Pages: 1135-1137
Abstract: Objectives. This study assessed interest in female-controlled methods of HIV and sexually transmitted disease (STD) prevention. Methods. Surveys were conducted with 168 African American women, aged 18 to 32 years, who had had unprotected sex and at least 3 sexual partners in the last 2 years. Results. Of 44 potential features, 'female control' (where women control the method by either wearing or applying it) ranked 22nd in average importance. Women who rated female control as highly important had fewer sex partners and fewer STDs and were more likely to use existing prevention methods frequently. Conclusions. Female control may be of less interest to women most at risk for HIV and other STDs. This underscores the need to take the priorities and preferences of women into consideration when developing new prevention methods.
Handle: RePEc:aph:ajpbhl:2000:90:7:1135-1137_9

Template-Type: ReDIF-Article 1.0
Title: A participant observation study using actors at 30 publicly funded HIV counseling and testing sites in Pennsylvania
Journal: American Journal of Public Health
Author-Name: Silvestre, A.J.
Author-Name: Gehl, M.B.
Author-Name: Encandela, J.
Author-Name: Schelzel, G.
Year: 2000
Volume: 90
Issue: 7
Pages: 1096-1099
Abstract: Objectives. This study was designed to augment an evaluation of Pennsylvania publicly funded HIV counseling and testing sites, particularly of the staff-client interaction. Methods. Actors were trained as research assistants and sent to 30 randomly chosen sites to be tested and counseled for HIV disease. Instruments based on Centers for Disease Control and Prevention (CDC) guidelines were designed and used to evaluate them. Results. Data were generated that identified the range of compliance with CDC guidelines and state policy. Among the findings were that 10 of 30 sites required signed consents despite a state policy allowing anonymous testing. Only 17% of providers developed a written risk reduction plan, even though 69% of all sites surveyed by mail asserted that such plans were developed. Only 2 of 5 HIV-positive actors were offered partner notification services, even though 100% of sites visited by an interviewer claimed to offer such services. Conclusions. The findings suggest that although evaluation methods such as mail surveys and site visits are useful for evaluating the existence of appropriate policies and protocols and gathering baseline data, they might not be sufficient for assessing actual staff-client interaction.
Handle: RePEc:aph:ajpbhl:2000:90:7:1096-1099_2

Template-Type: ReDIF-Article 1.0
Title: Self-reports of induced abortion: An empathetic setting can improve the quality of data
Journal: American Journal of Public Health
Author-Name: Rasch, V.
Author-Name: Muhammad, H.
Author-Name: Urassa, E.
Author-Name: Bergström, S.
Year: 2000
Volume: 90
Issue: 7
Pages: 1141-1144
Abstract: Objectives. This study estimated the proportion of incomplete abortions that are induced in hospital-based settings in Tanzania. Methods. A cross- sectional questionnaire was conducted in 2 phases at 3 hospitals in Tanzania. Phase 1 included 302 patients with a diagnosis of incomplete abortion, and phase 2 included 823 such patients. Results. In phase 1, in which cases were classified by clinical criteria and information from the patient, 3.9% to 16.1% of the cases were classified as induced abortion. In phase 2, in which the structured interview was changed to an empathetic dialogue and previously used clinical criteria were omitted, 30.9% to 60.0% of the cases were classified as induced abortion. Conclusions. An empathetic dialogue improves the quality of data collected among women with induced abortion.
Handle: RePEc:aph:ajpbhl:2000:90:7:1141-1144_6

Template-Type: ReDIF-Article 1.0
Title: HIV-infected parents and their children in the United States
Journal: American Journal of Public Health
Author-Name: Schuster, M.A.
Author-Name: Kanouse, D.E.
Author-Name: Morton, S.C.
Author-Name: Bozzette, S.A.
Author-Name: Miu, A.
Author-Name: Scott, G.B.
Author-Name: Shapiro, M.F.
Year: 2000
Volume: 90
Issue: 7
Pages: 1074-1081
Abstract: Objectives. This study sought to determine the number, characteristics, and living situations of children of HIV-infected adults. Methods. Interviews were conducted in 1996 and early 1997 with a nationally representative probability sample of 2864 adults receiving health care for HIV within the contiguous United States. Results. Twenty-eight percent of infected adults in care had children. Women were more likely than men to have children (60% vs 18%) and to live with them (76% vs 34%). Twenty-one percent of parents had been hospitalized during the previous 6 months, and 10% had probably been drug dependent in the previous year. Parents continued to have children after being diagnosed with HIV: 12% of all women conceived and bore their youngest child after diagnosis, and another 10% conceived before but gave birth after diagnosis. Conclusions. Clinical and support services for people affected by the HIV epidemic should have a family focus.
Handle: RePEc:aph:ajpbhl:2000:90:7:1074-1081_7

Template-Type: ReDIF-Article 1.0
Title: Perceived unmet need for oral treatment among a national population of HIV-positive medical patients: Social and clinical correlates
Journal: American Journal of Public Health
Author-Name: Marcus, M.
Author-Name: Freed, J.R.
Author-Name: Coulter, I.D.
Author-Name: Der-Martirosian, C.
Author-Name: Cunningham, W.
Author-Name: Andersen, R.
Author-Name: Garcia, I.
Author-Name: Schneider, D.A.
Author-Name: Maas, W.R.
Author-Name: Bozzette, S.A.
Author-Name: Shapiro, M.F.
Year: 2000
Volume: 90
Issue: 7
Pages: 1059-1063
Abstract: Objectives. This study examines social, behavioral, and clinical correlates of perceived unmet need for oral health care for people with HIV infection. Methods: Baseline in-person interviews with 2864 individuals were conducted with the HIV Cost and Services Utilization Study cohort, a nationally representative probability sample of HIV-infected persons in medical are Bivariate and logistic regression analyses were conducted, with unmet need in the last 6 months as the dependent variable and demographic, social, behavioral, and disease characteristics as independent variables. Results. We estimate that 19.3% of HIV-infected medical patients (n = 44550) had a perceived unmet need for dental care in the last 6 months. The odds of having unmet dental needs were highest for those on Medicaid in states without dental benefits (odds ratio [OR] = 2.21), for others with no dental insurance (OR = 2.26), for those with incomes under $5000 (OR = 2.20), and for those with less than a high school education (OR = 1.83). Low CD4 count was not significant. Conclusions. Perceived unmet need was related more to social and economic factors than to stage of infection. An expansion of dental benefits for those on Medicaid might reduce unmet need for dental care.
Handle: RePEc:aph:ajpbhl:2000:90:7:1059-1063_8

Template-Type: ReDIF-Article 1.0
Title: Scientific silence: AIDS and African Americans in the medical literature
Journal: American Journal of Public Health
Author-Name: Mackenzie, S.
Year: 2000
Volume: 90
Issue: 7
Pages: 1145-1146
Handle: RePEc:aph:ajpbhl:2000:90:7:1145-1146_4

Template-Type: ReDIF-Article 1.0
Title: HIV: Challenging the health care delivery system
Journal: American Journal of Public Health
Author-Name: Levi, J.
Author-Name: Kates, J.
Year: 2000
Volume: 90
Issue: 7
Pages: 1033-1036
Abstract: HIV offers a lens through which the underlying problems of the US health care system can be examined. New treatments offer the potential of prolonged quality of life for people living with HIV if they have adequate access to health care. However, increasing numbers of new cases of HIV occur among individuals with poor access to health care. Restrictions on eligibility for Medicaid (and state-by-state variability) contribute to uneven access to the most important safety net source of HIV care financing, while relatively modest discretionary programs attempt to fill in the gap with an ever- increasing caseload. Many poor people with HIV are going without care, even though aggregate public spending on HIV-related care will total $7.7 billion in fiscal year 2000, an amount sufficient to cover the care costs of one half of those living with HIV. But inefficiencies and inequities in the system (both structural and geographic) require assessment of the steps that can be taken to create a more rational model of care financing for people living with HIV that could become a model for all chronic diseases.
Handle: RePEc:aph:ajpbhl:2000:90:7:1033-1036_6

Template-Type: ReDIF-Article 1.0
Title: Bridging the gap between the science and service of HIV prevention: Transferring effective research-based HIV prevention interventions to community AIDS service providers
Journal: American Journal of Public Health
Author-Name: Kelly, J.A.
Author-Name: Somlai, A.M.
Author-Name: DiFranceisco, W.J.
Author-Name: Otto-Salaj, L.L.
Author-Name: McAuliffe, T.L.
Author-Name: Hackl, K.L.
Author-Name: Heckman, T.G.
Author-Name: Holtgrave, D.R.
Author-Name: Rompa, D.
Year: 2000
Volume: 90
Issue: 7
Pages: 1082-1088
Abstract: Objectives. AIDS service organizations (ASOs) rarely have access to the information needed to implement research-based HIV prevention interventions for their clients. We compared the effectiveness of 3 dissemination strategies for transferring HIV prevention models from the research arena to community providers of HIV prevention services. Methods. Interviews were conducted with the directors of 74 ASOs to assess current HIV prevention services. ASOs were randomized to programs that provided (1) technical assistance manuals describing how to implement research-based HIV prevention interventions, (2) manuals plus a staff training workshop on how to conduct the implementation, or (3) manuals, the training workshop, and follow-up telephone consultation calls. Follow-up interviews determined whether the intervention model had been adopted. Results. The dissemination package that provided ASOs with implementation manuals, staff training workshops, and follow-up consultation resulted in more frequent adoption and use of the research-based HIV prevention intervention for gay men, women, and other client populations. Conclusions. Strategies are needed to quickly transfer research-based HIV prevention methods to community providers of HIV prevention services. Active collaboration between researchers and service agencies results in more successful program adoption than distribution of implementation packages alone.
Handle: RePEc:aph:ajpbhl:2000:90:7:1082-1088_6

Template-Type: ReDIF-Article 1.0
Title: HIV testing among the general US population and persons at increased risk: Information from national surveys, 1987-1996
Journal: American Journal of Public Health
Author-Name: Anderson, J.E.
Author-Name: Carey, J.W.
Author-Name: Taveras, S.
Year: 2000
Volume: 90
Issue: 7
Pages: 1089-1095
Abstract: Objectives. We used data from national surveys to measure the rate of HIV testing in the general US population and among persons at increased behavioral risk and summarized what has been learned about HIV testing from these surveys. Methods. Three nationally representative surveys were used: the National Health Interview Survey for 1987 through 1995, the 1995 National Survey of Family Growth, and the 1996 National Household Survey on Drug Abuse. These surveys asked about HIV testing experience and behavioral risks for HIV. Rates of testing were computed for all persons, including those at increased risk for HIV. Results. From 1987 to 1995, the percentage of adults ever tested increased from 16% to 40%. The 3 surveys were consistent with one another, and all showed much higher rates of testing for persons at increased risk for HIV. Conclusions. Surveys have provided information on HIV testing that is not available elsewhere, including rates of testing from private sources and public programs. Efforts to measure HIV testing and its correlates should continue and should be improved to provide information essential for effective programs.
Handle: RePEc:aph:ajpbhl:2000:90:7:1089-1095_6

Template-Type: ReDIF-Article 1.0
Title: HIV transmission and the cost-effectiveness of methadone maintenance
Journal: American Journal of Public Health
Author-Name: Zaric, G.S.
Author-Name: Barnett, P.G.
Author-Name: Brandeau, M.L.
Year: 2000
Volume: 90
Issue: 7
Pages: 1100-1111
Abstract: Objectives. This study determined the cost-effectiveness of expanding methadone maintenance treatment for heroin addiction, particularly its effect on the HIV epidemic. Methods. We developed a dynamic epidemic model to study the effects of increased methadone maintenance capacity on health care costs and survival, measured as quality-adjusted life-years (QALYs). We considered communities with HIV prevalence among injection drug users of 5% and 40%. Results. Additional methadone maintenance capacity costs $8200 per QALY gained in the high-prevalence community and $10900 per QALY gained in the low-prevalence community. More than half of the benefits are gained by individuals who do not inject drugs. Even if the benefits realized by treated and untreated injection drug users are ignored, methadone maintenance expansion costs between $14100 and $15200 per QALY gained. Additional capacity remains cost-effective even if it is twice as expensive and half as effective as current methadone maintenance slots. Conclusions. Expansion of methadone maintenance is cost-effective on the basis of commonly accepted criteria for medical interventions. Barriers to methadone maintenance deny injection drug users access to a cost-effective intervention that generates significant health benefits for the general population.
Handle: RePEc:aph:ajpbhl:2000:90:7:1100-1111_9

Template-Type: ReDIF-Article 1.0
Title: Project CREST: A new model for mental health intervention after a community disaster
Journal: American Journal of Public Health
Author-Name: North, C.S.
Author-Name: Hong, B.A.
Year: 2000
Volume: 90
Issue: 7
Pages: 1057-1058
Handle: RePEc:aph:ajpbhl:2000:90:7:1057-1058_8

Template-Type: ReDIF-Article 1.0
Title: Racial and ethnic differences in the use of cardiovascular procedures: Findings from the California cooperative cardiovascular project
Journal: American Journal of Public Health
Author-Name: Ford, E.
Author-Name: Newman, J.
Author-Name: Deosaransingh, K.
Year: 2000
Volume: 90
Issue: 7
Pages: 1128-1134
Abstract: Objectives. This study used data from the California Cooperative Cardiovascular Project to examine the use of invasive and noninvasive cardiovascular procedures among Whites, African Americans, and Hispanics. Methods. The use of catheterization, percutaneous transluminal coronary angioplasty (PTCA), coronary artery bypass graft (CABG) surgery, and several noninvasive tests among all patients 65 years or older with a confirmed acute myocardial infarction in nonfederal hospitals from 1994 to 1995 was studied. Results. African Americans (n = 527) were less likely than Whites (n = 9489) to have received catheterization (adjusted odds ratio [OR] = 0.62, 95% confidence interval [CI] = 0.50, 0.76), PTCA (OR = 0.64, 95% CI = 0.49, 0.85), or CABG surgery (OR = 0.42, 95% CI = 0.27, 0.64); somewhat more likely to have received a stress test or an echocardiogram; and equally likely to have received a multiple-gated acquisition scan. Hispanics (n = 689) also were less likely than Whites to have received catheterization (OR = 0.82, 95% CI = 0.68, 0.98) or PTCA (OR = 0.58, 95% CI = 0.45, 0.75). Conclusions. African Americans were less likely than Whites to undergo costly invasive cardiovascular procedures. In addition, Hispanics were less likely than Whites to have received catheterization and PTCA.
Handle: RePEc:aph:ajpbhl:2000:90:7:1128-1134_7

Template-Type: ReDIF-Article 1.0
Title: Tracking the HIV epidemic: Current issues, future challenges
Journal: American Journal of Public Health
Author-Name: Fleming, P.L.
Author-Name: Wortley, P.M.
Author-Name: Karon, J.M.
Author-Name: DeCock, K.M.
Author-Name: Janssen, R.S.
Year: 2000
Volume: 90
Issue: 7
Pages: 1037-1041
Abstract: The emergence of a new infectious disease, AIDS, in the early 1980s resulted in the development of a national AIDS surveillance system. AIDS surveillance data provided an understanding of transmission risks and characterized communities affected by the epidemic. Later, these data provided the basis for allocating resources for prevention and treatment programs. New treatments have dramatically improved survival. Resulting declines in AIDS incidence and deaths offer hope that HIV disease can be successfully managed. However, to prevent and control HIV/AIDS in the coming decades, the public health community must address new challenges. These include the defining of the role of treatment in reducing infectiousness; the potential for an epidemic of treatment-resistant HIV; side effects treatment; complacency that leads to relapses to high-risk behaviors; and inadequate surveillance and research capacity at state and local to guide the development of health interventions. Meeting these challenges will require reinvesting in the public health capacity of state and local health departments, restructuring HIV/AIDS surveillance programs to collect the data needed to guide the response to the epidemic, and providing timely answers to emerging epidemiologic questions.
Handle: RePEc:aph:ajpbhl:2000:90:7:1037-1041_1

Template-Type: ReDIF-Article 1.0
Title: The social geography of AIDS and hepatitis risk: Qualitative approaches for assessing local differences in sterile-syringe access among injection drug users
Journal: American Journal of Public Health
Author-Name: Singer, M.
Author-Name: Stopka, T.
Author-Name: Siano, C.
Author-Name: Springer, K.
Author-Name: Barton, G.
Author-Name: Khoshnood, K.
Author-Name: De Puga, A.G.
Author-Name: Heimer, R.
Year: 2000
Volume: 90
Issue: 7
Pages: 1049-1056
Abstract: While significant gains have been achieved in understanding and reducting AIDS and hepatitis risks among injection drug users (IDUs), it is necessary to move beyond individual-level characteristics to gain a fuller understanding of the impact of social context on risk. In this study, 6 qualitative methods were used in combination with more traditional epidemiologic survey approaches and laboratory bioassay procedures to examine neighborhood differences in access to sterile syringes among IDUs in 3 northeastern cities. These methods consisted of (1) neighborhood-based IDU focus groups to construct social maps of local equipment acquisition and drug use sites; (2) ethnographic descriptions of target neighborhoods; (3) IDU diary keeping on drug use and injection equipment acquisition; (4) ethnographic day visits with IDUs in natural settings; (5) interviews with IDUs about syringe acquisition and collection of syringes for laboratory analysis; and (6) focused field observation and processual interviewing during drug injection. Preliminary findings from each these methods are reported to illustrate the methods' value in elucidating the impact of local and regional social factors on sterile syringe access.
Handle: RePEc:aph:ajpbhl:2000:90:7:1049-1056_2

Template-Type: ReDIF-Article 1.0
Title: Predicting smoking cessation and major depression in nicotine-dependent smokers
Journal: American Journal of Public Health
Author-Name: Breslau, N.
Author-Name: Johnson, E.O.
Year: 2000
Volume: 90
Issue: 7
Pages: 1122-1127
Abstract: Objectives. This study examined the relationship of nicotine dependence with smoking cessation and major depression, using the Fagerstrom Test for Nicotine Dependence (FTND) and the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition (DSM-III-R). Methods. In an epidemiologic study of young adults that used the FTND and the National Institute of Mental Health Diagnostic Interview Schedule, 238 daily smokers were assessed with respect to nicotine dependence. Cessation (abstinence for 1 year or more) was assessed 2 years later. Results. FTND-defined nicotine dependence predicted cessation, with non-dependent smokers 4 times more likely to quit. DSM-III-R-defined nicotine dependence also predicted cessation, but much more weakly. Number of cigarettes per day was the best predictor of cessation. FTND-defined dependence was unrelated to major depression, whereas DSM-III-R-defined dependence signaled a 3-fold risk for major depression. The association of DSM-III-R-defined nicotine dependence with major depression might be driven by the behavioral rather than the physiologic symptoms of dependence. Conclusions. The more a measure of dependence is based exclusively on level of daily smoking, the greater is its ability to predict cessation. The number of DSM-III-R behavioral symptoms might be an indicator of severity of dependence or of personality traits, which in turn might be associated with major depression.
Handle: RePEc:aph:ajpbhl:2000:90:7:1122-1127_2

Template-Type: ReDIF-Article 1.0
Title: Children and older persons: AIDS' unseen victims
Journal: American Journal of Public Health
Author-Name: Knodel, J.
Author-Name: VanLandingham, M.
Year: 2000
Volume: 90
Issue: 7
Pages: 1024-1025
Handle: RePEc:aph:ajpbhl:2000:90:7:1024-1025_6

Template-Type: ReDIF-Article 1.0
Title: Frequent use of lubricants for anal sex among men who have sex with men: The HIV prevention potential of a microbicidal gel
Journal: American Journal of Public Health
Author-Name: Carballo-Diéguez, A.
Author-Name: Stein, Z.
Author-Name: Sáez, H.
Author-Name: Dolezal, C.
Author-Name: Nieves-Rosa, L.
Author-Name: Díaz, F.
Year: 2000
Volume: 90
Issue: 7
Pages: 1117-1121
Abstract: Objectives. This study assessed frequency of rectal lubricant use, opinions about rectal microbicidal gels, and willingness to participate in acceptability trials of rectal microbicides among Latino men who have sex with men (MSM). Methods. Latino MSM (N=307) living in New York City were surveyed from October 1995 through November 1996. Eleven Latino MSM participated in a focus group. Results. Among those having anal sex during the prior year, 93% used lubricants (59% always and 74% in at least 80% of sexual encounters) regardless of condom use. Of the 29 men who practiced anal sex but did not use condoms, 90% used lubricants with similar frequency. Of those using lubricants, 94% used at least 1 teaspoon per occasion. A transparent product, free of smell and taste, was favored. Of the MSM in the sample, 92% said that they would use a lubricant with an anti-HIV microbicidal agent, and 87% expressed interest in participating in an acceptability trial. Product and dispenser preferences also were discussed. Conclusions. A rectal lubricant with microbicidal properties appears acceptable and desirable to Latino men who have anal sex with other men.
Handle: RePEc:aph:ajpbhl:2000:90:7:1117-1121_5

Template-Type: ReDIF-Article 1.0
Title: Delays in seeking HIV care due to competing caregiver responsibilities
Journal: American Journal of Public Health
Author-Name: Stein, M.D.
Author-Name: Crystal, S.
Author-Name: Cunningham, W.E.
Author-Name: Ananthanarayanan, A.
Author-Name: Andersen, R.M.
Author-Name: Turner, B.J.
Author-Name: Zierler, S.
Author-Name: Morton, S.
Author-Name: Katz, M.H.
Author-Name: Bozzette, S.A.
Author-Name: Shapiro, M.F.
Author-Name: Schuster, M.A.
Year: 2000
Volume: 90
Issue: 7
Pages: 1138-1140
Abstract: Objectives. This study sought to describe the characteristics of HIV- infected persons who delay medical care for themselves because they are caring for others. Methods. HIV-infected adults (n = 2864) enrolled in the HIV Cost and Services Utilization Study (1996-1997) were interviewed. Results. The odds were 1.6 times greater for women than for men to put off care (95% confidence interval [CI] = 1.2, 2.2); persons without insurance and with CD4 cell counts above 500 were also significantly more likely to put off care. Having a child in the household was associated with putting off care (odds ratio [OR] = 1.8, 95% CI = 1.4, 2.3). Conclusions. Women or individuals with a child in the household should be offered services that might allow them to avoid delays in seeking their own medical care.
Handle: RePEc:aph:ajpbhl:2000:90:7:1138-1140_1

Template-Type: ReDIF-Article 1.0
Title: Economic deprivation and AIDS incidence in Massachusetts
Journal: American Journal of Public Health
Author-Name: Zierler, S.
Author-Name: Krieger, N.
Author-Name: Tang, Y.
Author-Name: Coady, W.
Author-Name: Siegfried, E.
Author-Name: DeMaria, A.
Author-Name: Auerbach, J.
Year: 2000
Volume: 90
Issue: 7
Pages: 1064-1073
Abstract: Objectives: This study quantified AIDS incidence in Massachusetts in relation to economic deprivation. Methods. Using 1990 census block-group data, 1990 census population counts, and AIDS surveillance registry data for the years 1988 through 1994, we generated yearly and cumulative AIDS incidence data for the state of Massachusetts stratified by sex and by neighborhood measures of economic position for the total, Black, Hispanic, and White populations. Results. Incidence of AIDS increased with economic deprivation, with the magnitude of these trends varying by both race/ethnicity and sex. The cumulative incidence of AIDS in the total population was nearly 7 times higher among persons in block-groups where 40% or more of the population was below the poverty line (362 per 100 000) than among persons in block-groups where less than 2% of the population was below poverty (53 per 100 000). Conclusions. Observing patterns of disease burden in relation to neighborhood levels of economic well-being elucidates further the role of poverty as a population-level determinant of disease burden. Public health agencies and researchers can use readily available census data to describe neighborhood-level socioeconomic conditions. Such knowledge expands options for disease prevention and increases the visibility of economic inequality as an underlying cause of AIDS.
Handle: RePEc:aph:ajpbhl:2000:90:7:1064-1073_6

Template-Type: ReDIF-Article 1.0
Title: Culture, sexuality, and women's agency in the prevention of HIV/AIDS in Southern Africa
Journal: American Journal of Public Health
Author-Name: Susser, I.
Author-Name: Stein, Z.
Year: 2000
Volume: 90
Issue: 7
Pages: 1042-1048
Abstract: Using an ethnographic approach, the authors explored the awareness among women in southern Africa of the HIV epidemic and the methods they might use to protect themselves from the virus. The research, conducted from 1992 through 1999, focused specifically on heterosexual transmission in 5 sites that were selected to reflect urban and rural experiences, various populations, and economic and political opportunities for women at different historical moments over the course of the HIV epidemic. The authors found that the female condom and other woman-controlled methods are regarded as culturally appropriate among many men and women in southern Africa and are crucial to the future of HIV/AIDS prevention. The data reported in this article demonstrate that cultural acceptability for such methods among women varies along different axes, both over time and among different populations. For this reason, local circumstances need to be taken into account. Given that women have been clearly asking for protective methods they can use, however, political and economic concerns, combined with historically powerful patterns of gender discrimination and neglect of women's sexuality, must be viewed as the main obstacles to the development and distribution of methods women can control.
Handle: RePEc:aph:ajpbhl:2000:90:7:1042-1048_4

Template-Type: ReDIF-Article 1.0
Title: Behavioral risk reduction in a declining HIV epidemic: Injection drug users in New York City, 1990-1997
Journal: American Journal of Public Health
Author-Name: Des Jarlais, D.C.D.
Author-Name: Perlis, T.
Author-Name: Friedman, S.R.
Author-Name: Chapman, T.
Author-Name: Kwok, J.
Author-Name: Rockwell, R.
Author-Name: Paone, D.
Author-Name: Milliken, J.
Author-Name: Monterroso, E.
Year: 2000
Volume: 90
Issue: 7
Pages: 1112-1116
Abstract: Objectives. This study assessed trends in HIV risk behaviors among injection drug users in New York City from 1990 to 1997. Methods. Injection drug users were recruited continuously from a large drug detoxification treatment program (N = 2588) and a research storefront located in a high- drug-use area (N = 2701). Informed consent was obtained, and a trained interviewer administered a structured interview covering sociodemographics, drug use history, HIV risk behavior, and participation in syringe exchange. Results. Trends were assessed for 5 risk behaviors in the 6-month period before the interview. The 3 injection risk behaviors declined significantly over time at each site (all P<.01). When data were pooled across sites, all 5 risk behaviors declined significantly over time (all P<.01). Participation in syringe exchange programs and in HIV counseling and testing increased greatly from 1990 to 1997. Conclusions. The continuing risk reduction among injection drug users indicates a 'declining phase' in the large HIV epidemic in New York City. HIV prevention programs appear to be making an important contribution to the declining phase.
Handle: RePEc:aph:ajpbhl:2000:90:7:1112-1116_1

Template-Type: ReDIF-Article 1.0
Title: HIV prevention research: Accomplishments and challenges for the third decace of AIDS
Journal: American Journal of Public Health
Author-Name: Auerbach, J.D.
Author-Name: Coates, T.J.
Year: 2000
Volume: 90
Issue: 7
Pages: 1029-1032
Abstract: The past 2 decades have taught us that HIV prevention can work. We now have evidence from places as diverse as Senegal, Thailand, Uganda, and Australia that concerted HIV prevention efforts at the national level have resulted in the maintenance of low seroprevalence rates where they otherwise would have been expected to rise. We are beginning to observe declining rates of HIV prevalence and incidence in places and populations with historically high rates - for example, injection drug users in New York City. This trend points to the long-term impact of prevention efforts in those communities. The best of these efforts have been based on sound scientific research. As we move into the third decade of the AIDS epidemic, it is important to restate principles, acknowledge advances, and identify challenges and future directions in HIV prevention research.
Handle: RePEc:aph:ajpbhl:2000:90:7:1029-1032_6

Template-Type: ReDIF-Article 1.0
Title: It's time we became a profession
Journal: American Journal of Public Health
Author-Name: Sommer, A.
Author-Name: Akhter, M.N.
Year: 2000
Volume: 90
Issue: 6
Pages: 845-846
Handle: RePEc:aph:ajpbhl:2000:90:6:845-846_1

Template-Type: ReDIF-Article 1.0
Title: Social capital and self-rated health: Support for a contextual mechanism [2]
Journal: American Journal of Public Health
Author-Name: Ellaway, A.
Author-Name: Macintyre, S.
Year: 2000
Volume: 90
Issue: 6
Pages: 988
Handle: RePEc:aph:ajpbhl:2000:90:6:988_8

Template-Type: ReDIF-Article 1.0
Title: Misperceptions of 'objective measurements'? [3] (multiple letters)
Journal: American Journal of Public Health
Author-Name: Scuffham, P.
Author-Name: Battistutta, D.
Author-Name: Segui-Gomez, M.
Author-Name: Levy, J.
Author-Name: Roman, H.
Author-Name: Thompson, K.M.
Author-Name: McCabe, K.
Author-Name: Graham, J.D.
Year: 2000
Volume: 90
Issue: 6
Pages: 988-989
Handle: RePEc:aph:ajpbhl:2000:90:6:988-989_9

Template-Type: ReDIF-Article 1.0
Title: Objectivity and advocacy are not contradictory goals [1] (multiple letters)
Journal: American Journal of Public Health
Author-Name: Stenvig, T.E.
Author-Name: Savitz, D.A.
Author-Name: Poole, C.
Author-Name: Miller, W.C.
Year: 2000
Volume: 90
Issue: 6
Pages: 987-988
Handle: RePEc:aph:ajpbhl:2000:90:6:987-988_8

Template-Type: ReDIF-Article 1.0
Title: Time for a national agenda to improve the health of urban populations
Journal: American Journal of Public Health
Author-Name: Freudenberg, N.
Year: 2000
Volume: 90
Issue: 6
Pages: 837-840
Handle: RePEc:aph:ajpbhl:2000:90:6:837-840_5

Template-Type: ReDIF-Article 1.0
Title: Creating a community report card: The San Diego experience
Journal: American Journal of Public Health
Author-Name: Simmes, D.R.
Author-Name: Blaszcak, M.R.
Author-Name: Kurtin, P.S.
Author-Name: Bowen, N.L.
Author-Name: Ross, R.K.
Year: 2000
Volume: 90
Issue: 6
Pages: 880
Abstract: San Diego County population is the second largest in California and the fourth largest in the United States. The 2.7 million people of this large and heterogeneous area represent diverse racial and ethnic backgrounds and present many challenges to those providing public health and social services. Recent changes - welfare reform, the movement of Medicard to managed care, and restructuring of the county's Health and Human Services Agency - further challenge the ability to improve outcomes for children and families. The Country Board of Supervisors and the members of the community wanted to know what impact these changes might be having on the health and well-being of children and families. The board ordered the development of a monitoring system, and in response, the San Diego County Child and Family Health and Well-Being Report Card was created to monitor community-level outcomes. Community report cards provide a snapshot of the overall health and well- being of a community through the use of indicators or measurements of local trends. Such reports are used increasingly across the United States to bring critical information to community members, service groups, and policymakers. A national directory of such report cards has recently been released and is described elsewhere.
Handle: RePEc:aph:ajpbhl:2000:90:6:880_1

Template-Type: ReDIF-Article 1.0
Title: Breath of life: Stories of asthma from an exhibition at the National Library of Medicine
Journal: American Journal of Public Health
Author-Name: Guyer, R.L.
Year: 2000
Volume: 90
Issue: 6
Pages: 874-879
Handle: RePEc:aph:ajpbhl:2000:90:6:874-879_7

Template-Type: ReDIF-Article 1.0
Title: Acute hazards to young children from residential pesticide exposures
Journal: American Journal of Public Health
Author-Name: Spann, M.F.
Author-Name: Blondell, J.M.
Author-Name: Hunting, K.L.
Year: 2000
Volume: 90
Issue: 6
Pages: 971-973
Abstract: Objectives. This study assessed acute hazards to young children from pesticides toxic enough to require child-resistant packaging. Methods. The names of pesticides meeting acute toxicity criteria were ascertained from the Environmental Protection Agency. Poison Control Center reports identified children younger than 6 years who were exposed to these pesticides. Toxicity category, medical outcome, sex, and age were examined. Results. A higher proportion of children with exposure to the more toxic products had serious medical outcomes. Children 2 years and younger were the predominant age group exposed. Conclusions. Protective measures - substituting less lethal pesticides, reducing the concentration of the active ingredients, and improving packaging and storage - are recommended.
Handle: RePEc:aph:ajpbhl:2000:90:6:971-973_0

Template-Type: ReDIF-Article 1.0
Title: 'Going public' in the Journal
Journal: American Journal of Public Health
Author-Name: Northridge, M.E.
Year: 2000
Volume: 90
Issue: 6
Pages: 873-874
Handle: RePEc:aph:ajpbhl:2000:90:6:873-874_1

Template-Type: ReDIF-Article 1.0
Title: Mobility impairments and use of screening and preventive services
Journal: American Journal of Public Health
Author-Name: Iezzoni, L.I.
Author-Name: McCarthy, E.P.
Author-Name: Davis, R.B.
Author-Name: Siebens, H.
Year: 2000
Volume: 90
Issue: 6
Pages: 955-961
Abstract: Objectives. Primary care for people with disabilities often concentrates on underlying debilitating disorders to the exclusion of preventive health concerns. This study examined use of screening and preventive services among adults with mobility problems (difficulty walking, climbing stairs, or standing for extended periods). Methods. The responses of non- institutionalized adults to the 1994 National Health Interview Survey, including the disability and Healthy People 2000 supplements, were analyzed. Multivariable logistic regressions predicted service use on the basis of mobility level, demographic characteristics, and indicators of health care access. Results. Ten percent of the sample reported some mobility impairment; 3% experienced major problems. People with mobility problems were as likely as others to receive pneumonia and influenza immunizations but were less likely to receive other services. Adjusted odds ratios for women with major mobility difficulties were 0.6 (95% confidence interval [CI]=0.4, 0.9) for the Papanicolaou test and 0.7 (95% CI=0.5, 0.9) for mammography. Conclusions. More attention should be paid to screening and preventive services for people with mobility difficulties. Shortened appointment times, physically inaccessible care sites, and inadequate equipment could further compromise preventive care for this population.
Handle: RePEc:aph:ajpbhl:2000:90:6:955-961_8

Template-Type: ReDIF-Article 1.0
Title: The effect of a needle exchange program on numbers of discarded needles: A 2-year follow-up
Journal: American Journal of Public Health
Author-Name: Doherty, M.C.
Author-Name: Junge, B.
Author-Name: Rathouz, P.
Author-Name: Garfein, R.S.
Author-Name: Riley, E.
Author-Name: Vlahov, D.
Year: 2000
Volume: 90
Issue: 6
Pages: 936-939
Abstract: Objectives. This study estimates the quantity and geographic distribution of discarded needles, on the streets of Baltimore, Md, during the 2 years after a needle exchange program opened. Methods. Thirty-two city blocks were randomly sampled. Counts were taken of the number of syringes, drug vials, and bottles before the needle exchange program opened and then at 6 periodic intervals for 2 years after the program opened. Nonparametric and generalized estimating equation models were used to examine change over time. Results. Two years after the needle exchange program opened, there was a significant decline in the overall quantity of discarded needles relative to that of drug vials and bottles (background trash). The block mean of number of needles per 100 trash items was 2.42 before the program opened and 1.30 2 years later (mean within-block change=-0.028, P<.05). There was no difference in the number of discarded needles by distance from the program site. Conclusions. These data suggest that this needle exchange program did not increase the number or distribution of discarded needles.
Handle: RePEc:aph:ajpbhl:2000:90:6:936-939_6

Template-Type: ReDIF-Article 1.0
Title: Dr Louis T. Wright and the NAACP: Pioneers in hospital racial integration
Journal: American Journal of Public Health
Author-Name: Reynolds, P.P.
Year: 2000
Volume: 90
Issue: 6
Pages: 883-892
Abstract: Louis Tompkins Wright, the son of a man born into slavery, was an outstanding African American surgeon who devoted his life to the racial integration of health care in the United States. Despite the fact that both his father and stepfather were physicians, despite his innate intellectual gifts and disciplined character, Wright experienced discrimination throughout his life and career. This experience led him to fight for the rights of African Americans, both health care professionals and patients. In addition to making numerous contributions in the fields of surgery and infectious disease, Wright held leadership positions in the National Association for the Advancement of Colored People for more than 20 years, leaving a legacy of equity for African Americans in medical education and in health care.
Handle: RePEc:aph:ajpbhl:2000:90:6:883-892_9

Template-Type: ReDIF-Article 1.0
Title: The association between greater continuity of care and timely measles- mumps-rubella vaccination
Journal: American Journal of Public Health
Author-Name: Christakis, D.A.
Author-Name: Mell, L.
Author-Name: Wright, J.A.
Author-Name: Davis, R.
Author-Name: Connell, F.A.
Year: 2000
Volume: 90
Issue: 6
Pages: 962-965
Abstract: Objectives. This study assessed whether greater continuity of care is associated with timely administration of measles-mumps-rubella (MMR) vaccination. Methods. We studied 11 233 patients continuously enrolled in Group Health Cooperative (GHC) from birth to 15 months. We used a preestablished index to quantify continuity of care based on the number of primary care providers in relation to the number of clinic visits. MMR vaccination status at 15 months was assessed with automated immunization data systems at GHC. Results. In a logistic regression model, both medium continuity (odds ratio [OR] = 1.20, 95% confidence interval [CI] = 1.08, 1.33) and high continuity (OR = 1.36, 95% CI = 1.22, 1.52) were associated with increased likelihood of being immunized by 15 months compared with patients in the lowest tercile of continuity of care. Conclusion. Greater continuity of care is associated with more timely immunization.
Handle: RePEc:aph:ajpbhl:2000:90:6:962-965_0

Template-Type: ReDIF-Article 1.0
Title: State welfare reform policies and declines in health insurance
Journal: American Journal of Public Health
Author-Name: Chavkin, W.
Author-Name: Romero, D.
Author-Name: Wise, P.H.
Year: 2000
Volume: 90
Issue: 6
Pages: 900-908
Abstract: Objectives. This study sought to determine whether there is a relationship between state policies on Temporary Assistance to Needy Families (TANF), declines in both TANF and Medicaid caseloads, and the rise in the number of uninsured. Methods. Extant data sources of state TANF policies, TANF and Medicaid participation, and uninsurance rates were analyzed, with the state as the unit of analysis. The independent variables included state TANF policies that directly address receipt of benefits or relate to health; dependent variables included changes in state TANF enrollment, Medicaid enrollment, and health insurance status since the enactment of the law. Results. In the bivariate analysis, declines in Medicaid were associated with sanction for work noncompliance, lack of a child care guarantee, and strategies to deter TANF enrollment; this last factor was also associated with increased uninsurance. In the multivariate analysis, lack of a child care guarantee and deterrent strategies predicted TANF declines; deterrent strategies predicted Medicaid decline and uninsurance increases. Conclusions. This analysis suggests that policies deterring TANF enrollment may contribute to declines in Medicaid and increased uninsurance. To maintain health insurance for the poor, policymakers should consider revising policies that deter TANF enrollment.
Handle: RePEc:aph:ajpbhl:2000:90:6:900-908_1

Template-Type: ReDIF-Article 1.0
Title: Urban issues in health promotion strategies
Journal: American Journal of Public Health
Author-Name: Leviton, L.C.
Author-Name: Snell, E.
Author-Name: McGinnis, M.
Year: 2000
Volume: 90
Issue: 6
Pages: 863-866
Abstract: The powerful influence of behavioral choices on health status is well established. The implications and challenges for urban populations are formidable. Understanding urban environments will better prepare health promotion professionals to deal effectively with the forces affecting health- related behaviors. In thinking about urban health promotion in the United States, researchers often distinguish between 2 frameworks; one contending with urbanization, which affects most of us, and another contending with inner-city environments, where many of the deepest needs are. Urbanization confers both benefits and liabilities, but the single greatest challenge for health promotion may lie in reestablishing positive social connections. In contrast, 2 key features of the inner-city environment may be the negative ecological forces within neighborhoods and the lack of control over one's fate. Too often, prescriptions for the inner city stereotype its problems and ignore its strengths. For the inner city, important foundation stones for the future include ways to build on these strengths through positive connections and increased community control through coalition building.
Handle: RePEc:aph:ajpbhl:2000:90:6:863-866_2

Template-Type: ReDIF-Article 1.0
Title: Helping women quit smoking: Results of a community intervention program
Journal: American Journal of Public Health
Author-Name: Secker-Walker, R.H.
Author-Name: Flynn, B.S.
Author-Name: Solomon, L.J.
Author-Name: Skelly, J.M.
Author-Name: Dorwaldt, A.L.
Author-Name: Ashikaga, T.
Year: 2000
Volume: 90
Issue: 6
Pages: 940-946
Abstract: Objectives. This intervention was implemented to reduce the prevalence of cigarette smoking among women. Methods: We used community organization approaches to create coalitions and task forces to develop and implement a multicomponent intervention in 2 counties in Vermont and New Hampshire, with a special focus on providing support to help women quit smoking. Evaluation was by preintervention and postintervention random-digit-dialed telephone surveys in the intervention counties and the 2 matched comparison counties. Results. In the intervention counties, compared with the comparison counties, the odds of a woman being a smoker after 4 years of program activities were 0.88 (95% confidence interval=0.78, 1.00) (P=.02, 1-tailed); women smokers' perceptions of community norms about women smoking were significantly more negative (P=.002, 1-tailed); and the quit rate in the past 5 years was significantly greater (25.4% vs 21.4%; P=.02, 1-tailed). Quit rates were significantly higher in the intervention counties among younger women (aged 18 to 44 years); among women with household annual incomes of $25 000 or less; and among heavier smokers (those who smoked 25 or more cigarettes daily). Conclusions. In these rural counties, community participation in planning and implementing interventions was accompanied by favorable changes in women's smoking behavior.
Handle: RePEc:aph:ajpbhl:2000:90:6:940-946_0

Template-Type: ReDIF-Article 1.0
Title: Prevalence of home pregnancy testing among adolescents
Journal: American Journal of Public Health
Author-Name: Shew, M.L.
Author-Name: Hellerstedt, W.L.
Author-Name: Sieving, R.E.
Author-Name: Smith, A.E.
Author-Name: Fee, R.M.
Year: 2000
Volume: 90
Issue: 6
Pages: 974-976
Abstract: Objectives. This study estimated the prevalence of home pregnancy testing among adolescents. Methods. A survey was administered in 11 urban clinics to 600 females aged 13 to 19 years. Results. The prevalence of home pregnancy test use was 34% among 474 sexually experienced youths; 77% of the users had received at least 1 negative pregnancy test result, and 48% took no further action for confirmation. Compared with those who had never used such tests, users were older, younger at sexual debut, less likely to consistently use effective birth control, and more likely to have ever been pregnant. Conclusions. Health care clinics are important sources for pregnancy prevention, but clinics may have limited opportunity to intervene with some youths who use home pregnancy tests.
Handle: RePEc:aph:ajpbhl:2000:90:6:974-976_6

Template-Type: ReDIF-Article 1.0
Title: Water quality laws and waterborne diseases: Cryptosporidium and other emerging pathogens
Journal: American Journal of Public Health
Author-Name: Gostin, L.O.
Author-Name: Lazzarini, Z.
Author-Name: Neslund, V.S.
Author-Name: Osterholm, M.T.
Year: 2000
Volume: 90
Issue: 6
Pages: 847-853
Abstract: Waterborne diseases, such as cryptosporidiosis, cause many cases of serious illness in the United States annually. Water quality is regulated by a complex system of federal and state legal provisions and agencies, which has been poorly studied. The authors surveyed state and territorial agencies responsible for water quality about their laws, regulations, policies, and practices related to water quality and surveillance of cryptosporidiosis related to drinking water. In this commentary they review the development and current status of federal drinking water regulations, identify conflicts or gaps in legal authority between federal agencies and state and territorial agencies, and describe court-imposed limitations on federal authority with regard to regulation of water quality. Recommendations are made for government actions that would increase the efficiency of efforts to ensure water quality; protect watersheds; strengthen waterborne disease surveillance; and protect the health of vulnerable populations.
Handle: RePEc:aph:ajpbhl:2000:90:6:847-853_3

Template-Type: ReDIF-Article 1.0
Title: Menopausal hormones and breast cancer in a biracial population
Journal: American Journal of Public Health
Author-Name: Moorman, P.G.
Author-Name: Kuwabara, H.
Author-Name: Millikan, R.C.
Author-Name: Newman, B.
Year: 2000
Volume: 90
Issue: 6
Pages: 966-971
Abstract: Objectives. This study examined the association between menopausal hormones and breast cancer in a biracial population. Methods. Logistic regression was used to calculate odds ratios for breast cancer associated with hormone use among 397 cases and 425 controls, all menopausal women. Results. Odds ratios for ever use of hormones were 0.8 (95% confidence interval [CI] = 0.5, 1.2) for White women and 0.7 (95% CI = 0.4, 1.2) for Black women. Risk was not increased with longer duration of use or more recent use. Conclusions. Breast cancer risk was not increased among White or Black women who used menopausal hormones, despite patterns of use varying considerably between races.
Handle: RePEc:aph:ajpbhl:2000:90:6:966-971_0

Template-Type: ReDIF-Article 1.0
Title: To mitigate, resist, or undo: Addressing structural influences on the health of urban populations
Journal: American Journal of Public Health
Author-Name: Geronimus, A.T.
Year: 2000
Volume: 90
Issue: 6
Pages: 867-872
Abstract: Young to middle-aged residents of impoverished urban areas suffer extraordinary rates of excess mortality, to which deaths from chronic disease contribute heavily. Understanding of urban health disadvantages and attempts to reverse them will be incomplete if the structural factors that produced modern minority ghettos in central cities are not taken into account. Dynamic conceptions of the role of race/ethnicity in producing health inequalities must encompass (1) social relationships between majority and minority populations that privilege the majority population and (2) the autonomous institutions within minority populations that members develop and sustain to mitigate, resist, or undo the adverse effects of discrimination. Broad social and economic policies that intensify poverty or undermine autonomous protections can reap dire consequences for health. Following from this structural analysis and previous research, guiding principles for action and suggestions for continued research are proposed. Without taking poverty and race/ethnicity into account, public health professionals who hope to redress the health problems of urban life risk exaggerating the returns that can be expected of public health campaigns or overlooking important approaches for mounting successful interventions.
Handle: RePEc:aph:ajpbhl:2000:90:6:867-872_8

Template-Type: ReDIF-Article 1.0
Title: Gender differences in health care access indicators in an urban, low- income community
Journal: American Journal of Public Health
Author-Name: Merzel, C.
Year: 2000
Volume: 90
Issue: 6
Pages: 909-916
Abstract: Objectives. This study examined factors associated with gender differences in health insurance coverage and having a usual source of medical care. Methods. In-person interviews were conducted with a community sample of 695 residents of Central Harlem, New York City. Predictors of the 2 outcome variables and the interaction of key variables with gender were analyzed via logistic regression. Results. No strong patterns emerged to explain gender differentials in having insurance coverage and having a usual provider. However, women employed full time had increased odds of insurance coverage, whereas employment had no similar effect among men. Public assistance evidenced a strong relationship with insurance coverage among both men and women. Socioeconomic factors and health insurance were important independent predictors of having a usual source of health care for men but had little effect among women. Conclusions. Expanding the availability of both public insurance and affordable private coverage for men living in low-income communities is an important means of reducing gender disparities in access to health care. Public assistance is an important means of enabling access to health care for men as well as women.
Handle: RePEc:aph:ajpbhl:2000:90:6:909-916_5

Template-Type: ReDIF-Article 1.0
Title: Effects of after-school physical activity on fitness, fatness, and cognitive self-perceptions: A pilot study among urban, minority adolescent girls
Journal: American Journal of Public Health
Author-Name: Colchico, K.
Author-Name: Zybert, P.
Author-Name: Basch, C.E.
Year: 2000
Volume: 90
Issue: 6
Pages: 977-978
Handle: RePEc:aph:ajpbhl:2000:90:6:977-978_4

Template-Type: ReDIF-Article 1.0
Title: Small taxes on soft drinks and snack foods to promote health
Journal: American Journal of Public Health
Author-Name: Jacobson, M.F.
Author-Name: Brownell, K.D.
Year: 2000
Volume: 90
Issue: 6
Pages: 854-857
Abstract: Health officials often wish to sponsor nutrition and other health promotion programs but are hampered by lack of funding. One source of funding is suggested by the fact that 18 states and 1 major city levy special taxes on soft drinks, candy, chewing gum, or snack foods. The tax rates may be too small to affect sales, but in some jurisdictions, the revenues generated are substantial. Nationally, about $1 billion is raised annually from these taxes. The authors propose that state and local governments levy taxes on foods of low nutritional value and use the revenues to fund health promotion programs.
Handle: RePEc:aph:ajpbhl:2000:90:6:854-857_7

Template-Type: ReDIF-Article 1.0
Title: Getting political: Racism and urban health
Journal: American Journal of Public Health
Author-Name: Cohen, H.W.
Author-Name: Northridge, M.E.
Year: 2000
Volume: 90
Issue: 6
Pages: 841-842
Handle: RePEc:aph:ajpbhl:2000:90:6:841-842_5

Template-Type: ReDIF-Article 1.0
Title: A reply to Sullivan's reanalysis of managed care plan performance since 1980
Journal: American Journal of Public Health
Author-Name: Miller, R.H.
Author-Name: Luft, H.S.
Year: 2000
Volume: 90
Issue: 6
Pages: 984-986
Handle: RePEc:aph:ajpbhl:2000:90:6:984-986_4

Template-Type: ReDIF-Article 1.0
Title: The neglected epidemic and the surgeon general's report: A call to action for better oral health
Journal: American Journal of Public Health
Author-Name: Allukian Jr., M.
Year: 2000
Volume: 90
Issue: 6
Pages: 843-845
Handle: RePEc:aph:ajpbhl:2000:90:6:843-845_3

Template-Type: ReDIF-Article 1.0
Title: Health insurance coverage of immigrants living in the United States: Differences by citizenship status and country of origin
Journal: American Journal of Public Health
Author-Name: Carrasquillo, O.
Author-Name: Carrasquillo, A.I.
Author-Name: Shea, S.
Year: 2000
Volume: 90
Issue: 6
Pages: 917-923
Abstract: Objectives. This study examined health insurance coverage among immigrants who are not US citizens and among individuals from the 16 countries with the largest number of immigrants living in the United States. Methods. We analyzed data from the 1998 Current Population Survey, using logistic regression to standardize rates of employer-sponsored coverage by country of origin. Results. In 1997, 16.7 million immigrants were not US citizens. Among noncitizens, 43% of children and 12% of elders lacked health insurance, compared with 14% of nonimmigrant children and 1% of nonimmigrant elders. Approximately 50% of noncitizen full-time workers had employer- sponsored coverage, compared with 81% of nonimmigrant full-time workers. Immigrants from Guatemala, Mexico, El Salvador, Haiti, Korea, and Vietnam were the most likely to be uninsured. Among immigrants who worked full time, sociodemographic and employment characteristics accounted for most of the variation in employer health insurance. For Central American immigrants, legal status may play a role in high uninsurance rates. Conclusions. Immigrants who are not US citizens are much less likely to receive employer- sponsored health insurance or government coverage; 44% are uninsured. Ongoing debates on health insurance reform and efforts to improve coverage will need to focus attention on this group.
Handle: RePEc:aph:ajpbhl:2000:90:6:917-923_0

Template-Type: ReDIF-Article 1.0
Title: Dietary supplements and physical exercise affecting bone and body composition in frail elderly persons
Journal: American Journal of Public Health
Author-Name: De Jong, N.
Author-Name: Chin A Paw, M.J.M.
Author-Name: De Groot, L.C.P.G.M.
Author-Name: Hiddink, G.J.
Author-Name: Van Staveren, W.A.
Year: 2000
Volume: 90
Issue: 6
Pages: 947-954
Abstract: Objectives. This study determined the effect of enriched foods and all- around physical exercise on bone and body composition in frail elderly persons. Methods: A 17-week randomized, controlled intervention trial, following a 2x2 factorial design - (1) enriched foods, (2) exercise; (3) both, or (4) neither - was performed in 143 frail elderly persons (aged 78.6±5.6 years). Foods were enriched with multiple micronutrients; exercises focused on skill training, including strength, endurance, coordination, and flexibility. Main outcome parameters were bone and body composition. Results. Exercise preserved lean mass (mean difference between exercisers and nonexercisers: 0.5 kg ± 1.2 kg; P&lt;.02). Groups receiving enriched food had slightly increased bone mineral density (+0.4%), bone mass (+0.6%), and bone calcium (+0.6%) compared with groups receiving nonenriched foods, in whom small decreases of 0.1%, 0.2%, and 0.4%, respectively, were found. These groups differed in bone mineral density (0.006±0.020 g/cm2; P=.08), total bone mass (19±g; P=.04), and bone calcium (8±21 g; P=.03). Conclusions. Foods containing a physiologic dose of micronutrients slightly increased bone density, mass, and calcium, whereas moderately intense exercise preserved lean body mass in frail elderly persons.
Handle: RePEc:aph:ajpbhl:2000:90:6:947-954_6

Template-Type: ReDIF-Article 1.0
Title: Asthma and Latino cultures: Different prevalence reported among groups sharing the same environment
Journal: American Journal of Public Health
Author-Name: Ledogar, R.J.
Author-Name: Penchaszadeh, A.
Author-Name: Garden, C.C.I.
Author-Name: Acosta, L.G.
Year: 2000
Volume: 90
Issue: 6
Pages: 929-935
Abstract: Objectives. This 1999 study measured asthma prevalence among Latinos of different cultural traditions who live on the same streets and in the same buildings. Methods. Health promoters from El Puente in North Brooklyn, New York City, surveyed 3015 people in 946 households, asking standard asthma prevalence questions. Results. Some 46% of households identified themselves as Dominican, 42% as Puerto Rican, 6% as other Latino, and 6% as other. Reported asthma period prevalence was 5.3% (93 of 1749) among Dominicans and other Latinos, compared with 13.2% (147 of 1115) among Puerto Ricans (odds ratio = 0.37; 95% confidence interval=0.28, 0.49), a difference not explained by location (cluster or building), household size, use of home remedies, educational attainment, or country where education was completed. Differences were least detectable among 13- to 24-year-olds of both sexes and sharpest among women aged 45 years and older and girls from birth to 12 years. Conclusions. Further research on gene-environment interactions is needed among Puerto Ricans and Dominicans, but asthma's associations with low income and unhealthy environment, which more recent immigrants seem better able to withstand, should not be overlooked.
Handle: RePEc:aph:ajpbhl:2000:90:6:929-935_2

Template-Type: ReDIF-Article 1.0
Title: What people really know about their health insurance: A comparison of information obtained from individuals and their insurers
Journal: American Journal of Public Health
Author-Name: Nelson, D.E.
Author-Name: Thompson, B.L.
Author-Name: Davenport, N.J.
Author-Name: Penaloza, L.J.
Year: 2000
Volume: 90
Issue: 6
Pages: 924-928
Abstract: Objectives. This study determined the validity of self-reported data on selected health insurance characteristics. Methods. We obtained telephone survey data on the presence of health insurance, source of insurance, length of time insured, and type of insurance (managed care or fee-for-service) from a random sample of 351 adults in 3 Wisconsin counties and compared findings with data from respondents health insurers. Results. More than 97% of the respondents correctly reported that they were currently insured. For source of insurance among persons aged 18 to 64 years, sensitivity was high for those covered through private health insurance (93.8%) but low for those covered through public insurance (6.7%). Only 33.1% of the respondents accurately categorized length of enrollment in their current plan. Overall estimates for managed care enrollment were similar for the 2 sources, but individual validity was low: 84.2% of those in fee-for-service believed that they were in managed care. Conclusions. Information obtained from the general population about whether they have health insurance is valid, but self- reported data on source of insurance, length of time insured, and type of insurance are suspect and should be used cautiously.
Handle: RePEc:aph:ajpbhl:2000:90:6:924-928_4

Template-Type: ReDIF-Article 1.0
Title: Community, service, and policy strategies to improve health care access in the changing urban environment
Journal: American Journal of Public Health
Author-Name: Andrulis, D.P.
Year: 2000
Volume: 90
Issue: 6
Pages: 858-862
Abstract: Urban communities continue to face formidable historic challenges to improving public health. However, reinvestment initiatives, changing demographics, and growth in urban areas are creating changes that offer new opportunities for improving health while requiring that health systems be adapted to residents' health needs. This commentary suggests that health care improvement in metropolitan areas will require setting local, state, and national agendas around 3 priorities. First, health care must reorient around powerful population dynamics, in particular, cultural diversity, growing numbers of elderly, those in welfare-workplace transition, and those unable to negotiate an increasingly complex health system. Second, communities and governments must assess the consequences of health professional shortages, safety net provider closures and conversions, and new marketplace pressures in terms of their effects on access to care for vulnerable urban populations; they must also weigh the potential value of emerging models for improving those populations' care. Finally, governments at all levels should use their influence through accreditation, standards, tobacco settlements, and other financing streams to educate and guide urban providers in directions that respond to urban communities' health care needs.
Handle: RePEc:aph:ajpbhl:2000:90:6:858-862_5

Template-Type: ReDIF-Article 1.0
Title: For the welfare of children: The origins of the relationship between US public health workers and pediatricians
Journal: American Journal of Public Health
Author-Name: Markel, H.
Year: 2000
Volume: 90
Issue: 6
Pages: 893-899
Abstract: The majority of children living in the United States today enjoy excellent health and access to health care. This was not always so; before the late 19th century, the field of pediatric medicine scarcely existed, and the combination of harsh and unsanitary living conditions in the urban areas where most immigrants settled, infectious diseases, and improper handling of milk was particularly deadly for infants and children. This article discusses the relationship between pediatric medicine and the broader children's health and public health movements in the United States in the early decades of the 20th century. That relationship resulted in 3 developments that had a profound impact on children's health: the establishment of dispensaries and milk stations that served impoverished children, campaigns to educate parents about illness prevention and child rearing, and the medical inspection of public schools and schoolchildren. Today, American children face both new threats to health and the reemergence of infectious diseases that were once thought conquered. Pediatricians and public health professionals must work together in the same spirit of social activism and community responsibility to meet these challenges.
Handle: RePEc:aph:ajpbhl:2000:90:6:893-899_1

Template-Type: ReDIF-Article 1.0
Title: The role of emergency obstetric care in the safe motherhood initiative [2]
Journal: American Journal of Public Health
Author-Name: Tita, A.T.N.
Year: 2000
Volume: 90
Issue: 5
Pages: 810
Handle: RePEc:aph:ajpbhl:2000:90:5:810_3

Template-Type: ReDIF-Article 1.0
Title: The role of health services research in the safe motherhood initiative [3]
Journal: American Journal of Public Health
Author-Name: Hotchkiss, D.R.
Author-Name: Eckert, E.
Author-Name: Macintyre, K.
Year: 2000
Volume: 90
Issue: 5
Pages: 810-811
Handle: RePEc:aph:ajpbhl:2000:90:5:810-811_7

Template-Type: ReDIF-Article 1.0
Title: Recent data are needed to support public health training and workforce initiatives [1] (multiple letters)
Journal: American Journal of Public Health
Author-Name: Gerzoff, R.B.
Author-Name: Van Devanter, N.L.
Year: 2000
Volume: 90
Issue: 5
Pages: 809-810
Handle: RePEc:aph:ajpbhl:2000:90:5:809-810_6

Template-Type: ReDIF-Article 1.0
Title: Heralding a change: Field action reports
Journal: American Journal of Public Health
Author-Name: Tilson, H.H.
Year: 2000
Volume: 90
Issue: 5
Pages: 691-692
Handle: RePEc:aph:ajpbhl:2000:90:5:691-692_1

Template-Type: ReDIF-Article 1.0
Title: Public health practice and the Journal
Journal: American Journal of Public Health
Author-Name: Halverson, P.K.
Year: 2000
Volume: 90
Issue: 5
Pages: 692-693
Handle: RePEc:aph:ajpbhl:2000:90:5:692-693_5

Template-Type: ReDIF-Article 1.0
Title: The past and future of public health practice
Journal: American Journal of Public Health
Author-Name: Fee, E.
Author-Name: Brown, T.M.
Year: 2000
Volume: 90
Issue: 5
Pages: 690-691
Handle: RePEc:aph:ajpbhl:2000:90:5:690-691_0

Template-Type: ReDIF-Article 1.0
Title: A brief smoking cessation intervention for women in low-income planned parenthood clinics
Journal: American Journal of Public Health
Author-Name: Glasgow, R.E.
Author-Name: Whitlock, E.P.
Author-Name: Eakin, E.G.
Author-Name: Lichtenstein, E.
Year: 2000
Volume: 90
Issue: 5
Pages: 786-789
Abstract: Objectives. The purpose of this study was to evaluate a brief smoking cessation intervention for women 15 to 35 years of age attending Planned Parenthood clinics. Methods. Female smokers (n = 1154) were randomly assigned either to advice only or to a brief intervention that involved a 9-minute video, 12 to 15 minutes of behavioral counseling, clinician advice to quit, and follow-up telephone calls. Results. Seventy-six percent of those eligible participated. Results revealed a clear, short-term intervention effect at the 6-week follow-up (7-day self-reported abstinence: 10.2% vs. 6.9% for advice only, P<.05) and a more ambiguous effect at 6 months (30-day biochemically validated abstinence: 6.4% vs. 3.8%, NS). Conclusions. This brief, clinic- based intervention appears to be effective in reaching and enhancing cessation among female smokers, a traditionally underserved population.
Handle: RePEc:aph:ajpbhl:2000:90:5:786-789_4

Template-Type: ReDIF-Article 1.0
Title: Don Quixote, Machiavelli, and Robin Hood: Public health practice, past and present
Journal: American Journal of Public Health
Author-Name: Mullan, F.
Year: 2000
Volume: 90
Issue: 5
Pages: 702-706
Abstract: Since the mid-19th century, when the first formal health departments were established in the United States, commissioners, directors, and secretaries of public health have functioned as senior members of the staff of public executives, mayors, governors, and president. They have provided important political, managerial, and scientific leadership to agencies of government that have played increasingly important roles in national life, from the sanitary revolution of the 19th century to the prevention of HIV/AIDS and the control of tobacco use today. Although public health officials came from a variety of backgrounds and oversee agencies of varied size and composition, there are philosophical themes that describe and define the commonality of their work. Theses themes are captured metaphorically by 3 celebrated figures: Don Quixote, Machiavelli, and Robin Hood. By turns, the public health official functions as a determined idealist (Don Quixote), a cunning political strategist (Machiavelli), and an agent who redistributes resources from the wealthier sectors of society to the less well off (Robin Hood.) All 3 personae are important but, it is argued, Robin Hood is the most endangered.
Handle: RePEc:aph:ajpbhl:2000:90:5:702-706_5

Template-Type: ReDIF-Article 1.0
Title: Cigarettes and suicide: A prospective study of 50 000 men
Journal: American Journal of Public Health
Author-Name: Miller, M.
Author-Name: Hemenway, D.
Author-Name: Rimm, E.
Year: 2000
Volume: 90
Issue: 5
Pages: 768-773
Abstract: Objectives. This study examined the relation between smoking and suicide, controlling for various confounders. Methods. More than 50 000 predominantly White, middle-aged and elderly male health professionals were followed up prospectively with biennial questionnaires from 1986 through 1994. The primary end point was suicide. Characteristics controlled for included age, marital status, body mass index, physical activity, alcohol intake, coffee consumption, and history of cancer. Results. Eighty-two members of the cohort committed suicide during the 8-year follow-up period. In age-adjusted analyses with never smokers as the comparison group, the relative risk of suicide was 1.4 (95% confidence interval [CI] = 0.8, 2.3) among former smokers, 2.6 (95% CI = 0.9, 7.5) for light smokers (<15 cigarettes/day), and 4.5 (95% CI = 2.3, 8.8) among heavier smokers. After adjustment for potential confounders, the relative risks were 1.4 (95% CI = 0.9, 2.4), 2.5 (95% CI = 0.9, 7.3), and 4.3 (95% CI = 2.2, 8.5), respectively. Conclusion. We found a positive, dose-related association between smoking and suicide among White men. Although inference about causality is not justified, our findings indicate that the smoking-suicide connection is not entirely due to the greater tendency among smokers to be unmarried, to be sedentary, to drink heavily, or to develop cancers.
Handle: RePEc:aph:ajpbhl:2000:90:5:768-773_5

Template-Type: ReDIF-Article 1.0
Title: Helping the urban poor stay with antiretroviral HIV drug therapy
Journal: American Journal of Public Health
Author-Name: Bamberger, J.D.
Author-Name: Unick, J.
Author-Name: Klein, P.
Author-Name: Fraser, M.
Author-Name: Chesney, M.
Author-Name: Katz, M.H.
Year: 2000
Volume: 90
Issue: 5
Pages: 699-701
Handle: RePEc:aph:ajpbhl:2000:90:5:699-701_9

Template-Type: ReDIF-Article 1.0
Title: Cigars, youth, and the Internet link
Journal: American Journal of Public Health
Author-Name: Malone, R.E.
Author-Name: Bero, L.A.
Year: 2000
Volume: 90
Issue: 5
Pages: 790-792
Abstract: Objectives. This study examined the accessibility and appeal to youth of cigar marketing sites on the Internet. Methods. Sites marketing cigars (n=141) were examined for age restrictions, prices, health warnings, and other elements. Results. Although it is illegal for minors to purchase tobacco, only 36 sites (25.5%) prohibited purchases by minors. Sites offered low prices, and 32% accepted money orders, cashier's checks, or cash-on- delivery (COD) orders. Almost 30% of the sites included elements with potential youth appeal; only 3.5% displayed health warnings. Conclusions. The unregulated promotion of cigars on the Internet has the potential to attract youth, and there are few barriers to Internet tobacco purchased by minors.
Handle: RePEc:aph:ajpbhl:2000:90:5:790-792_3

Template-Type: ReDIF-Article 1.0
Title: Plastic wall materials in the home and respiratory health in young children
Journal: American Journal of Public Health
Author-Name: Jaakkola, J.J.K.
Author-Name: Verkasalo, P.K.
Author-Name: Jaakkola, N.
Year: 2000
Volume: 90
Issue: 5
Pages: 797-799
Abstract: Objectives. The relation between the presence of plastic wall materials in the home and respiratory health in children was assessed. Methods. This population-based cross-sectional study involved 2568 Finnish children aged 1 to 7 years. Results. In logistic regression models, lower respiratory tract symptoms - persistent wheezing (adjusted odds ratio [OR]=3.42, 95% confidence interval [CI]=1.13, 10.36), cough (OR=2.41, 95% CI=1.04, 5.63), and phlegm (OR=2.76, 95% CI=1.03, 7.41) - were strongly related to the presence of plastic wall materials, whereas upper respiratory symptoms were not. The risk of asthma (OR=1.52, 95% CI=0.35, 6.71) and pneumonia (OR=1.81, 95% CI=0.62, 5.29) was also increased in children exposed to such materials. Conclusions. Emissions from plastic materials indoors may have adverse effects on the lower respiratory tracts of small children.
Handle: RePEc:aph:ajpbhl:2000:90:5:797-799_1

Template-Type: ReDIF-Article 1.0
Title: Impact of vaccine financing on vaccinations delivered by health department clinics
Journal: American Journal of Public Health
Author-Name: Szilagyi, P.G.
Author-Name: Humiston, S.G.
Author-Name: Shone, L.P.
Author-Name: Barth, R.
Author-Name: Kolasa, M.S.
Author-Name: Rodewald, L.E.
Year: 2000
Volume: 90
Issue: 5
Pages: 739-745
Abstract: Objectives. This study measured the number of childhood vaccinations delivered at health department clinics (HDCs) before and after changes in vaccine financing in 1994, and it assessed the impact of changes in financing on HDC operations. Methods. We measured the number of vaccination doses administered annually at all 57 HDCs in New York State between 1991 and 1996, before and after the financing changes. Interviews of HDC personnel assessed the impact of financing changes. A secondary study measured trends in Pennsylvania and California. Results. HDC vaccinations for preschool children in New York State declined slightly prior to the financing changes (6%-8% between 1991 and 1993) but declined markedly thereafter (53%-56% between 1993 and 1996). According to nearly two thirds of New York State's HDCs, the primary cause for this decline was the vaccine-financing changes. HDC vaccinations for preschool children in Pennsylvania declined by 12% between 1991 and 1993 and by 56% between 1993 and 1997. HDC vaccinations for polio- containing vaccines in California declined by 31% between 1993 and 1997. Conclusions. Substantially fewer vaccinations have been administered at HDCs since changes in vaccine financing, thereby keeping preschool children in their primary care medical homes.
Handle: RePEc:aph:ajpbhl:2000:90:5:739-745_0

Template-Type: ReDIF-Article 1.0
Title: The impact of workplace smoking ordinances in California on smoking cessation
Journal: American Journal of Public Health
Author-Name: Moskowitz, J.M.
Author-Name: Lin, Z.
Author-Name: Hudes, E.S.
Year: 2000
Volume: 90
Issue: 5
Pages: 757-761
Abstract: Objectives. The effect of local workplace smoking laws in California was assessed to determine whether such laws increase smoking cessation. Methods. Workplace smoking ordinance data from 1990 were appended to 1990 California Tobacco Survey data from 4680 adult indoor workers who were current cigarette smokers or reported smoking in the 6 months before the survey. Ordinance effects on cigarette smoking and worksite policy were estimated by using multiple logistic regression controlling for sociodemographic variables. Results. Smokers who worked in localities with a strong workplace ordinance (compared with no workplace ordinance) were more likely to report the existence of a worksite smoking policy (odds ratio [OR] = 1.6; 95% confidence interval [CI] = 1.2, 2.2) and to report quitting smoking in the prior 6 months (OR = 1.5; 95% CI = 1.1, 1.7). In communities with strong ordinances, an estimated 26.4% of smokers quit smoking within 6 months of the survey and were abstinent at the time of the survey, compared with an estimated 19.1% in communities with no ordinance. Conclusions. Workplace smoking ordinances increased smoking cessation among employed smokers, indicating that these laws may benefit smokers as well as nonsmokers.
Handle: RePEc:aph:ajpbhl:2000:90:5:757-761_3

Template-Type: ReDIF-Article 1.0
Title: The effect of the Taiwan motorcycle helmet use law on head injuries
Journal: American Journal of Public Health
Author-Name: Chiu, W.-T.
Author-Name: Kuo, C.-Y.
Author-Name: Hung, C.-C.
Author-Name: Chen, M.
Year: 2000
Volume: 90
Issue: 5
Pages: 793-796
Abstract: Objectives. This study evaluated the effect of the motorcycle helmet law implemented in Taiwan on June 1, 1997. Methods. Collecting data on 8795 cases of motorcycle-related head injuries from 56 major Taiwanese hospitals, we compared the situation 1 year before and after implementation of the helmet law. Results. After implementation of the law, the number of motorcycle- related head injuries decreased by 33%, from 5260 to 3535. Decreases in length of hospital stay and in severity of injury and better outcome were also seen. The likelihood ratio χ2 test showed that severity decreased after the law's implementation (P&lt;.001). Full helmets were found to be safer than half-shell helmets. Conclusion. The helmet law effectively decreased the mortality and morbidity from motorcycle-related head injuries.
Handle: RePEc:aph:ajpbhl:2000:90:5:793-796_0

Template-Type: ReDIF-Article 1.0
Title: The effect of a structured smoking cessation program, independent of exposure to existing interventions
Journal: American Journal of Public Health
Author-Name: Manfredi, C.
Author-Name: Crittenden, K.S.
Author-Name: Cho, Y.I.
Author-Name: Engler, J.
Author-Name: Warnecke, R.
Year: 2000
Volume: 90
Issue: 5
Pages: 751-756
Abstract: Objectives. This study assessed the effectiveness of a smoking cessation program for women in public health clinics, controlling for reported exposures to 4 common intervention components (provider advice, booklet, video segment, posters) among smokers in the control group. Methods. After a baseline control period, 10 pair-matched clinics were randomly assigned to study groups. A total of 1042 smokers in the combined baseline and control groups and 454 smokers in the intervention group completed a preintervention questionnaire and a postintervention telephone interview 5 to 8 weeks later. Eight smoking outcomes, including quitting, were analyzed for the effect of reported exposure to intervention components, experimental program, and clinic service. Results. Greater exposure to intervention components, being in the experimental program, and being seen in prenatal clinics independently improved smoking outcomes. Conclusions. The number of interventions reported by smokers in the control group ranged from none to 4 and varied across clinic services. The experimental program we tested produced better outcomes than the minimal smoking cessation interventions already existing in the control clinics, after we controlled for whether smokers were or were not exposed to these interventions.
Handle: RePEc:aph:ajpbhl:2000:90:5:751-756_2

Template-Type: ReDIF-Article 1.0
Title: Preparing currently employed public health nurses for changes in the health system
Journal: American Journal of Public Health
Author-Name: Gebbie, K.M.
Author-Name: Hwang, I.
Year: 2000
Volume: 90
Issue: 5
Pages: 716-721
Abstract: Objectives. This article describes a core public health nursing curriculum, part of a larger project designed to identify the skills needed by practicing public health workers if they are to successfully fill roles in the current and emerging public health system. Methods. Two focus groups of key informants, representing state and local public health nursing practice, public health nursing education, organizations interested in public health and nursing education, federal agencies, and academia, synthesized material form multiple sources and outlined the key content for a continuing education curriculum appropriate to the current public health nursing workforce. Results. The skills identified as most needed were those required for analyzing data, practicing epidemiology, measuring health status and organizational change, connecting people to organizations, bringing about change in organizations, building strength in diversity, conducting population-based intervention, building coalitions, strengthening environmental health, developing and advocating policy, evaluating programs, and devising approaches to quality improvement. Conclusions. Collaboration between public health nursing practice and education and partnerships with other public health agencies will be essential for public health nurses to achieve the required skills to enhance public health infrastructure.
Handle: RePEc:aph:ajpbhl:2000:90:5:716-721_2

Template-Type: ReDIF-Article 1.0
Title: Public health advocacy: Process and product
Journal: American Journal of Public Health
Author-Name: Christoffel, K.K.
Year: 2000
Volume: 90
Issue: 5
Pages: 722-726
Abstract: Objectives. In this article the author describes public health advocacy and proposes a conceptual framework for understanding how it works. Methods. The proposed framework incorporates the image of an assembly line. The public health advocacy assembly line produces changes in societal resource allocation that are necessary for optimizing public health. The framework involves 3 main stages: information, strategy, and action. These stages are conceptually sequential but, in practice, simultaneous. The work at each stage is continually adjusted at the other stages. Results. The framework has practical implications; for example, public health advocacy teams need members with complementary skills in distinct roles. Potential applications are illustrated via two public health advocacy efforts. Conclusions. The framework may be useful in assessing staffing and funding need for public health advocacy endeavors, explaining common problems in these endeavors and suggesting solutions, and guiding decisions concerning effort allocation. Application of the framework to a variety of public health advocacy endeavors will clarify its strengths and weaknesses.
Handle: RePEc:aph:ajpbhl:2000:90:5:722-726_2

Template-Type: ReDIF-Article 1.0
Title: Effect of the tobacco price support program on cigarette consumption in the United States: An updated model
Journal: American Journal of Public Health
Author-Name: Zhang, P.
Author-Name: Husten, C.
Author-Name: Giovino, G.
Year: 2000
Volume: 90
Issue: 5
Pages: 746-750
Abstract: Objectives. This study evaluated the direct effect of the tobacco price support program on domestic cigarette consumption. Methods. We developed an economic model of demand and supply of US tobacco to estimate how much the price support program increases the price of tobacco. We calculated the resultant increase in cigarette prices from the change in the tobacco price and the quantity of domestic tobacco contained in US cigarettes. We then assessed the reduction in cigarette consumption attributable to the price support program by applying the estimated increase in the cigarette price to assumed price elasticities of demand for cigarettes. Results. We estimated that the tobacco price support program increased the price of tobacco leaf by $0.36 per pound. This higher tobacco price translates to a $0.01 increase in the price of a pack of cigarettes and an estimated 0.21% reduction in cigarette consumption. Conclusion. Because the tobacco price support program increases the price of cigarettes minimally, its potential health benefit is likely to be small. The adverse political effect of the tobacco program might substantially outweigh the potential direct benefit of the program on cigarette consumption.
Handle: RePEc:aph:ajpbhl:2000:90:5:746-750_8

Template-Type: ReDIF-Article 1.0
Title: The potential and limitations of data from population-based state cancer registries
Journal: American Journal of Public Health
Author-Name: Izquierdo, J.N.
Author-Name: Schoenbach, V.J.
Year: 2000
Volume: 90
Issue: 5
Pages: 695-698
Abstract: Cancer incidence varies markedly among states because of population heterogeneity regarding risk, genetic, and demographic factors. Population- based cancer registries are essential to monitoring cancer trends and control. The Centers for Disease Control and Prevention and the North American Association of Central Cancer Registries, through the National Program of Cancer registries, are helping state registries generate more and better data nationwide. The National Program of Cancer Registries has supported the enhancement of 36 registries and the creation of 13 new registries in 45 states, 3 territories, and the District of Columbia, providing national standards for completeness, timeless, and quality; financial support; and technical assistance. Users must be aware of diverse issues that influence collection and interpretation of cancer diagnoses, duplicate reports, reporting delays, misclassification of race/ethnicity, and pitfalls in estimation to these issues and intense use of the available data for cancer surveillance will enable maximum societal benefit from the emerging network of population-based state cancer registries.
Handle: RePEc:aph:ajpbhl:2000:90:5:695-698_0

Template-Type: ReDIF-Article 1.0
Title: Antagonism and accommodation: Interpreting the relationship between public health and medicine in the United States during the 20th century
Journal: American Journal of Public Health
Author-Name: Brandt, A.M.
Author-Name: Gardner, M.
Year: 2000
Volume: 90
Issue: 5
Pages: 707-715
Abstract: Throughout the course of the 20th century, many observers have noted important tensions and antiphaties between public health and medicine. At the same time, reformers have often called for better engagement and collaboration between the 2 fields. This article examines the history of the relationship between medicine and public health to examine how they developed as separated and often conflicting professions. The historical character of this relationship can be understood only in the context of institutional development in professional education, the rise of the biomedical model of disease, and the epidemiologic transition from infectious disease to the predominance of systemic chronic diseases. Many problems in the contemporary burden of diseases pose opportunity for effective collaborations between population-based and clinical interventions. A stronger alliance between public health and medicine through accommodation to a reductionist biomedicine, however, threatens to subvert public health's historical commitment to understanding and addressing the social roots of disease.
Handle: RePEc:aph:ajpbhl:2000:90:5:707-715_7

Template-Type: ReDIF-Article 1.0
Title: Effectiveness of food fortification in the United States: The case of Pellagra
Journal: American Journal of Public Health
Author-Name: Park, Y.K.
Author-Name: Sempos, C.T.
Author-Name: Barton, C.N.
Author-Name: Vanderveen, J.E.
Author-Name: Yetley, E.A.
Year: 2000
Volume: 90
Issue: 5
Pages: 727-738
Abstract: Objectives. We evaluated the possible role of niacin fortification of the US food supply and other concurrent influences in eliminating the nutritional deficiency disease pellagra. Methods. We traced chronological changes in pellagra mortality and morbidity and compared them with the development of federal regulations, state laws, and other national activities pertaining to the fortification of cereal-grain products with niacin and other B vitamins. We also compared these changes with other concurrent changes that would have affected pellagra mortality or morbidity. Results. The results show the difficulty of evaluating the effectiveness of a single public health initiative such as food fortification without controlled experimental trials. Nonetheless, the results provide support for the belief that food fortification played a significant role in the elimination of pellagra in the United States. Conclusions. Food fortification that is designed to restore amounts of nutrients lost through grain milling was an effective tool in preventing pellagra, a classical nutritional deficiency disease, during the 1930s and 1940s, when food availability and variety were considerably less than are currently found in the United States.
Handle: RePEc:aph:ajpbhl:2000:90:5:727-738_0

Template-Type: ReDIF-Article 1.0
Title: An interactive CD-ROM for nutrition screening and counseling
Journal: American Journal of Public Health
Author-Name: Block, G.
Author-Name: Miller, M.
Author-Name: Harnack, L.
Author-Name: Kayman, S.
Author-Name: Mandel, S.
Author-Name: Cristofar, S.
Year: 2000
Volume: 90
Issue: 5
Pages: 781-785
Abstract: Objectives. The goal of this project was to develop an interactive CD- ROM for nutrition screening and counseling, designed to produce dietary behavior change in fat and fruit and vegetable intake. Methods. The design was based on principles of relevance to the learner, readiness for change, feedback, individualization, facilitation of skills, and goal setting. It was tested in community settings such as libraries, senior centers, and Women, Infants, and Children clinics. Results. Nearly 80% of the respondents (n = 284), including numerous low-income persons, reported learning something new about nutrition and health or their own dietary habits. More than 50% of those recontacted 2 to 4 weeks later had put some of their dietary goals into practice. Conclusions. This program is useful for dietary screening, feedback, skill building, and motivation in settings in which in-person counseling by nutrition professionals is not feasible.
Handle: RePEc:aph:ajpbhl:2000:90:5:781-785_6

Template-Type: ReDIF-Article 1.0
Title: Trends in fruit and vegetable consumption among adults in 16 US states: Behavioral Risk Factor Surveillance System, 1990-1996
Journal: American Journal of Public Health
Author-Name: Li, R.
Author-Name: Serdula, M.
Author-Name: Bland, S.
Author-Name: Mokdad, A.
Author-Name: Bowman, B.
Author-Name: Nelson, D.
Year: 2000
Volume: 90
Issue: 5
Pages: 777-781
Abstract: Objectives. This study examined trends in fruit and vegetable consumption among adults in 16 US states. Methods. Data from telephone surveys were used to stratify respondents by sociodemographic and health- related characteristics. Results. The proportion of adults who consumed fruits and vegetables at least 5 times daily was 19%, 22%, and 23% in 1990, 1994, and 1996, respectively. While the proportion increased among those with active leisure-time physical activities and normal weight, it remained almost the same among inactive people and dropped among the obese. Conclusions. Progress in fruit and vegetable intake from 1990 to 1994 was encouraging, but it changed little between 1994 and 1996.
Handle: RePEc:aph:ajpbhl:2000:90:5:777-781_9

Template-Type: ReDIF-Article 1.0
Title: Failure to defend a successful state tobacco control program: Policy lessons from Florida
Journal: American Journal of Public Health
Author-Name: Givel, M.S.
Author-Name: Glantz, S.A.
Year: 2000
Volume: 90
Issue: 5
Pages: 762-767
Abstract: Objectives. This investigation sought to define policy and political factors related to the undermining of Florida's successful Tobacco Pilot Program in 1999. Methods. Data were gathered from interviews with public health lobbyists, tobacco control advocates, and state officials; news reports; and public documents. Results. As a result of a recent legal settlement with Florida, the tobacco industry agreed to fund a youth anti- smoking pilot program. The program combined community-based interventions and advertisements. In less than 1 year, the teen smoking prevalence rate dropped from 23.3% to 20.9%. The program also enjoyed high public visibility and strong public support. Nevertheless, in 1999, the state legislature cut the program's funding from $70.5 million to $38.7 million, and the Bush administration dismantled the program's administrative structure. Voluntary health agencies failed to publicly hold specific legislators and the governor responsible for the cuts. Conclusions. The legislature and administration succeeded in dismantling this highly visible and successful tobacco control program because pro-health forces limited their activities to behind-the- scenes lobbying and were unwilling to confront the politicians who made these decisions in a public forum.
Handle: RePEc:aph:ajpbhl:2000:90:5:762-767_5

Template-Type: ReDIF-Article 1.0
Title: Human rights: The foundation of public health practice
Journal: American Journal of Public Health
Author-Name: Rodriguez-Garcia, R.
Author-Name: Akhter, M.N.
Year: 2000
Volume: 90
Issue: 5
Pages: 693-694
Handle: RePEc:aph:ajpbhl:2000:90:5:693-694_6

Template-Type: ReDIF-Article 1.0
Title: Breast cancer screening in the United States and Canada, 1994: Socioeconomic gradients persist
Journal: American Journal of Public Health
Author-Name: Katz, S.J.
Author-Name: Zemencuk, J.K.
Author-Name: Hofer, T.P.
Year: 2000
Volume: 90
Issue: 5
Pages: 799-803
Abstract: Objectives. This study compared rates of annual mammography screening across socioeconomic status between the United States and Canada in 1994. Methods. Population-based cross-sectional surveys were used to compare the rates. Results. Screening rates were higher in the United States than in Canada for women aged 50 to 69 years (47.3% vs 38.8%, P<.01). Women with higher education and with higher incomes were more likely to receive screening in both countries, with no significant differences between countries. Conclusions. For women aged 50 to 69 years, screening rates in Canada have substantially increased relative to those in the United States. However, disparities in screening across levels of socioeconomic status persist in both countries.
Handle: RePEc:aph:ajpbhl:2000:90:5:799-803_7

Template-Type: ReDIF-Article 1.0
Title: Uses of Behavioral Risk Factor Surveillance System data, 1993-1997
Journal: American Journal of Public Health
Author-Name: Figgs, L.W.
Author-Name: Bloom, Y.
Author-Name: Dugbatey, K.
Author-Name: Stanwyck, C.A.
Author-Name: Nelson, D.E.
Author-Name: Brownson, R.C.
Year: 2000
Volume: 90
Issue: 5
Pages: 774-776
Abstract: Objectives. The purpose of this study was to document and describe Behavioral Risk Factor Surveillance System (BRFSS) data use patterns, benefits, and barriers from 1993 to 1997. Methods. Data use information was gathered via a Medline database search and a telephone survey of BRFSS program directors (n = 54). Results. The database search uncovered 109 BRFSS- based reports. Program directors indicated that BRFSS data frequently were used to support health policies regarding diabetes, physical activity, and smoking. Frequent data use barriers included insufficient special population data, insufficient city- or county-specific data, and insufficient staff. Conclusions. Use of BRFSS data, which aid several state health activities, increased from 1993 to 1997.
Handle: RePEc:aph:ajpbhl:2000:90:5:774-776_3

Template-Type: ReDIF-Article 1.0
Title: Community education efforts enhance postabortion care program in Ghana
Journal: American Journal of Public Health
Author-Name: Baird, T.L.
Author-Name: Billings, D.L.
Year: 2000
Volume: 90
Issue: 4
Pages: 631-632
Handle: RePEc:aph:ajpbhl:2000:90:4:631-632_0

Template-Type: ReDIF-Article 1.0
Title: Ethics and schools of public health [2]
Journal: American Journal of Public Health
Author-Name: Hyder, A.A.
Author-Name: Coughlin, S.S.
Year: 2000
Volume: 90
Issue: 4
Pages: 639-640
Handle: RePEc:aph:ajpbhl:2000:90:4:639-640_5

Template-Type: ReDIF-Article 1.0
Title: Editor's note: Whither occupational health and safety?
Journal: American Journal of Public Health
Author-Name: Bayer, R.
Year: 2000
Volume: 90
Issue: 4
Pages: 532
Handle: RePEc:aph:ajpbhl:2000:90:4:532_7

Template-Type: ReDIF-Article 1.0
Title: Relative effect of genetic and environmental factors on body height: Differences across birth cohorts among finnish men and women
Journal: American Journal of Public Health
Author-Name: Silventoinen, K.
Author-Name: Kaprio, J.
Author-Name: Lahelma, E.
Author-Name: Koskenvuo, M.
Year: 2000
Volume: 90
Issue: 4
Pages: 627-630
Abstract: Objectives. This study examined the change in heritability of adult body height across birth cohorts in Finland. Methods. In 1981, cross-sectional questionnaires were completed by 10 968 twin pairs born before 1958. The effect of genetic factors was estimated via genetic modeling. Results. Heritability increased from the cohort born before 1929 (0.76, 95% confidence interval [CI]=0.65, 0.88 in men; 0.66, 95% CI=0.55, 0.77 in women) to that born in 1947 through 1957 (0.81, 95% CI=0.73, 0.87 in men; 0.82. 95% CI = 0.75, 0.89 in women). Conclusions. Heritability of height increased across finnish birth cohorts born in the first half of this century and leveled off after World War II. Environmental factors, compared with genetic factors, appear to be more important among women than men.
Handle: RePEc:aph:ajpbhl:2000:90:4:627-630_4

Template-Type: ReDIF-Article 1.0
Title: The effect of economic sanctions on the mortality of Iraqi children prior to the 1991 Persian Gulf War
Journal: American Journal of Public Health
Author-Name: Daponte, B.O.
Author-Name: Garfield, R.
Year: 2000
Volume: 90
Issue: 4
Pages: 546-552
Abstract: Objectives. This study examined the effect of sanctions on mortality among Iraqi children. Methods. The effects of economic sanctions on health are not well known. Past studies on the effect of economic sanctions on mortality have suffered from unreliable data sources and the collinearity of sanctions with other negative economic events. We overcame these weaknesses by using individual child records from a retrospective survey of mothers conducted after the 1991 Persian Gulf War to examine the effect of sanctions on mortality among Iraqi children. Multivariate proportional hazards analysis was used to assess the effect of economic sanctions prior to war (from August through December 1990). Results. We found that after controlling for child and maternal characteristics, when economic sanctions were entered into the proportional hazards equation, the risk of dying increased dramatically. This increase was highly significant statistically. Conclusions. Innovative application of robust epidemiologic research tools can contribute to assessments of health and well-being even under the methodological and practical constraints of comprehensive economic sanctions, but more research is needed.
Handle: RePEc:aph:ajpbhl:2000:90:4:546-552_4

Template-Type: ReDIF-Article 1.0
Title: The relation of residential segregation to all-cause mortality: A study in black and white
Journal: American Journal of Public Health
Author-Name: Jackson, S.A.
Author-Name: Anderson, R.T.
Author-Name: Johnson, N.J.
Author-Name: Sorlie, P.D.
Year: 2000
Volume: 90
Issue: 4
Pages: 615-617
Abstract: Objectives. This study investigated the influence of an aggregate measure of the social environment on racial differences in all-cause mortality. Methods. Data from the National Longitudinal Mortality Study were analyzed. Results. After adjustment for family income, age-adjusted mortality risk increased with increasing minority residential segregation among Blacks aged 25 to 44 years and non-Blacks aged 45 to 64 years. In most age/race/gender groups, the highest and lowest mortality risks occurred in the highest and lowest categories of residential segregation, respectively. Conclusions. These results suggest that minority residential segregation may influence mortality risk and underscore the traditional emphasis on the social underpinnings of disease and death.
Handle: RePEc:aph:ajpbhl:2000:90:4:615-617_7

Template-Type: ReDIF-Article 1.0
Title: Frequency and correlates of intimate partner violence by type: Physical, sexual, and psychological battering
Journal: American Journal of Public Health
Author-Name: Coker, A.L.
Author-Name: Smith, P.H.
Author-Name: McKeown, R.E.
Author-Name: King, M.J.
Year: 2000
Volume: 90
Issue: 4
Pages: 553-559
Abstract: Objectives. This study estimated the frequency and correlates of intimate parmer violence by type (physical, sexual, battering, or emotional abuse) among women seeking primary health care. Methods. Women aged 18 to 65 years who attended family practice clinics in 1997 and 1998 took part. Participation included a brief in-clinic survey assessing intimate partner violence. Multiple polytomous logistic regression was used to assess correlates of partner violence by type. Results. Of 1401 eligible women surveyed, 772 (55.1%) had experienced some type of intimate parmer violence in a current, most recent, or past intimate relationship with a male partner; 20.2% were currently experiencing intimate partner violence. Among those who had experienced partner violence in any relationship, 77.3% experienced physical or sexual violence, and 22.7% experienced nonphysical abuse. Alcohol and/or drug abuse by the male partner was the strongest correlate of violence. Conclusions. Partner substance abuse and intimate partner violence in the woman's family of origin were strong risk factors for experiencing violence. Efforts to universally screen for parmer violence and to effectively intervene to reduce the impact of such violence on women's lives must be a public health priority.
Handle: RePEc:aph:ajpbhl:2000:90:4:553-559_4

Template-Type: ReDIF-Article 1.0
Title: Social context and geographic patterns of homicide among US black and white males
Journal: American Journal of Public Health
Author-Name: Cubbin, C.
Author-Name: Pickle, L.W.
Author-Name: Fingerhut, L.
Year: 2000
Volume: 90
Issue: 4
Pages: 579-587
Abstract: Objectives. The recently published Atlas of United States Mortality depicted striking regional differences in homicide rates for Black and White males in the United States. This study examined these rates to gain an understanding of the contribution of social context to geographic variability in homicide. Methods. Homicide rates were calculated by health service area for the years 1988 to 1992. The contributions of age, geographic location, urbanization, and sociostructural characteristics were evaluated by means of a weighted linear mixed effects model. Results. Regional differences in urbanization explained much of the geographic variation in homicide rates, but sociostructural factors also had a significant impact. The results suggest that these effects operate similarly for White and Black males, although differences were found in the magnitudes of the effects for the 2 groups. Conclusions. Results point to a strong association between homicide and urbanization and socioeconomic conditions in all regions of the country for both Black and White males. These findings shed light on the potential correlates of high homicide rates in the United States in the near future.
Handle: RePEc:aph:ajpbhl:2000:90:4:579-587_9

Template-Type: ReDIF-Article 1.0
Title: Local labor unions' positions on worksite tobacco control
Journal: American Journal of Public Health
Author-Name: Sorensen, G.
Author-Name: Stoddard, A.M.
Author-Name: Youngstrom, R.
Author-Name: Emmons, K.
Author-Name: Barbeau, E.
Author-Name: Khorasanizadeh, F.
Author-Name: Levenstein, C.
Year: 2000
Volume: 90
Issue: 4
Pages: 618-620
Abstract: Objectives. This report describes local unions' position on tobacco control initiatives and factors related to those positions. Method. A national random sample of local union leaders was surveyed by telephone. Results. Forty-eight percent of local unions supported worksite smoking bans or restrictions, and only 8% opposed both a ban and a restriction. Conclusions. Support from tobacco control initiatives among local union was higher than might b expected or the basis of previous evidence. Engaging unions in smoking policy formation is likely to contribute to the larger public health goal of reducing smoking and exposure to secondhand smoke among workers.
Handle: RePEc:aph:ajpbhl:2000:90:4:618-620_9

Template-Type: ReDIF-Article 1.0
Title: Lifetime prevalence of suicide symptoms and affective disorders among men reporting same-sex sexual partners: Results from NHANES III
Journal: American Journal of Public Health
Author-Name: Cochran, S.D.
Author-Name: Mays, V.M.
Year: 2000
Volume: 90
Issue: 4
Pages: 573-578
Abstract: Objectives. This study examined lifetime prevalence of suicide symptoms and affective disorders among men reporting a history of same-sex sexual partners. Methods. In the third National Health and Nutrition Examination Survey, men aged 17 to 39 years were assessed for lifetime history of affective disorders and sexual behavior patterns. The study classified this subset of men into 3 groups: those reporting same-sex sexual partners, those reporting only female sexual partners, and those reporting no sexual partners. Groups were compared for histories of suicide symptoms and affective disorders. Results. A total of 2.2% (95% confidence interval [CI]=1.3%, 3.1%) of men reported same-sex sexual partners. These men evidenced greater lifetime prevalence rates of suicide symptoms than men reporting only female partners. However, homosexually/bisexually experienced men were no more likely than exclusively heterosexual men to meet criteria for lifetime diagnosis of other affective disorders. Conclusions. These data provide further evidence of an increased risk for suicide symptoms among homosexually experienced men. Results also hint at a small, increased risk of recurrent depression among gay men, with symptom onset occurring, on average, during early adolescence.
Handle: RePEc:aph:ajpbhl:2000:90:4:573-578_5

Template-Type: ReDIF-Article 1.0
Title: Domestic violence and childhood sexual abuse in HIV-infected women and women at risk for HIV
Journal: American Journal of Public Health
Author-Name: Cohen, M.
Author-Name: Deamant, C.
Author-Name: Barkan, S.
Author-Name: Richardson, J.
Author-Name: Young, M.
Author-Name: Holman, S.
Author-Name: Anastos, K.
Author-Name: Cohen, J.
Author-Name: Melnick, S.
Year: 2000
Volume: 90
Issue: 4
Pages: 560-565
Abstract: Objectives. The purpose of this study was to determine the prevalence and effect of domestic violence and childhood sexual abuse in women with HIV or at risk for HIV infection. Methods. Participant with HIV or at risk for HIV infection enrolled in the Women's Interagency HIV study. Childhood sexual abuse; all physical, sexual, and coercive violence by a partner; HIV serostatus; demographic data; and substance use and sexual habits were assessed. Results. The lifetime prevalence of domestic violence was 66% and 67%, respectively, in 1288 women. One quarter of the women reported recent abuse, and 31% of the HIV-seropositive women and 27 % of the HIV-seronegative women reported childhood sexual abuse. Childhood sexual abuse was strongly associated with a lifetime history of domestic violence and high-risk behaviors, including using drugs, have more than 10 male sexual partners and having male partners at risks for HIV infection, and exchanging sex for drugs, money, or shelter. Conclusions. Our data support the hypothesis of a continuum of risk, with early childhood abuse leading to later domestic violence, which may increase the risk of behaviors leading to HIV infection.
Handle: RePEc:aph:ajpbhl:2000:90:4:560-565_3

Template-Type: ReDIF-Article 1.0
Title: The global burden of injuries
Journal: American Journal of Public Health
Author-Name: Krug, E.G.
Author-Name: Sharma, G.K.
Author-Name: Lozano, R.
Year: 2000
Volume: 90
Issue: 4
Pages: 523-526
Abstract: The traditional view of injuries a 'accidents', or random events, has resulted in the historical events, has resulted in the historical neglect of this area of public health. However, the most recent estimates show that injuries are among the leading causes of death and disability in the world. They affect all populations, regardless of age, sex, income, or geographic region. In 1998, about 5.8 million people (97.9 per 100,000 population) died of injuries worldwide, and injuries caused 16% of the global burden of disease. Road traffic injuries are the 10th leading cause of death and the 9th leading cause of the burden of disease; self-inflicted injuries, falls, and interpersonal violence follow closely. Injuries affect mostly young people, often causing long-term disability. Decreasing the burden of injuries is among the main challenges for public health in the next century - injuries are preventable, and many effective strategies are available. Public health officials must gain a better understanding of the magnitude and characteristics of the problem, contribute to the development and evaluation of injury prevention programs, and develop the best possible prehospital and hospital care and rehabilitation for injured persons.
Handle: RePEc:aph:ajpbhl:2000:90:4:523-526_3

Template-Type: ReDIF-Article 1.0
Title: Revisiting the effect of the pap test on cervical cancer
Journal: American Journal of Public Health
Author-Name: Holmquist, N.D.
Year: 2000
Volume: 90
Issue: 4
Pages: 620-623
Abstract: Objectives. This report documents the effect of not having had Papanicolaou (Pap) test on survival with uterine cervical squamous carcinoma. Methods. Data were derived from Charity Hospital of Louisiana at New Orleans Tumor Registry reports for 1984-1996. Results. During the 5 study years, 101 of 213 women (47%) with invasive carcinoma had not undergone a previous Pap test. From 1984-1987, the observed 5-year survival rate for 171 patients with invasive carcinoma was 43%. The observed 5-year rate for 107 patients with carcinoma in situ from 1984 to 1986 99%. Conclusions. The goal of a yearly Pap test for all women can be approached by a number or different routes, with the use of all health facilities augmented with collection of specimens by trained nonphysician personnel.
Handle: RePEc:aph:ajpbhl:2000:90:4:620-623_6

Template-Type: ReDIF-Article 1.0
Title: Suffocated prone: The iatrogenic tragedy of SIDS
Journal: American Journal of Public Health
Author-Name: Högberg, U.
Author-Name: Bergström, E.
Year: 2000
Volume: 90
Issue: 4
Pages: 527-531
Abstract: Epidemiologic research has shown that prone sleeping is a major risk factor for sudden infant death syndrome (SIDS). In a public health review from Sweden, we explored the historical background of the SIDS epidemic, starting with the view of the Catholic Church that sudden infant deaths were infanticides and ending with the slowly disseminated recommendation of a prone sleeping position during the 1960s, 1970s, and 1980s. The story of the SIDS epidemic illustrates a pitfall of preventive medicine - the translation of health care routines for patients to general health advice that targets the whole population. False advice, as well as correct advice, may have a profound effect on public health because of the many individuals concerned. Preventive measures must be based on scientific evidence, and systematic supervision and evaluations are necessary to identify the benefits or the harm of the measures. The discovery of the link between prone sleeping and SIDS has been called a success story for epidemiology, but the slow acceptance of the causal relationship between prone sleeping and SIDS illustrates the weak position of epidemiology and public health within the health care system.
Handle: RePEc:aph:ajpbhl:2000:90:4:527-531_8

Template-Type: ReDIF-Article 1.0
Title: Homicide prosecutions and progress toward workplace safety
Journal: American Journal of Public Health
Author-Name: Edgar, H.
Year: 2000
Volume: 90
Issue: 4
Pages: 533-534
Handle: RePEc:aph:ajpbhl:2000:90:4:533-534_8

Template-Type: ReDIF-Article 1.0
Title: Reproductive health services in rural Washington State: Scope of practice and provision of medical abortions, 1996-1997
Journal: American Journal of Public Health
Author-Name: Dobie, S.A.
Author-Name: Rosenblatt, R.A.
Author-Name: Glusker, A.
Author-Name: Madigan, D.
Author-Name: Hart, L.G.
Year: 2000
Volume: 90
Issue: 4
Pages: 624-626
Abstract: Objectives. This study explored reproductive health care in rural Washington State, reason given by providers for not offering abortions, and providers' willingness to use medical abortifacients. Methods. Physicians, midwives, nurse practitioners, and physician assistants in rural Washington completed an inventory of reproductive health services that they provide, whether and why they do not perform abortions, and whether they would use medical abortifacients. Results. Of the respondents, 89.2% reported providing reproductive health care. Only 1.2% reported performing surgical abortions, and 26.1% indicated that they would probably prescribe medical abortifacients. Conclusions. Few providers offer surgical abortions in rural Washington Greater numbers report a willingness to prescribe medical abortifacients.
Handle: RePEc:aph:ajpbhl:2000:90:4:624-626_1

Template-Type: ReDIF-Article 1.0
Title: Lifetime prevelance of and risk factors for psychiatric disorders among Mexican migrant farmworkers in California
Journal: American Journal of Public Health
Author-Name: Alderete, E.
Author-Name: Vega, W.A.
Author-Name: Kolody, B.
Author-Name: Aguilar-Gaxiola, S.
Year: 2000
Volume: 90
Issue: 4
Pages: 608-614
Abstract: Objectives. In this study, the prevalence of and risk factors for 12 psychiatric disorders were examined by sex and ethnicity (Indian vs non- Indian) among Mexican migrant farm-workers working in Fresno county, California. Methods. Subjects aged 18 through 59 years were selected under a cluster sampling design (n=1001). A modified version of the Composite International Diagnostic Interview was used for case ascertainment. The effects of socio-demographic and acculturation factors on lifetime psychiatric disorders were tested. Results. Lifetime rates of any psychiatric disorders were as follows: men, 26.7% (SE=1.9); women, 16.8% (SE=1.7%); Indians, 26.0% (SE=4.5); non-Indians, 20.1% (SE=1.3). Total lifetime rates were as follows: affective disorders, 5.7%; anxiety disorders, 12.5%; any substance abuse or dependence, 8.7%; antisocial personality 0.2%. Lifetime prevelance of any psychiatric disorder was lower from migrants than for Mexican Americans and for the US population as a whole. High acculturation and primary US residence increased the likehood of life-time psychiatric disorders. Conclusions. The results underscore the risk posed by cultural adjustment problems, the potential from progressive deterioration of this population's mental health, and the need for culturally appropriate mental health services.
Handle: RePEc:aph:ajpbhl:2000:90:4:608-614_5

Template-Type: ReDIF-Article 1.0
Title: Effects of pool-fencing ordinances and other factors on childhood drowning in Los Angeles County, 1990-1995
Journal: American Journal of Public Health
Author-Name: Morgenstern, H.
Author-Name: Bingham, T.
Author-Name: Reza, A.
Year: 2000
Volume: 90
Issue: 4
Pages: 595-601
Abstract: Objectives. This study estimated the effects of local pool-fencing ordinances and other factors on the rate of childhood drowning in Los Angeles County California. Methods. Stage 1 was a retrospective dynamic cohort study of all drowning among children younger than 10 years that occurred in residential swimming pools in Los Angeles County between 1990 and 1995. Stage 2 was a matched case-control study that compared pools in which childhood drownings occurred (cases) with randomly selected pools in which drownings did not occur (controls). Results. The drowning rate was relatively high among toddlers (aged 1-4 years), boys, and African Americans and in areas with a high density of residential swimming pools. Pool-fencing ordinances were not associated with a reduced overall rate childhood drowning. Conclusions. Local ordinances enacted in Los Angeles County before 1996 do not appear to have been effective in reducing the rate of childhood drowning in residential pools. Possible reasons for this ineffectiveness are insufficient building codes for isolating pools from homes, inadequate enforcement of the ordinances, and inadequate operation or maintenance of fencing equipment by pool owners.
Handle: RePEc:aph:ajpbhl:2000:90:4:595-601_2

Template-Type: ReDIF-Article 1.0
Title: OSHA matters: Workers and managers say it backs them up [1]
Journal: American Journal of Public Health
Author-Name: Brown, M.P.
Author-Name: Lippin, T.M.
Author-Name: Eckman, A.K.
Year: 2000
Volume: 90
Issue: 4
Pages: 633
Handle: RePEc:aph:ajpbhl:2000:90:4:633_4

Template-Type: ReDIF-Article 1.0
Title: Firearm storage patterns in US homes with children
Journal: American Journal of Public Health
Author-Name: Schuster, M.A.
Author-Name: Franke, T.M.
Author-Name: Bastian, A.M.
Author-Name: Sor, S.
Author-Name: Halfon, N.
Year: 2000
Volume: 90
Issue: 4
Pages: 588-594
Abstract: Objectives. This study determined the prevalence and storage patterns of firearms in US homes with children. Methods. We analyzed data from the 1994 National Health Interview Survey and Year 2000 objectives supplement. A multistage sample design was used to represent the civilian non- institutionalized US population. Results. Respondents from 35% of the homes with children younger than 18 years (representing more than 22 million children in more than 11 million homes) reported having at least 1 firearm. Among homes with children and firearms, 43% had at least 1 unlocked firearm (i.e., not in a locked place and not locked with a trigger lock or other locking mechanism). Overall, 9% kept firearms unlocked and loaded, and 4% kept them unlocked, unloaded and stored with ammunition; thus, a total of 13% of the homes with children and firearms- 1.4 million homes with 2.6 million children- stored firearms in a manner most accessible to children. In contrast, 39% of these families kept firearms locked, unloaded, and separate from ammunition. Conclusions. Many children live in homes with firearms that are stored in an accessible manner. Efforts to prevent children's access to firearms are needed.
Handle: RePEc:aph:ajpbhl:2000:90:4:588-594_3

Template-Type: ReDIF-Article 1.0
Title: Psychiatric morbidity, service use, and need for care in the general population: Results of the Netherlands Mental Health Survey and incidence study
Journal: American Journal of Public Health
Author-Name: Bijl, R.V.
Author-Name: Ravelli, A.
Year: 2000
Volume: 90
Issue: 4
Pages: 602-607
Abstract: Objectives. This study examined the use of primary health care, mental health care, and informal care services, as well as unmet care needs, by individuals with different psychiatric diagnoses. Methods. Data were derived from the Netherlands Mental Health Survey and Incidence Study and were based on a representative sample (n=7147) of the general population (aged 18-64 years). Results. In a 12-month period, 33.9% of those with a psychiatric disorder used some form of care; 27.2% used primary care, and 15.3% used mental health care. Patients with mood disorders were the most likely to enlist professional care; those with alcohol- and drug-related disorders were the least likely to do so. Higher educated persons who live alone, single parents, unemployed persons, and disabled persons were more likely to use mental health care. Unmet need for professional help was reported by 16.8% (men 9.9%, women 23.9%) of those with a disorder. Conclusion. Care use varies widely by diagnostic category. The role of general medical practioners in treating persons with psychiatric disorders is more limited than was anticipated. Patients in categories associated with extensive use of professional care are more likely to have unmet care needs.
Handle: RePEc:aph:ajpbhl:2000:90:4:602-607_8

Template-Type: ReDIF-Article 1.0
Title: Work-related death: A continuing epidemic
Journal: American Journal of Public Health
Author-Name: Herbert, R.
Author-Name: Landrigan, P.J.
Year: 2000
Volume: 90
Issue: 4
Pages: 541-545
Abstract: Worldwide, work-related illnesses and injuries kill approximately 1.1 million people per year. In 1992, an estimated 65 000 people in the United States died of occupational injuries or illness. Most estimates indicate that occupational diseases account for far more fatalities than occupational injuries. However, an accurate enumeration of occupational disease fatalities is hampered by a paucity of data, owing to underdiagnosis of occupational diseases and inadequacy of current surveillance systems. In this commentary, the authors review the epidemiology of death due to occupational disease arid injury in the United States and discuss vulnerable populations, emerging trends, and prevention strategies for this ongoing public health problem.
Handle: RePEc:aph:ajpbhl:2000:90:4:541-545_5

Template-Type: ReDIF-Article 1.0
Title: When does a worker's death become murder?
Journal: American Journal of Public Health
Author-Name: Rosner, D.
Year: 2000
Volume: 90
Issue: 4
Pages: 535-540
Abstract: During the past 2 decades, a growing number of manslaughter and even murder charges have been brought against employers in cases involving the death of workers on the job. In this commentary, the author reviews some of these recent cases and looks at other periods in American history when workers' deaths were considered a form of homicide. He examines the social forces that shape how we define a worker's death: as an accidental chance occurrence for which no individual is responsible, or as a predictable result of gross indifference to human life for which management bears criminal responsibility. He asks whether there is a parallel between the conditions of 19th-century laissez-faire capitalism that led to popular movements promoting workplace safety and the move in recent decades toward deregulation and fewer restraints on industry that has led state and local prosecutors to criminalize some work-place accidents. Despite an increased federal presence, the activities of state and local district attorneys perhaps signal a redefinition of the popular understanding of employers' responsibility in maintaining a safe workplace.
Handle: RePEc:aph:ajpbhl:2000:90:4:535-540_7

Template-Type: ReDIF-Article 1.0
Title: Early predictors of adolescent violence
Journal: American Journal of Public Health
Author-Name: Ellickson, P.L.
Author-Name: McGuigan, K.A.
Year: 2000
Volume: 90
Issue: 4
Pages: 566-572
Abstract: Objectives. This study sought to identify early predictors of adolescent violence and to assess whether they vary bye sex and across different types and levels of violence. Methods. Data from a 5-year longitudinal self-report survey of more than 4300 high school seniors and dropouts from California and Oregon were used to regress measures of relational, predatory, and overall violence on predictors measured 5 years earlier. Results. Deviant behavior in grade 7, poor grades, and weak bonds with middle school predicted violent behavior 5 years later. Attending a middle school with comparatively high levels of cigarette and marijuana use was also linked with subsequent violence. Early drug use and peer drug use predicted increased levels of predatory violence but not its simple occurrence. Girls with low self-esteem during early adolescence were more likely to hit others later on; boys who attended multiple elementary schools were also more likely to engage in relational violence. Conclusions. Violence prevention programs for younger adolescents should include efforts to prevent or reduce troublesome behavior in school and poor academic performance. Adolescent girls may also profit from efforts to raise self-esteem; adolescent boys may need extra training in resisting influences that encourage deviant behavior. Programs aimed at preventing drug use may yield an added violence reduction bonus.
Handle: RePEc:aph:ajpbhl:2000:90:4:566-572_9

Template-Type: ReDIF-Article 1.0
Title: Reaching out to the underserved: A successful volunteer program
Journal: American Journal of Public Health
Author-Name: Ahmed, S.M.
Year: 2000
Volume: 90
Issue: 3
Pages: 439-440
Handle: RePEc:aph:ajpbhl:2000:90:3:439-440_0

Template-Type: ReDIF-Article 1.0
Title: The effect of the law on underage drinking and driving [1]
Journal: American Journal of Public Health
Author-Name: London, W.M.
Year: 2000
Volume: 90
Issue: 3
Pages: 446
Handle: RePEc:aph:ajpbhl:2000:90:3:446_8

Template-Type: ReDIF-Article 1.0
Title: Achieving the implausible in the next decade's tobacco control objectives
Journal: American Journal of Public Health
Author-Name: Green, L.W.
Author-Name: Eriksen, M.P.
Author-Name: Bailey, L.
Author-Name: Husten, C.
Year: 2000
Volume: 90
Issue: 3
Pages: 337-339
Handle: RePEc:aph:ajpbhl:2000:90:3:337-339_7

Template-Type: ReDIF-Article 1.0
Title: Vaccination strategies for targeted and difficult-to-access group [3]
Journal: American Journal of Public Health
Author-Name: Trubatch, B.N.
Author-Name: Fisher, D.G.
Author-Name: Cagle, H.H.
Author-Name: Fenaughty, A.M.
Year: 2000
Volume: 90
Issue: 3
Pages: 447
Handle: RePEc:aph:ajpbhl:2000:90:3:447_0

Template-Type: ReDIF-Article 1.0
Title: Prospects for a public health perspective on psychoactive drug use
Journal: American Journal of Public Health
Author-Name: Des Jarlais, D.C.
Year: 2000
Volume: 90
Issue: 3
Pages: 335-337
Handle: RePEc:aph:ajpbhl:2000:90:3:335-337_3

Template-Type: ReDIF-Article 1.0
Title: Maternal cigarette smoking during pregnancy and infant ponderal index at birth in the Swedish Medical Birth Register, 1991-1992
Journal: American Journal of Public Health
Author-Name: Lindley, A.A.
Author-Name: Gray, R.H.
Author-Name: Herman, A.A.
Author-Name: Becker, S.
Year: 2000
Volume: 90
Issue: 3
Pages: 420-423
Abstract: Objectives. This study examined the effect of maternal smoking during pregnancy on infant body proportion. Methods. The ponderal index, defined as birthweight divided by crown-heel length cubed, was examined in 207 607 infants from the Swedish Medical Birth Register for 1991 and 1992. Results. Infant ponderal index was used as the outcome variable in an ordinary least squares continuous regression, which included early pregnancy smoking status, gestational age, and birthweight among the predictors. Ponderal index increased by 0.030 (± 0.0014) among infants of moderate smokers and by 0.040 (± 0.0017) among infants of heavy smokers, showing a dose response. Conclusions. Smoking differentially alters the trajectory of weight vs length growth in the fetus.
Handle: RePEc:aph:ajpbhl:2000:90:3:420-423_0

Template-Type: ReDIF-Article 1.0
Title: Historical and cultural roots of drinking problems among American Indians
Journal: American Journal of Public Health
Author-Name: Frank, J.W.
Author-Name: Moore, R.S.
Author-Name: Ames, G.M.
Year: 2000
Volume: 90
Issue: 3
Pages: 344-351
Abstract: Roots of the epidemic of alcohol-related problems among many Native North Americans are sought in cultural responses to European arrival, the role of alcohol in frontier society, and colonial and postcolonial policies. Evidence from the historical record is considered within the framework of current social science. Initially, Native American's responses to alcohol were heavily influenced by the example of White frontiersmen, who drank immoderately and engaged in otherwise unacceptable behavior while drunk. Whites also deliberately pressed alcohol upon the natives because it was an immensely profitable trade good; in addition, alcohol was used as a tool of 'diplomacy' in official dealings between authorities and natives. The authors argue that further research into the origins of modern indigenous people's problems with alcohol would benefit from an interdisciplinary 'determinants of health' approach in which biological influences on alcohol problems are investigated in the context of the cultural social, and economic forces that have shaped individual and group drinking patterns.
Handle: RePEc:aph:ajpbhl:2000:90:3:344-351_8

Template-Type: ReDIF-Article 1.0
Title: The relationship between external threats and smoking in Central Harlem
Journal: American Journal of Public Health
Author-Name: Ganz, M.L.
Year: 2000
Volume: 90
Issue: 3
Pages: 367-371
Abstract: Objectives. This study assessed the relationship between external risks, such as personal and neighborhood danger, and smoking by using a new theoretical framework based on competing mortality risk models. Methods. Regression analyses of self-reported data from residents of Central Harlem, New York, surveyed from 1992 through 1994 (n = 695, response rate = 72%) were used to assess the relationship between smoking and 2 measures of external health threats: levels of neighborhood danger and lifetime trauma. Results. Support for the framework was mixed. At the 95% confidence level, exposure to lifetime trauma was positively related to current smoking status but was not related to the number of cigarettes smoked, conditional on being a smoker. Living in a 'somewhat unsafe neighborhood' was also statistically significantly related to the current smoking status. Conclusions. Although the framework implies that policies directed at improving the physical and social environment might improve health through their indirect effects on behaviors, little supporting evidence was found. Smoking rates may decrease if exposure to violence and neighborhood danger is reduced. This framework needs to be tested on larger and more information-rich data sets.
Handle: RePEc:aph:ajpbhl:2000:90:3:367-371_4

Template-Type: ReDIF-Article 1.0
Title: Quality of diabetes care in community health centers
Journal: American Journal of Public Health
Author-Name: Chin, M.H.
Author-Name: Auerbach, S.B.
Author-Name: Cook, S.
Author-Name: Harrison, J.F.
Author-Name: Koppert, J.
Author-Name: Jin, L.
Author-Name: Thiel, F.
Author-Name: Karrison, T.G.
Author-Name: Harrand, A.G.
Author-Name: Schaefer, C.T.
Author-Name: Takashima, H.T.
Author-Name: Egbert, N.
Author-Name: Chiu, S.-C.
Author-Name: McNabb, W.L.
Year: 2000
Volume: 90
Issue: 3
Pages: 431-434
Abstract: Objectives. This study assessed the quality of diabetes care in community health centers. Methods. In 55 midwestern community health centers, we reviewed the charts of 2865 diabetes adults for American Diabetes Association measures of quality. Results. On average, 70% of the patients in each community health center had measurements of glycosylated hemoglobin, 26% had dilated eye examinations, 66% had diet intervention, and 51% received foot care. The average glycosylated hemoglobin value per community health center was 8.6%. Practice guidelines were independently associated with higher quality of care. Conclusions. Rates of adherence to process measures of quality were relatively low among community health centers, compared with the targets established by the American Diabetes Association.
Handle: RePEc:aph:ajpbhl:2000:90:3:431-434_8

Template-Type: ReDIF-Article 1.0
Title: Tobacco marketing and adolescent smoking: More support for a causal inference
Journal: American Journal of Public Health
Author-Name: Biener, L.
Author-Name: Siegel, M.
Year: 2000
Volume: 90
Issue: 3
Pages: 407-411
Abstract: Objectives. This prospective study examined the effort of tobacco marketing on progression to established smoking. Methods. Massachusetts adolescents (n = 529) who at baseline had smoked no more than 1 cigarette were reinterviewed by telephone in 1997. Analyses examined the effect of receptivity to tobacco marketing at baseline on progression to established smoking, controlling for significant covariates. Results. Adolescents who, at baseline, owned a tobacco promotional item and named a brand whose advertisements attracted their attention were more than twice as likely to become established smokers (odds ration = 2.70) than adolescents who did neither. Conclusions. Participation in tobacco marketing often precedes, and is likely to facilitate, progression to established smoking. Hence, restrictions on tobacco marketing and promotion could reduce addiction to tobacco.
Handle: RePEc:aph:ajpbhl:2000:90:3:407-411_5

Template-Type: ReDIF-Article 1.0
Title: Characterizing and identifying 'hard-core' smokers: Implications for further reducing smoking prevalence
Journal: American Journal of Public Health
Author-Name: Emery, S.
Author-Name: Gilpin, E.A.
Author-Name: Ake, C.
Author-Name: Farkas, A.J.
Author-Name: Pierce, J.P.
Year: 2000
Volume: 90
Issue: 3
Pages: 387-394
Abstract: Objectives. Some smokers may never quit. Depending on how many of these 'hard-core' smokers exist, tobacco control efforts could reach the limits of a minimum achievable smoking prevalence. We defined the hard core as heavy smokers with weak quitting histories who expect never quit smoking. We compared them with other smokers and analyzed whether they represent a meaningful barrier to further reducing smoking prevalence. Methods. We used data from the 1996 California Tobacco Surveys (18616 adults; response rate = 72.9%). Results. In 1996, 5.2% of California smokers 26 years and older (1.3% of the California population) were hard-core smokers. Compared with other smokers, hard-core smokers were more likely to be retired non-Hispanic White males, with 12 years or less of education and incomes below $30000 a year, who live alone. They began smoking at younger ages and attributed fewer negative health consequences to smoking than other smokers. Conclusions. Current tobacco control effort have long way to go before they 'hit the wall.' Nonetheless, the group of hard-core smokers represents a challenge because they appear to be largely unaffected by the messages of tobacco control.
Handle: RePEc:aph:ajpbhl:2000:90:3:387-394_1

Template-Type: ReDIF-Article 1.0
Title: New NHLBI clinical guidelines for obesity and overweight: Will they promote health?
Journal: American Journal of Public Health
Author-Name: Strawbridge, W.J.
Author-Name: Wallhagen, M.I.
Author-Name: Shema, S.J.
Year: 2000
Volume: 90
Issue: 3
Pages: 340-343
Abstract: Objectives. The purpose of this study was to assess the justification, on the basis of mortality, of the new National Heart, Lung, and Blood Institute (NHLBI) guidelines on obesity and overweight and to discuss the health implications of declaring all adults with a body mass index of 25 through 29 'overweight.' Methods. The relationships between NHLBI body mass index categories and mortality for individuals older than 31 years were analyzed for 6253 Alameda County Study respondents aged 21 through 75 years. Time-dependent proportional hazards models were used to adjust for changes in risk factors and weight during follow-up. Results. Adjusted relative risks of mortality for 4 NHLBI categories compared with the category 'normal' indicated that only being underweight or moderately/extremely obese were associated with higher mortality. Specific risks varied significantly by sex. Conclusions. Our results are consistent with other studies and fail to justify lowering the overweight threshold on the basis of mortality. Current interpretations of the revised guidelines stigmatize too many people as overweight, fail to account for sex, race/ethnicity, age, and other differences; and ignore the serious health risks associated with low weight and efforts to maintain an unrealistically lean body mass.
Handle: RePEc:aph:ajpbhl:2000:90:3:340-343_4

Template-Type: ReDIF-Article 1.0
Title: The dynamics of alcohol and marijuana initiation: Patterns and predictors of first use in adolescence
Journal: American Journal of Public Health
Author-Name: Kosterman, R.
Author-Name: Hawkins, J.D.
Author-Name: Guo, J.
Author-Name: Catalano, R.F.
Author-Name: Abbott, R.D.
Year: 2000
Volume: 90
Issue: 3
Pages: 360-366
Abstract: Objectives. This study, guided by the social development model, examined the dynamic patterns and predictors of alcohol and marijuana use onset. Methods. Survival analysis and complementary log-log regression were used to model hazard rates and etiology of initiation with time-varying covariates. The sample was derived from a longitudinal study of 808 youth interviewed annually from 10 to 16 years of age and at 18 years of age. Results. Alcohol initiation rose steeply up to the age of 13 years and then increased more gradually; most participants had initiated by 13 years of age. Marijuana initiation showed a different pattern, with more participants initiating after the age of 13 years. Conclusions. This study showed that: (1) the risk initiation spans the entire course of adolescent development; (2) young people exposed to others who use substances are at higher risk for early initiation; (3) proactive parents can help delay initiation; and (4) clear family standards and proactive family management are important in delaying alcohol and marijuana use, regardless of how closely bonded at child is to his or her mother.
Handle: RePEc:aph:ajpbhl:2000:90:3:360-366_7

Template-Type: ReDIF-Article 1.0
Title: The impact of an antismoking media campaign on progression to established smoking: Results of a longitudinal youth study
Journal: American Journal of Public Health
Author-Name: Siegel, M.
Author-Name: Biener, L.
Year: 2000
Volume: 90
Issue: 3
Pages: 380-386
Abstract: Objectives. We examined the impact of a statewide antismoking media campaign on progression to established smoking among Massachusetts adolescents. Methods. We conducted a 4-year longitudinal survey of 592 Massachusetts youths, aged 12 to 15 years at baseline in 1993. We examined the effect of baseline exposure to television, radio, and outdoor antismoking advertisements on progression to established smoking (defined as having smoked 100 or more cigarettes), using multiple logistic regression and controlling for age; sex; race; baseline smoking status; smoking by parents, friends, and siblings; television viewing; and exposure to antismoking messages not related to the media campaign. Results. Among younger adolescents (aged 12 to 13 years at baseline), those reporting baseline exposure to television antismoking advertisements were significantly less likely to progress to established smoking (odds ratio = 0.49, 95% confidence interval = 0.26, 0.93). Exposure to television antismoking, advertisements had no effect on progression to established smoking among older adolescents (aged 14 to 15 years at baseline), and there were no effects of exposure to radio or outdoor advertisements. Conclusions. These results suggest that the television component of the Massachusetts antismoking media campaign may have reduced the rate of progression to established smoking among young adolescents.
Handle: RePEc:aph:ajpbhl:2000:90:3:380-386_7

Template-Type: ReDIF-Article 1.0
Title: Predictors of continued smoking over 25 years of follow-up in the normative aging study
Journal: American Journal of Public Health
Author-Name: Nordstrom, B.L.
Author-Name: Kinnunen, T.
Author-Name: Utman, C.H.
Author-Name: Krall, E.A.
Author-Name: Vokonas, P.S.
Author-Name: Garvey, A.J.
Year: 2000
Volume: 90
Issue: 3
Pages: 404-406
Abstract: Objectives. This study tested the hypothesis that high daily cigarette consumption and addiction to smoking are risk factors for the long-term continuation of smoking. Methods. Using longitudinal data from 986 male smokers, we entered cigarettes per day, psychological addiction, age, and education into a survival analysis as predictors of continued smoking over a 25-year period. Results. Younger men and those who smoked more cigarettes per day were more likely to remain smokers in the long term. Addiction and education level were not significant predictors of continued smoking. Conclusions. Heavier smokers are more at risk than lighter smokers for long- term smoking. It is therefore very important to provide smoking cessation treatments for heavy smokers as early as possible after the initiation of smoking.
Handle: RePEc:aph:ajpbhl:2000:90:3:404-406_2

Template-Type: ReDIF-Article 1.0
Title: Trends in adult cigarette smoking in California compared with the rest of the United States, 1978-1994
Journal: American Journal of Public Health
Author-Name: Siegel, M.
Author-Name: Mowery, P.D.
Author-Name: Pechacek, T.P.
Author-Name: Strauss, W.J.
Author-Name: Schooley, M.W.
Author-Name: Merritt, R.K.
Author-Name: Novotny, T.E.
Author-Name: Giovino, G.A.
Author-Name: Eriksen, M.P.
Year: 2000
Volume: 90
Issue: 3
Pages: 372-379
Abstract: Objectives. This study compared trends in adult cigarette smoking prevalence in California and the remainder of the United States between 1978 and 1994. Methods. We used data from National Health Interview Surveys and Behavioral Risk Factor Surveillance System surveys to compare trends in smoking prevalence among persons 18 years and older. Results. In both California and the remainder of the United States, the estimated annual rate of decline in adult smoking prevalence accelerated significantly from 1985 to 1990: to -12.2 percentage points per year (95% confidence interval [C] = - 1.51, -0.93) in California and to -0.93 percentage points per year (95% CI = -1.13, -0.73) in the remainder of the nation. The rate of decline showed significantly from 1990 to 1994: to -0.39 percentage points per year (95% Cl = -0.76, -0.03) in California and to -0.05 percentage points per year (95% Cl = -0.34, 0.24) in the remainder of the United States. Conclusions. The presence of an aggressive tobacco control intervention has supported a significant decline in adult smoking prevalence in California from 1985 to 1990 and a slower but still significant decline from 1990 to 1994, a period in which there was no significant decline in the remainder of the nation. To restore nationwide progress in reducing smoking prevalence, other states should consider similar interventions.
Handle: RePEc:aph:ajpbhl:2000:90:3:372-379_0

Template-Type: ReDIF-Article 1.0
Title: The effects of race/ethnicity and income on early childhood asthma prevalence and health care use
Journal: American Journal of Public Health
Author-Name: Miller, J.E.
Year: 2000
Volume: 90
Issue: 3
Pages: 428-430
Abstract: Objectives. Asthma is the most common chronic illness among US children and is most prevalent in low-income and minority groups. We used multivariate models to disentangle the effects of race/ethnicity, income, and other individual-level risk factors on asthma in a population-based sample of children aged 3 years. Methods. Data are from the 1988 National Maternal and Infant Health Survey and 1991 Longitudinal Follow-Up. Odds ratios of asthma prevalence, hospitalization, and emergency room use were estimated, with control for socioeconomic characteristics, health behaviors, and insurance. Results. Asthma prevalence, hospitalization, and emergency room use declined with increasing income for non-Black but not Black children. Conclusions. Lifetime income and sociodemographic characteristics do not explain the excess risks of asthma and emergency health care use for asthma among young Black children.
Handle: RePEc:aph:ajpbhl:2000:90:3:428-430_6

Template-Type: ReDIF-Article 1.0
Title: Maternal smoking and adverse birth outcomes among singletons and twins
Journal: American Journal of Public Health
Author-Name: Pollack, H.
Author-Name: Lantz, P.M.
Author-Name: Frohna, J.G.
Year: 2000
Volume: 90
Issue: 3
Pages: 395-400
Abstract: Objectives. This study assessed the effects of maternal smoking on birth outcomes among singletons and twins. Methods. An algorithm was developed to link twins with their siblings in the 1995 Perinatal Mortality Data Set. A random-effects logistic regression model was then used to estimate the association between maternal smoking and several adverse outcomes for a random sample of singletons and for all twins with available maternal smoking information. Results. The algorithm successfully linked siblings pairs for 91% of the twin sample. Maternal smoking was associated with a significantly increased risk of low birthweight, very low birthweight, and gestation of less than 33 weeks for both singletons and twins and with an increased risk of gestation of less than 38 weeks, infant mortality, and placental abruption for singletons. Among smokers, negative impacts on the risk of low birthweight, very low birthweight, and extreme premature delivery were significantly higher for women carrying twins. Conclusions. Some of the negative effects of smoking on low birthweight and preterm delivery are greater for twins than for singletons. Women carrying twins should be warned that smoking increases their already high risk of serious infant health problems.
Handle: RePEc:aph:ajpbhl:2000:90:3:395-400_3

Template-Type: ReDIF-Article 1.0
Title: Tobacco and alcohol use during pregnancy and risk of oral clefts
Journal: American Journal of Public Health
Author-Name: Lorente, C.
Author-Name: Cordier, S.
Author-Name: Goujard, J.
Author-Name: Aymé, S.
Author-Name: Bianchi, F.
Author-Name: Calzolari, E.
Author-Name: De Walle, H.E.K.
Author-Name: Knill-Jones, R.
Year: 2000
Volume: 90
Issue: 3
Pages: 415-419
Abstract: Objectives. This study examined the relationship between maternal tobacco and alcohol consumption during the first trimester of pregnancy and oral clefts. Methods. Data were derived from a European multicenter case- control studying including 161 infants with oral clefts and 1134 control infants. Results. Multivariate analyses showed an increased risk of cleft lip with or without cleft palate associated with smoking (odds ratio [OR] = 1.79, 95% confidence interval [CI] = 1.07. 3.04) and an increased risk of cleft palate associated with alcohol consumption (OR = 2.28, 95% CI = 1.02, 5.09). The former risk increased with the number of cigarettes smoked. Conclusions. This study provides further evidence of the possible role of prevalent environmental exposures such as tobacco and alcohol in the etiology of oral clefts.
Handle: RePEc:aph:ajpbhl:2000:90:3:415-419_6

Template-Type: ReDIF-Article 1.0
Title: HIV incidence among injection drug users in New York City, 1992-1997: Evidence for a declining epidemic
Journal: American Journal of Public Health
Author-Name: Des Jarlais, D.C.
Author-Name: Marmor, M.
Author-Name: Friedmann, P.
Author-Name: Titus, S.
Author-Name: Aviles, E.
Author-Name: Deren, S.
Author-Name: Torian, L.
Author-Name: Glebatis, D.
Author-Name: Murrill, C.
Author-Name: Monterroso, E.
Author-Name: Friedman, S.R.
Year: 2000
Volume: 90
Issue: 3
Pages: 352-359
Abstract: Objectives. We assessed recent (1992-1997) HIV incidence in the large HIV epidemic among injection drug users in New York City. Methods. Data were compiled from 10 separate studies (N = 4979), including 6 cohort studies, 2 'repeat service user' studies, and 2 analyses of voluntary HIV testing and counseling services within drug treatment programs. Results. In the 10 studies, 52 seroconversions were found in 6344 person-year at risk. The observed incidence rates among the 10 studies were all within a narrow range, from 0 per 100 person-years at risk to 2.96 per 100 person-years at risk. In 9 of the 10 studies, the observed incidence rate was less than 2 per 100 person-years at risk. The weighted average incidence rate was 0.7 per 100 person-years at risk. Conclusions. The recent incidence rate in New York City is quite low for a high-seroprevalence population of injection drug users. The very large HIV epidemic among injection drugs users in New York City appears to have entered a 'declining phase,' characterized by low incidence and declining prevalence. The data suggest that very large high- seroprevalence HIV epidemics may be 'reversed'.
Handle: RePEc:aph:ajpbhl:2000:90:3:352-359_1

Template-Type: ReDIF-Article 1.0
Title: Smoking prevalence in 2010: Why the healthy people goal is unattainable
Journal: American Journal of Public Health
Author-Name: Mendez, D.
Author-Name: Warner, K.E.
Year: 2000
Volume: 90
Issue: 3
Pages: 401-403
Abstract: Objectives. This study examined the changes in smoking initiation and cessation needed to realize the Healthy People 2010 national adult smoking prevalence objective (13%). Methods. Using data from the National Health Interview Surveys, we calculated smoking prevalence over time with a dynamic population demographics model, examining the effects or changes in smoking initiation and cessation. Results. The draft objective is unattainable solely through decreases in smoking initiation. It could be achieved through smoking cessation alone only if cessation rates immediately increased by a factor of more than 3.5. Assuming plausible decreases in initiation and increases in cessation, the draft objective is virtually unattainable. Conclusions. The health objectives should challenge the status quo but be achievable. Formal analysis often can assist in establishing reasonable objectives.
Handle: RePEc:aph:ajpbhl:2000:90:3:401-403_3

Template-Type: ReDIF-Article 1.0
Title: Minimal smoking cessation interventions in prenatal, family planning, and well-child public health clinics
Journal: American Journal of Public Health
Author-Name: Manfredi, C.
Author-Name: Crittenden, K.S.
Author-Name: Cho, Y.I.
Author-Name: Engler, J.
Author-Name: Warnecke, R.
Year: 2000
Volume: 90
Issue: 3
Pages: 423-427
Abstract: Objectives. This study assessed the prevalence and effectiveness of smoking cessation interventions for women of childbearing age in public health clinics. Methods. Smokers in prenatal, family planning, and well-child services in 10 public health clinics (n = 1021) were interviewed 5 to 8 weeks after a medical visit to assess their exposure to smoking cessation interventions and smoking cessation outcomes. Results. Depending on clinic service and intervention component (poster, video segment, provider advice, booklet), 16% to 63% of women reported exposure to an intervention component during their visit. Women in prenatal services received more interventions and had better outcomes than those in the other services. Conclusions. Exposure to more interventions increased readiness and motivation to quit and the number of actions taken toward quitting.
Handle: RePEc:aph:ajpbhl:2000:90:3:423-427_3

Template-Type: ReDIF-Article 1.0
Title: Women and smoking in Hollywood movies: A content analysis
Journal: American Journal of Public Health
Author-Name: Escamilla, G.
Author-Name: Cradock, A.L.
Author-Name: Kawachi, I.
Year: 2000
Volume: 90
Issue: 3
Pages: 412-414
Abstract: Objectives. We analyzed the portrayal of smoking in Hollywood films starring 10 popular actresses. Methods. Five movies were randomly sampled for each actress, for a total of 96 hours of film footage that was analyzed in 11165-minute intervals. Results. Leading female actors were as likely to smoke in movies aimed at juvenile audiences (PG/PG-13) as in R-rated movies, whereas male actors were 2.5 times more likely to smoke in R-rated movies. PG/PG-13-rated movies were less likely than R-rated movies to contain negative messages about smoking. Conclusions. Smoking is highly prevalent in Hollywood films featuring popular actress and may influence young audiences for whom movie stars serve as role models.
Handle: RePEc:aph:ajpbhl:2000:90:3:412-414_0

Template-Type: ReDIF-Article 1.0
Title: Hospitalization of homeless persons with tuberculosis in the United States
Journal: American Journal of Public Health
Author-Name: Marks, S.M.
Author-Name: Taylor, Z.
Author-Name: Burrows, N.R.
Author-Name: Qayad, M.G.
Author-Name: Miller, B.
Year: 2000
Volume: 90
Issue: 3
Pages: 435-438
Abstract: Objectives. This study assessed whether homeless patients are hospitalized for tuberculosis (TB) more frequently and longer than other patients and possible reasons for this. Methods. We prospectively studied hospitalizations of a cohort of TB patients. Results. HIV-infected homeless patients were hospitalized more frequently than other patients, while homeless patients who had no insurance or whose insurance status was unknown were hospitalized longer. Hospitalization cost $2000 more per homeless patient than for other patients. The public sector paid nearly all costs. Conclusions. Homeless people may be hospitalized less if given access to medical care that provides early detection and treatment of TB infection and disease and HIV infection. Providing housing and social services may also reduce hospital utilization and increase therapy completion rates.
Handle: RePEc:aph:ajpbhl:2000:90:3:435-438_8

Template-Type: ReDIF-Article 1.0
Title: The occupational safety and health administration and the public health model
Journal: American Journal of Public Health
Author-Name: McDiarmid, M.A.
Year: 2000
Volume: 90
Issue: 2
Pages: 186-187
Handle: RePEc:aph:ajpbhl:2000:90:2:186-187_0

Template-Type: ReDIF-Article 1.0
Title: Educating public health professionals [3]
Journal: American Journal of Public Health
Author-Name: Jung, B.C.
Year: 2000
Volume: 90
Issue: 2
Pages: 294-295
Handle: RePEc:aph:ajpbhl:2000:90:2:294-295_3

Template-Type: ReDIF-Article 1.0
Title: Microbes without borders: Infectious disease, public health, and the journal
Journal: American Journal of Public Health
Author-Name: Schuchat, A.
Year: 2000
Volume: 90
Issue: 2
Pages: 181-183
Handle: RePEc:aph:ajpbhl:2000:90:2:181-183_9

Template-Type: ReDIF-Article 1.0
Title: The microbial menace, then and now
Journal: American Journal of Public Health
Author-Name: Fee, E.
Author-Name: Brown, T.M.
Year: 2000
Volume: 90
Issue: 2
Pages: 184-185
Handle: RePEc:aph:ajpbhl:2000:90:2:184-185_0

Template-Type: ReDIF-Article 1.0
Title: Re McKinlay and Marceau's 'Tale of 3 Tails' [2]
Journal: American Journal of Public Health
Author-Name: Oldenburg, B.
Author-Name: Scuffham, P.
Year: 2000
Volume: 90
Issue: 2
Pages: 294
Handle: RePEc:aph:ajpbhl:2000:90:2:294_4

Template-Type: ReDIF-Article 1.0
Title: What's housing got to do with it?
Journal: American Journal of Public Health
Author-Name: Fullilove, M.T.
Author-Name: Fullilove III, R.E.
Year: 2000
Volume: 90
Issue: 2
Pages: 183-184
Handle: RePEc:aph:ajpbhl:2000:90:2:183-184_7

Template-Type: ReDIF-Article 1.0
Title: Need for HIV/AIDS early identification and preventive measures among middle-aged and elderly women [1]
Journal: American Journal of Public Health
Author-Name: Tabnak, F.
Author-Name: Sun, R.
Year: 2000
Volume: 90
Issue: 2
Pages: 287-288
Handle: RePEc:aph:ajpbhl:2000:90:2:287-288_4

Template-Type: ReDIF-Article 1.0
Title: Acceptability and feasibility of urine screening for chlamydia and gonorrhea in community organizations: Perspectives from Denver and St Louis
Journal: American Journal of Public Health
Author-Name: Bull, S.S.
Author-Name: Jones, C.A.
Author-Name: Granberry-Owens, D.
Author-Name: Stoner, B.P.
Author-Name: Rietmeijer, C.A.
Year: 2000
Volume: 90
Issue: 2
Pages: 285-286
Handle: RePEc:aph:ajpbhl:2000:90:2:285-286_6

Template-Type: ReDIF-Article 1.0
Title: Effectiveness of an intervention promoting the female condom to patients at sexually transmitted disease clinics
Journal: American Journal of Public Health
Author-Name: Artz, L.
Author-Name: Macaluso, M.
Author-Name: Brill, I.
Author-Name: Kelaghan, J.
Author-Name: Austin, H.
Author-Name: Fleenor, M.
Author-Name: Robey, L.
Author-Name: Hook III, E.W.
Year: 2000
Volume: 90
Issue: 2
Pages: 237-244
Abstract: Objective. This study evaluated a behavioral intervention designed to promote female condoms and reduce unprotected sex among women at high risk for acquiring sexually transmitted diseases (STDS). Methods. The effect of the intervention on barrier use was evaluated with a pretest-posttest design with 1159 female STD clinic patients. Results. Among participants with follow-up data, 79% used the female condom at least once and often multiple times. More than one third of those who completed the study used female condoms throughout follow-up. Use of barrier protection increased significantly after the intervention, and high use was maintained during a 6- month follow-up. To account for attrition, the use of protection by all subjects was projected under 3 conservative assumptions. The initial visit and termination visit projections suggest that use increased sharply after the intervention and declined during follow-up but remained elevated compared with the baseline. Conclusions. Many clients of public STD clinics will try, and some will continue, to use female condoms when they are promoted positively and when women are trained to use them correctly and to promote them to their partners. A behavioral intervention that promotes both female and male condoms can increase barrier use.
Handle: RePEc:aph:ajpbhl:2000:90:2:237-244_4

Template-Type: ReDIF-Article 1.0
Title: Risk factors for homelessness among indigent urban adults with no history of psychotic illness: A case control study
Journal: American Journal of Public Health
Author-Name: Caton, C.L.M.
Author-Name: Hasin, D.
Author-Name: Shrout, P.E.
Author-Name: Opler, L.A.
Author-Name: Hirshfield, S.
Author-Name: Dominguez, B.
Author-Name: Felix, A.
Year: 2000
Volume: 90
Issue: 2
Pages: 258-263
Abstract: Objectives. This study identified risk factors for homelessness among indigent urban adults without dependent children and with no history of psychotic illness. Methods. We conducted a matched case-control study, stratified by sex, of 200 newly homeless men and women and 200 indigent men and women with no history of homelessness. Newly homeless case subjects were recruited from shelter assessment centers in New York City. Never-homeless control subjects, selected from public assistance centers, were single adults applying for home relief. Control subjects were matched with case subjects according to ethnicity, age, and sex. Trained interviewers employed standardized research instruments to probe 3 domains of risk factors: symptom severity and substance use disorder, family support and functioning, and prior use of services. Results. Significant interaction effects by sex were present for symptom severity, heroin use disorder, and prior service use. Greater numbers of the homeless of both sexes lacked a high school diploma and had less income from all sources, including from their families, than of the never homeless. Conclusions. Newly homeless men and women with no history of PSYchotic illness differed from their never-homeless counterparts in the 3 domains investigated, but socioeconomic factors were also important.
Handle: RePEc:aph:ajpbhl:2000:90:2:258-263_4

Template-Type: ReDIF-Article 1.0
Title: Diminishing educational differences in breast cancer mortality among Finnish women: A register-based 25-year follow-up
Journal: American Journal of Public Health
Author-Name: Martikainen, P.
Author-Name: Valkonen, T.
Year: 2000
Volume: 90
Issue: 2
Pages: 277-280
Abstract: Objectives. This study examined trends in breast cancer mortality by education, age, and birth cohort. Methods: Census records of Finnish women 35 years and older were linked with death records for 1971 through 1995. Results. Excess breast cancer mortality of more-educated women has declined rapidly, mainly because of increasing mortality among less-educated women and stable or decreasing mortality among more-educated 35- to 64-year-old women. During the 1990s, mortality among more-educated 50- to 64-year-old women declined particularly fast. Conclusions. The causes of declining differences by education in breast cancer mortality are difficult to verify, but they may be due in part to narrowing differences in reproductive behavior among the younger birth cohorts and to a period effect possibly associated with the introduction of breast cancer screening in the late 1980s.
Handle: RePEc:aph:ajpbhl:2000:90:2:277-280_7

Template-Type: ReDIF-Article 1.0
Title: Prevalence and risk factors of drug-resistant tuberculosis along the Mexico-Texas border
Journal: American Journal of Public Health
Author-Name: Taylor, J.P.
Author-Name: Suarez, L.
Year: 2000
Volume: 90
Issue: 2
Pages: 271-273
Abstract: Objectives. This study determined factors associated with drug resistance among 3496 patients with tuberculosis who resided in Texas counties along the Mexican border. Methods. Univariate and logistic regression analyses were performed to identify risk factors associated with drug resistance Results. Among patients with a history of previous tuberculosis, being 19 years or younger was the only factor associated with multiple drug resistance. Female sex, being 20 to 39 years of age, and foreign birth were risk factors for resistance among patients with no history of previous tuberculosis: Conclusions. Factors contributing to drug resistance among Hispanic tuberculosis patients along the Texas-Mexico border may differ from those among other populations in the United States.
Handle: RePEc:aph:ajpbhl:2000:90:2:271-273_6

Template-Type: ReDIF-Article 1.0
Title: Relationships between obesity and DSM-IV major depressive disorder, suicide ideation, and suicide attempts: Results from a general population study
Journal: American Journal of Public Health
Author-Name: Carpenter, K.M.
Author-Name: Hasin, D.S.
Author-Name: Allison, D.B.
Author-Name: Faith, M.S.
Year: 2000
Volume: 90
Issue: 2
Pages: 251-257
Abstract: Objectives. This study sought to test the relationships between relative body weight and clinical depression, suicide ideation, and suicide attempts in an adult US general population sample. Methods. Respondents were 40 086 African American and White participants interviewed in a national survey. Outcome measures were past-year major depression, suicide ideation, and suicide attempts diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The primary predictor was relative body weight, treated both continuous (i.e., body mass index [BMI]) and categorically in logistic regression analyses. Covariates included age, income and education, disease status, and drug and alcohol use. Results. Relative body weight was associated with major depression, suicide attempts, and suicide ideation, although relationships were different for men and women. Among women, increased BMI was associated with both major depression and suicide ideation. Among men, lower BMI was associated with major depression, suicide attempts, and suicide ideation. There were no racial differences. Conclusions. Differences in BMI, or weight status, were associated with the probability of past-year major depression, suicide attempts, and suicide ideation. Longitudinal studies are needed to differentiate the causal pathways and mechanisms linking physical and psychiatric conditions.
Handle: RePEc:aph:ajpbhl:2000:90:2:251-257_1

Template-Type: ReDIF-Article 1.0
Title: A community-level HIV prevention intervention for inner-city women: Results of the women and infants demonstration projects
Journal: American Journal of Public Health
Author-Name: Lauby, J.L.
Author-Name: Smith, P.J.
Author-Name: Stark, M.
Author-Name: Person, B.
Author-Name: Adams, J.
Year: 2000
Volume: 90
Issue: 2
Pages: 216-222
Abstract: Objectives. This study examined the effects of a multisite community- level HIV prevention intervention on women's condom-use behaviors. Methods. The theory-based behavioral intervention was implemented with low-income, primarily African American women in 4 urban communities. It was evaluated with data from pre- and postintervention cross-sectional surveys in matched intervention and comparison communities. Results. At baseline, 68% of the women had no intention of using condoms with their main partners and 70% were not using condoms consistently with other partners. After 2 years of intervention activities, increases in rates of talking with main partners about condoms were significantly larger in intervention communities than in comparison communities (P = .03). Intervention communities also had significant increases in the proportion of women who had tried to get their main partners to use condoms (P=.01). The trends for condom use with other partners were similar but nonsignificant. Conclusions. Many women at risk for HIV infection are still not using condoms. Community-level interventions may be an effective way to reach large numbers of women and change their condom- use behaviors, particularly their behaviors with regard to communication with main sex partners.
Handle: RePEc:aph:ajpbhl:2000:90:2:216-222_4

Template-Type: ReDIF-Article 1.0
Title: Patterns and correlates of physical activity among US women 40 years and older
Journal: American Journal of Public Health
Author-Name: Brownson, R.C.
Author-Name: Eyler, A.A.
Author-Name: King, A.C.
Author-Name: Brown, D.R.
Author-Name: Shyu, Y.-L.
Author-Name: Sallis, J.F.
Year: 2000
Volume: 90
Issue: 2
Pages: 264-270
Abstract: Objectives. This study describes the patterns of physical activity among minority women by using a variety of definitions and determines sociodemographic and behavioral correlates of physical activity in this population. Methods. A cross-sectional study was conducted in 1996 and 1997 among US women 40 years and older (n = 2912) of the following racial/ethnic groups: African American, American Indian/Alaskan Native, Hispanic, and White. Results. Physical activity was low est among African Americans and American indians/Alaskan Natives (adjusted odds ratios [ORs] for no leisure- time activity were 1.35 [95% confidence interval (CI) = 1.08,1.68] and 1.65 [95% CI = 1.33, 2.06], respectively). A much higher proportion of women were classified as being physically active when occupational activity rather than more traditional assessments of leisure activity were used to determine level of physical activity. On the basis of a composite definition of physical activity, 72% of respondents reported being physically more likely than urban inhabitants to be completely inactive during leisure time. Conclusions. Minority women are among the least active subgroups in American society, although not all groups are less active than White women when all domains of physical activity are taken into account.
Handle: RePEc:aph:ajpbhl:2000:90:2:264-270_3

Template-Type: ReDIF-Article 1.0
Title: Thinking about vaginal microbicide testing
Journal: American Journal of Public Health
Author-Name: Potts, M.
Year: 2000
Volume: 90
Issue: 2
Pages: 188-190
Abstract: A vaginal microbicide could slow the spread of HIV. To date, volunteers in placebo-controlled trials of candidate microbicides have been counseled to use condoms. This does not reduce the number of volunteers expose to possible risk, but it shifts the allotment of risk from those conducting the trial to those women who may be to make autonomous decisions. Alternative ways of meeting the obligation to offer volunteers active benefits are explored. Counseling the use of condoms prolongs clinical trials and could cause tens of thousands of otherwise avoidable deaths.
Handle: RePEc:aph:ajpbhl:2000:90:2:188-190_6

Template-Type: ReDIF-Article 1.0
Title: The making of a germ panic, then and now
Journal: American Journal of Public Health
Author-Name: Tomes, N.
Year: 2000
Volume: 90
Issue: 2
Pages: 191-198
Abstract: Over the last 2 decades, a heightened interest in germs has been evident in many aspects of American popular culture, including news coverage, advertisements, and entertainment media. Although clearly a response to the AIDS epidemic and other recent disease outbreaks, current obsessions with germs have some striking parallels with a similar period of intense anxiety about disease germs that occurred between 1900 and 1940. A comparison of these 2 periods of germ 'panic' suggests some of the long-term cultural trends that contributed to their making. Both germ panics reflected anxieties about societal incorporation, associated with expanding markets, transportation networks, and mass immigration. They were also shaped by new trends in public health education, journalism, advertising and entertainment media. In comparison to the first germ panic, the current discourse about the 'revenge of the superbugs' is considerably more pessimistic because of increasing worries about the environment, suspicions of governmental authority, and distrust of expert knowledge. Yet, as popular anxieties about infectious disease have increased, public health scientists have-been attracting favorable coverage in their role as 'medical detectives' on the trail of the 'killer germ'.
Handle: RePEc:aph:ajpbhl:2000:90:2:191-198_4

Template-Type: ReDIF-Article 1.0
Title: Increasing trends in the use of breast-conserving surgery in California
Journal: American Journal of Public Health
Author-Name: Morris, C.R.
Author-Name: Cohen, R.
Author-Name: Schlag, R.
Author-Name: Wright, W.E.
Year: 2000
Volume: 90
Issue: 2
Pages: 281-284
Abstract: Objectives. The purpose of this study was to determine temporal trends in breast-conserving surgery in California from 1988 through 1995. Methods. Logistic regression was used to analyze data oh 104 466 cases of early-stage breast cancer reported to the California Cancer Registry. Results. A monotonically increasing trend in breast-conserving surgery was detected after adjustment for age, race/ethnicity, stage at diagnosis, and neighborhood education level. Breast-conserving surgery increased at similar rates among all racial/ethnic groups. Older age, Asian or Hispanic race/ethnicity late-stage diagnosis, and residence in an undereducated neighborhood were factors associated with lower use of breast-conserving surgery. Conclusions. Although disparities are evident, use of breast- conserving surgery increased steadily in all groups examined in this study.
Handle: RePEc:aph:ajpbhl:2000:90:2:281-284_5

Template-Type: ReDIF-Article 1.0
Title: Factors associated with tympanostomy tube insertion among preschool-aged children in the United States
Journal: American Journal of Public Health
Author-Name: Kogan, M.D.
Author-Name: Overpeck, M.D.
Author-Name: Hoffman, H.J.
Author-Name: Casselbrant, M.L.
Year: 2000
Volume: 90
Issue: 2
Pages: 245-250
Abstract: Objectives. Recurrent and persistent otitis media is often treated by tympanostomy tube insertion to ventilate the middle ear and restore hearing. This study examined the factors that predict which children are most likely to receive tympanostomy tubes through 3 years of age. Methods. Multiple logistic regression was conducted on data from a nationally representative sample of children (N = 8285). Results. By 3 years of age, 6.8% of US children had tubes inserted. Logistic regression indicated that after control for number of ear infections, children without any gaps in health insurance, who attended a day-care center, who were White, whose birth-weight was less than 1500 g, and who lived in the Midwest or South were significantly more likely to have tympanostomy tubes. Conclusions. These data suggest that differences exist as to who receives tubes. Of particular concern are differences by race/ethnicity and continuity of health insurance coverage. With expansions in health care coverage to larger proportions of uninsured children, it will be important to monitor these programs to ensure that all children who may need tympanostomy tubes have access to them.
Handle: RePEc:aph:ajpbhl:2000:90:2:245-250_1

Template-Type: ReDIF-Article 1.0
Title: Violence victimization after HIV infection in a US probability sample of adult patients in primary care
Journal: American Journal of Public Health
Author-Name: Zierler, S.
Author-Name: Cunningham, W.E.
Author-Name: Andersen, R.
Author-Name: Shapiro, M.F.
Author-Name: Bozzette, S.A.
Author-Name: Nakazono, T.
Author-Name: Morton, S.
Author-Name: Crystal, S.
Author-Name: Stein, M.
Author-Name: Turner, B.
Author-Name: St. Clair, P.
Year: 2000
Volume: 90
Issue: 2
Pages: 208-215
Abstract: Objectives. This study estimated the proportion of HIV-infected adults who have been assaulted by a partner or someone important to them since their HIV diagnosis and the extent to which they reported HIV-seropositive status as a cause of the violence. Methods. Study participants were from a nationally representative probability sample of 2864 HIV-infected adults who were receiving medical care and were enrolled in the HIV Costs and Service Utilization Study. All interviews (91% in person, 9% by telephone)were conducted with computer-assisted personal interviewing instruments. Interviews began in January 1996 and ended 15 months later. Results. Overall, 20.5% of the women, 11.5% of the men who reported having sex with men, and 7.5% of the heterosexual men reported physical harm since diagnosis, of whom nearly half reported HIV-seropositive status as a cause of violent episodes. Conclusions. HIV-related care is an appropriate setting for routine assessment of violence. Programs to cross-train staff in antiviolence agencies and HIV care facilities need to be developed for men and women with HIV infection.
Handle: RePEc:aph:ajpbhl:2000:90:2:208-215_2

Template-Type: ReDIF-Article 1.0
Title: Mortality from invasive pneumococcal pneumonia in the era of antibiotic resistance, 1995-1997
Journal: American Journal of Public Health
Author-Name: Feikin, D.R.
Author-Name: Schuchat, A.
Author-Name: Kolczak, M.
Author-Name: Barrett, N.L.
Author-Name: Harrison, L.H.
Author-Name: Lefkowitz, L.
Author-Name: McGeer, A.
Author-Name: Farley, M.M.
Author-Name: Vugia, D.J.
Author-Name: Lexau, C.
Author-Name: Stefonek, K.R.
Author-Name: Patterson, J.E.
Author-Name: Jorgensen, J.H.
Year: 2000
Volume: 90
Issue: 2
Pages: 223-229
Abstract: Objectives. This study examined epidemiologic factors affecting mortality from pneumococcal pneumonia in 1995 through 1997. Methods. Persons: residing in a surveillance area who had community-acquired pneumonia requiring hospitalization and Streptococcus pneumoniae isolated from a sterile site were included in the analysis. Factors affecting mortality were evaluated in univariate and multivariate analyses. The number of deaths from pneumococcal pneumonia requiring hospitalization in the United States in 1996 was estimated. Results. Of 5837-cases, 12% were fatal. Increased mortality was associated with older age, underlying disease, Asian race, and residence in Toronto/Peel, Ontario. When these factors were controlled for, increased mortality was not associated with resistance to penicillin i or cefotaxime. However, when deaths during the first 4 hospital days were excluded, mortality was significantly associated with penicillin minimum inhibitory concentrations of 4.0 or higher and cefotaxime minimum inhibitory concentrations of 2.0 or higher. In 1996, about 7000 to 12500 deaths occurred in the United States from pneumococcal pneumonia requiring hospitalization. Conclusions. Older age and underlying disease remain the most important factors influencing death from pneumococcal pneumonia. Mortality was not elevated in most infections with β-actam-resistant pneumococci.
Handle: RePEc:aph:ajpbhl:2000:90:2:223-229_9

Template-Type: ReDIF-Article 1.0
Title: 'Broken windows' and the risk of gonorrhea
Journal: American Journal of Public Health
Author-Name: Cohen, D.
Author-Name: Spear, S.
Author-Name: Scribner, R.
Author-Name: Kissinger, P.
Author-Name: Mason, K.
Author-Name: Wildgen, J.
Year: 2000
Volume: 90
Issue: 2
Pages: 230-236
Abstract: Objectives. We examined the relationships between neighborhood conditions and gonorrhea. Methods. We assessed 55 block groups by rating housing and street conditions. We mapped all cases of gonorrhea between 1994 and 1996 and calculated aggregated case rates by block group. We obtained public school inspection reports and assigned findings to the block groups served by the neighborhood schools. A 'broken windows' index measured housing quality, abondoned cars, graffiti, trash, and public school deterioration. Using data from the 1990 census and 1995 updates, we determined the association between 'broken windows,' demographic characteristics, and gonorrhea rates. Results. The broken windows index explained more of the variance in gonorrhea rates than did a poverty index measuring income, unemployment, and low education. In high-poverty neighborhood, block groups with high broken windows scores had significantly higher gonorrhea rates than block groups with low broken windows scores (46.6 per 1000 vs 25.8 per 1000; P<.001). Conclusions. The robust association of deteriorated physical conditions of local neighborhoods with gonorrhea rates, independent of poverty, merits an intervention trial to test whether the environment has a causal role in influencing high-risk sexual behaviors.
Handle: RePEc:aph:ajpbhl:2000:90:2:230-236_8

Template-Type: ReDIF-Article 1.0
Title: Implementation of guidelines for HIV counseling and voluntary HIV testing of pregnant women
Journal: American Journal of Public Health
Author-Name: Joo, J.
Author-Name: Carmack, A.
Author-Name: Garcia-Buñuel, E.
Author-Name: Kelly, C.J.
Year: 2000
Volume: 90
Issue: 2
Pages: 273-276
Abstract: Objectives. This study assessed HIV counseling and testing among pregnant women. Methods. A survey was administered to 9115 women who gave birth at 66 Chicago-area hospitals in 1997 and 1998. Results. Fifty-eight percent of the women received HIV counseling, and 65% were offered testing. Fifty-six percent were tested for HIV. Among the women tested, 88% were given their test results. Women were more likely to be tested if they received HIV counseling and were more likely to be offered testing if they received such counseling. Conclusions. Rates of HIV counseling for, and offers of testing to, pregnant women need to be increased.
Handle: RePEc:aph:ajpbhl:2000:90:2:273-276_5

Template-Type: ReDIF-Article 1.0
Title: Immunization and the American way: 4 Childhood vaccines
Journal: American Journal of Public Health
Author-Name: Baker, J.P.
Year: 2000
Volume: 90
Issue: 2
Pages: 199-207
Abstract: Childhood immunization constitutes one of the great success-stories of American public health in the 20th century. This essay provides a historical examination of this topic through 4 particularly important examples: diphtheria, pertussis, polio, and measles. Each case study illustrates how new vaccines have posed unique challenges related to basic science, clinical trial methodology, medical ethics, and public acceptance. A brief comparison of each story to the experience of Great Britain, however, suggests an underlying unity connecting all 4 examples. Whereas the British led the way in introducing formal clinical trial methodology in the field of immunization development, the Americans excelled in the rapid translation of laboratory knowledge into strategies suitable for mass application. Although this distinction appears to have diminished in recent years, it offers insight into the sources of creativity underlying American vaccine development and the corresponding difficulties sometimes created for utilizing vaccines' fruits rationally.
Handle: RePEc:aph:ajpbhl:2000:90:2:199-207_7

Template-Type: ReDIF-Article 1.0
Title: Worldwide surveillance of risk factors to promote global health
Journal: American Journal of Public Health
Author-Name: Morabia, A.
Year: 2000
Volume: 90
Issue: 1
Pages: 22-24
Handle: RePEc:aph:ajpbhl:2000:90:1:22-24_2

Template-Type: ReDIF-Article 1.0
Title: The journal: New chapter, new century
Journal: American Journal of Public Health
Author-Name: Johnson, N.
Year: 2000
Volume: 90
Issue: 1
Pages: 19-22
Handle: RePEc:aph:ajpbhl:2000:90:1:19-22_9

Template-Type: ReDIF-Article 1.0
Title: The economic implications of self-care: The effect of lifestyle, functional adaptations, and medical self-care among a national sample of medicare beneficiaries
Journal: American Journal of Public Health
Author-Name: Stearns, S.C.
Author-Name: Bernard, S.L.
Author-Name: Fasick, S.B.
Author-Name: Schwartz, R.
Author-Name: Konrad, T.R.
Author-Name: Ory, M.G.
Author-Name: DeFriese, G.H.
Year: 2000
Volume: 90
Issue: 10
Pages: 1608-1612
Abstract: Objectives. Self-care includes actions taken by individuals to promote or ensure their health, to recover from diseases or injuries, or to manage their effects. This study measured associations between self-care practices (lifestyle practices, adaptations to functional limitations, and medical self-care) and Medicare expenditures among a national sample of adults 65 years and older. Methods. Regression models of Medicare use and expenditures were estimated by using the National Survey of Self-Care and Aging and Medicare claims for 4 years following a baseline interview. Results. Lifestyle factors (swimming and walking) and functional adaptations (general home modifications) were associated with reductions in monthly Medicare expenditures over a 12-month follow-up period. Expenditure reductions were found over the 48-month follow-up period for participation in active sports, gardening, and medical self-care. Practices associated with increases in expenditures included smoking, physical exercise (possibly of a more strenuous nature), and specific home modifications. Conclusions. Certain self-care pracrices appear to have significant implications for Medicare expenditures and presumptively for the health status of older adults. Such practices should be encouraged among older adults as a matter of national health policy.
Handle: RePEc:aph:ajpbhl:2000:90:10:1608-1612_5

Template-Type: ReDIF-Article 1.0
Title: Trends in social consequences and dependence symptoms in the United States: The National Alcohol Surveys, 1984-1995
Journal: American Journal of Public Health
Author-Name: Midanik, L.T.
Author-Name: Greenfield, T.K.
Year: 2000
Volume: 90
Issue: 1
Pages: 53-56
Abstract: Objectives. Given the decline in alcohol use in the United States since the 1980s, the purpose of this study was to assess shifts in self-reported social consequences of alcohol use (and 5 consequences subscales) and dependence symptoms from 1984 to 1995. Methods. This study used data from 3 national alcohol surveys based on household probability samples of current drinkers (adults) in 1984, 1990, and 1995; sample sizes were 1503, 1338, and 1417, respectively. Results. Overall, few changes in prevalence of social consequences or dependence symptoms were found. Significantly lower prevalence rates of 2 consequences subscales (accidents/legal problems and work problems) were reported between 1984 and 1990, but prevalence rates did not change for any of the scales from 1990 to 1995. Conclusions. This stability in alcohol-related outcomes despite reductions in alcohol consumption may be a result of cultural shifts in which problem amplification occurs in 'drier' historical periods. Furthermore, rates of alcohol-related problems may be approaching their lowest limit and may not be readily influenced by any additional decreases in alcohol consumption.
Handle: RePEc:aph:ajpbhl:2000:90:1:53-56_3

Template-Type: ReDIF-Article 1.0
Title: Erratum: Helping women quit smoking: Results of a community intervention program (American Journal of Public Health (2000) 90 (940-946))
Journal: American Journal of Public Health
Author-Name: Secker-Walker, R.H.
Author-Name: Flynn, B.S.
Author-Name: Solomon, L.J.
Author-Name: Skelly, J.M.
Author-Name: Dorwaldt, A.L.
Author-Name: Ashikaga, T.
Year: 2000
Volume: 90
Issue: 12
Pages: 1953
Handle: RePEc:aph:ajpbhl:2000:90:12:1953_9

Template-Type: ReDIF-Article 1.0
Title: Erratum: The impact of economic sanctions on health and human rights in Haiti, 1991-1994 (American Journal of Public Health (1999) 89 (1499-1504))
Journal: American Journal of Public Health
Author-Name: Gibbons, E.
Author-Name: Garfield, R.
Year: 2000
Volume: 90
Issue: 1
Pages: 140
Handle: RePEc:aph:ajpbhl:2000:90:1:140_7

Template-Type: ReDIF-Article 1.0
Title: Unit conversion as a source of misclassification in US birthweight data
Journal: American Journal of Public Health
Author-Name: Umbach, D.M.
Year: 2000
Volume: 90
Issue: 1
Pages: 127-129
Abstract: Objectives. This study explains why frequency polygons for US birthweights in 100-g weight classes appear spiky compared with their European counterprarts. Methods. A probability model is used to describe how unit conversion can induce misclassification. Birthweights from the United States and Norway are used to illustrate that misclassification operates in grouped US data. Results. Spikiness represents misclassification that arises when measured birthweights are rounded to the nearer ounce, converted to grams, and then grouped into weight classes. Misclassification is ameliorated, not eliminated, with 200-g weight classes. Conclusions. Possible biases from misclassification should be carefully evaluated when fitting statistical models to grouped US birthweights.
Handle: RePEc:aph:ajpbhl:2000:90:1:127-129_2

Template-Type: ReDIF-Article 1.0
Title: Put prevention into practice: A controlled evaluation
Journal: American Journal of Public Health
Author-Name: Melnikow, J.
Author-Name: Kohatsu, N.D.
Author-Name: Chan, B.K.S.
Year: 2000
Volume: 90
Issue: 10
Pages: 1622-1625
Abstract: Objectives. The purpose of this study was to evaluate whether Put Prevention Into Practice (PPIP) materials affected the delivery of 8 clinical preventive services. Methods. Program materials were provided to a family medicine practice serving a diverse, low-income population. Appropriate use of clinical preventive services was assessed via medical record reviews at baseline, 6 months, 18 months and 30 months at both intervention and control sites. Results. The delivery rates of 7 clinical preventive services were higher in the intervention site at 6 months. These rates had flattened or decreased by 30 months. Conclusions. Use of PPIP materials modestly improved delivery of certain clinical preventive services. Sustained improvement will require substantial system changes and ongoing support.
Handle: RePEc:aph:ajpbhl:2000:90:10:1622-1625_2

Template-Type: ReDIF-Article 1.0
Title: Time to diagnosis and treatment of breast cancer: Results from the National Breast and Cervical Cancer Early Detection Program, 1991-1995
Journal: American Journal of Public Health
Author-Name: Caplan, L.S.
Author-Name: May, D.S.
Author-Name: Richardson, L.C.
Year: 2000
Volume: 90
Issue: 1
Pages: 130-134
Abstract: Objectives. This study examined times to diagnosis and treatment for medically underserved women screened for breast cancer. Methods. Intervals from first positive screening test to diagnosis to initiation of treatment were determined for 1659 women 40 years and older diagnosed with breast cancer. Results. Women with abnormal mammograms had shorter diagnostic intervals than women with abnormal clinical breast examinations and normal mammograms. Women with self-reported breast symptoms had shorter diagnostic intervals than asymptomatic women. Diagnostic intervals were less than 60 days in 78% of cases. Treatment intervals were generally 2 weeks or less. Conclusions. Most women diagnosed with breast cancer were followed up in a timely after screening. Further investigation is needed to identify and then address factors associated with longer diagnostic and treatment intervals to maximize the benefits of early detection.
Handle: RePEc:aph:ajpbhl:2000:90:1:130-134_0

Template-Type: ReDIF-Article 1.0
Title: Lack of standards in direct standardization
Journal: American Journal of Public Health
Author-Name: Reitsma, J.B.
Author-Name: Bonsel, G.J.
Author-Name: Gunning-Schepers, L.J.
Author-Name: Tijssen, J.G.P.
Year: 2000
Volume: 90
Issue: 1
Pages: 139-140
Handle: RePEc:aph:ajpbhl:2000:90:1:139-140_8

Template-Type: ReDIF-Article 1.0
Title: Risk and prevalence of treatable sexually transmitted diseases at a Birmingham substance abuse treatment facility
Journal: American Journal of Public Health
Author-Name: Bachmann, L.H.
Author-Name: Lewis, I.
Author-Name: Allen, R.
Author-Name: Schwebke, J.R.
Author-Name: Leviton, L.C.
Author-Name: Siegal, H.A.
Author-Name: Hook III, E.W.
Year: 2000
Volume: 90
Issue: 10
Pages: 1615-1618
Abstract: Objectives. We evaluated the prevalence of gonorrhea, chlamydia, trichmoniasis, and syphilis in patients entering residential drug treatment. Methods. Data on sexual and substance abuse histories were collected. Participants provided specimens for chlamydia and gonorrhea ligase chain reaction testing, Trichomonas vaginalis culture, and syphilis serologic testing. Results. Of 311 patients, crack cocaine use was reported by 67% and multisubstance use was reported by 71%. Sexually transmitted disease (STD) risk behaviors were common. The prevalence of infection was as follows: Chlamydia trachomatis, 2.3%; Neisseria gonorrhoeae, 1.6%; trichomoniasis, 43%; and syphilis, 6%. Conclusions. STD counseling and screening may be a useful adjunct to in patient drug treatment.
Handle: RePEc:aph:ajpbhl:2000:90:10:1615-1618_5

Template-Type: ReDIF-Article 1.0
Title: Measles eradication: Is it in our future?
Journal: American Journal of Public Health
Author-Name: Orenstein, W.A.
Author-Name: Strebel, P.M.
Author-Name: Papania, M.
Author-Name: Sutter, R.W.
Author-Name: Bellini, W.J.
Author-Name: Cochi, S.L.
Year: 2000
Volume: 90
Issue: 10
Pages: 1521-1525
Abstract: Measles eradication would avert the current annual 1 million deaths and save the $1.5 billion in treatment and prevention costs due to measles in perpetuity. The authors evaluate the biological feasibility of eradicating measles according to 4 criteria: (1) the role of humans in maintaining transmission, (2) the availability of a accurate diagnostic tests, (3) the existence of effective vaccines, and (4) the need to demonstrate elimination of measles from a large geographic area. Recent successes in interrupting measles transmission in the United States, most other countries in the Western Hemisphere, and selected countries in other regions provide evidence for the feasibility of global eradication. Potential impediments to eradication include (1) lack of political will in some industrialized countries, (2) transmission among adults, (3) increasing urbanization and population density, (4) the HIV epidemic, (5) waning immunity and the possibility of transmission from subclinical cases, and (6) risk of unsafe injections. Despite these challenges, a compelling case can be made in favor of measles eradication, and the authors believe that it is in our future. The question is when.
Handle: RePEc:aph:ajpbhl:2000:90:10:1521-1525_9

Template-Type: ReDIF-Article 1.0
Title: Erratum: Implementation of guidelines for HIV counseling and voluntary HIV testing of pregnant women (American Journal of Public Health (2000) 90 (273-276))
Journal: American Journal of Public Health
Author-Name: Joo, E.
Author-Name: Carmack, A.
Author-Name: Garcia-Bunuel, E.
Author-Name: Kelly, C.J.
Year: 2000
Volume: 90
Issue: 4
Pages: 640
Handle: RePEc:aph:ajpbhl:2000:90:4:640_8

Template-Type: ReDIF-Article 1.0
Title: Childhood mortality impact and costs of integrating vitamin A supplementation into immunization campaigns
Journal: American Journal of Public Health
Author-Name: Ching, P.
Author-Name: Birmingham, M.
Author-Name: Goodman, T.
Author-Name: Sutter, R.
Author-Name: Loevinsohn, B.
Year: 2000
Volume: 90
Issue: 10
Pages: 1526-1529
Abstract: Country-specific activity and coverage data were used to estimate the childhood mortality impact (deaths averted) and costs of integrating vitamin A supplements into immunization campaigns conducted in 1998 and 1999. More than 94 million doses of vitamin A were administered in 41 countries in 1998, helping to avert nearly 169 000 deaths. During 1999, delivery of more than 97 million doses in 50 countries helped avert an estimated 242 000 deaths. The estimated incremental cost per death averted was US $72 (range: 36-142) in 1998 and US $64 (range: 32-126) in 1999. The estimated average total cost of providing supplementation per death averted was US $310 (range: 157-609) in 1998 and US $276 (range: 139-540) in 1999. Costs per death averted varied by campaign, depending on the number and proportion of the child population reached, number of doses received per child, and child mortality rates.
Handle: RePEc:aph:ajpbhl:2000:90:10:1526-1529_5

Template-Type: ReDIF-Article 1.0
Title: Determining immunization rates for inner-city infants: Statewide registry data vs medical record review
Journal: American Journal of Public Health
Author-Name: Stille, C.J.
Author-Name: Christison-Lagay, J.
Year: 2000
Volume: 90
Issue: 10
Pages: 1613-1615
Abstract: Objective. This study evaluated the benefit of consulting a statewide immunization registry for inner-city infants whose immunizations appeared, after single-site chart review, to have been delayed. Methods. We prospectively enrolled 315 newborns in 3 inner-city pediatric clinics. When the infants turned 7 months old, we obtained immunization data from clinic charts and the state registry. Results. On the basis of chart review, 147 infants (47%) were assessed to be delayed in their immunizations; of these, registry data revealed that 28 (19%) had received additional immunizations and 15 (10%) were actually up to date. Conclusions. A statewide registry can capture immunizations from multiple sources, improving accurate determination of immunization rates in a mobile, inner-city population.
Handle: RePEc:aph:ajpbhl:2000:90:10:1613-1615_3

Template-Type: ReDIF-Article 1.0
Title: Estimating future hepatitis C morbidity, mortality, and costs in the United States
Journal: American Journal of Public Health
Author-Name: Wong, J.B.
Author-Name: McQuillan, G.M.
Author-Name: McHutchison, J.G.
Author-Name: Poynard, T.
Year: 2000
Volume: 90
Issue: 10
Pages: 1562-1569
Abstract: Obectives: This Study esttmated future morbidity, mortality, and costs resulting from hepatitis C virus (HCV). Methods: We used a computer cohort simulation of the natural history of HCV/n the US population. Results: From the year 2010 through 2019, our model projected 165 900 deaths from chronic liver disease, 27 200 deaths from hepatocellular carcinoma, and $10.7 billion in direct medical expenditures for HCV. Drug this period, HCV may lead to 720 700 years of decompensated cirrhosis and hepatocellular carcinoma and to the loss of 1.83 million years of life in those younger than 65 at a societal cost of $21.3 and $54:2 billion, respectively, sensitivity analysis, these estimates depended on (1) whether patients with HCV and normal transaminase levels develop progressive liver disease, (2) the extent of alcohol ingestion, and (3) the likelihood of dying from other causes related to the rotate of HCV acquisition. Conclusions: Our results confirm prior Centers for Disease Control and Prevention projections and suggest that HCV may lead to a substantial health and economic burden over the next 10 to 20 years.
Handle: RePEc:aph:ajpbhl:2000:90:10:1562-1569_8

Template-Type: ReDIF-Article 1.0
Title: Physical activity and incident diabetes mellitus in postmenopausal women
Journal: American Journal of Public Health
Author-Name: Folsom, A.R.
Author-Name: Kushi, L.H.
Author-Name: Hong, C.-P.
Year: 2000
Volume: 90
Issue: 1
Pages: 134-138
Abstract: Objectives. This study determined whether the incidence of diabetes is reduced among physically active older women. Methods. We assessed physical activity by mailed questionnaire and 12-year incidence (ostensibly type 2 diabetes) in a cohort of 34257 women aged 55 to 69 years. Results. After adjustment for age, education, smoking, alcohol intake, estrogen use, dietary variables, and family history of diabetes, women who reported any physical activity had a relative risk of diabetes of 0.69 (95% confidence interval = 0.63, 0.77) compared with sedentary women. Conclusions. These findings suggest that physical activity is important for type 2 diabetes prevention among older women.
Handle: RePEc:aph:ajpbhl:2000:90:1:134-138_1

Template-Type: ReDIF-Article 1.0
Title: Optimal immunization practices for the special supplemental nutrition program for women, infants, and children
Journal: American Journal of Public Health
Author-Name: Kendal, A.P.
Author-Name: Neville, L.J.
Author-Name: Manning, C.C.
Year: 2000
Volume: 90
Issue: 10
Pages: 1640-1641
Handle: RePEc:aph:ajpbhl:2000:90:10:1640-1641_8

Template-Type: ReDIF-Article 1.0
Title: Putting diversity into practice
Journal: American Journal of Public Health
Author-Name: Northridge, M.E.
Year: 2000
Volume: 90
Issue: 5
Pages: 689-690
Handle: RePEc:aph:ajpbhl:2000:90:5:689-690_4

Template-Type: ReDIF-Article 1.0
Title: Erratum: Violence victimization after HIV infection in a US probability sample of adult patients in primary care (American Journal of Public Health (2000) 90 (208-215))
Journal: American Journal of Public Health
Author-Name: Zierler, S.
Author-Name: Cunningham, W.E.
Author-Name: Andersen, R.
Year: 2000
Volume: 90
Issue: 3
Pages: 447
Handle: RePEc:aph:ajpbhl:2000:90:3:447_9

Template-Type: ReDIF-Article 1.0
Title: Using public media to teach medicaid recipients about managed care
Journal: American Journal of Public Health
Author-Name: Mason, D.J.
Author-Name: Nichols, T.E.
Author-Name: Molnar, C.
Author-Name: Bernstein, A.
Year: 2000
Volume: 90
Issue: 1
Pages: 34-35
Handle: RePEc:aph:ajpbhl:2000:90:1:34-35_5

Template-Type: ReDIF-Article 1.0
Title: Demonstrating pelvic measurement to midwives
Journal: American Journal of Public Health
Author-Name: Helfand, W.H.
Author-Name: Lazarus, J.
Author-Name: Theerman, P.
Year: 2000
Volume: 90
Issue: 8
Pages: 1196
Handle: RePEc:aph:ajpbhl:2000:90:8:1196_4

Template-Type: ReDIF-Article 1.0
Title: Erratum: (American Journal of Public Health (2000) 90 (702-706))
Journal: American Journal of Public Health
Author-Name: Mullan, F.
Author-Name: Quixote, D.
Author-Name: Machiavelli
Author-Name: Hood, M.R.
Year: 2000
Volume: 90
Issue: 7
Pages: 1146
Handle: RePEc:aph:ajpbhl:2000:90:7:1146_8

Template-Type: ReDIF-Article 1.0
Title: Smoking cessation counseling with pregnant and postpartum women: A survey of community health center providers
Journal: American Journal of Public Health
Author-Name: Zapka, J.G.
Author-Name: Pbert, L.
Author-Name: Stoddard, A.M.
Author-Name: Ockene, J.K.
Author-Name: Goins, K.V.
Author-Name: Bonollo, D.
Year: 2000
Volume: 90
Issue: 1
Pages: 78-84
Abstract: Objectives. This study assessed providers' performance of smoking cessation counseling steps with low-income pregnant and postpartum women receiving care at community health centers. Methods. WIC (Special Supplemental Nutrition Program for Women, Infants and Children) program staff obstetric clinicians, and pediatric clinicians a 6 community health centers were asked to complete surveys. Smoking intervention practices (performance), knowledge and attitudes, and organizational facilitators were measured. Factors associated with performance were explored with analysis of variance and regression analysis. Results. Performance scores differed significantly by clinic and provider type. Providers in obstetric clinics had the highest scores and those in pediatric clinics had the lowest scores. Nurse practitioners and nutritionists had higher scores than other providers. Clinic type, greater smoking-related knowledge, older age, and perception of smoking cessation as a priority were independently related to better counseling performance. Conclusions. Mean performance scores demonstrated room for improvement in all groups. Low scores for performance of steps beyond assessment and advice indicate a need for emphasis or the assistance and follow-up steps of national guidelines. Providers' own commitment to helping mothers stop smoking was important.
Handle: RePEc:aph:ajpbhl:2000:90:1:78-84_0

Template-Type: ReDIF-Article 1.0
Title: Condom promotion in mircobicide trials [2]
Journal: American Journal of Public Health
Author-Name: Van de Wijgert, J.
Author-Name: Elias, C.
Author-Name: Ellertson, C.
Author-Name: McGrory, E.
Author-Name: Blanchard, K.
Author-Name: Friedland, B.
Author-Name: Winikoff, B.
Author-Name: Brown, G.
Year: 2000
Volume: 90
Issue: 7
Pages: 1153-1154
Handle: RePEc:aph:ajpbhl:2000:90:7:1153-1154_3

Template-Type: ReDIF-Article 1.0
Title: The alcohol warning and adolescents: 5-Year effects
Journal: American Journal of Public Health
Author-Name: MacKinnon, D.P.
Author-Name: Nohre, L.
Author-Name: Pentz, M.A.
Author-Name: Stacy, A.W.
Year: 2000
Volume: 90
Issue: 10
Pages: 1589-1594
Abstract: Objectives. This study, a follow-up to the authors' earlier report, examined the effects of the alcohol warning label on adolescents during the first 5 years that the warning was required. Methods. Surveys were administered to 10th-grade (n= 16661) and 12th-grade (n= 15856) students from the 1989-1990 school year through the 1994-1995 school year. The measures were awareness of, exposure to, and recognition memory of the alcohol warning label; beliefs about the risks listed on the warning; and open-ended statements about consequences of alcohol use, alcohol consumption, and self-reported driving after drinking. Results. There were increases in warning awareness, exposure, and recognition memory. These effects leveled off approximately 3.5 years aider the inclusion of the warning on alcohol beverage containers. There was no beneficial change attributable to the warning in beliefs, alcohol consumption, or driving after drinking. Conclusions. The initial positive effects of the alcohol warning label on adolescents have leveled off, consistent with theories of repeated exposure to persuasive information. The alcohol warning has not affected adolescents beliefs about alcohol or alcohol-related behaviors.
Handle: RePEc:aph:ajpbhl:2000:90:10:1589-1594_6

Template-Type: ReDIF-Article 1.0
Title: Sources of prenatal care data and their association with birth outcomes of HIV-infected women
Journal: American Journal of Public Health
Author-Name: Turner, B.J.
Author-Name: Cocroft, J.
Author-Name: Newschaffer, C.J.
Author-Name: Hauck, W.W.
Author-Name: Fanning, T.R.
Author-Name: Berlin, M.
Year: 2000
Volume: 90
Issue: 1
Pages: 118-121
Abstract: Objectives. Different sources of prenatal care data were used to examine the association between birth outcomes of HIV-infected women and the Adequacy of Prenatal Care Utilization (APNCU) index. Methods. Adjusted odds ratios of birth outcomes for 1858 HIV-positive mothers were calculated for APNCU indexes on the basis of birth certificate data or 3 types of physician visits on Medicaid claims. Results. Claims- and birth certificate-based APNCU indexes agreed poorly (κ<0.3). Only the broadest claims-based APNCU index had lower adjusted odds ratios for low birthweight (0.64; 95% confidence interval [CI] = 0.49, 0.84) and preterm birth (0.70; 95% CI = 0.54, 0.91). The birth certificate-based index had a reduced adjusted odds ratio (0.73; 95% CI = 0.56, 0.95) only for preterm birth. Conclusions. The association of birth outcomes and adequacy of prenatal care in this HIV-infected cohort differed significantly depending on the source of prenatal care data.
Handle: RePEc:aph:ajpbhl:2000:90:1:118-121_3

Template-Type: ReDIF-Article 1.0
Title: 'Cater to the children': The role of the lead industry in a public health tragedy, 1900-1955
Journal: American Journal of Public Health
Author-Name: Markowitz, G.
Author-Name: Rosner, D.
Year: 2000
Volume: 90
Issue: 1
Pages: 36-46
Abstract: A major source of childhood lead poisoning, still a serious problem in the United States, is paint. The dangers of lead were known even in the 19th century, and the particular dangers to children were documented in the English-language literature as early as 1904. During the first decades of the 20th century, many other countries banned or restricted the use of lead paint for interior painting. Despite this knowledge, the lead industry in the United States did nothing to discourage the use of lead paint on interior walls and woodwork. In fact, beginning in the 1920s, the Lead Industries Association and its members conducted an intensive campaign to promote the use of paint containing white lead, even targeting children in their advertising. It was not until the 1950s that the industry, under increasing pressure, adopted a voluntary standard limiting the amount of lead in interior paints.
Handle: RePEc:aph:ajpbhl:2000:90:1:36-46_8

Template-Type: ReDIF-Article 1.0
Title: The association of sexual behaviors with socioeconomic status, family structure, and race/ethnicity among US adolescents
Journal: American Journal of Public Health
Author-Name: Santelli, J.S.
Author-Name: Lowry, R.
Author-Name: Brener, N.D.
Author-Name: Robin, L.
Year: 2000
Volume: 90
Issue: 10
Pages: 1582-1588
Abstract: Objectives. This study assessed the relation of socioeconomic status (SES), family structure, and race/ethnicity to adolescent sexual behaviors that are key determinants sexual behaviors that are key determinants of pregnancy and sexually transmitted diseases (STDs). Methods. The 1992 Youth Risk Behavior Survey/Supplement to the National Health Interview Survey provided family data from household adults and behavioral data from adolescents. Results. Among male and female adolescents, greater parental education, living in a 2-parent family, and White race were independently associated with never having had sexual intercourse. Parental education did not show a linear association with other behaviors. Household income was not linearly related to any sexual behavior. Adjustment for SES and family structure had a limited effect on the association between race/ethnicity and sexual behaviors. Conclusions. Differences in adolescent sexual behavior by race and SES were not large enough to fully explain differences in rates of pregnancy and STD infection. This suggests that other factors, including access to health services and community prevalence of STDs, may be important mediating variables between SES and STD transmission and pregnancy among adolescents.
Handle: RePEc:aph:ajpbhl:2000:90:10:1582-1588_9

Template-Type: ReDIF-Article 1.0
Title: Erratum: Hospitalization of homeless persons with tuberculosis in the Unites States (American Journal of Public Health (2000) 90 (435-436))
Journal: American Journal of Public Health
Author-Name: Marks, S.
Author-Name: Taylor, Z.
Author-Name: Burrows, N.R.
Author-Name: Qayad, M.
Author-Name: Miller, B.
Year: 2000
Volume: 90
Issue: 4
Pages: 640
Handle: RePEc:aph:ajpbhl:2000:90:4:640_7

Template-Type: ReDIF-Article 1.0
Title: The effect of the doctor-patient relationship on emergency department use among the elderly
Journal: American Journal of Public Health
Author-Name: Rosenblatt, R.A.
Author-Name: Wright, G.E.
Author-Name: Baldwin, L.-M.
Author-Name: Chan, L.
Author-Name: Clitherow, P.
Author-Name: Chen, F.M.
Author-Name: Hart, L.G.
Year: 2000
Volume: 90
Issue: 1
Pages: 97-102
Abstract: Objectives. This study sought to determine the rate of emergency department use among the elderly and examined whether that use is reduced if the patient has a principal-care physician. Methods. The Health Care Financing Administration's National Claims History File was used to study emergency department use by Medicare patients older than 65 years in Washington State during 1994. Results. A total of 18.1% of patients had 1 or more emergency department visits during the study year; the rate increased with age and illness severity. Patients with principal-care physicians were much less likely to use the emergency department for every category of disease severity. After case mix, Medicaid eligibility, and rural/urban residence were controlled for, the odds ratio for having any emergency department visit was 0.47 for patients with a generalist principal-care physician and 0.58 for patients with a specialist principal-care physician. Conclusions: The rate of emergency department use among the elderly is substantial, and most visits are for serious medical problems. The presence of a continuous relationship with a physician regardless of specialty may reduce emergency department use.
Handle: RePEc:aph:ajpbhl:2000:90:1:97-102_9

Template-Type: ReDIF-Article 1.0
Title: Domestic violence and HIV/AIDS
Journal: American Journal of Public Health
Author-Name: Klein, S.J.
Author-Name: Birkhead, G.S.
Author-Name: Wright, G.
Year: 2000
Volume: 90
Issue: 10
Pages: 1648
Handle: RePEc:aph:ajpbhl:2000:90:10:1648_9

Template-Type: ReDIF-Article 1.0
Title: Erratum: (American Journal of Public Health (2000) 90 (833-892))
Journal: American Journal of Public Health
Author-Name: Reynolds, P.P.
Year: 2000
Volume: 90
Issue: 10
Pages: 1642
Handle: RePEc:aph:ajpbhl:2000:90:10:1642_6

Template-Type: ReDIF-Article 1.0
Title: Outcomes of a randomized community-level HIV prevention intervention for women living in 18 low-income housing developments
Journal: American Journal of Public Health
Author-Name: Sikkema, K.J.
Author-Name: Kelly, J.A.
Author-Name: Winett, R.A.
Author-Name: Solomon, L.J.
Author-Name: Cargill, V.A.
Author-Name: Roffman, R.A.
Author-Name: McAuliffe, T.L.
Author-Name: Heckman, T.G.
Author-Name: Anderson, E.A.
Author-Name: Wagstaff, D.A.
Author-Name: Norman, A.D.
Author-Name: Perry, M.J.
Author-Name: Crumble, D.A.
Author-Name: Mercer, M.B.
Year: 2000
Volume: 90
Issue: 1
Pages: 57-63
Abstract: Objectives. Women impoverished inner-city neighborhoods are at high risk for contracting HIV. A randomized, multisite community-level HIV prevention trial was undertaken with women living in 18 low-income housing developments in 5 US cities. Methods. Baseline and 12-month follow-up population risk characteristics were assessed by surveying 690 women at both time points. In the 9 intervention condition housing developments, a community-level intervention was undertaken that included HIV risk reduction workshops and community HIV prevention events implemented by women who were popular opinion leaders among their peers. Results. The proportion of women in the intervention developments who had any unprotected intercourse in the past 2 months declined from 50% to 37.6%, and the percentage of women's acts of intercourse protected by condoms increased from 30.2% to 47.2%. Among women exposed to intervention activities, the mean frequency of unprotected acts of intercourse in the past 2 months tended to be lower at follow-up (mean = 4.0) than at baseline (mean = 6.0). These changes were corroborated by changes in other risk indicators. Conclusions. Community-level interventions that involve and engage women in neighborhood-based HIV prevention activities can bring about reductions in high-risk sexual behaviors.
Handle: RePEc:aph:ajpbhl:2000:90:1:57-63_0

Template-Type: ReDIF-Article 1.0
Title: A 10-year national trend study of alcohol consumption, 1984-1995: Is the period of declining drinking over?
Journal: American Journal of Public Health
Author-Name: Greenfield, T.K.
Author-Name: Midanik, L.T.
Author-Name: Rogers, J.D.
Year: 2000
Volume: 90
Issue: 1
Pages: 47-52
Abstract: Objectives. Data from the 1984, 1990, and 1995 National Alcohol Surveys were used to investigate whether declines shown previously in drinking and heavy drinking across many demographic subgroups have continued. Methods. Three alcohol consumption indicators - current drinking (vs abstaining), weekly drinking, and weekly heavy drinking (5 or more drinks in a day) - were assessed for the total US population and for demographic subgroups. Results. Rates of current drinking, weekly drinking, and frequent heavy drinking, previously reported to have decreased between the 1984 and 1990 surveys, remained unchanged between 1990 and 1995. Separate analyses for each beverage type (beer, wine, and spirits) and most demographic subgroups revealed similar temporal patterns. Conclusions. Alcohol consumption levels, declining since the early 1980s, may reach a minimum by the 21st century. Consumption levels should be monitored carefully over the next few years in the event that long-term alcohol consumption trends may be shifting.
Handle: RePEc:aph:ajpbhl:2000:90:1:47-52_1

Template-Type: ReDIF-Article 1.0
Title: An outbreak of Shigella sonnei associated with a recreational spray fountain
Journal: American Journal of Public Health
Author-Name: Fleming, C.A.
Author-Name: Caron, D.
Author-Name: Gunn, J.E.
Author-Name: Horine, M.S.
Author-Name: Matyas, B.T.
Author-Name: Barry, M.A.
Year: 2000
Volume: 90
Issue: 10
Pages: 1641-1642
Handle: RePEc:aph:ajpbhl:2000:90:10:1641-1642_9

Template-Type: ReDIF-Article 1.0
Title: Driver air bag effectiveness by severity of the crash
Journal: American Journal of Public Health
Author-Name: Segui-Gomez, M.
Year: 2000
Volume: 90
Issue: 10
Pages: 1575-1581
Abstract: Objectives. This analysis provided effectiveness estimates of the driver-side air bag while controlling for severity of the crash and other potential confounders. Methods. Data were from the National Automotive Sampling System (1993-1996). Injury severity was described on the basis of the Abbreviated Injury Scale, Injury Severity Score, Functional Capacity Index, and survival. Ordinal, linear, and logistic multivariate regression methods were used. Results. Air bag deployment in frontal or near-frontal crashes decreases the probability of having severe and fatal injuries (e.g., Abbreviated Injury Scale score of 4-6), including those causing a long-lasting high degree of functional limitation. However, air bag deployment in low-severity crashes increases the probability that a driver (particularly a woman) will sustain injuries of Abbreviated Injury Scale level 1 to 3. Air bag deployment exerts a net injurious effect in low-severity crashes and a net protective effect in high-severity crashes. The level of crash severity at which air bags are protective is higher for female than for male drivers. Conclusions. Air bag improvement should minimize the injuries induced by their deployment. One possibility is to raise their deployment level so that they deploy only in more severe crashes.
Handle: RePEc:aph:ajpbhl:2000:90:10:1575-1581_3

Template-Type: ReDIF-Article 1.0
Title: Association of hepatitis B virus infection with other sexually transmitted infections in homosexual men
Journal: American Journal of Public Health
Author-Name: Remis, R.S.
Author-Name: Dufour, A.
Author-Name: Alary, M.
Author-Name: Vincelette, J.
Author-Name: Otis, J.
Author-Name: Masse, B.
Author-Name: Turmel, B.
Author-Name: LeClerc, R.
Author-Name: Parent, R.
Author-Name: Lavoie, R.
Year: 2000
Volume: 90
Issue: 10
Pages: 1570-1574
Abstract: Objectives. This study determined the prevalence and factors associated with hepatitis B virus (HBV) infection among men who have sex with men. Methods. At the baseline visit of an HIV study among men who have sex with men, we asked about HBV vaccination status and tested for HBV markers. Results. Of 625 subjects, 48% had received at least 1 dose of HBV vaccine. Of 328 unvaccinated men, 41% had 1 or more HBV markers. HBV prevalence increased markedly with age and was associated with many sexual and drug-related behaviors. In a multivariate model, 7 variables were independently associated with HBV infection: ulcerative sexually remitted diseases (odds ratio [OR] = 10.1; 95% confidence interval [CI]=2.6, 54); injection drug use (OR=5.2; 95% CI=1.2, 26); gonorrhea or chlamydia (OR=4.0; 95% CI=1.9, 8.9); sexual partner with HIV/AIDS (OR=3.6; 95% CI=1.8, 7.1); 50 or more casual partners (OR=3.4; 95% CI=1.6, 7.1); received money for sex (OR=3.0; 95% CI=1.2, 7.8); and 20 or more regular partners (OR=2.5; 95% CI=1.1, 6.1). Conclusions. In Montreal, men who have sex with men are at risk for HBV infection, but a substantial proportion remain unvaccinated; new strategies are required to improve coverage. Men who have sex with men and who have a sexually transmitted infection, especially a genito-ulcerative infection, appear to be at particularly high risk for HBV infection.
Handle: RePEc:aph:ajpbhl:2000:90:10:1570-1574_6

Template-Type: ReDIF-Article 1.0
Title: Socioeconomic status and the occurrence of fatal and nonfatal injury in the United States
Journal: American Journal of Public Health
Author-Name: Cubbin, C.
Author-Name: LeClere, F.B.
Author-Name: Smith, G.S.
Year: 2000
Volume: 90
Issue: 1
Pages: 70-77
Abstract: Objectives. This study examined the contribution of socioeconomic status (SES) to the risk of injury mortality and morbidity among working-age adults. Methods. The sample consisted of respondents to the National Health Interview Survey (1987-1994), and separate analyses were conducted for injury deaths to respondents by linking to the National Death Index. Proportional hazards regression models were used to analyze mortality. Logistic regression models were used to analyze morbidity. Results. The effects of SES varied substantially by cause of injury mortality and indicator of SES. In the multivariate models, blue-collar workers were at significantly increased odds of nonfatal injury. Education was unrelated to total injury morbidity, although associations were observed after stratification of the outcome by severity and place of occurrence. Black persons were at increased risk for homicide, and Black and Hispanic persons were at decreased risk for suicide and nonfatal injuries, after adjustment for SES. Conclusions. SES is an important determinant of injury, although the effect depends on the indicator of SES and the cause and severity of injury.
Handle: RePEc:aph:ajpbhl:2000:90:1:70-77_0

Template-Type: ReDIF-Article 1.0
Title: Editor's note: Public health nihilism revisited
Journal: American Journal of Public Health
Author-Name: Bayer, R.
Year: 2000
Volume: 90
Issue: 12
Pages: 1838
Handle: RePEc:aph:ajpbhl:2000:90:12:1838_7

Template-Type: ReDIF-Article 1.0
Title: Elections and public health
Journal: American Journal of Public Health
Author-Name: DeMarco, V.
Author-Name: Schneider, G.E.
Year: 2000
Volume: 90
Issue: 10
Pages: 1513-1514
Handle: RePEc:aph:ajpbhl:2000:90:10:1513-1514_0

Template-Type: ReDIF-Article 1.0
Title: Knowledge, attitudes, and screening practices among older men regarding prostate cancer
Journal: American Journal of Public Health
Author-Name: Steele, C.B.
Author-Name: Miller, D.S.
Author-Name: Maylahn, C.
Author-Name: Uhler, R.J.
Author-Name: Baker, C.T.
Year: 2000
Volume: 90
Issue: 10
Pages: 1595-1600
Abstract: Objectives. This study determined population-based rates of reported prostate cancer screening and assessed prostate cancer-related knowledge, attitudes, and screening practices among men in New York aged 50 years and older. Methods. Two telephone surveys were conducted. One was included in the 1994 and 1995 statewide Behavioral Risk Factor Surveillance System interviews, and the other was a community-level survey that targeted Black men (African-American Men Survey). Prevalence estimates were computed for each survey, and prostate cancer screening practices were assessed with logistic regression models. Results. Overall, fewer than 10% of the men in each survey perceived their prostate cancer risk to be high; almost 20% perceived no risk of developing the disease. Approximately 60% of the men in each survey reported ever having had a prostate-specific antigen (PSAA test. In both surveys, physician advice was significantly associated with screening with a PSA test or a digital rectal examination. Also, race was significantly associated with screening in the statewide survey. Conclusions. Many New York men appear to be unaware of risk factors for prostate cancer. However, a substantial percentage reported having been screened for the disease; physician advice may have been a major determining factor in their decision to be tested.
Handle: RePEc:aph:ajpbhl:2000:90:10:1595-1600_9

Template-Type: ReDIF-Article 1.0
Title: The association of dietary folate, B6, and B12 with cardiovascular mortality in spain: An ecological analysis
Journal: American Journal of Public Health
Author-Name: Medrano, M.J.
Author-Name: Sierra, M.J.
Author-Name: Almazan, J.
Author-Name: Olalla, M.T.
Author-Name: Lopez-Abente, G.
Year: 2000
Volume: 90
Issue: 10
Pages: 1636-1638
Abstract: Objectives. This study assessed the association of dietary folate, vitamin B6, and vitamin B12 with cardiovascular mortality. Methods. Poisson regression analyses assessed coronary/cerebrovascular mortality rates via nutrient data obtained from the National Nutrition Survey, which recorded 7-day food intakes from a national sample of 21 155 households. Results. In regard to coronary mortality, male and female rate ratios (highest vs lowest quintile) were 0.83 (95% confidence interval[CT]=0.77, 0.91) and 0.95 (95% CI=0.86, 1.05), respectively, for folate and 0.74 (95% CI=0.65, 0.84) and 0.86 (95% CI=0.73, 0.99), respectively, for B12. Intake of folate and B6 (but not B12) was significantly associated with cerebrovascular mortality. Conclusions. B vitamins are associated with cardiovascular mortality in the general population.
Handle: RePEc:aph:ajpbhl:2000:90:10:1636-1638_7

Template-Type: ReDIF-Article 1.0
Title: Hunger in legal immigrants in California, Texas, and Illinois
Journal: American Journal of Public Health
Author-Name: Kasper, J.
Author-Name: Gupta, S.K.
Author-Name: Tran, P.
Author-Name: Cook, J.T.
Author-Name: Meyers, A.F.
Year: 2000
Volume: 90
Issue: 10
Pages: 1629-1633
Abstract: Objectives. This study determined the prevalence of food insecurity and hunger in low-income legal immigrants. Methods. We conducted a cross-sectional survey of Latino and Asian legal immigrants attending urban clinics and community centers in California, Texas, and Illinois with a food security questionnaire. Results. Among 630 respondents, 40% of the households were food insecure without hunger and 41% were food insecure with hunger. Independent predictors of hunger were income below federal poverty level (odds ratio [OR] = 2.72, 95% confidence interval [CI] = 1.72, 4.30), receipt of food stamps (OR = 2.53, 95% CI = 1.57, 4.09), Latino ethnicity (OR = 2.39, 95% CI = 1.49, 3.82), and poor English (OR = 1.76, 95% CI = 1.10, 2.82). Conclusions. The prevalence of hunger among low-income legal immigrants is unacceptably high. Access to food assistance programs is important for the health and well-being of this population.
Handle: RePEc:aph:ajpbhl:2000:90:10:1629-1633_2

Template-Type: ReDIF-Article 1.0
Title: The effect of poverty, social inequity, and maternal education on infant mortality in Nicaragua, 1988-1993
Journal: American Journal of Public Health
Author-Name: Peña, R.
Author-Name: Wall, S.
Author-Name: Persson, L.-A.
Year: 2000
Volume: 90
Issue: 1
Pages: 64-69
Abstract: Objectives. This study assessed the effect of poverty and social inequity on infant mortality risks in Nicaragua from 1988 to 1993 and the preventive role of maternal education. Methods. A cohort analysis of infant survival, based on reproductive histories of a representative sample of 10876 women aged 15 to 49 years in Leon, Nicaragua, was conducted. A total of 7073 infants were studied; 342 deaths occurred during 6394 infant-years of follow- up. Outcome measures were infant mortality rate (IMR) and relative mortality risks for different groups. Results. IMR was 50 per 1000 live births. Poverty, expressed as unsatisfied basic needs (UBN) of the household, increased the risk of infant death (adjusted relative risk [RR] = 1.49, 95% confidence interval [CI] = 1.15, 1.92). Social inequity, expressed as the contrast between the household UBN and the predominant UBN of the neighborhood, further increased the risk (adjusted RR = 1.74; 95% CI = 1.12, 2.71). A protective effect of the mother's educational level was seen only in poor households. Conclusions. Apart from absolute level of poverty, social inequity may be an independent risk factor for infant mortality in a low- income country. In poor households, female education may contribute to preventing infant mortality.
Handle: RePEc:aph:ajpbhl:2000:90:1:64-69_2

Template-Type: ReDIF-Article 1.0
Title: Cancer incidence and survival following bereavement
Journal: American Journal of Public Health
Author-Name: Levav, I.
Author-Name: Kohn, R.
Author-Name: Iscovich, J.
Author-Name: Abramson, J.H.
Author-Name: Tsai, W.Y.
Author-Name: Vigdorovich, D.
Year: 2000
Volume: 90
Issue: 10
Pages: 1601-1607
Abstract: Objectives. This study investigated the effect of parental bereavement on cancer incidence and survival. Methods. A cohort of 6284 Jewish Israelis who lost an adult son in the Yom Kippur War or in an accident between 1970 and 1977 was followed for 20 years. We compared the incidence of cancer in this cohort with that among nonbereaved members of the population by logistic regression analysis. The survival of bereaved parents with cancer was compared with that of matched controls with cancer. Results. Increased incidence was found for lymphatic and hematopoietic malignancies among the parents of accident victims (odds ratio [OR] =2.01; 95% confidence interval [CI] = 1.30, 3.11) and among war-bereaved parents (OR = 1.47; 95% CI=1.13, 1.92), as well as for melanomas (OR=4.62 [95% CI= 1.93, 11.06] and 1.71 [95% CI = 1.06, 2.76], respectively). Accident-bereaved parents also had an increased risk of respiratory cancer (OR=1.50; 95% CI=1.07, 2.11). The survival study showed that the risk of death was increased by bereavement if the cancer had been diagnosed before the loss, but not after. Conclusions. This study showed an effect of stress on the incidence of malignancies for selected sites and accelerated demise among parents bereaved following a diagnosis of cancer, but not among those bereaved before such a diagnosis.
Handle: RePEc:aph:ajpbhl:2000:90:10:1601-1607_1

Template-Type: ReDIF-Article 1.0
Title: Physician-evaluated and self-reported morbidity for predicting disability
Journal: American Journal of Public Health
Author-Name: Ferraro, K.F.
Author-Name: Su, Y.-P.
Year: 2000
Volume: 90
Issue: 1
Pages: 103-108
Abstract: Objectives. This study compared the predictive validity of physician- evaluated morbidity and self-reported morbidity on disability among adults. Methods. Subjects from a large national survey (n = 6913) received a detailed medical examination by a physician and were asked about the presence of 36 health conditions at baseline. Disability measured 10 and 15 years later was regressed on the morbidity measures and covariates with tobit models. Results. Although physician-evaluated morbidity and self-reported morbidity were associated with greater disability, self-reports of chronic nonserious illnesses manifested greater predictive validity. Disability was also higher for obese subjects and those of lower socioeconomic status. Conclusions. The findings demonstrate the predictive utility of self-reported morbidity measures on functional disability.
Handle: RePEc:aph:ajpbhl:2000:90:1:103-108_3

Template-Type: ReDIF-Article 1.0
Title: Endemic goiter associated with high iodine intake
Journal: American Journal of Public Health
Author-Name: Zhao, J.
Author-Name: Wang, P.
Author-Name: Shang, L.
Author-Name: Sullivan, K.M.
Author-Name: Van der Haar, F.
Author-Name: Maberly, G.
Year: 2000
Volume: 90
Issue: 10
Pages: 1633-1635
Abstract: Objectives. This study assessed the relation of iodine content of household water to thyroid size and urinary iodine excretion in an area with high iodine concentration in the water. Methods. The iodine content of household water and indicators of iodine status (thyroid size and urinary iodine level) were assessed in selected villages in Jiangsu Province, China. Results. Water iodine levels were positively correlated with urinary iodine levels and indicators of thyroid size at the township level. Conclusions. Excess iodine in household water was the likely cause of endemic goiter and elevated urinary, iodine levels in the study area. This finding affects public health policy on the institution of universal salt iodization for the elimination of iodine deficiency disorders.
Handle: RePEc:aph:ajpbhl:2000:90:10:1633-1635_6

Template-Type: ReDIF-Article 1.0
Title: To boldly go...
Journal: American Journal of Public Health
Author-Name: McKinlay, J.B.
Author-Name: Marceau, L.D.
Year: 2000
Volume: 90
Issue: 1
Pages: 25-33
Abstract: The threshold of the new millennium offers an opportunity to celebrate remarkable past achievements and to reflect on promising new directions for the field of public health. Despite historic achievements, much will always remain to be done (this is the intrinsic nature of public health). While every epoch has its own distinct health challenges, those confronting us today are unlike those plaguing public health a century ago. The perspectives and methods developed during the infectious and chronic disease eras have limited utility in the face of newly emerging challenges to public health. In this paper, we take stock of the state of public health in the United States by (1) describing limitations of conventional US public health, (2) identifying different social philosophies and conceptions of health that produce divergent approaches to public health, (3) discussing institutional resistance to change and the subordination of public health to the authority of medicine, (4) urging a move from risk factorology to multilevel explanations that offer different types of intervention, (5) noting the rise of the new 'right state' with its laissez-faire attitude and antipathy toward public interventions, (6) arguing for a more ecumenical approach to research methods, and (7) challenging the myth of a value-free public health.
Handle: RePEc:aph:ajpbhl:2000:90:1:25-33_9

Template-Type: ReDIF-Article 1.0
Title: Continued risky behavior in HIV-infected youth
Journal: American Journal of Public Health
Author-Name: Diamond, C.
Author-Name: Buskin, S.
Year: 2000
Volume: 90
Issue: 1
Pages: 115-118
Abstract: Objectives. The purpose of this study was to describe and compare risky behaviors in HIV-infected youths and adults. Methods. Records of HIV-infected outpatients were reviewed for the period January 1990 to February 1998. Youths (younger than 22 years at HIV diagnosis and younger than 25 years at study entry, n = 139) were compared with adults (22 years or older at HIV diagnosis or 25 years or older at study entry, n = 2880). Risky behaviors occurring after HIV diagnosis included unsafe sex and needle sharing. Results. Female and mate youths were more than twice as likely as adults to engage in risky behavior (adjusted odds ratios of 2.6 and 2.3, respectively). Conclusions. Both youths and adults continue to engage in risky behaviors after HIV diagnosis. Prospective studies are needed, along with targeted public health campaigns, for youths with HIV and for those at risk of infection.
Handle: RePEc:aph:ajpbhl:2000:90:1:115-118_9

Template-Type: ReDIF-Article 1.0
Title: The Safe Dates program: 1-Year follow-up results
Journal: American Journal of Public Health
Author-Name: Foshee, V.A.
Author-Name: Bauman, K.E.
Author-Name: Greene, W.F.
Author-Name: Koch, G.G.
Author-Name: Linder, G.F.
Author-Name: MacDougall, J.E.
Year: 2000
Volume: 90
Issue: 10
Pages: 1619-1622
Abstract: Objectives. An earlier report described desirable 1-month follow-up effects of the Safe Dates program on psychological, physical, and sexual dating violence. Mediators of the program-behavior relationship also were identified. The present report describes the 1-year follow-up effects of the Safe Dates program. Methods. Fourteen schools were in the randomized experiment. Data were gathered by questionnaires in schools before program activities and 1 year after the program ended. Results. The short-term behavioral effects had disappeared at 1 year, but effects on mediating variables such as dating violence norms, conflict management skills, and awareness of community services for dating violence were maintained. Conclusions. The findings are considered in the context of why program effects might have decayed and the possible role of boosters for effect maintenance.
Handle: RePEc:aph:ajpbhl:2000:90:10:1619-1622_5

Template-Type: ReDIF-Article 1.0
Title: Unseen blindness, unheard deafness, and unrecorded death and disability: Congenital rubella in Kumasi, Ghana
Journal: American Journal of Public Health
Author-Name: Lawn, J.E.
Author-Name: Reef, S.
Author-Name: Baffoe-Bonnie, B.
Author-Name: Adadevoh, S.
Author-Name: Caul, E.O.
Author-Name: Griffin, G.E.
Year: 2000
Volume: 90
Issue: 10
Pages: 1555-1561
Abstract: Objectives: Although rubella sero-susceptibility among women of reproductive age in West Africa ravages from 10% to 30%, congenital rubella syndrome has not been reported. In Ghana, rubella immunization and serologic testing are unavailable. Our objectives were to identify congenital rubella Syndrome cases, ascertain rubella antibody sero-prevalence during pregnancy, and recommend strategies for congenital rubella syndrome surveillance. Methods: Congenital rubella syndrome cases were identified through prospective surveillance and retrospective surveys of hospital records. A rubella serosurvey of pregnant urban and rural women was performed. Results: Eighteen infants born within a 5-month period met the congenital rubella syndrome case definitions, coinciding with a 9-fold increase in presentation of infantile congenital cataract. The congenital nibella syndrome rate for this otherwise unrecorded rubella epidemic was conservatively estimated to be 0.8 per 1000 live births. A postepidemic rubella immunity rate of 92.6% was documented among 405 pregnant women; susceptibility was significantly associated with younger age (P=.000) and ethnicity (northern tribes, P=.024). Conclusions: Congenital rubella syrdrome occurs in Ghana but is not reported. Information about congenital rubella syndrome and rubella in sub-Saharan Africa is needed to evaluate inclusion of rubella vaccine in proposed measles control campaigns.
Handle: RePEc:aph:ajpbhl:2000:90:10:1555-1561_2

Template-Type: ReDIF-Article 1.0
Title: A time to be born
Journal: American Journal of Public Health
Author-Name: Anderka, M.
Author-Name: Declercq, E.R.
Author-Name: Smith, W.
Year: 2000
Volume: 90
Issue: 1
Pages: 124-126
Abstract: Objectives. This study used a large population-based data set (n = 619455) to establish reference standards of the timing of spontaneous vaginal births. Methods. Low-risk births in Massachusetts from 1989 to 1995 were studied. This group comprised 242276 births that met the following criteria singleton, vertex, vaginal births with a birthweight of between 2500 and 4000 g; gestation between 37 and 42 weeks; a 5-minute Apgar score greater than 6, and no induction or stimulation. Results. Low-risk births displayed a mild circadian pattern, with a peak between 11:00 AM and 1:00 PM and a trough between 11:00 PM and 1:00 AM. Subgroup analysis showed no clear differences except for parity. Conclusions. Reference standards should be developed and used as comparative norms for hospital and practice-based perinatal studies of diurnal patterns of birthing.
Handle: RePEc:aph:ajpbhl:2000:90:1:124-126_5

Template-Type: ReDIF-Article 1.0
Title: Use of physical restraints and psychotropic medications in Alzheimer special care units in nursing homes
Journal: American Journal of Public Health
Author-Name: Phillips, C.D.
Author-Name: Spry, K.M.
Author-Name: Sloane, P.D.
Author-Name: Hawes, C.
Year: 2000
Volume: 90
Issue: 1
Pages: 92-96
Abstract: Objectives. This study analyzed the use of mechanical restraints and psychotropic medication in Alzheimer special care units (SCUs) in nursing homes. Methods. We analyzed 1993 data for more than 71000 nursing home residents in 4 states, including more than 1100 residents in 48 SCUs. The dependent variable in multinomial logistic regression was use of physical restraints or psychotropic medication. Models contained covariates representing facility and resident characteristics, and multivariate matching strategies were used to protect against selection bias. Results. Residents in SCUs did not differ from similar residents in traditional units in their likelihood of being physically restrained. Residents in SCUs were more likely to receive psychotropic medication. Conclusions. With regard to the measures used in this research, the findings indicate that residents in the SCUs in the 4 study states did not receive quality of care superior to that provided to similar residents in traditional units. In fact, the results related to drug use raise the question of whether some may have received poorer care.
Handle: RePEc:aph:ajpbhl:2000:90:1:92-96_8

Template-Type: ReDIF-Article 1.0
Title: Cholera in Paris
Journal: American Journal of Public Health
Author-Name: Helfand, W.H.
Author-Name: Lazarus, J.
Author-Name: Theerman, P.
Year: 2000
Volume: 90
Issue: 10
Pages: 1530
Handle: RePEc:aph:ajpbhl:2000:90:10:1530_6

Template-Type: ReDIF-Article 1.0
Title: Roeper and Voas respond [2]
Journal: American Journal of Public Health
Author-Name: Roeper, P.
Author-Name: Voas, R.
Year: 2000
Volume: 90
Issue: 3
Pages: 446-447
Handle: RePEc:aph:ajpbhl:2000:90:3:446-447_9

Template-Type: ReDIF-Article 1.0
Title: Factors predicting completion of a home visitation program by high-risk pregnant women: The North Carolina Maternal Outreach Worker Program
Journal: American Journal of Public Health
Author-Name: Navaie-Waliser, M.
Author-Name: Martin, S.L.
Author-Name: Campbell, M.K.
Author-Name: Tessaro, I.
Author-Name: Kotelchuck, M.
Author-Name: Cross, A.W.
Year: 2000
Volume: 90
Issue: 1
Pages: 121-124
Abstract: Objectives. This study sought to identify characteristics of high-risk pregnant women that predicted long-term participation in a home visitation program. Methods. Data regarding sociodemographic characteristics, perceived needs, psychological functioning, substance use, and informal social support were collected prospectively from 152 short-term and 221 long-term program participants. Results. In comparison with short-term participants, long-term participants were more likely to have been African American, married, nonsmokers, and enrolled in the program during their second trimester of pregnancy, and they were more likely to have had emotional and instrumental support needs. Conclusions. Women with greater social support needs and healthier behaviors were more receptive to long-term home visitation than other women.
Handle: RePEc:aph:ajpbhl:2000:90:1:121-124_9

Template-Type: ReDIF-Article 1.0
Title: Erratum: Human rights is a US problem, too: The case of women and HIV (American Journal of Public Health (1999) 89 (1479-1482))
Journal: American Journal of Public Health
Author-Name: Gollub, E.L.
Year: 2000
Volume: 90
Issue: 1
Pages: 140
Handle: RePEc:aph:ajpbhl:2000:90:1:140_6

Template-Type: ReDIF-Article 1.0
Title: Estimates of US children exposed to alcohol abuse and dependence in the family
Journal: American Journal of Public Health
Author-Name: Grant, B.F.
Year: 2000
Volume: 90
Issue: 1
Pages: 112-115
Abstract: Objectives. This study sought to provide direct estimates of the number of US children younger than 18 years who are exposed to alcohol abuse or alcohol dependence in the family. Methods. Data were derived from the National Longitudinal Alcohol Epidemiologic Survey. Results. Approximately 1 in 4 children younger than 18 years in the United States is exposed to alcohol abuse or alcohol dependence in the family. Conclusions. There is a need for approaches that integrate systems of services to enhance the lives of these children.
Handle: RePEc:aph:ajpbhl:2000:90:1:112-115_5

Template-Type: ReDIF-Article 1.0
Title: When is a disease eradicable? 100 Years of lessons learned
Journal: American Journal of Public Health
Author-Name: Aylward, B.
Author-Name: Hennessey, K.A.
Author-Name: Zagaria, N.
Author-Name: Olive, J.-M.
Author-Name: Cochi, S.
Year: 2000
Volume: 90
Issue: 10
Pages: 1515-1520
Abstract: Since the 1915 launch of the first international eradication initiative targeting a human pathogen, much has been learned about the determinants of eradicability of an organism. The authors outline the first 4 eradication efforts, summarizing the lessons learned in terms of the 3 types of criteria for disease eradication programs: (1) biological and technical feasibility, (2) costs and benefits, and (3) societal and political considerations.
Handle: RePEc:aph:ajpbhl:2000:90:10:1515-1520_7

Template-Type: ReDIF-Article 1.0
Title: Implementing a syphilis elimination and importation control strategy in a low-incidence urban area: San Diego County, California, 1997-1998
Journal: American Journal of Public Health
Author-Name: Gunn, R.A.
Author-Name: Harper, S.L.
Author-Name: Borntrager, D.E.
Author-Name: Gonzales, P.E.
Author-Name: St. Louis, M.E.
Year: 2000
Volume: 90
Issue: 10
Pages: 1540-1544
Abstract: Objectives. This study assessed a strategy designed to contain imported cases of syphilis and prevent reestablishment of ongoing transmission. Methods. Reported syphilis cases during an endemic period (1990-1992) and an elimination period (1997-1998) were compared in San Diego, Calif. The elimination strategy, which focuses on rapid reporting of infectious syphilis cases by clinicians, prompt partner and sexual network management, outreach to marginalized populations, and implementation of an outbreak containment plan, was evaluated. Results. Infectious syphilis incidence rates declined from 18.3 per 100 000 in 1988 to 1.0 per 100 000 in 1998. Of the 46 cases involving probable infection during 1997-1998, 19 (41%) were imported, mostly (79%) from Mexico. Outbreak containment procedures were implemented successfully for 2 small clusters. Outreach workers provided sexually transmitted disease information to a large number of individuals; however, no cases of infectious syphilis were identified, suggesting that syphilis transmission was not occurring among marginalized groups. Conclusions. This syphilis elimination and importation control strategy will require monitoring and adjustments. Controlling syphilis along the US-Mexico border is a necessary component of syphilis elimination in the United States.
Handle: RePEc:aph:ajpbhl:2000:90:10:1540-1544_8

Template-Type: ReDIF-Article 1.0
Title: Improved birth outcomes among HIV-infected women with enhanced medicaid prenatal care
Journal: American Journal of Public Health
Author-Name: Turner, B.J.
Author-Name: Newschaffer, C.J.
Author-Name: Cocroft, J.
Author-Name: Fanning, T.R.
Author-Name: Marcus, S.
Author-Name: Hauck, W.W.
Year: 2000
Volume: 90
Issue: 1
Pages: 85-91
Abstract: Objectives. This study evaluated the impact of enhanced prenatal care on the birth outcomes of HIV-infected women. Methods. Medicaid claims files linked to vital statistics were analyzed for 1723 HIV-infected women delivering a live-born singleton from January 1993 to October 1995. Prenatal care program visits were indicated by rate codes. Logistic models controlling for demographic, substance use and health care variables were used to assess the program's effect on preterm birth (less than 37 weeks) and low birthweight (less than 2500 g). Results. Of the women included in the study, 75.3% participated in the prenatal care program. Adjusted program care odds were 0.58 (95% confidence interval [CI] = 0.42, 0.81) for preterm birth and 0.37 (95% CI = 0.24, 0.58) for low-birthweight deliveries in women without a usual source of prenatal care. Women with a usual source had lower odds of low-birthweight deliveries if they had more than 9 program visits. The effect of program participation persisted in sensitivity analyses that adjusted for an unmeasured confounder. Conclusions. A statewide prenatal care Medicaid program demonstrates significant reductions in the risk of adverse birth outcomes for HIV-infected women.
Handle: RePEc:aph:ajpbhl:2000:90:1:85-91_2

Template-Type: ReDIF-Article 1.0
Title: Physician firearm ownership as a predictor of firearm injury prevention practice
Journal: American Journal of Public Health
Author-Name: Becher, E.C.
Author-Name: Cassel, C.K.
Author-Name: Nelson, E.A.
Year: 2000
Volume: 90
Issue: 10
Pages: 1626-1628
Abstract: Objectives. This study explored the relation between physicians' gun ownership and their attitudes and practices regarding firearm injury prevention. Methods. Internists and Surgeons were surveyed, and logistic regression models were developed with physicians' personal involvement with firearms (in the form of a gun score) as the primary independent variable. Results. Higher gun scores were associated with less agreement that firearm injury is a public health issue and that physicians should be involved in firearm injury prevention but with a greater likelihood of reporting the inclusion of firearm ownership and storage as part of patient safety counseling. Conclusions. Despite being less likely to say that doctors should participate in firearm injury prevention, physician gun owners are more likely than nonowners to report counseling patients about firearm safety.
Handle: RePEc:aph:ajpbhl:2000:90:10:1626-1628_3

Template-Type: ReDIF-Article 1.0
Title: Strategies to eradicate rubella in the english-speaking Caribbean
Journal: American Journal of Public Health
Author-Name: Irons, B.
Author-Name: Lewis, M.J.
Author-Name: Dahl-Regis, M.
Author-Name: Castillo-Solorzano, C.
Author-Name: Carrasco, P.A.
Author-Name: De Quadros, C.A.
Year: 2000
Volume: 90
Issue: 10
Pages: 1545-1549
Abstract: Objective. This report presents the strategies used to eradicate rubella in the Caribbean region and the challenges faced by that effort. Methods. Using the surveillance system for measles cases that was instituted in all countries in the Caribbean Community (CARICOM), 12 countries confirmed cases of rubella between 1992 and 1996. Rubella infections occurred in epidemic proportions in 6 countries during that period. Results. On the basis of the rubella prevalence data, rubella-congenital rubella syndrome (CRS) cost-benefit analysis, and cost-effectiveness of the mass campaign, the Council for Human and Social Development of CARICOM resolved, on April 21, 1998, that every effort would be made to eradicate rubella, as well as to prevent the occurrence of new cases of CRS by the end of 2000. Using the Pan American Health Organization's template for measles eradication, CARICOM proposed and implemented the main strategies for rubella and CRS eradication, and rubella mass campaigns were conducted in 18 countries. The target population, which included males and females (aged 20-40 years), was approximately 2.2 million. Conclusion. The major challenges for rubella eradication are attaining high vaccine coverage in the adult population and maintaining an effective surveillance system able to detect rubella activity.
Handle: RePEc:aph:ajpbhl:2000:90:10:1545-1549_1

Template-Type: ReDIF-Article 1.0
Title: Erratum: (American Journal of Public Health (1999) 89 (1647-1648))
Journal: American Journal of Public Health
Author-Name: Fee, E.
Author-Name: Brown, T.M.
Author-Name: Winslow, C.-E.A.
Year: 2000
Volume: 90
Issue: 7
Pages: 1146
Handle: RePEc:aph:ajpbhl:2000:90:7:1146_9

Template-Type: ReDIF-Article 1.0
Title: Opinion leaders' support for tobacco control policies and participation in tobacco control activities
Journal: American Journal of Public Health
Author-Name: Howard, K.A.
Author-Name: Rogers, T.
Author-Name: Howard-Pitney, B.
Author-Name: Flora, J.A.
Author-Name: Norman, G.J.
Author-Name: Ribisl, K.M.
Year: 2000
Volume: 90
Issue: 8
Pages: 1282-1287
Abstract: Objectives. Because opinion leaders hold positions from which they may influence tobacco control efforts, this study examined their support for tobacco control policies and their involvement in tobacco control activities. Methods. A telephone survey was administered to 712 California opinion leaders who were randomly selected from constructed lists representing 8 types of organizations: health, education, law enforcement, media; government, business, ethnic, and youth. Hierarchical regression analysis was used to identify predictors of support for and participation in tobacco control activities. Results. Approximately one half to two thirds of opinion leaders supported the tobacco control policies queried; 60% reported involvement in tobacco control-related activities during the previous year. Organizational affiliation was a strong predictor of support and involvement, with leaders from health and educational organizations reporting the highest levels and business and media leaders reporting the lowest. Tobacco issue involvement variables (e.g., having a friend or family member with a smoking- related illness) were significantly associated with the outcomes, while sociodemographics, for the most part, were not. Conclusions. Study result can be used to mobilize opinion leaders' support for tobacco control more effectively.
Handle: RePEc:aph:ajpbhl:2000:90:8:1282-1287_4

Template-Type: ReDIF-Article 1.0
Title: Globalization, states, and the health of indigenous peoples
Journal: American Journal of Public Health
Author-Name: Kunitz, S.J.
Year: 2000
Volume: 90
Issue: 10
Pages: 1531-1539
Abstract: The consequences of globalization are mixed, and for the indigenous peoples of poor countries globalization has potentially important benefits. These are the result not of participation in the global economy but of participation in global networks of other indigenous peoples, environmental activists, and now governmental organizations. Since World War II, nonstate actors such as these have gained standing in international forums. It is indigenous peoples' growing visibility and ability to mobilize international support against the policies of their own national governments that has contributed in some important instances to their improved chances of survival.
Handle: RePEc:aph:ajpbhl:2000:90:10:1531-1539_8

Template-Type: ReDIF-Article 1.0
Title: In appreciation: Abram S. 'Bud' Benenson, MD
Journal: American Journal of Public Health
Author-Name: Northridge, M.E.
Author-Name: Fee, E.
Author-Name: Schuchat, A.
Year: 2000
Volume: 90
Issue: 2
Pages: 179-180
Handle: RePEc:aph:ajpbhl:2000:90:2:179-180_5

Template-Type: ReDIF-Article 1.0
Title: Trends in funding and use of alcohol and drug abuse treatment at specialty facilities, 1990-1994
Journal: American Journal of Public Health
Author-Name: Dayhoff, D.A.
Author-Name: Urato, C.J.
Author-Name: Pope, G.C.
Year: 2000
Volume: 90
Issue: 1
Pages: 109-111
Abstract: Objectives. This study examined trends in funding and use of alcohol and drug abuse treatment at specialty facilities between 1990 and 1994. Methods. The 1990 and 1994 National Drug and Alcohol Treatment Unit Surveys were used to estimate annual funding and number of clients in treatment. Results. Public funding increased by 5%, whereas private funding decreased by 28% in real terms between 1990 and 1994. The number of publicly and privately funded clients decreased slightly. Conclusions. The rapid growth in private and public sector substance abuse funding during the 1980s has not continued into the 1990s.
Handle: RePEc:aph:ajpbhl:2000:90:1:109-111_3

Template-Type: ReDIF-Article 1.0
Title: Toward elimination of Haemophilus influenzae type B carriage and disease among high-risk American Indian children
Journal: American Journal of Public Health
Author-Name: Millar, E.V.
Author-Name: O'Brien, K.L.
Author-Name: Levine, O.S.
Author-Name: Kvamme, S.
Author-Name: Reid, R.
Author-Name: Santosham, M.
Year: 2000
Volume: 90
Issue: 10
Pages: 1550-1554
Abstract: Objectives. This report describes the epidemiology of Haemophilus influenzae type b (Hib) invasive disease and oropharyngeal colonization among Navajo and White Mountain Apache children younger than 7 years in an era of widespread immunization. Methods. We conducted active surveillance for invasive H influenzae disease from 1992 to 1999 and an oropharyngeal carriage study from 1997 to 1999. The predominant vaccine used was PedvaxHib. Results. The average annual incidence of invasive Hib disease among children younger than 24 months was 22 cases per 100 000. Of 381 children younger than 7 years, only 1 (0.3%; 95% confidence interval = 0.0%, 1.3%) was colonized with Hib; 370 (97%) had received 2 or more doses of Hib conjugate vaccine. Conclusions. Among Navajo and White Mountain Apache children, Hib conjugate vaccines have led to a sustained reduction in invasive Hib disease and a reduction in oropharyngeal Hib carriage. The disease incidence among children younger than 24 months remains 20 times higher than in the general US population. Hib elimination will require additional characterization of colonization and disease in these high-risk populations.
Handle: RePEc:aph:ajpbhl:2000:90:10:1550-1554_3